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Purpose – At present, there is no reference to Attention Autism (AA) as a framework and therapeutic tool with autistic children in occupational therapy (OT) literature. By way of introducing AA as a potential intervention to the OT community, this study aims to investigate the extent to which participation in a two-day AA training could contribute to increasing confidence and inspire changes in practice for Irish occupational therapists (OTs) supporting autistic children. Design/methodology/approach – A pilot study design with mixed qualitative and quantitative methods was used to evaluate the impact of a two-day AA training on six OTs. The OTs support autistic children throughout Ireland across public, private and voluntary sectors. They completed brief, non-standardised questionnaires 2 weeks before the training (Time 1) and again 12 weeks post (Time 2) training session. At Time 2, additional exploratory questions were answered by OTs regarding their use of AA in practice. Findings – This explorative study’s quantitative findings presented percentage change increases within three areas of confidence for all OTs. These include establishing attention, motivating and developing functional skill goals with autistic children. One of the participants did not score any change in confidence in a fourth area, building rapport, however, the five other participants scored percentage change increases. Qualitative data provided by participants showed that they were implementing AA in practice since attending the training. Five of the participants reported positive experiences of using AA and one participant reported the programme was not suitable for her caseload because of their level of understanding and need. Research limitations/implications – This was a small, exploratory, practice-based study. As this is the first study exploring this area of practice for OTs, to the best of the authors’ knowledge, there were no standardised methods of assessment available, therefore a self-designed survey was used by the author which had a limited number of open-ended questions and four Likert scale questions. This study was also limited in that there was one main researcher who also delivered the two-day AA training. The sample data set was small which resulted in the limitation of the choice of methods used to analyse the quantitative data. Percentage changes were used as the only available and reliable method for a small data set. Originality/value – Findings of this study, despite their preliminary nature, indicate that AA training may be a useful professional development consideration for OTs who provide a service for autistic children. Further AA research in OT is required including larger and more rigorous studies. An alternative training option of The Curiosity Programme may be considered for OTs supporting children who may not yet be ready to participate in AA.

This exploratory study considered the impact of a whole school programme to enhance relationships, promote positive behaviour, and reduce teacher stress in a secondary school. The programme was facilitated by the school's educational psychologist (EP) drawing on psychological theory and practice across a range of paradigms (ecosystemic, cognitive, attribution, attachment, developmental, and relational). Some key aims of the programme were to change teacher attributions around challenging behaviour and to promote a whole school ethos to further embed relational approaches. The qualitative data suggest that the programme was supportive for teachers, increased their self-efficacy and reduced feelings of stress. Further longitudinal research is needed to compare programmes like the one described here with matched controls, ideally including observational measures of teachers and students. Challenges in progressing organisational change in secondary schools are discussed. EPs are well positioned to support school communities through systems consultation and the application of psychological problem solving frameworks.

Abstract Background Many migraine patients do not respond adequately to conventional preventive treatments and are therefore described as treatment/medically resistant or difficult to treat cases. Calcitonin gene-related peptide monoclonal antibodies are a relatively novel molecular treatment for episodic and chronic migraine that have been shown to be effective in short duration clinical trials in approximately 40–50% of all chronic migraine patients. Patient Related Outcome Measures (PROM) or Quality of Life (QoL) questionnaires are used to help measure response to treatment in migraine. Although some open label extension studies have become available for erenumab, there is a lack of real-world data pertaining to quality of life in the medium to long-term for chronic and treatment resistant migraine patients. Methods A total of 177 treatment resistant CM patients were started on erenumab (70 mg or 140 mg subcutaneous injection every 4 weeks) in our three specialist Headache Clinics. Of these, 174 had their first injection between December 2018 and October 2019. All patients were evaluated with the following PROM: the Headache Impact Test− 6, Migraine Associated Disability Assessment test and Migraine-Specific QoL Questionnaire, before starting treatment with erenumab and at intervals of 3–12 months after starting treatment. The decision to continue treatment was based on subjective clinical improvement of at least 30% (as reported by the patient), supported with diaries and QoL questionnaires. We present here the QoL measurements for this group of 177 patients. Prior preventive migraine treatments included conventional oral prophylactic medications (such as topiramate, candesartan, propranolol, or amitriptyline), at least two cycles of PREEMPT protocol onabotulinumtoxin A or (in a small number of cases) neuromodulation with single pulse Transcranial Magnetic Stimulation. Results Of the 177 patients who started treatment with erenumab, 68/177 (38.4%) stopped during the first year, either due to lack of efficacy (no significant benefit or only minimal improvement) and/or possible side effects. 109/177 (61.6%) patients reported clinically significant improvement after 6–12 months and wished to stay on treatment. Twelve of these 109 patients subsequently stopped treatment in the period between 1 year and up to June 2021 (mainly due to a worsening of their migraine). Therefore, a total of 97/177 patients (54.8%) remained on treatment as of June 2021 (duration of treatment 17–30 months, median of 25 months). Conclusion Approximately 55% of treatment resistant or difficult to treat CM patients who trialled erenumab in our clinics reported a subjective benefit and were still on treatment after 17–30 months.

