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Sample records for intervention early cumulative

  1. Early Educational Intervention, Early Cumulative Risk, and the Early Home Environment as Predictors of Young Adult Outcomes within a High-Risk Sample

    Science.gov (United States)

    Pungello, Elizabeth P.; Kainz, Kirsten; Burchinal, Margaret; Wasik, Barbara H.; Sparling, Joseph J.; Ramey, Craig T.; Campbell, Frances A.

    2010-01-01

    The extent to which early educational intervention, early cumulative risk, and the early home environment were associated with young adult outcomes was investigated in a sample of 139 young adults (age 21) from high-risk families enrolled in randomized trials of early intervention. Positive effects of treatment were found for education attainment,…

  2. Cumulative environmental risk in substance abusing women: early intervention, parenting stress, child abuse potential and child development.

    Science.gov (United States)

    Nair, Prasanna; Schuler, Maureen E; Black, Maureen M; Kettinger, Laurie; Harrington, Donna

    2003-09-01

    To assess the relationship between cumulative environmental risks and early intervention, parenting attitudes, potential for child abuse and child development in substance abusing mothers. We studied 161 substance-abusing women, from a randomized longitudinal study of a home based early intervention, who had custody of their children through 18 months. The intervention group received weekly home visits in the first 6 months and biweekly visits from 6 to 18 months. Parenting stress and child abuse potential were assessed at 6 and 18 months postpartum. Children's mental and motor development (Bayley MDI and PDI) and language development (REEL) were assessed at 6, 12, and 18 months postpartum. Ten maternal risk factors were assessed: maternal depression, domestic violence, nondomestic violence, family size, incarceration, no significant other in home, negative life events, psychiatric problems, homelessness, and severity of drug use. Level of risk was recoded into four categories (2 or less, 3, 4, and 5 or more), which had adequate cell sizes for repeated measures analysis. Repeated measures analyses were run to examine how level of risk and group (intervention or control) were related to parenting stress, child abuse potential, and children's mental, motor and language development over time. Parenting stress and child abuse potential were higher for women with five risks or more compared with women who had four or fewer risks; children's mental, motor, and language development were not related to level of risk. Children in the intervention group had significantly higher scores on the PDI at 6 and 18 months (107.4 vs. 103.6 and 101.1 vs. 97.2) and had marginally better scores on the MDI at 6 and 12 months (107.7 vs. 104.2 and 103.6 vs. 100.1), compared to the control group. Compared to drug-abusing women with fewer than five risks, women with five or more risks found parenting more stressful and indicated greater inclination towards abusive and neglectful behavior

  3. Parenting intervention and the caregiving environment : cumulative risk and process evaluation

    NARCIS (Netherlands)

    Stolk, Mirjam Neeltje

    2007-01-01

    The objective of the research described in this thesis was to study single and cumulative family risk in relation to early childhood externalizing problems and the effectiveness of a parenting intervention program. The Video-feedback Intervention to promote Positive Parenting and Sensitive

  4. Guideline for Early Interventions

    National Research Council Canada - National Science Library

    Vries, de, Maaike

    2006-01-01

    .... During the last years, the demand for early interventions has been increasing. International literature has shown that the psychosocial effects of disaster and military deployment may last for years...

  5. Early Intervention in Budapest.

    Science.gov (United States)

    Gallai, Maria; Katona, Ferenc; Balogh, Erzsebet; Schultheisz, Judit; Deveny, Anna; Borbely, Sjoukje

    2000-01-01

    This article presents five models of early intervention used in Budapest. Diagnostic and treatment methods used by the Pediatric Institute and the Conductive Education System are described, along with the Deveny Special Manual Technique and Gymnastic Method, the Gezenguz method and techniques used in the Early Developmental Center. (CR)

  6. Early Intervention in Psychosis

    Science.gov (United States)

    McGorry, Patrick D.

    2015-01-01

    Abstract Early intervention for potentially serious disorder is a fundamental feature of healthcare across the spectrum of physical illness. It has been a major factor in the reductions in morbidity and mortality that have been achieved in some of the non-communicable diseases, notably cancer and cardiovascular disease. Over the past two decades, an international collaborative effort has been mounted to build the evidence and the capacity for early intervention in the psychotic disorders, notably schizophrenia, where for so long deep pessimism had reigned. The origins and rapid development of early intervention in psychosis are described from a personal and Australian perspective. This uniquely evidence-informed, evidence-building and cost-effective reform provides a blueprint and launch pad to radically change the wider landscape of mental health care and dissolve many of the barriers that have constrained progress for so long. PMID:25919380

  7. Early intervention in psychosis

    DEFF Research Database (Denmark)

    Csillag, Claudio; Nordentoft, Merete; Mizuno, Masafumi

    2017-01-01

    AIM: Early intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges to their implementa......AIM: Early intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges...... benefits alone is not enough to promote implementation, as economic arguments and political and social pressure have shown to be important elements in efforts to achieve implementation. CONCLUSIONS: Users' narratives, close collaboration with community organizations and support from policy-makers and known...

