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Difficulties in adaptive functioning are common in autism spectrum disorder (ASD) and contribute to negative outcomes across the lifespan. Research indicates that cognitive ability is related to degree of adaptive functioning impairments, particularly in young children with ASD. However, the extent to which other factors, such as socioeconomic status (SES) and ASD symptom severity, predict impairments in adaptive functioning remains unclear. The goal of this study was to determine the extent to which SES, ASD symptom severity, and cognitive ability contribute to variability in domain-specific and global components of adaptive functioning in preschool-aged children with ASD. Participants were 99 preschool-aged children (2-6 years) with ASD who attended a tertiary diagnostic service. Results demonstrate that cognitive ability accounted for a significant proportion of variance in domain-specific and global components of adaptive functioning, with higher cognitive ability predicting better adaptive functioning. Results also demonstrate that SES accounted for some variability in domain-specific communication skills and global adaptive functioning when compared to basic demographic factors alone (age and gender). By contrast, ASD symptom severity did not predict variability in domain-specific or global components of adaptive functioning. These findings provide support for a relationship between cognitive ability and adaptive functioning in preschool-aged children with ASD and help to explain specific contributions of verbal and nonverbal ability to adaptive functioning; from this, we can better understand which children are likely to show the greatest degree of impairments across components of adaptive functioning early in development. LAY SUMMARY: People with autism often have difficulties with everyday communication, daily living, and social skills, which are also called adaptive functioning skills. This study investigated factors that might be related to these difficulties in preschoolers with autism. We found that better cognitive ability, but not autism symptoms, were associated with better adaptive functioning. This suggests that interventions for young children with autism should take into account cognitive ability to better understand which children are likely to have difficulties with adaptive functioning.

Background: There is a growing need for cost-efficient and patient-centred approaches to support families in hospital and community-based neurodevelopmental services. For such purposes, electronic data collection (EDC) may hold advantages over paper-based data collection. Such EDC approaches enable automated data collection for scoring and interpretation, saving time for clinicians and services and promoting more efficient service delivery. Objective: The current pilot study evaluated the efficacy of EDC for the Child Development Unit, a hospital-based diagnostic assessment clinic in the Sydney Children’s Hospital Network. Caregiver response rates and preference for EDC or paper-based methods were evaluated as well as the moderating role of demographic characteristics such as age, level of education and ethnic background. Methods: Families were sent either a paper-based questionnaire via post or an electronic mail link for completion before attending their first onsite clinic appointment for assessment. A total of 62 families were provided a paper version of the questionnaire, while 184 families were provided the online version of the same questionnaire. Results: Completion rates of the questionnaire before the first appointment were significantly higher for EDC (89.1%) in comparison to paper-based methods (38.7%; P

BACKGROUND There is a growing need for cost-efficient and patient-centered approaches to support families in hospital- and community-based neurodevelopmental services. For such purposes, electronic data collection (EDC) may hold advantages over paper-based data collection. Such EDC approaches enable automated data collection for scoring and interpretation, saving time for clinicians and services and promoting more efficient service delivery. OBJECTIVE This pilot study evaluated the efficacy of EDC for the Child Development Unit, a hospital-based diagnostic assessment clinic in the Sydney Children’s Hospital Network. Caregiver response rates and preference for EDC or paper-based methods were evaluated as well as the moderating role of demographic characteristics such as age, level of education, and ethnic background. METHODS Families were sent either a paper-based questionnaire via post or an electronic mail link for completion before attending their first on-site clinic appointment for assessment. A total of 62 families were provided a paper version of the questionnaire, while 184 families were provided the online version of the same questionnaire. RESULTS Completion rates of the questionnaire before the first appointment were significantly higher for EDC (164/184, 89.1%) in comparison to paper-based methods (24/62, 39%; PPP=.04). CONCLUSIONS These results show that EDC is feasible in hospital-based clinics and has the potential to offer substantial benefits in terms of centralized data collation, time and cost savings, efficiency of service, and resource allocation. The results of this study therefore support the continued use of electronic methods to improve family-centered care in clinical practices.

