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Community-based intervention to reduce stigma for children with disabilities in Lusaka, Zambia: a pilot
No full textPurpose: This pilot intervention aims to reduce stigma towards children with disabilities living in family-based care.Materials and methods: Kusamala + is a pre-post evaluation of a pilot community-based intervention in two low-income compounds in Lusaka, Zambia. Door-to-door canvassing and community referrals were used to identify and enroll children with disabilities. Parents/guardians and community members completed surveys regarding stigma and support. Health professionals supervised, trained, and provided ongoing support for 2-3 community caregivers (CCGs). CCG\u27s provided home-based education, referrals, playgroups, and social support for 20-25 families each. Community events were held at health facilities, churches and community spaces to reduce community-level stigma towards children with disabilities.Results: Staff identified 632 children with disabilities. Staff completed over 4500 home visits, 288 children joined playgroups, made 775 referrals, and over 23,000 attended community sensitization events. Longitudinal data was available for 129 families with a child with a disability. Over one year, families and community members reported less perceived rejection by family and peers but less agreement that children with disabilities should be treated the same as other children.Conclusion: Kusamala + was a feasible, acceptable and broad reach with limited program impact. Future work will incorporate lessons learned with a focus on sustainability and scalability.Implications for rehabilitationChildren with disability are often hidden and isolated in low- and middle-income countries (LMIC), particularly in low-resource communities.Stigma towards children with disabilities continues in LMIC and further reduces that child\u27s ability to engage fully in social and civic life.Community- and home-based programming is a feasible and acceptable approach to engaging with community and families with a child with a disability.The identification and referral of additional children with disabilities to physiotherapy and other government services can provide additional strain on already limited resources.Once a pilot program is deemed acceptable and feasible, any further design planning must include considerations for sustainability and scalability.System strengthening is a key component of sustainability and scalability to ensure success in planning, implementation, monitoring and evaluation
Nighttime Postural Care Sleep-Based Outcome Measures and Education: Preparing Care Providers of Children with Cerebral Palsy
No full textBACKGROUND Nighttime postural care (NTPC), an intervention using sleep-systems to position the body symmetrically during sleep, is particularly suited for children with severe Cerebral Palsy (CP); however, its impact yields mixed conclusions (Wynn & Wickham, 2009; Gericke, 2006).This variation may be due to the types of assessments used and lack of effective caregiver training.AIM of DISSERTATION 1) examine sleep-based measures used in previous NTPC research and 2) investigate the sleep care positioning training program’s (Lesson A), an online NTPC training program, feasibility to educate caregivers.METHOD Completed studies include: 1) systematic literature review of NTPC sleep-based measures and 2) randomized control trial, comparing caregiver competence pre and post educational intervention. Investigators randomized 38 participants into groups (Lesson A or Lesson B) to complete differently formatted 2-hour online training (interactive video-based or self-guided web-links) on topics of NTPC evidence, risk monitoring, sleep-system types and set up, positioning methods, and outcome measures.RESULTS 1). Systematic review revealed no sleep-based measures used in past NTPC intervention research are fully suitable as outcome measures for children with severe CP. 2) Randomized trial showed Lesson A group had significantly greater change in self-rated competence for NTPC implementation (0.46 points [SE 0.17], p = 0.0078). Subjective themes describe Lesson A as a better lesson matching my learning style and Lesson B as overwhelming, not knowing what I was supposed to learn. Post-training, Lesson A and B groups correctly completed 11.85 [SE 0.83] and 12.60 [SE 0.84] of 16 positioning-tasks, not differing significantly (average difference 0.75 items [SE 0.54], p = 0.17). Professionals performed significantly better than non-professionals (F(1,92.34) = 16.62, p \u3c 0.0001). Commonly missed tasks include “placing head/neck in neutral” and “snugging up parts”, with more error variation among Lesson B group.INTERPRETATION 1) To capture meaningful change and understand NTPC’s impact on sleep, combined use of the Sleep Disturbance Scale for Children-R and triaxial actigraph may be recommended for children with severe CP. 2) Sleep care positioning education caused increased perceived competence for health professionals and non-professionals. Post online-training caregivers accurately completed most sleep-system positioning tasks. Lesson A better prepares NTPC caregivers.* The Sleep Care Positioning Training Program, revised version of Lesson A, can be found at https://stkatentpc.weebly.com
