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Cognitive dysfunction is a core feature of schizophrenia. Deficits are moderate to severe across several domains, including attention, working memory, verbal learning and memory, and executive functions. These deficits pre-date the onset of frank psychosis and are stable throughout the course of the illness in most patients. Over the past decade, the focus on these deficits has increased dramatically with the recognition that they are consistently the best predictor of functional outcomes across outcome domains and patient samples. Recent treatment studies, both pharmacological and behavioral, suggest that cognitive deficits are malleable. Other research calls into question the meaningfulness of cognitive change in schizophrenia. In this article, we review cognitive deficits in schizophrenia and focus on their treatment and relationship to functional outcome.

Purpose – The purpose of this paper is to develop a delivery model for embedding Functional Skills in a prison environment, i.e. HMP Oakwood, to promote Functional Skills (FS) on vocational courses, i.e. Maths and Plumbing at Level 1, establish a research culture in a brand new organisation and raise standards in teaching, learning and outcomes. Design/methodology/approach – The design/methodology of this research included the implementation of a qualitative approach based on classroom research, a focus group with seven students on the Level 1 Plumbing course, joint Practice Development meetings with FS and vocational staff, the development of key principles for creating an embedded model for vocational courses, the creation of lesson plan/bespoke resource developments, lesson observations of the new model followed by teacher and learner evaluation, a practical task (fitting a bathroom suite) undertaken by learners, initial maths exercises drawn from practical task which were vocationally relevant, associations made with real jobs and work, use of IT/video for added interest, highlighting of transferable skills and users undertook dedicated functional maths exercises. Findings – A delivery model/logical sequence was agreed that worked for the teacher and learners – practical task/contextualised maths/transferable skills focus/situated maths. Targeted questions generated interest – will a litre of bath water hold if you use four in joists? The study allowed learners to reflect on maths elements from the practical task. The delivery model is implemented by vocational, not FS tutors. IT/video was used to introduce further maths for transferability to other related plumbing areas, i.e. fitting an outside garage tap. Constant links with use of maths for real job activity need to be made/reinforce relevance. Good tutor subject knowledge in maths is strongly recommended. Learners are ready to do dedicated/situated maths once they have built up their confidence. Research limitations/implications – This delivery model can be used across all other vocational courses at HMP Oakwood, i.e. bricklaying, multi-skills, painting and decorating, site carpentry, horticulture, industrial cleaning, catering, horticulture, etc. A framework/pedagogical guide can be developed for vocational tutors to implement this delivery model in their own subject areas as a basis for continued research. Bespoke CPD sessions for vocational staff can be run to share good practice in session plans and resources relevant to the delivery model. Peer observations can be arranged across the vocational department and the impact of the model on lesson observation grades and success rates can be analysed. Practical implications – Practical implications can include the development of a two-year Learning and Skills Research Strategy with a focus on embedded pedagogy. A senior team leader in FS can become the research lead for the Education Department, and an extensive embedded learning audit across 35 courses can be undertaken by July 2013. Social implications – Further pedagogical research into embedded learning across the whole department including employability/PSD/IT/business courses can be conducted. Originality/value – This study offers a simple, practical and ready to use delivery model which will help particularly non-specialist FS maths and English tutors working in vocational areas (i.e. construction, catering, etc.) to embed the teaching of maths and English in their subject areas.

Purpose - The current study was conducted to increase our understanding of factors that influence the employability of university graduates. Through the use of both qualitative and quantitative approaches, the paper explores the relative importance of 17 factors that influence new graduate employability.Design methodology approach - An extensive review of the existing literature was used to identify 17 factors that affect new graduate employability. A two-phase, mixed-methods study was conducted to examine: Phase One, whether these 17 factors could be combined into five categories; and Phase Two, the relative importance that employers place on these factors. Phase One involved interviewing 30 employers, and Phase Two consisted of an empirical examination with an additional 115 employers.Findings - Results from both the qualitative and quantitative phases of the current study demonstrated that 17 employability factors can be clustered into five higher-order composite categories. In addition, findings illustrate that, when hiring new graduates, employers place the highest importance on soft-skills and the lowest importance on academic reputation.Research limitations implications - The sectors in which employers operated were not completely representative of their geographical region.Practical implications - The findings suggest that, in order to increase new graduates' employability, university programmes and courses should focus on learning outcomes linked to the development of soft-skills. In addition, when applying for jobs, university graduates should highlight their soft-skills and problem-solving skills.Originality value - This study contributes to the body of knowledge on the employability of university graduates by empirically examining the relative importance of five categories of employability factors that recruiters evaluate when selecting new graduates.