  8. Early cumulative risk predicts externalizing behavior at age 10: The mediating role of adverse parenting.

    Science.gov (United States)

    Gach, Emily J; Ip, Ka I; Sameroff, Arnold J; Olson, Sheryl L

    2018-02-01

    Multiple environmental risk factors in early childhood predict a broad range of adverse developmental outcomes. However, most prior longitudinal research has not illuminated explanatory mechanisms. Our main goals were to examine predictive associations between cumulative ecological risk factors in early childhood and children's later externalizing problems and to determine whether these associations were explained by variations in parenting quality. Participants were 241 children (118 girls) at risk for school-age conduct problems and their parents and teachers. Children were approximately 3 years old at Time 1 (T1) and 10 years old at Time 2 (T2). Reports of contextual risk at T1 were used to develop a cumulative risk index consisting of 6 singular risk variables from 3 ecological levels: social resources (low income; social isolation), family resources (marital aggression; poor total family functioning), and maternal resources (single parent status; poor maternal mental health). At T1, parenting variables were measured (corporal punishment, warm responsiveness, maternal efficacy, and negative perceptions of child behavior). At T2, mothers, fathers, and teachers reported child externalizing problems. Johnson's relative weight analysis revealed that the cumulative risk index was a more powerful predictor of age 10 years externalizing behavior than any of the singular contextual risk variables. Adverse parenting mediated the effects of cumulative risk on later child externalizing problems. Our findings have significant implications for understanding long-term effects of multiple contextual risk factors present in early childhood and for the implementation of positive parenting interventions early on. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. Genetic moderation of multiple pathways linking early cumulative socioeconomic adversity and young adults' cardiometabolic disease risk.

    Science.gov (United States)

    Wickrama, Kandauda A S; Lee, Tae Kyoung; O'Neal, Catherine Walker

    2018-02-01

    Recent research suggests that psychosocial resources and life stressors are mediating pathways explaining socioeconomic variation in young adults' health risks. However, less research has examined both these pathways simultaneously and their genetic moderation. A nationally representative sample of 11,030 respondents with prospective data collected over 13 years from the National Study of Adolescent to Adult Health was examined. First, the association between early cumulative socioeconomic adversity and young adults' (ages 25-34) cardiometabolic disease risk, as measured by 10 biomarkers, through psychosocial resources (educational attainment) and life stressors (accelerated transition to adulthood) was examined. Second, moderation of these pathways by the serotonin transporter linked polymorphic region gene (5-HTTLPR) was examined. There was evidence for the association between early socioeconomic adversity and young adults' cardiometabolic disease risk directly and indirectly through educational attainment and accelerated transitions. These direct and mediating pathways were amplified by the 5-HTTLPR polymorphism. These findings elucidate how early adversity can have an enduring influence on young adults' cardiometabolic disease risk directly and indirectly through psychosocial resources and life stressors and their genetic moderation. This information suggests that effective intervention and prevention programs should focus on early adversity, youth educational attainment, and their transition to young adulthood.

  10. Family Resources and Effects on Child Behavior Problem Interventions: A Cumulative Risk Approach.

    Science.gov (United States)

    Tømmerås, Truls; Kjøbli, John

    2017-01-01

    Family resources have been associated with health care inequality in general and with social gradients in treatment outcomes for children with behavior problems. However, there is limited evidence concerning cumulative risk-the accumulation of social and economic disadvantages in a family-and whether cumulative risk moderates the outcomes of evidence-based parent training interventions. We used data from two randomized controlled trials evaluating high-intensity ( n  = 137) and low-intensity ( n  = 216) versions of Parent Management Training-Oregon (PMTO) with a 50:50 allocation between participants receiving PMTO interventions or regular care. A nine-item family cumulative risk index tapping socioeconomic resources and parental health was constructed to assess the family's exposure to risk. Autoregressive structured equation models (SEM) were run to investigate whether cumulative risk moderated child behaviors at post-treatment and follow-up (6 months). Our results showed opposite social gradients for the treatment conditions: the children exposed to cumulative risk in a pooled sample of both PMTO groups displayed lower levels of behavior problems, whereas children with identical risk exposures who received regular care experienced more problems. Furthermore, our results indicated that the social gradients differed between PMTO interventions: children exposed to cumulative risk in the low-intensity (five sessions) Brief Parent Training fared equally well as their high-resource counterparts, whereas children exposed to cumulative risk in the high-intensity PMTO (12 sessions) experienced vastly better treatment effects. Providing evidence-based parent training seem to be an effective way to counteract health care inequality, and the more intensive PMTO treatment seemed to be a particularly effective way to help families with cumulative risk.