Integrated Oral Health Teams: An Opportunity for Occupational Therapy in Primary Care
No full textThis poster presentation identifies opportunities for the occupational therapy role within integrated pediatric healthcare teams and articulates considerations for providing healthcare services and education within an integrated pediatric healthcare team model
The Landing Error Scoring System-Real Time (LESS-RT): A Validation Study for Jump Landing Biomechanics
No full textPURPOSE/HYPOTHESIS:Anterior cruciate ligament (ACL) injuries are very common in athletes. Factors associated with increased risk of ACL injury include decreased hip and knee flexion, increased knee valgus, and increased GRF, among others. Screening tools are available that attempt to identify movement dysfunction that may increase the risk of injury. One measure that has been proven to be valid and reliable is the LESS. The LESS-RT requires the same validity and reliability assessment as it is more clinically useful from an efficiency perspective. The purpose of this study was to investigate the ability of the LESS-RT to accurately detect abnormal biomechanics during a jump-landing task to determine its validity by comparing investigator visual scoring with the gold standard of 3-D motion analysis of the lower extremity. Authors hypothesize that the LESS-RT will identify subjects with potentially high risk jump landing biomechanics. And more specifically, poor LESS scores will be associated with decreased hip and knee flexion angles, increased knee valgus angle and moment, increased hip and tibial rotation, and increased ground reaction forces. SUBJECTS: 50 MATERIALS/METHODS:Fifty subjects, including 24 males (26.5 ±3.3yrs, 70.9 ±2.1in, 181.8 ±27.1lbs) and 26 females (23.8 ±0.4yrs, 65.6 ±2.6in, 154.6 ±32.4lbs) participated in this study. Subjects performed 4 trials of a jump-landing task from a 30 cm box with simultaneous data collection of 3D hip and knee motion and LESS-RT visual scoring by 3 raters. Kinematic and kinetic measures from 3D motion analysis and forceplate data were compared across LESS score quartiles using a series of 1-way ANOVAs; LESS quartiles were compared by sex using a chi-square. Interrater reliability was also computed using ICC2,k and SEM calculations. RESULTS:Subjects with high/poor LESS-RT scores demonstrated significantly different kinematics and kinetics compared to those with low/excellent LESS-RT scores for bilateral hip and knee flexion displacement and bilateral peak hip and knee flexion angles; peak right knee valgus moment; right peak hip adduction and internal rotation moments; and bilateral vertical GRF (p\u3c.05). Women had higher/worse LESS-RT scores than men (5.5 vs. 3.4). Interrater reliability of the LESS-RT was good at 0.85 and SEM at .42. CONCLUSIONS: The LESS-RT demonstrates preliminary results that support it as a potentially valid tool for identifying high-risk movement patterns during a jump-landing task. Reliability is favorable and similar to what was previously demonstrated in a larger study. A larger sample size is required to confirm these results. CLINICAL RELEVANCE: Given clinical time constraints, a quick and easy assessment that provides an accurate and valid reflection of lower extremity movement patterns that may result in knee injury provides a useful tool for clinicians to utilize as a basis for exercise programming
Climate Change and Violence: The relationship between severe weather events and domestic violence in Kenya
No full textLife and Death: Criminal Justice, Capital Punishment, and the Work of Sister Helen Prejean
No full textIntegrated Learning Series/Endowed Chai
Models of Equity and Inclusion for Social Work Students with Disabilities: A scoping review.
No full textProfessional Socialization of Macro Practice Social Workers
No full textIn times of war, depressions, or significant cultural shifts, macro level approaches have been used and promoted. However, assisting individual adaptation to dominant cultural, environmental and structural forces been a constant focus of social service provision. This workshop explored how macro practice social workers navigate these historic and current tensions. How does one become a professional macro practice social worker when the dominant leaders and institutions discourage, marginalize or ignore your entry into the field