194 resultados para Early intervention programs


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Intervention programs aimed at promoting study and work opportunities in the Information and Communications Technology (ICT) field to schoolgirls (Interventions) have been encouraged to combat a decline in the interest among girls to study ICT at school. The goal of our study is to investigate the influence of Interventions on schoolgirls’ intentions to choose a career in the ICT field by analysing the  comprehensive survey data (n = 3577), collected during four interventions in Australia, using the Partial Least Squares method. Our study is also aimed at identifying other factors influencing ICT career intentions. We found that the attitude towards interventions has an indirect influence on ICT career intentions by affecting interest in ICT. Our results also challenge several existing theoretical studies by showing that factors that had previously been suggested as influencers were found to have little or no impact in this study, these being same-sex education and computer usage.

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The paper aims to provide a brief overview of key ideas related to outcome measurement relevant to community based mental health services and their consumers in WA. Due to the breadth of scope of the paper, it is not an extensive or rigorous literature review but provides a scan of the literature that could shape a more thorough literature review in any of the content areas. The paper has been written with the aim of informing the sector of key ideas, issues, concepts and approaches.

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 Purpose: To investigate use patterns and learning outcomes associated with the use of Therapy Outcomes By You (TOBY. Playpad, an early intervention iPad application. Methods: Participants were 33 families with a child with an autism spectrum disorder (ASD) aged 16 years or less, and with a diagnosis of autism or pervasive developmental disorder - not otherwise specified, and no secondary diagnoses. Families were provided with TOBY and asked to use it for 4-6 weeks, without further prompting or coaching. Dependent variables included participant use patterns and initial indicators of child progress. Results: Twenty-three participants engaged extensively with TOBY, being exposed to at least 100 complete learn units and completing between 17% and 100% of the curriculum. Conclusions: TOBY may make a useful contribution to early intervention programming for children with ASD delivering high rates of appropriate learning opportunities. Further research evaluating the efficacy of TOBY in relation to independent indicators of functioning is warranted.

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Research on early childhood education emphasises the importance of quality in early childhood intervention. This study examines the quality of Early Childhood Intervention Services based on parents’ experiences raising a child with developmental delay or disability. The study builds on the philosophy of Family-Centred Practice and professionals’ experiences with family-centred interventions. A qualitative case study approach was adopted to gain insight about families who are raising a child with additional needs. Nine in-depth parent-interviews and three focus groups with professionals were conducted in the first two terms of 2010. The case explicates the experiences of parents and professionals who were associated with Specialist Children’s Services in a metropolitan region of Victoria. The research concentrated on the first point of entry to early intervention, the referrals process and the waiting list. It also addressed parents' experiences, priorities and expectations. As a small-scale study, it examined parents’ and children’s needs as well as children’s access to therapy in early intervention. It also investigated community support and parent-professional relationships in the context of early childhood intervention services. The study found that family-centred intervention is beneficial to both parents and children with developmental delay or disability. However, to implement an effective family-centred approach, practitioner support in the form of professional development, supervision and peer mentorship is required to develop professionals’ reflexivity and self-efficacy in family-centred interventions. The study also identified strategies to promote effective practice, gaps in universal and specialised services, and implications for policy.

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The current study aimed to investigate emotion regulation (ER) strategy use in a sample of 21 clinic-referred children and adolescents (10-14 years old) presenting with school refusal, all of whom were diagnosed with at least one anxiety disorder. Being the first known study to examine ER and school refusal, hypotheses were guided by previous research on anxiety. It was hypothesized that the school refusal sample would report less healthy ER strategy use compared to an age- and sex-matched nonclinical sample (n = 21). As expected, the school refusal sample reported less use of cognitive reappraisal and greater use of expressive suppression to regulate their emotions than did the nonclinical sample. Although preliminary, the findings provide important information regarding the emotional functioning of children and adolescents presenting with school refusal. Future directions for research and implications for improved prevention and intervention programs are discussed.

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Programs designed to detect students at risk of depression and suicidality have shown success (Shaffer et al., 2004). The current study sought to examine whether or not such a program was acceptable to participants and whether or not it caused distress. Participants were boys aged 14 to 16. Participants were assessed using an on-line questionnaire; acceptability was measured via postal questionnaire. Of 272 participants, 31 (11.4%) were considered at-risk; 13 required ongoing support, 8 of whom had not previously sought help. Overall screening did not appear to cause significant undue distress, although some differences were evident between at-risk and not at-risk students. All participants found the program acceptable. When conducted carefully, early detection programs can be an effective and acceptable method of identifying at-risk adolescents.

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A model of staging in the field of bipolar disorder (BD) should offer a means for clinicians to predict response to treatment and more general outcome measures, such as the level of functioning and autonomy. The present staging model emphasizes the assessment of patients in the interepisodic period and includes: latent phase: individuals who present mood and anxiety symptoms and increased risk for developing threshold BD; Stage I – patients with BD who present well established periods of euthymia and absence of overt psychiatric morbidity between episodes; Stage II – patients who present rapid cycling or current axis I or II comorbidities; Stage III – patients who present a clinically relevant pattern of cognitive and functioning deterioration, as well as altered biomarkers; and Stage IV – patients who are unable to live autonomously and present altered brain scans and biomarkers. Such a model implies a longitudinal appraisal of clinical variables, as well as assessment of neurocognition and biomarkers in the interepisodic period. Staging facilitates understanding of the mechanisms underlying progression of the disorder, assists in treatment planning and prognosis and, finally, underscores the imperative for early intervention.