  11. Early Intervention in Bipolar Disorder.

    Science.gov (United States)

    Vieta, Eduard; Salagre, Estela; Grande, Iria; Carvalho, André F; Fernandes, Brisa S; Berk, Michael; Birmaher, Boris; Tohen, Mauricio; Suppes, Trisha

    2018-05-01

    Bipolar disorder is a recurrent disorder that affects more than 1% of the world population and usually has its onset during youth. Its chronic course is associated with high rates of morbidity and mortality, making bipolar disorder one of the main causes of disability among young and working-age people. The implementation of early intervention strategies may help to change the outcome of the illness and avert potentially irreversible harm to patients with bipolar disorder, as early phases may be more responsive to treatment and may need less aggressive therapies. Early intervention in bipolar disorder is gaining momentum. Current evidence emerging from longitudinal studies indicates that parental early-onset bipolar disorder is the most consistent risk factor for bipolar disorder. Longitudinal studies also indicate that a full-blown manic episode is often preceded by a variety of prodromal symptoms, particularly subsyndromal manic symptoms, therefore supporting the existence of an at-risk state in bipolar disorder that could be targeted through early intervention. There are also identifiable risk factors that influence the course of bipolar disorder, some of them potentially modifiable. Valid biomarkers or diagnosis tools to help clinicians identify individuals at high risk of conversion to bipolar disorder are still lacking, although there are some promising early results. Pending more solid evidence on the best treatment strategy in early phases of bipolar disorder, physicians should carefully weigh the risks and benefits of each intervention. Further studies will provide the evidence needed to finish shaping the concept of early intervention. AJP AT 175 Remembering Our Past As We Envision Our Future April 1925: Interpretations of Manic-Depressive Phases Earl Bond and G.E. Partridge reviewed a number of patients with manic-depressive illness in search of a unifying endo-psychic conflict. They concluded that understanding either phase of illness was "elusive" and

  12. Early Childhood Intervention in China

    Science.gov (United States)

    Zheng, Yuzhu; Maude, Susan P.; Brotherson, Mary Jane

    2015-01-01

    With rapid economic development and increasing awareness of the importance of early childhood intervention (ECI), China is re-examining its social and educational practices for young children with disabilities. This re-examination may have a significant impact on young children with disabilities in China. It may also set an example for other…

  13. Supporting Families through Early Intervention

    Directory of Open Access Journals (Sweden)

    Roy McConkey

    2003-09-01

    Full Text Available Internationally early intervention programmes for infants and preschoolers with disabilities have proved to be remarkably successful. In many countries, they began with teachers for visually impaired or hearing impaired children visiting the family home to teach parents how they could overcome the child's impairments. The logic of early intervention was inequitable. For example, the sooner children with visual impairments learnt to be independently mobile, then the greater their potential to learn and to kad an ordinary life. In time, this philosophy was extended to children with neurological and developmental delays, such as mental retardation, although success could be variable. In part, many different factors contributed to this variability: the form the interventions took, the extent of family involvement in the intervention and the lack of sensitivity of the measures used to assess a child's progress, to name but three. Perhaps the most extensive and intensive Early intervention schemes have been in the United States with their Head Start programmes. They were aimed at promoting the educational potential of preschoolers from deprived socio - economic backgrounds. Although the first phase of programmes had varying success, those in the second phase yielded impressive results which were mainly attributed to a greater focus on parental participation and links forged with the school system. Recently in developing countries, priority has been given to establishing early intervention as a means of creating new styles of family-based and community-based service in these countries in contrast to the hospital or institutional-services that were a legacy from a previous generation. Although formal evaluations are largely lacking, informal reports have been broadly enthusiastic. In sum, early intervention is no longer a new approach to developmental disabilities. It is an approach of proven effectiveness with children who have different impairments

  14. Cumulative Risk and Continuity in Nonparental Care from Infancy to Early Adolescence

    OpenAIRE

    Colwell, Malinda J.; Pettit, Gregory S.; Meece, Darrell; Bates, John E.; Dodge, Kenneth A.

    2001-01-01

    Variations in amounts of nonparental care across infancy, preschool, early elementary school, and early adolescence were examined in a longitudinal sample (N = 438). Of interest was (a) continuity in use of the different arrangements, (b) whether the arrangements were additively and cumulatively associated with children’s externalizing behavior problems, and (c) whether predictive relations were accounted for by social-ecological (socioeconomic status, mothers’ employment status, marital stat...

  15. Application of the ELDO approach to assess cumulative eye lens doses for interventional cardiologists

    International Nuclear Information System (INIS)

    Farah, J.; Jacob, S.; Clairand, I.; Struelens, L.; Vanhavere, F.; Auvinen, A.; Koukorava, C.; Schnelzer, M.

    2015-01-01

    In preparation of a large European epidemiological study on the relation between eye lens dose and the occurrence of lens opacities, the European ELDO project focused on the development of practical methods to estimate retrospectively cumulative eye lens dose for interventional medical professionals exposed to radiation. The present paper applies one of the ELDO approaches, correlating eye lens dose to whole-body doses, to assess cumulative eye lens dose for 14 different Finnish interventional cardiologists for whom annual whole-body dose records were available for their entire working period. The estimated cumulative left and right eye lens dose ranged from 8 to 264 mSv and 6 to 225 mSv, respectively. In addition, calculations showed annual eye lens doses sometimes exceeding the new ICRP annual limit of 20 mSv. The work also highlights the large uncertainties associated with the application of such an approach proving the need for dedicated dosimetry systems in the routine monitoring of the eye lens dose. (authors)

  16. Early intervention services in psychosis

    DEFF Research Database (Denmark)

    Csillag, Claudio; Nordentoft, Merete; Mizuno, Masafumi

    2016-01-01

    AIM: Early intervention (EI) in psychosis is a comprehensive and evidence-based approach aimed at detection and treatment of psychotic symptoms in their early stages. This paper presents core features and noteworthy aspects of the evidence basis and limitations of EI, the importance of programme ....... Wider dissemination of EI services will probably benefit from better integration of potential funders, promotion of joint targets and shared financial or budgetary incentives....... overcome these difficulties. CONCLUSIONS: Funding for mental health in general and for EI services appears low relative to need. One key argument for better funding for EI can be found in its favourable cost-effectiveness, but not all stakeholders beyond mental health administrators are aware of this...