Abstract Background Calcitonin gene-related peptide (CGRP) is expressed throughout the body and is a known mediator of migraine, exerting this biological effect through activation of trigeminovascular, meningeal and associated neuronal pathways located in close proximity to the central nervous system. Monoclonal antibodies (mAb) targeting the CGRP pathway are an effective new preventive treatment for migraine, with a generally favourable adverse event profile. Pre-clinical evidence supports an anti-inflammatory/immunoregulatory role for CGRP in other organ systems, and therefore inhibition of the normal action of this peptide may promote a pro-inflammatory response. Cases We present a case series of eight patients with new or significantly worsened inflammatory pathology in close temporal association with the commencement of CGRP mAb therapy. Conclusion This case series provides novel insights on the potential molecular mechanisms and side-effects of CGRP antagonism in migraine and supports clinical vigilance in patient care going forward.

Background A run‐in period may increase adherence to intervention and reduce loss to follow‐up. Whether use of a run‐in period affects the magnitude of treatment effects is unknown. Methods and Results We conducted a meta‐analysis comparing treatment effects from 11 systematic reviews of cardiovascular prevention trials using a run‐in period with matched trials not using a run‐in period. We matched run‐in with non–run‐in trials by population, intervention, control, and outcome. We calculated a ratio of relative risks (RRRs) using a random‐effects meta‐analysis. Our primary outcome was a composite of cardiovascular events, and the primary analysis was a matched comparison of clinical trials using a run‐in period versus without a run‐in period. We identified 66 run‐in trials and 111 non–run‐in trials (n=668 901). On meta‐analysis there was no statistically significant difference in the magnitude of treatment effect between run‐in trials (relative risk [RR], 0.83 [95% CI, 0.80–0.87]) compared with non–run‐in trials (RR, 0.88 [95% CI, 0.84–0.91]; RRR, 0.95 [95% CI, 0.90–1.01]). There was no significant difference in the RRR for secondary outcomes of all‐cause mortality (RRR, 0.97 [95% CI, 0.91–1.03]) or medication discontinuation because of adverse events (RRR, 1.05 [95% CI, 0.85–1.21]). Post hoc exploratory univariate meta‐regression showed that on average a run‐in period is associated with a statistically significant difference in treatment effect (RRR, 0.94 [95% CI, 0.90–0.99]) for cardiovascular composite outcome, but this was not statistically significant on multivariable meta‐regression analysis (RRR, 0.95 [95% CI, 0.90–1.0]). Conclusions The use of a run‐in period was not associated with a difference in the magnitude of treatment effect among cardiovascular prevention trials.

Abstract Raynaud's phenomenon is a rare side effect of CGRP monoclonal antibodies. These molecular treatments are a relatively new class of drugs for the prevention of migraine. It is likely that we will see this side effect more often in the future. Patients with a background of Raynaud's phenomenon may experience worsening of their symptoms if started on these treatments.

Background: School is an important setting for creating healthy and sustainable food environments. Using participatory methods, this pilot study examined food and packaging waste and nutrition quality within the school food system. Methods: One secondary school in Ireland participated in a waste audit. Eleven male students (15–17 years) participated as citizen scientists. Students collected waste over 1 day and documented data on waste categories. Nutrition labels were photographed for analysis. Students created a video and participated in a focus group. Quantitative data were summarised using descriptive frequencies. A Nutrient Profile Model was applied to summarise nutrition quality. The focus group discussion was analysed using content analysis. Results: Highest weights of waste were organic waste (14.2 kg), paper and cardboard (5.0 kg), and hard plastics (4.1 kg). Materials banned by the European Union Single Use Plastics Directive were found. Recycling bins were contaminated with food waste. Nutrition labels from 132 food packages were analysed, of which 115 items (87%) were low‐nutrient, energy dense foods. Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups. Students were not surprised by the unhealthy food choices; however, they were shocked and saddened at the waste practices. Their proposed solutions mapped across individual, community and organisational levels. Conclusions: The methodologies allowed successful engagement with students on this topic. The use of unnecessary plastics to serve food, poor waste separation practices, and the production of avoidable waste from low‐nutrient, energy‐dense products were key issues identified. Students proposed solutions that are achievable in the short‐term. Key highlights: Eleven 15–17‐year‐old secondary school students successfully participated as citizen scientists in a waste audit at their school that characterised the quantity, type and nutrition quality of waste associated with the food system.Organic waste, paper and cardboard, and hard plastics represented the most frequent waste. Recycling bins were contaminated with organic waste.Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups.The researchers conduced a focus group with students when they expressed shock and sadness at the waste practices. Their proposed solutions mapped across individual, community and organisational levels. [ABSTRACT FROM AUTHOR]