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Background
Children from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families.

Methods
Searches of major electronic databases identified articles published from 1993–2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity.

Results
Thirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m2 to -0.54 kg/m2 for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3–5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery.

Conclusion
There is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required.

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Clinical staging is widespread in medicine - it informs prognosis, clinical course, and treatment, and assists individualized care. Staging places an individual on a probabilistic continuum of increasing potential disease severity, ranging from clinically at-risk or latency stage through first threshold episode of illness or recurrence, and, finally, to late or end-stage disease. The aim of the present paper was to examine and update the evidence regarding staging in bipolar disorder, and how this might inform targeted and individualized intervention approaches.

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We discuss the rationale behind staging systems described specifically for bipolar disorders. Current applications, future directions and research gaps in clinical staging models for bipolar disorders are outlined.

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Personalized medicine is rapidly becoming a reality in today's physical medicine. However, as yet this is largely an aspirational goal in psychiatry, despite significant advances in our understanding of the biochemical, genetic and neurobiological processes underlying major mental disorders. Preventive medicine relies on the availability of predictive tools; in psychiatry we still largely lack these. Furthermore, our current diagnostic systems, with their focus on well-established, largely chronic illness, do not support a pre-emptive, let alone a preventive, approach, since it is during the early stages of a disorder that interventions have the potential to offer the greatest benefit. Here, we present a clinical staging model for severe mental disorders and discuss examples of biological markers that have already undergone some systematic evaluation and that could be integrated into such a framework. The advantage of this model is that it explicitly considers the evolution of psychopathology during the development of a mental illness and emphasizes that progression of illness is by no means inevitable, but can be altered by providing appropriate interventions that target individual modifiable risk and protective factors. The specific goals of therapeutic intervention are therefore broadened to include the prevention of illness onset or progression, and to minimize the risk of harm associated with more complex treatment regimens. The staging model also facilitates the integration of new data on the biological, social and environmental factors that influence mental illness into our clinical and diagnostic infrastructure, which will provide a major step forward in the development of a truly pre-emptive psychiatry.

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 Objective: Vitamin B12 deficiency is common in older adults, and may increase the risk of cognitive impairment. The distribution of vitamin B12 insufficiency in younger age groups is less studied. This study aims to assess the prevalence of vitamin B12 deficiency (<156ρmol/L) and subclinical low-normal levels (156-250ρmol/L) in a large, random sample of the Australian population across the adult life span.
Methods: We examined serum vitamin B12 levels in a random sample of 1,085 men and 1,125 women aged 20-97 years between 1994 and 2006; in the Barwon Statistical Division, a regional area in south eastern Australia that is representative of the socioeconomic status of the Australian population.
Results: The age-standardised prevalence of vitamin B12 deficiency in this cohort of men and women was 3.6%. Subclinical low-normal vitamin B12 levels (156-250ρmol/L) were found in 26%. Serum vitamin B12 levels declined with age among men (p-value <0.001) and were lower in men than women (p-value <0.001). Vitamin B12 levels were higher among supplement users (8.0% of the cohort).
Conclusions: Vitamin B12 levels decline with age, and have been associated with neurodegenerative diseases and cognitive decline. Early intervention by diet education or supplement use to address this age-associated decline in vitamin levels may be an effective strategy to prevent decline in a significant segment of the population. Such intervention may need to start in mid-life (from 50-years of age) before the onset age-related decline in vitamin B12 levels.

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Intervention programs aimed at promoting study and work opportunities in the Information and Communications Technology (ICT) field to schoolgirls have been encouraged to combat a decline in the interest among girls to study ICT at school. The goal of our study is to investigate the influence of such interventions on schoolgirls’ intentions to choose a career in the ICT field by analysing comprehensive survey data (n = 3577), collected during four interventions in Australia, using the Partial Least Squares method. Our study is also aimed at identifying other factors influencing ICT career intentions. We found that the attitude towards interventions has an indirect influence on ICT career intentions by affecting interest in ICT. Our results also challenge several existing theoretical studies by showing that factors that had previously been suggested as influencers were found to have little or no impact in this study, these being same-sex education and computer usage.

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Staging models are widely used in clinical medicine, and offer an insight into the progressive nature of many disorders. In general, the earlier stages of illness may be associated with a better prognosis and a higher treatment response. Once chronicity is reached, more complex and invasive treatments may be required, and the utility of treatments may decline. There is evidence that treatment response is greatest in the early phases of the disorder. There is also a progressive social and psychological burden of ongoing illness. This is paralleled by the twin notions of neuroprotection, which is supported by increasing evidence that structural changes in the disorder may be progressive and reversible with algorithm appropriate treatment, and that of early intervention, which posits that the optimal window for intervention is early in the illness course. A staging model compliments existing and proposed classifications of bipolar disorder, adding a temporal dimension to a cross sectional view. It may inform treatment choice and prognosis, and could have utility as a course specifier.