  17. Cumulative Risk and Continuity in Nonparental Care from Infancy to Early Adolescence.

    Science.gov (United States)

    Colwell, Malinda J; Pettit, Gregory S; Meece, Darrell; Bates, John E; Dodge, Kenneth A

    2001-04-01

    Variations in amounts of nonparental care across infancy, preschool, early elementary school, and early adolescence were examined in a longitudinal sample (N = 438). Of interest was (a) continuity in use of the different arrangements, (b) whether the arrangements were additively and cumulatively associated with children's externalizing behavior problems, and (c) whether predictive relations were accounted for by social-ecological (socioeconomic status, mothers' employment status, marital status) and social-experiential (parenting quality, exposure to aggressive peers) factors. Correlations among overall amounts of care provided little evidence of cross-time continuity. Consistent with the cumulative risk perspective, Grade 1 self-care and Grade 6 unsupervised peer contact incrementally predicted Grade 6 externalizing problems. Most of the predictive associations were accounted for by family background and social relationship factors.

  18. Association of Cumulative Childhood Adversity and Adolescent Violent Offending With Suicide in Early Adulthood.

    Science.gov (United States)

    Björkenstam, Emma; Hjern, Anders; Björkenstam, Charlotte; Kosidou, Kyriaki

    2018-02-01

    Childhood adversity (CA) is associated with an increased risk of suicide in young adulthood that might be explained by maladaptive trajectories during adolescence. Although adolescent violent offending is linked with suicide, little is known about its role in the association between CA and suicide. To examine whether adolescent violent offending mediates the association between CA and suicide in early adulthood. This population-based, longitudinal cohort study with a follow-up time spanning 5 to 9 years included 476 103 individuals born in Sweden between 1984 and 1988. The study population was prospectively followed up from 20 years of age until December 31, 2013, with respect to suicide. Data analysis was performed from January 1, 1984, to December 31, 2013. Register-based CAs included parental death, parental substance abuse and psychiatric disorder, parental criminal offending, parental separation, public assistance recipiency, child welfare intervention, and residential instability. Adolescent violent offending was defined as being convicted of a violent crime between the ages of 15 and 19 years. Estimates of risk of suicide after 20 years of age (from 2004 if born in 1984 and from 2008 if born in 1988) until the end of 2013 were calculated as incidence rate ratios (IRRs) with 95% CIs using Poisson regression analysis. Adjustments were made for demographics and psychiatric disorder. In addition, binary mediation analysis with logistic regression was used. A total of 476 103 individuals (231 699 [48.7%] female) were included in the study. Those with a conviction for violent offending had been exposed to all CAs to a greater extent than those with no violent offending. Cumulative CA was associated with risk of suicide in nonconvicted (adjusted IRR, 2.4; 95% CI, 1.5-3.9) and convicted youths, who had a higher risk of suicide (adjusted IRR, 8.5; 95% CI, 4.6-15.7). Adolescent violent offending partly mediated the association between CA and suicide. Individuals

  19. Early identification and intervention in cerebral palsy

    DEFF Research Database (Denmark)

    Herskind, Anna; Greisen, Gorm; Nielsen, Jens Bo

    2015-01-01

    Infants with possible cerebral palsy (CP) are commonly assumed to benefit from early diagnosis and early intervention, but substantial evidence for this is lacking. There is no consensus in the literature on a definition of 'early', but this review focuses on interventions initiated within...

  20. Early intervention as a catalyst for effective early childhood ...

    African Journals Online (AJOL)

    ... of positive attitudes towards children with disabilities in a country like Ghana. ... As Ghana strides towards mainstreaming early childhood education in the quest ... an integrated, inclusive and effective early intervention programme becomes ...

  1. THE SIGNIFICANCE OF CUMULATIVE WATER BALANCE IN THE DEVELOPMENT OF EARLY COMPLICATIONS AFTER MAJOR ABDOMINAL SURGERY.

    Science.gov (United States)

    Musaeva, T S; Karipidi, M K; Zabolotskikh, I B

    2016-11-01

    a comprehensive assessment of the water balance on the basis of daily, cumulative balance and 10% of the body weight gain and their role in the development of early complications after major abdominal surgery. A retrospective study of the perioperative period in 150 patients who underwent major abdomi- nal surgery was performed. The physical condition of the patients corresponded to ASA 3 class. The average age was 46 (38-62) years. The following stages ofresearch: an analysis of daily balance and cumulative balance in complicated and uncomplicated group and their role in the development of complications; the timing of development ofcomplications and possible relationship with fluid overload and the development of complications; changes in the level of albumin within 10 days of the postoperative period. The analysis of complications didn't show significant differences between complicated and uncomplicated groups according to the water balance during the surgery and by the end of the first day. When constructing the area under the ROC curve (A UROC) low resolution ofthe balance in intraoperative period and the first day and the balance on the second day to predict complications was shown. Significant diferences according to the cumulative balance was observed from the third day of the postoperative period Also with the third day of the postoperative period there is a good resolution for prediction ofpostoperative complications according to the cumulative balance with the cut-offpoint > of 50,7 ml/kg. the excessive infusion therapy is a predictor of adverse outcome in patients after major abdominal surgery. Therefore, after 3 days of postoperative period it is important to maintain mechanisms for the excretion of excess fluid or limitations of infusion therapy.