Background There is a growing need for cost-efficient and patient-centered approaches to support families in hospital- and community-based neurodevelopmental services. For such purposes, electronic data collection (EDC) may hold advantages over paper-based data collection. Such EDC approaches enable automated data collection for scoring and interpretation, saving time for clinicians and services and promoting more efficient service delivery. Objective This pilot study evaluated the efficacy of EDC for the Child Development Unit, a hospital-based diagnostic assessment clinic in the Sydney Children’s Hospital Network. Caregiver response rates and preference for EDC or paper-based methods were evaluated as well as the moderating role of demographic characteristics such as age, level of education, and ethnic background. Methods Families were sent either a paper-based questionnaire via post or an electronic mail link for completion before attending their first on-site clinic appointment for assessment. A total of 62 families were provided a paper version of the questionnaire, while 184 families were provided the online version of the same questionnaire. Results Completion rates of the questionnaire before the first appointment were significantly higher for EDC (164/184, 89.1%) in comparison to paper-based methods (24/62, 39%; P Conclusions These results show that EDC is feasible in hospital-based clinics and has the potential to offer substantial benefits in terms of centralized data collation, time and cost savings, efficiency of service, and resource allocation. The results of this study therefore support the continued use of electronic methods to improve family-centered care in clinical practices.

Experiencing a stroke can significantly impact on a person's emotional wellbeing. As nurses play a key role in stroke rehabilitation, their responses to the emotional experience of stroke may be crucial to the wellbeing of the patient and their relatives. This interpretive ethnographic study involved a purposive sample of 10 cases, with each ‘case’ comprising a patient, their closest relative and the nurses who provided their care. Data were constructed through participant observation, interviews and document review. Analysis revealed that the relationships built and sustained between nurses, patients and relatives were central to creating a positive culture of caring, which promotes emotional wellbeing and aids recovery in stroke rehabilitation. The importance of this culture should be more fully acknowledged, both within nursing and the wider multi-professional rehabilitation team.

Although rehabilitation literature frequently refers to recovery as the ultimate goal of therapeutic interventions, what recovery actually means is not clearly explained. However, the recovery model has been widely discussed in the context of mental health services, and it has been suggested that this model may also be applied to services for people with other long-term health conditions. This article explores this suggestion further by examining the recovery model and its relationship to physical rehabilitation.

Aims and objectives To evaluate the learning effect and resource use cost of workplace-based, blended e-learning about dysphagia for stroke rehabilitation nurses. Background Dysphagia is a potentially life-threatening problem that compromises quality of life. In many countries, nurses play a crucial role in supporting the management of patients with swallowing problems, yet the literature reports a need for training. Design A single-group, pre- and post-study with mixed methods. Methods Each blended e-learning session comprised a needs analysis, e-learning programmes, practical skills about modifying fluids and action planning to transfer learning into practice. Participants were the population of registered nurses (n = 22) and healthcare assistants (n = 10) on a stroke rehabilitation ward in a large, teaching hospital in England between August 2010–March 2011. Data collection comprised observation (34 hours), questionnaires administered at four time points to examine change in attitude, knowledge and practice, and estimating the resource use cost for the service. Nonparametric tests and content analysis were used to analyse the data. Results All participants achieved a nationally recognised level of competence. The learning effect was evident on the post- and follow-up measures, with some items of dysphagia knowledge and attitude achieving significance at the p ≤ 0·05 level. The most common self-reported changes in practice related to medicines management, thickening fluids and oral hygiene. The resource use cost was estimated at £2688 for 108 hours training. Conclusions Workplace-based, blended e-learning was an acceptable, cost effective way of delivering essential clinical knowledge and skills about dysphagia. Relevance to clinical practice Dysphagia should be viewed as a patient safety issue because of the risks of malnutrition, dehydration and aspiration pneumonia. As such, it is pertinent to many members of the interdisciplinary team. Consideration should be given to including dysphagia management in initial education and continuing professional development programmes.