Purpose – At present, there is no research to support teachers’ use of sensory interventions in the classroom. This study aims to investigate the extent to how participation in a sensory processing training session would improve teachers’ competence, confidence and practice towards supporting children with autism. Design/methodology/approach – A pilot study design with mixed qualitative and quantitative methods was used to evaluate the impact of sensory processing training on six teachers who taught at least one child with autism in a mainstream school. The Autism Education Trust Competency Framework and face-to-face semi-structured interviews were completed with participants both pre (Time 1) and post (Time 2) training session. Findings – Quantitative findings presented statistically significant differences (p < 0.05) in results with large effect sizes in the areas of confidence, knowledge, implementing sensory strategies, adjusting sensory environments, reviewing and reflecting. Qualitative data provided by participants corroborated this and indicated a need for further and more detailed training in the area. There was no change in the practice of teachers consulting with pupils about their sensory needs. Practical implications – This study found that the attendance of teachers at sensory processing training is justified and the promotion of sensory processing training is therefore warranted. Originality/value – Findings of this pilot study indicate that sensory processing training for teachers does improve competence, confidence and practice towards supporting children with autism. Review of the session to allow more detail, including consulting with the children themselves, is recommended.

A cognitively intensive companion service course has been introduced to the main fall general chemistry class at Cornell University. For years 2015 and 2016, priority students (those from groups under-represented and economically disadvantaged) show respectively improvement of +0.67 and +0.51 standard deviations in final course grade compared to priority students not in the program. Non-priority students show respectively a +0.66 and +0.62 standard deviation improvement. Progressive improvement (as measured by higher than expected Final Exam scores than what would have been expected solely from a given student's earlier Exam 1 score) demonstrates conclusively the service course's role in the enhanced outcomes. Progressive retention (as measured by the following year fall semester's organic chemistry exam scores compared to what would have been expected based on a given student's general chemistry final exam score) demonstrates that, on the average, the earlier observed progressive improvement is significantly retained in a chemistry course one year later. Preliminary retention statistics suggest a significant increase in first year to second year retention. A meta analysis of results from previously reported chemistry service courses indicate that such performance gains are difficult to achieve and hence common elements of the few effective programs may be of high value to the STEM education community.

Cognitive behavioural approaches emphasize the links between thoughts, feelings and behaviour (Greig, 2007). Previous research has indicated that these approaches are efficacious in reducing disruptive behaviour in adolescents. The aim of the current study was to provide further evaluation of cognitive behavioural group work to reduce disruptive behaviour with this population and to determine if improvements made were maintained in the longer term. The sample comprised 22 adolescents aged 13- to 14-years-old identified by school staff as displaying disruptive behaviour (Cameron, 1998). A curriculum based on Squires (2001), using key cognitive behavioural approaches, was delivered over a seven-week period to the participants. Participant, parent, and teacher ratings on the Strengths and Difficulties Questionnaire (SDQ) immediately after the intervention all indicated significant reductions in disruptive behaviour. Other positive effects included enhanced ratings of self-concept on the Beck Youth Inventories, 2nd Edition and trait emotional intelligence on the Trait Emotional Intelligence Questionnaire-Adolescent Short Form (TEIQue-ASF). Improvements in behaviour and self-concept were maintained at six-month follow-up according to participant and teacher ratings. However, parent ratings of behaviour had returned to pre-intervention levels. Further research, with different age groups and demographic populations along with concurrent parent programmes is recommended. (Contains 3 tables and 2 figures.)

An introduction is presented in which the editor discusses various reports within the issue on topics youth who have offended, role of educational psychologists working with youth offending teams, and antisocial and criminal behavior of young people.