  2. The EHDI and Early Intervention Connection

    Science.gov (United States)

    Nelson, Lauri; Bradham, Tamala S.; Houston, K. Todd

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. For the early intervention focus question, 48 coordinators listed 273 items, and themes were identified within each SWOT category. A…

  3. Infusing Early Childhood Mental Health into Early Intervention Services

    Science.gov (United States)

    Grabert, John C.

    2009-01-01

    This article describes the process of enhancing early childhood mental health awareness and skills in non-mental health staff. The author describes a pilot training model, conducted the U.S. Army's Early Intervention Services, that involved: (a) increasing early childhood mental health knowledge through reflective readings, (b) enhancing…

  4. Tracing Early Interventions on Childhood Overweight

    DEFF Research Database (Denmark)

    Ditlevsen, Kia

    This thesis presents results from a qualitative research project on early interventions to counter childhood obesity in Denmark. Overall, it was found that these interventions in families with preschool children were rarely performed. One barrier to the interventions is the structural setting...... in families with a non-western ethnic minority background and with low socioeconomic status. In families who participated in interventions, other social problems and a sense of insecurity caused by precarious living conditions of different kinds influenced the parents’ readiness to restrict children in order...... in the Danish health care system, which was found to be insufficient to initiate and facilitate early interventions. In addition, cultural stereotypes were found to affect the health care practitioners who are performing early interventions, and this can create reluctance to address overweight problems...

  5. News in early intervention in autism.

    Science.gov (United States)

    Geoffray, Marie-Maude; Thevenet, Marion; Georgieff, Nicolas

    2016-09-01

    Autism Spectrum Disorder (ASD) is a complex neurodevelopmental trouble which prevents the child from socio-communicative interaction, and learning from his environment. Non-medical early intervention attempts to improve prognosis. We will review the main current hypothesis, intervention models and scientific supports about early intervention. We conducted a search of the literature published on Medline between 2010 and 2015 related to intervention models provided to children with ASD aged less than 3 years. Data were extracted from systematic reviews and recent randomized controlled trials with moderate to high GRADE quality of evidence. Early intervention refers to brain plasticity theory. With the epidemiological studies of infant "at risk" there is an attempt to intervene earlier before full syndrome is present. Interventions tend to follow more on a developmental hierarchy of socio-communicative skills and to focus on the dyadic relation between the child and the caregivers to improve the core autistic symptoms. Over the last 6 years, there's been news and fine-tuned ways about early intervention, and more and more systematic evaluation. However, there are only few interventions which were evaluated in trial with a strong GRADE recommendation and all of them have methodological concerns. It is important to be cautious in recommendations for mental health politic, even if it is important to improve access to services for all children and their families, hence finance and design rigorous project in research.

  6. Challenges and limitations in early intervention

    NARCIS (Netherlands)

    Hadders-Algra, Mijna

    Research over the past three decades has shown that early intervention in infants biologically at risk of developmental disorders, irrespective of the presence of a brain lesion, is associated with improved cognitive development in early childhood without affecting motor development. However, at

  7. Early diagnosis and early intervention in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Mijna eHadders-Algra

    2014-09-01

    Full Text Available This paper reviews the opportunities and challenges for early diagnosis and early intervention in cerebral palsy (CP. CP describes a group of disorders of the development of movement and posture, causing activity limitation, that are attributed to disturbances that occurred in the fetal or infant brain. Therefore the paper starts with a summary of relevant information from developmental neuroscience. Most lesions underlying CP occur in the second half of gestation, when developmental activity in the brain reaches its summit. Variations in timing of the damage not only result in different lesions, but also in different neuroplastic reactions and different associated neuropathologies. This turns CP into a heterogeneous entity. This may mean that the best early diagnostics and the best intervention methods may differ for various subgroups of children with CP. Next, the paper addresses possibilities for early diagnosis. It discusses the predictive value of neuromotor and neurological exams, neuro-imaging techniques and neurophysiological assessments. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group best prediction is achieved with the combination of neuro-imaging and the assessment of general movements, in the latter group best prediction is based on carefully documented milestones and neurological assessment. The last part reviews early intervention in infants developing CP. Most knowledge on early intervention is based on studies in high risk infants without CP. In these infants early intervention programs promote cognitive development until preschool age; motor development profits less. The few studies on early intervention in infants developing CP suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising. More research is

  8. Early intervention for childhood overweight

    DEFF Research Database (Denmark)

    Larsen, Lone Marie; Hertel, Niels Thomas; Mølgaard, Christian

    2015-01-01

    , identified by International Obesity Task Force criteria, aged 5-9 years. INTERVENTION: Model 1 with health consultations in general practice during a two-year period or Model 2, an educational programme for the children and their families in addition to the health consultations. MAIN OUTCOME MEASURES: Change...... in body mass index (BMI) z-score in order to compare the results, independent of gender- and age-related changes over time. RESULTS: A total of 80 children were recruited with 35 and 45 children allocated to Model 1 and Model 2, respectively. No significant differences were found in the change in BMI z...

