BackgroundChildren with developmental language disorder (DLD) are at higher risk of poorer mental health compared with children without DLD. There are, however, considerable individual differences that need to be interpreted, including the identification of protective factors.AimsPathways from the early language and communication environment (ELCE, 1–2 years) to internalizing (peer and emotional problems) and externalizing (conduct problems and hyperactivity) problems in middle childhood (11 years) were mapped using structural equation modelling. Specifically, the role of indirect pathways via social skills (friendships, play and prosociality) in childhood (7–9 years) was investigated.Methods & ProceduresSecondary analysis of existing data from the Avon Longitudinal Study of Parents and Children (ALSPAC) was undertaken. The study sample consisted of 6531 children (394 with DLD).Outcomes & ResultsThe pathways from the ELCE to internalizing and externalizing problems were similar for children with and without DLD. For both groups, a positive ELCE was associated with more competent social play and higher levels of prosociality in childhood, which in turn were associated with fewer externalizing problems in middle childhood. Furthermore, better friendships and higher levels of prosociality in childhood were both associated with fewer internalizing problems in middle childhood.Conclusions & ImplicationsA child's ELCE is potentially important not only for the development of language but also for social development. Furthermore, in the absence of adequate language ability, play and prosocial behaviours may allow children with DLD to deploy, practise and learn key social skills, thus protecting against externalizing problems. We suggest that consideration be given to play‐ and prosociality‐based educational and therapeutic services for children with DLD.What this paper addsWhat is already known on this subject On the whole, children with DLD tend to have poorer mental health compared with their unaffected peers. There are, however, considerable differences and poor outcomes are not inevitable. What this study adds to the existing knowledge We demonstrate that children's ECLE is important for the development of social play behaviours and prosociality. Whilst children with DLD tend to have less competent social play and lower levels of prosociality compared with their unaffected peers, those with more competent social play and higher levels of prosociality are likely to have fewer externalizing problems later in childhood. We speculate that in the absence of adequate structural language ability, play and prosocial behaviours allow children with DLD to deploy, practise and learn key relationship skills, alongside behavioural and emotional regulation skills, thus protecting against externalizing problems. What are the potential or actual clinical implications of this work? Understanding the relationships among play, prosociality and externalizing problems may pave the way for play‐ and prosociality‐based interventions in children with DLD. This may be particularly appealing for practitioners as such interventions capitalize on one of the most intuitive means of learning in childhood: play with friends. The likelihood of acceptability and engagement with such interventions may be higher in children than for traditional adult‐led, paper‐and‐pencil activities.
Context: Continuing professional development (CPD) activities for healthcare professionals are central to the optimisation of patient safety and person-centred care.Although there is some evidence on the economics of healthcare professionals training, very little is known about the costs and benefits of CPD. Methods: This study aimed to review the research evidence on economic evaluations of CPD activities for healthcare professionals. CINAHL, MEDLINE/PubMed, Scopus, Econlit and Web of Science databases were used to identify articles published between 2010 and 2021. Results: Of the 6791 titles identified, 119 articles met the inclusion criteria and were included in this scoping review. The majority of articles were partial economic evaluations of CPD programmes (n = 70); half were from the USA. Studies that included multiple professions were most prevalent (n = 54), followed by nurses (n = 34) and doctors (n = 23). Patient outcomes were the most commonly reported outcome (n = 51), followed by change in clinical practice (n = 38) and healthcare professionals' knowledge gain (n = 19).Conclusions: There is an urgent call for more evidence regarding the economic evaluations of CPD. This is particularly important in view of the rising costs of healthcare globally. The majority of studies included in this review did not provide detailed information on the evaluations and many focused exclusively on the cost of CPD activities rather than outcomes.
The European Centre of Excellence (CoE) for Research in Continuing Professional Development (UPGRADE) is a pan-European network of researchers, clinicians, regulators, educators, and professional bodies, established in 2020 through a consensus group of experts, who defined its mission, vision, values, aims and objectives. The Centre’s aim is to advance the science of Continuing Professional Development (CPD) for healthcare professionals through research and dissemination of best practices for CPD. Debate among UPGRADE partners and interchange of research data will yield best practices across countries to optimise quality CPD programmes. Collaboration, information exchange and communication among CPD experts will be facilitated through UPGRADE via an online Community of Inquiry (CoI). UPGRADE aims to evolve as a driving force network of academics and health professional leaders in research, education, professional regulation, and clinical practice whose collaborative work ensures quality and safe person-centred care. UPGRADE members are from 22 European countries, represented by strategic leaders in diverse sectors of health, policy, academia, and professional organisations. Three research-working groups constitute the pillars of UPGRADE, which addresses gaps in research, collect and create critical databases, and solidify the effectiveness of CPD.
Eleven years post EU enlargement, there are approximately 150,000 Polish nationals living in Ireland. The main aim of the study was to estimate levels of depression, anxiety, and stress through comparisons with normative data drawn from clinical and non-clinical samples. An opportunity sample of 354 Polish migrant participants completed the Depression, Anxiety, and Stress Scale (DASS-21; Lovibond & Lovibond, 1995) accompanied with demographic information. The results indicated that the majority of the participants are employed, well educated, and reported good psychological status. However, it is possible that a minority of the participants are struggling with severe levels of anxiety and depression. The results contribute to the existing literature on Polish migration and suggest that the migrants' psychological status is relatively positive.
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