With over two years of remote online learning, this paper assessed the extent to which academics in a School of Education (SoE) at a South African university employed their espoused (Technological, Pedagogical, and Content Knowledge) TPACK in preparing teachers for the Fourth Industrial Revolution (4IR) classroom. Besides facilitating the development of disciplinary expertise, academics were expected to engage students with technological and other cross-functional skills needed to succeed as global citizens in a digitized society. Premised on the TPACK framework, a mixed-method approach using data from questionnaires distributed to all the academics in the SoE and interviews with five academics from the different disciplinary clusters of the SoE were analysed to explore their self-assessed TPACK to understand how academics prepare future teachers for the digitized 4IR classrooms. The findings suggest that academics may possess the relevant TPACK, but online educational practices may not have sufficiently equipped future teachers with the competence to thrive in the 4IR classroom. The outcome of this research provides valuable insights into academics' TPACK, especially those in teacher education, regarding their online pedagogical pursuit, the SoE in their quest to produce teachers fit for the 4IR classroom, and the scholarship of digital transformation in general.

Highlights This is the largest study to date to investigate the acquisition, retention and loss of functional skills in MECP2 duplication syndrome (MDS). Females were more likely than males to acquire gross and fine motor skills. Use of words was the most common parent-reported skill regression. Those with seizures had lower functional ability than those without seizures. There is a need for better understanding of the role of interventional therapy for functional skill retention in MDS. MECP2 duplication syndrome (MDS) is an ultrarare, X-linked neurodevelopmental disorder that is poorly understood in terms of its natural history and phenotypic variability. There is limited information on how individuals with MDS acquire, retain or lose fundamental functional skills (gross motor, purposeful hand function and communication) – that of which this study aimed to better characterise in the largest case series to date. For 160 individuals with MDS (median age 9.06 y, range: 0.57–51.63 y; 84% male), we report that phenotypic penetrance in females can, in some, result in a similar functional skill deficits to males. However, a higher proportion of females acquired gross motor and fine motor skills compared to males. Use of words was the most common parent-reported skill regression (34/90 [38%]) followed by fine motor/hand function (26/90 [29%]), independent walking (25/90 [28%]) and feeding (25/90 [28%]). Additionally, lower proportions of functional ability were present in those with seizures compared to those without. A general trend was also observed for decreasing functional skills with increasing age. Additionally, those with a larger duplication length (1 + Mb) were less likely to be able to acquire independent walking compared with those with less than a 1 + Mb duplication ( p  < 0.001). This is the first study to comprehensively map the developmental trajectory of functional skills in MDS and provides a seminal baseline for better characterising the natural history of this disorder. Further investigations are required to understand the importance of interventional therapy on the retainment of functional skills.

Background Young children with cerebral palsy (CP) receive a variety of interventions to prevent and/or reduce activity limitations and participation restrictions. Some of these interventions are intensive, and it is a challenge to identify the optimal intensity. Therefore, the objective of this systematic review was to describe and categorise intensive motor function and functional skills training among young children with CP, to summarise the effects of these interventions, and to examine characteristics that may contribute to explain the variations in these effects. Methods Ten databases were searched for controlled studies that included young children (mean age less than seven years old) with CP and assessments of the effects of intensive motor function and functional skills training. The studies were critically assessed by the Risk of bias tool (RoB) and categorised for intensity and contexts of interventions. Standardised mean difference were computed for outcomes, and summarised descriptively or in meta-analyses. Results Thirty-eight studies were included. Studies that targeted gross motor function were fewer, older and with lower frequency of training sessions over longer training periods than studies that targeted hand function. Home training was most common in studies on hand function and functional skills, and often increased the amount of training. The effects of constraint induced movement therapy (CIMT) on hand function and functional skills were summarised in six meta-analyses, which supported the existing evidence of CIMT. In a majority of the included studies, equal improvements were identified between intensive intervention and conventional therapy or between two different intensive interventions. Conclusions Different types of training, different intensities and different contexts between studies that targeted gross and fine motor function might explain some of the observed effect variations. Home training may increase the amount of training, but are less controllable. These factors may have contributed to the observed variations in the effectiveness of CIMT. Rigorous research on intensive gross motor training is needed. Systematic review registration number CRD42013004023.