  9. Readability of Early Intervention Program Literature

    Science.gov (United States)

    Pizur-Barnekow, Kris; Patrick, Timothy; Rhyner, Paula M.; Cashin, Susan; Rentmeester, Angela

    2011-01-01

    Accessibility of early intervention program literature was examined through readability analysis of documents given to families who have a child served by the Birth to 3 program. Nine agencies that serve families in Birth to 3 programs located in a county in the Midwest provided the (n = 94) documents. Documents were included in the analysis if…

  10. Early math intervention for marginalized students

    DEFF Research Database (Denmark)

    Overgaard, Steffen; Tonnesen, Pia Beck

    2016-01-01

    This study is one of more substudies in the project Early Math Intervention for Marginalized Students (TMTM2014). The paper presents the initial process of this substudy that will be carried out fall 2015. In the TMTM2014 project, 80 teachers, who completed a one week course in the idea of TMTM...

  11. Mothers' Coping and Hope in Early Intervention

    Science.gov (United States)

    Einav, Michal; Levi, Uzi; Margalit, Malka

    2012-01-01

    The goals of the study were to examine the relations between maternal coping and hope among mothers who participated in early intervention program for their infants. Earlier studies focused attention on mothers' experiences of stress and their coping. Within the salutogenic construct, we aim at examining relations between mothers' coping and hope…

  12. Twenty-years of lung transplantation in Taiwan: Effects of cumulative institutional experience on early outcomes

    Directory of Open Access Journals (Sweden)

    Shun-Mao Yang

    2017-11-01

    Conclusion: Although the results were undesirable in the first decade of the transplant program, the cumulative institutional experience led to significantly improved outcomes in the second decade of the transplant program.

  13. The impact of ergonomics intervention on trunk posture and cumulative compression load among carpet weavers.

    Science.gov (United States)

    Afshari, Davood; Motamedzade, Majid; Salehi, Reza; Soltanian, Alir Raze

    2015-01-01

    Work-related musculoskeletal disorders of back among weavers are prevalent. Epidemiological studies have shown an association between poor working postures and back disorders among carpet weavers. Therefore, the present study aimed to evaluate the impact of the traditional (A) and ergonomically designed (B) workstations on trunk posture and cumulative compression load in carpet weavers. In this study, subtasks were identified in terms of stressful postures and carpet weaving process. Postural data were collected during knotting and compacting subtasks using inclinometer during four hours for each workstation. Postural data, weight and height of the weavers were entered into the University of Michigan three-dimensional static biomechanical model for estimation of the compression load and cumulative load were estimated from the resultant load and exposure time. Thirteen healthy carpet weavers (four males and nine females) participated in the study. Median trunk flexion angle was reduced with workstation B during knotting subtask (18° versus 8.5°, pergonomically designed workstation.

  14. A cumulative risk factor model for early identification of academic difficulties in premature and low birth weight infants.

    Science.gov (United States)

    Roberts, G; Bellinger, D; McCormick, M C

    2007-03-01

    Premature and low birth weight children have a high prevalence of academic difficulties. This study examines a model comprised of cumulative risk factors that allows early identification of these difficulties. This is a secondary analysis of data from a large cohort of premature (mathematics. Potential predictor variables were categorized into 4 domains: sociodemographic, neonatal, maternal mental health and early childhood (ages 3 and 5). Regression analysis was used to create a model to predict reading and mathematics scores. Variables from all domains were significant in the model, predicting low achievement scores in reading (R (2) of 0.49, model p-value mathematics (R (2) of 0.44, model p-value intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Lower mathematics scores were predicted by lower maternal education, income and age and Black or Hispanic race (sociodemographic); lower birth weight and higher head circumference (neonatal); lower maternal responsivity (maternal mental health); lower intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Sequential early childhood risk factors in premature and LBW children lead to a cumulative risk for academic difficulties and can be used for early identification.

  15. Low Fruit/Vegetable Consumption in the Home: Cumulative Risk Factors in Early Childhood

    Science.gov (United States)

    Ward, Wendy L.; Swindle, Taren M.; Kyzer, Angela L.; Whiteside-Mansell, Leanne

    2015-01-01

    Cumulative risk theory suggests that a variety of social risk factors would have an additive effect on obesity risk. Multiple studies have suggested that obesity is related to basic resources such as transportation and financial resources. Additional research points to parental engagement and parental monitoring as additional sources of risk. This…

  16. Interactive Contributions of Cumulative Peer Stress and Executive Function Deficits to Depression in Early Adolescence

    Science.gov (United States)

    Agoston, Anna M.; Rudolph, Karen D.