Aims To determine the appropriateness of using the Griffiths' Mental Developmental Scales (birth - 2 years) to assess development in a cohort of urban Aboriginal children at 12 months of age. Methods The Gudaga study is a prospective longitudinal cohort study assessing the health, development and service use of urban Aboriginal infants residing in south west Sydney. All infants receive a full heath and development assessment (including the Griffiths' Mental Developmental Scales) when they are 12 months of age. This study analyses the results of the first 55 infants. Results The distribution of the General Quotient for the first 55 Gudaga infants is normal with a mean of 98.5 (SD 10.5). There is no significant difference between the Gudaga cohort and the Griffiths' standardisation sample for locomotor, personal-social, hearing and language, and eye and hand coordination sub-quotient scores. Conclusion The Griffiths' Mental Developmental Scales may be an appropriate tool to use for the assessment of development in urban Aboriginal infants.

Undertaking the Birthrate Plus (BR+) Programme in so many units indicated other areas of information needed for staffing decisions. This has produced a basis for calculating extra allowances of time for day-to-day supervision of midwifery and this is added to the example of how the different ratios per hospital, home/caseload based births:whole time equivalent (w.t.e.) midwives can be used for strategic planning. A ratio for cross-border cases per w.t.e. midwife is also indicated but needs further validation. There is an urgent need for the profession to debate the issue of staffing standards for midwife-led units and a way forward is suggested. The results of the BR+ Programme to date have provided a basis for staffing standards in midwifery and continuing data if funding allows will provide further validation and understanding.

Fourteen qualified nurses working in a stroke rehabilitation unit were interviewed in order to ascertain their understanding of post-stroke depression, what they do to help a patient who becomes depressed and what they feel unable to do. They were also asked what would improve the situation. The nurses were able to describe the characteristics of depression following a stroke and recognize its effect on the subject's rehabilitation. They were able to identify patients who were becoming depressed and tried to help them to the best of their abilities. They felt constrained, however; mainly by lack of time, limited skills and lack of appropriate training. They themselves wanted to be able to meet the needs of depressed patients and thought that this could be achieved through better staff education and access to other health professionals experienced in providing psychological care. It is recommended that nurses have access to expert personnel both as a source of referral for patients and as a resource for support and guidance to staff. In addition, an education programme combining theoretical and practical aspects of psychological care would be useful.

Since the start of 2001, 101 maternity units have entered the Birthrate Plus programme and of these 64 have completed their studies, with many more in progress. Although not designed or funded as a comparative study of midwifery workload and staffing needs, a coordinated analysis of the data gives a unique insight into demand for and patterns of midwifery care in England at the present time and has produced ratios of births:work-time-equivalent midwives which could form a basis for standards of care.

To determine the appropriateness of using the Griffiths' Mental Developmental Scales (birth - 2 years) to assess development in a cohort of urban Aboriginal children at 12 months of age.The Gudaga study is a prospective longitudinal cohort study assessing the health, development and service use of urban Aboriginal infants residing in south west Sydney. All infants receive a full heath and development assessment (including the Griffiths' Mental Developmental Scales) when they are 12 months of age. This study analyses the results of the first 55 infants.The distribution of the General Quotient for the first 55 Gudaga infants is normal with a mean of 98.5 (SD 10.5). There is no significant difference between the Gudaga cohort and the Griffiths' standardisation sample for locomotor, personal-social, hearing and language, and eye and hand coordination sub-quotient scores.The Griffiths' Mental Developmental Scales may be an appropriate tool to use for the assessment of development in urban Aboriginal infants.

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.

I thought readers might be interested to know of work which is being undertaken through the European Association of Neuroscience Nurses (EANN).