The purpose of this study was to determine the effects of a Pilates exercises program on the cognitive and physical functioning of older Spanish women. This study is a randomized clinical trial; a total of 110 women aged ≥60 years were initially allocated to either a Pilates group (PG, n = 55), who underwent a 12-week Pilates exercise program, or to a control group (CG, n = 55), who did not receive any intervention. Global cognitive function (Mini-Mental State Examination), verbal fluency (Isaacs test), executive function (Trail Making Test), functional flexibility (Back Scratch Test and Chair Sit-and-Reach Test), and lower-body strength (30 s Chair-Stand Test) were assessed before and immediately after the intervention period. The main findings of this study suggest that women in the PG (within-group differences) experienced improvements across all the variables examined except for global cognitive function. When compared with the CG (between-group differences), our analysis revealed significant benefits in the PG for all measures except for global cognitive function and functional flexibility (Back Scratch Test). In conclusion, our results suggest that Pilates has the potential to improve both cognitive and functional abilities among Spanish women aged 60 years and over.

Purpose This paper is a commentary that aims to address themes arising from the paper by Vascelli and Iacomini (2024); including compassionate teaching, barriers to component teaching and interdisciplinary working. Design/methodology/approach This opinion piece explores broader considerations of this research, such as the importance of efficient and effective teaching, social validity and the value of interdisciplinary collaboration. Findings This commentary discusses areas to consider the importance of identifying effective reinforcing consequences to maximise effective teaching and considerations for ensuring that the skills are embedded into everyday life, alongside discussion on some of the barriers around teaching discrete and component skills in isolation. Originality/value This commentary discusses how vital it is to involve caregivers, analyse caregiver contingencies and assess social validity to remain focused on teaching applied, socially significant skills.

Background Current conceptual models of health literacy (HL) illustrate the link between HL and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into their framework. This article outlines the development of Chronic Airway Disease (CAD) Management and Health Literacy (CADMaHL) conceptual model that integrates the aforementioned elements and factors into a single framework. Methods Information obtained during the following stages informed the development of our model: (1) a systematic review of existing CAD HL measurement tools that apply core HL domains; (2) patient-oriented focus group sessions to understand HL barriers to CAD self-management practices; (3) key-informant interviews to obtain potential strategies to mitigate CAD management barriers, and validate disease self-management topics; (4) elicited the perspectives of Canadian respirologist’s on the ideal functional HL skills for asthma and COPD patients. Results Throughout the study process many stakeholders (i.e., patients, key-informants, and an international HL advisory panel) contributed to and reviewed the model. The process enabled us to organize the CADMaHL model into 6 primary modules, including: INPUT, consisting of four HL core components (access, understand, communicate, evaluate,) and numeracy skills; OUTPUT , including application of the obtained information; OUTCOME , covering patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, consisting of information about functionality and relevancy of CADMaHL; IMPACT, including mediators between HL and health outcomes; CROSSCUTTING FACTORS, consisting of diverse socio-demographics and health-system factors with applicability across the HL domains. Conclusions We developed the CADMaHL model, with input from key-stakeholders, which addresses a knowledge gap by integrating various disease management, health-system and socio-demographic factors absent from previous published frameworks. We anticipate that our model will serve as the backbone for the development of a comprehensive HL measurement tool, which may be utilized for future HL interventions for CAD patients. Trial registration NCT01474928 - Date of registration: 11/26/2017.

Few studies have examined the relationship between autistic symptomatology and competence in independent living skills in adolescents and young adults with fragile X syndrome (FXS). In this study, 70 individuals with FXS, aged 15–25 years, and 35 matched controls were administered direct measures of independent living skills and autistic symptomatology. Results showed that higher levels of autistic symptomatology were associated with lower levels of competence in independent living skills in individuals with FXS, but not in controls. These data indicated that the relationship between autistic symptomatology and independent living skills was syndrome-specific. Early intervention strategies that address autistic symptomatology are sorely needed to improve functional outcomes in this population.