    2016-01-01

    Exposure to peer stress contributes to adolescent depression, yet not all youth experience these effects. Thus, it is important to identify individual differences that shape the consequences of peer stress. This research investigated the interactive contribution of cumulative peer stress during childhood (second-fifth grades) and executive…

  17. A study of the relationship between peak skin dose and cumulative air kerma in interventional neuroradiology and cardiology

    International Nuclear Information System (INIS)

    Neil, S; Padgham, C; Martin, C J

    2010-01-01

    A study of peak skin doses (PSDs) during neuroradiology and cardiology interventional procedures has been carried out using Gafchromic XR-RV2 film. Use of mosaics made from squares held in cling film has allowed doses to the head to be mapped successfully. The displayed cumulative air kerma (CAK) has been calibrated in terms of cumulative entrance surface dose (CESD) and results indicate that this can provide a reliable indicator of the PSD in neuroradiology. Results linking PSD to CESD for interventional cardiology were variable, but CAK is still considered to provide the best option for use as an indicator of potential radiation-induced effects. A CESD exceeding 3 Gy is considered a suitable action level for triggering follow-up of patients in neuroradiology and cardiology for possible skin effects. Application of dose action levels defined in this way would affect 8% of neurological embolisation procedures and 5% of cardiology ablation and multiple stent procedures at the hospitals where the investigations were carried out. A close relationship was observed between CESD and dose-area product (DAP) for particular types of procedure, and DAPs of 200-300 Gy cm 2 could be used as trigger levels where CAK readings were not available. The DAP value would depend on the mean field size and would need to be determined for each application.

  18. Early mathematics intervention in a Danish municipality

    DEFF Research Database (Denmark)

    Lindenskov, Lena; Weng, Peter

    2013-01-01

    We describe a pilot project 2009 – 2010 about early intervention in second grade mathematics (about 8 years old) in Frederiksberg, a Danish urban municipality. We shortly describe the background of the pilot project, aims and organisation in four design cycles. We explore the pilot teachers......' feedback during the pilot process, how pilot teacher feedback was applied in material production, and the relations between the feedback and the project’s theoretical basis. The project is based on original theory (Math Holes theory), but international frameworks, like Mathematics Recovery, serve...

  19. Early detection and intervention in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Larsen, Tor Ketil; Friis, Svein; Haahr, U

    2001-01-01

    OBJECTIVE: To review the literature on early intervention in psychosis and to evaluate relevant studies. METHOD: Early intervention was defined as intervention in the prodromal phase (primary prevention) and intervention after the onset of psychosis, i.e. shortening of duration of untreated psych...

  20. Prevention of food allergy - Early dietary interventions.

    Science.gov (United States)

    Du Toit, George; Foong, Ru-Xin M; Lack, Gideon

    2016-10-01

    The prevalence of food allergy has increased over the last 30 years and remains a disease, which significantly impacts on the quality of life of children and their families. Several hypotheses have been formulated to explain the increasing prevalence; this review will focus on the hypothesis that dietary factors may influence the development of food allergy. Historically, the prevention of food allergy has focused on allergen avoidance. However, recent findings from interventional studies have prompted a shift in the mind set from avoidance to early introduction of potentially allergenic foods. This review aims to facilitate a better understanding of contemporary research studies that make use of early introduction of common allergenic foods into infant diets as a preventative strategy against the development of food allergy. Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  1. Mediators and moderators in early intervention research.

    Science.gov (United States)

    Breitborde, Nicholas J K; Srihari, Vinod H; Pollard, Jessica M; Addington, Donald N; Woods, Scott W

    2010-05-01

    The goal of this paper is to provide clarification with regard to the nature of mediator and moderator variables and the statistical methods used to test for the existence of these variables. Particular attention will be devoted to discussing the ways in which the identification of mediator and moderator variables may help to advance the field of early intervention in psychiatry. We completed a literature review of the methodological strategies used to test for mediator and moderator variables. Although several tests for mediator variables are currently available, recent evaluations suggest that tests which directly evaluate the indirect effect are superior. With regard to moderator variables, two approaches ('pick-a-point' and regions of significance) are available, and we provide guidelines with regard to how researchers can determine which approach may be most appropriate to use for their specific study. Finally, we discuss how to evaluate the clinical importance of mediator and moderator relationships as well as the methodology to calculate statistical power for tests of mediation and moderation. Further exploration of mediator and moderator variables may provide valuable information with regard to interventions provided early in the course of a psychiatric illness.

  2. Early Nutrition and Physical Activity Interventions in Childhood Cancer Survivors.

    Science.gov (United States)

    Zhang, Fang Fang; Kelly, Michael J; Must, Aviva

    2017-06-01

    Childhood cancer survivors experience excessive weight gain early in treatment. Lifestyle interventions need to be initiated early in cancer care to prevent the early onset of obesity and cardiovascular disease (CVD). We reviewed the existing literature on early lifestyle interventions in childhood cancer survivors and consider implications for clinical care. Few lifestyle interventions focus on improving nutrition in childhood cancer survivors. A consistent effect on reducing obesity and CVD risk factors is not evident from the limited number of studies with heterogeneous intervention characteristics, although interventions with a longer duration and follow-up show more promising trends. Future lifestyle interventions should be of a longer duration and include a nutrition component. Interventions with a longer duration and follow-up are needed to assess the timing and sustainability of the intervention effect. Lifestyle interventions introduced early in cancer care are both safe and feasible.

