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Objectives: The primary objective was to compare the percentage of Antiretroviral Therapy (ART) uncorrected errors during hospital admission before and after the implementation of an Antiretroviral Stewardship Program (ARVSP).Practice Description: This was a 2-year single-center, pre-post quality improvement study. Included in the study were admitted patients at least 18 years of age, diagnosed with human immunodeficiency virus (HIV), and taking at least 1 antiretroviral. The baseline percentage of uncorrected ARV errors was retrospectively determined during the first year. The second year consisted of implementing an ARVSP that prospectively audited ART orders. The ARVSP consisted of a pharmacy resident, a medical resident, an infectious disease, HIV trained pharmacist, an infectious disease physician, and ancillary health care providers. The impact of the ARVSP was assessed by comparing the percentage of uncorrected errors between the 2 time periods.Results: The number of uncorrected errors were 64.1% versus 31.1% before and after ARVSP implementation, respectively (P < 0.05). Delay in therapy errors were statistically significantly reduced (30.1% vs. 22.2%; P < 0.05). The time to overall correction of any error before ARVSP was 3.1 days, and after ARVSP, it was 1.8 days (P = 0.11).Conclusion: Implementation of an ARVSP reduces the number of uncorrected antiretroviral-related errors. Because health care resources are finite and focused on the acute care of hospitalized patients, this multidisciplinary practice model may provide a practical approach for similar institutions to improve antiretroviral stewardship surveillance in the inpatient setting. [ABSTRACT FROM AUTHOR]

Objectives: The primary objective was to compare the percentage of Antiretroviral Therapy (ART) uncorrected errors during hospital admission before and after the implementation of an Antiretroviral Stewardship Program (ARVSP).Practice Description: This was a 2-year single-center, pre-post quality improvement study. Included in the study were admitted patients at least 18 years of age, diagnosed with human immunodeficiency virus (HIV), and taking at least 1 antiretroviral. The baseline percentage of uncorrected ARV errors was retrospectively determined during the first year. The second year consisted of implementing an ARVSP that prospectively audited ART orders. The ARVSP consisted of a pharmacy resident, a medical resident, an infectious disease, HIV trained pharmacist, an infectious disease physician, and ancillary health care providers. The impact of the ARVSP was assessed by comparing the percentage of uncorrected errors between the 2 time periods.Results: The number of uncorrected errors were 64.1% versus 31.1% before and after ARVSP implementation, respectively (P < 0.05). Delay in therapy errors were statistically significantly reduced (30.1% vs. 22.2%; P < 0.05). The time to overall correction of any error before ARVSP was 3.1 days, and after ARVSP, it was 1.8 days (P = 0.11).Conclusion: Implementation of an ARVSP reduces the number of uncorrected antiretroviral-related errors. Because health care resources are finite and focused on the acute care of hospitalized patients, this multidisciplinary practice model may provide a practical approach for similar institutions to improve antiretroviral stewardship surveillance in the inpatient setting. [ABSTRACT FROM AUTHOR]

The increasingly diverse student population within classrooms potentially stretches the competencies of every teacher. Differentiated instruction has been offered to help teachers accommodate diverse learners, but most instructional strategies are typically directed at compensating for – not remediating – cognitive and academic skill deficits. This differentiated instruction approach is contrasted with the extant learning science and educational neuroscience literature, which suggests early intervention and remediation of skill deficits is the preferred evidence-based practice. To overcome these competing and apparently contradictory positions, we argue children should be provided with systematic brain-based differentiated instruction in inclusive classrooms to prevent skill deficits, with compensatory accommodations provided only as necessary to help children access the general education curriculum. For those who continue to struggle, we argue remedial efforts should occur outside of, and in addition to, inclusive general education instruction, given the empirical evidence supporting both practices. Implications for training and system-level reform will be addressed. [ABSTRACT FROM AUTHOR]

Highlights: [•] The construct validity of the FOS-R was examined for Singapore. [•] There was a fit between the current data set and the FOS-R structure. [•] Caregivers reported moderately high attainment of family outcomes. [•] Cross-cultural application of instruments is possible but cannot be assumed. [Copyright &y& Elsevier]

Highlights: [•] Parent–child agreement in reporting anxiety in ASD was examined in a non-clinical sample. [•] Thirty-eight dyads completed the Spence Children's Anxiety Scale (SCAS). [•] Agreement was strongest in Physical Injury, Separation and GAD subscales. [•] 14/38 SCAS items largely describing overt anxiety symptoms showed moderate/strong agreement. [•] More autistic symptoms were associated with poorer agreement in GAD, Panic and OCD subscales. [Copyright &y& Elsevier]

Abstract: Aims: This study examined parental perspectives on the importance and likelihood of future adult outcomes for children with Autism Spectrum Disorders (ASD), Intellectual Disabilities (ID), or Multiple Disabilities (MD) and some of the factors that may affect parental aspirations. Methods: Parents of 105 children with ASD, ID, or MD were presented with 21 possible future outcomes and were asked to indicate how important and how likely they considered these outcomes for their children with disabilities when they become adults. Results: Parents rated the overall likelihood of their child attaining various future outcomes significantly lower than the importance they placed on these same outcomes. They mostly valued future outcomes relating to their children''s personal satisfaction, safety and security over and above those relating to social participation. Parental ratings of the importance or likelihood of outcomes did not differ across the diagnostic groups. Ratings of importance were independent of the child''s age, gender, diagnosis, or severity of functioning, but likelihood ratings were significantly predicted by the children''s symptom severity. Conclusions: The implications of this study''s findings for service development, intervention and transitioning planning, and treatment outcome research are discussed in relation to existing literature and the study''s strengths and limitations. [Copyright &y& Elsevier]

This study sought to understand the profile of and the factors which impact upon challenging behaviors among children with autism spectrum disorders (ASD) and multiple disabilities (MD). Teachers of 322 and 132 children with ASD and MD, respectively, attending special schools in Singapore, completed the Developmental Behavior Checklist, Teacher Version (DBC-T; ). The findings suggest that children with ASD exhibit elevated levels of challenging behavior in all areas, relative to children with MD. Multiple regression analyses also indicate that diagnostic category was associated with all aspects of challenging behavior measured by the DBC-T. In addition, age was associated with only disruptive/antisocial behaviors in this study. Theoretical and practical implications were discussed. [Copyright &y& Elsevier]

Background: With family centred practice as one of the tenets in early childhood intervention (ECI), it is important to understand family outcomes as a means of assessing the effectiveness of ECI services.Aims: The present paper investigates the psychometric properties of an expanded measure of caregivers' perceptions of helpfulness of ECI services, the Family Outcomes Survey - Revised, Expanded Part B (FOS-RE B).Methods and Procedures: Two-hundred and forty-six caregivers of children enrolled in an ECI programme in Singapore completed the FOS-RE B, as well as convergent validity measures (FOS-R Part A, Depression, Stress and Anxiety Scale and questions addressing perceptions of family situation and optimism for the child's future). Confirmatory factor analysis was used to examine the factor structure of the FOS-RE B and correlations were used to examine convergent validity.Outcomes and Results: The factor structure of the FOS-RE B was found to mirror the structure of the FOS-R A, as hypothesized. Evidence for convergent validity, in the form of correlations with family well-being measures was found, as well as evidence for good internal consistency reliability.Conclusions and Implications: It is concluded that the FOS-RE B presents a promising measure of perceived helpfulness of ECI services. [ABSTRACT FROM AUTHOR]