  3. Early Intervention in Children with Developmental Disabilities

    Directory of Open Access Journals (Sweden)

    Beena Johnson

    2016-01-01

    Full Text Available Developmental disabilities consist of conditions that delay or impair the physical, cognitive, and/or psychological development of children. If not intervened at the earliest, these disabilities will cause significant negative impact on multiple domains of functioning such as learning, language, self-care and capacity for independent living. Common developmental disabilities include autism spectrum disorders, intellectual disabilities, developmental delay and cerebral palsy. About one fourth of young children in developing countries are at risk for or have developmental delay or disabilities. Inadequate stimulation has significant negative impact on physical, socioemotional and cognitive development of children. Hence early scientific intervention programs are necessary in the management of children at risk for developmental delay.

  4. Weighted cumulative exposure models helped identify an association between early knee-pain consultations and future knee OA diagnosis.

    Science.gov (United States)

    Yu, Dahai; Peat, George; Bedson, John; Edwards, John J; Turkiewicz, Aleksandra; Jordan, Kelvin P

    2016-08-01

    To establish the association between prior knee-pain consultations and early diagnosis of knee osteoarthritis (OA) by weighted cumulative exposure (WCE) models. Data were from an electronic health care record (EHR) database (Consultations in Primary Care Archive). WCE functions for modeling the cumulative effect of time-varying knee-pain consultations weighted by recency were derived as a predictive tool in a population-based case-control sample and validated in a prospective cohort sample. Two WCE functions ([i] weighting of the importance of past consultations determined a priori; [ii] flexible spline-based estimation) were comprehensively compared with two simpler models ([iii] time since most recent consultation; total number of past consultations) on model goodness of fit, discrimination, and calibration both in derivation and validation phases. People with the most recent and most frequent knee-pain consultations were more likely to have high WCE scores that were associated with increased risk of knee OA diagnosis both in derivation and validation phases. Better model goodness of fit, discrimination, and calibration were observed for flexible spline-based WCE models. WCE functions can be used to model prediagnostic symptoms within routine EHR data and provide novel low-cost predictive tools contributing to early diagnosis. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Developments in early intervention for psychosis in Hong Kong.

    Science.gov (United States)

    Wong, G H Y; Hui, C L M; Wong, D Y; Tang, J Y M; Chang, W C; Chan, S K W; Lee, E H M; Xu, J Q; Lin, J J X; Lai, D C; Tam, W; Kok, J; Chung, D W S; Hung, S F; Chen, E Y H

    2012-09-01

    The year 2011 marked the 10-year milestone of early intervention for psychosis in Hong Kong. Since 2001, the landscape of early psychosis services has changed markedly in Hong Kong. Substantial progress has been made in the areas of early intervention service implementation, knowledge generation, and public awareness promotion. Favourable outcomes attributable to the early intervention service are supported by solid evidence from local clinical research studies; early intervention service users showed improved functioning, ameliorated symptoms, and decreased hospitalisation and suicide rates. Continued development of early intervention in Hong Kong over the decade includes the introduction and maturation of several key platforms, such as the Hospital Authority Early Assessment Service for Young People with Psychosis programme, the Psychosis Studies and Intervention Unit by the University of Hong Kong, the Hong Kong Early Psychosis Intervention Society, the Jockey Club Early Psychosis Project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. In this paper, we reviewed some of the major milestones in local service development with reference to features of the Hong Kong mental health system. We describe chronologically the implementation and consolidation of public early intervention services as well as recent progresses in public awareness work that are tied in with knowledge generation and transfer, and outline the prospects for early intervention in the next decade and those that follow.

  6. Multiple procedures and cumulative individual radiation exposure in interventional cardiology: A long-term retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Weltermann, Birgitta M.; Rock, Thomas; Berndt, Peter; Viehmann, Anja; Reinders, Sabrina; Gesenhues, Stefan [University of Duisburg-Essen, Institute for General Medicine, University Hospital, Essen (Germany); Brix, Gunnar; Schegerer, Alexander [Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg (Germany)

    2015-09-15

    Various studies address discrepancies between guideline recommendations for coronary angiographies and clinical practice. While the issue of the appropriateness of recurrent angiographies was studied focusing on the role of the cardiologist, little is known about individual patients' histories and the associated radiation exposures. We analyzed all patients with coronary artery disease (CAD) in an academic teaching practice who underwent at least one angiography with or without intervention between 2004 and 2009. All performed angiographies in these patients were analyzed and rated by three physicians for appropriateness levels according to cardiology guidelines. Typical exposure data from the medical literature were used to estimate individual radiation exposure. In the cohort of 147 patients, a total of 441 procedures were analyzed: between 1981 and 2009, three procedures were performed per patient (range 1-19) on average. Appropriateness ratings were 'high/intermediate' in 71 %, 'low/no' in 27.6 % and data were insufficient for ratings in 1.4 %. Procedures with 'low/no' ratings were associated with potentially avoidable exposures of up to 186 mSv for single patients. Using retrospective data, we exemplify the potential benefit of guideline adherence to decrease patients' radiation exposures. (orig.)

  7. VIA Family - Family Based Early Intervention Versus Treatment as Usual

    Science.gov (United States)

    2018-04-12

    Early Intervention; Child of Impaired Parents; Child; Adolescent; Mental Disorders, Severe; Schizophrenia; Bipolar Disorder; Depressive Disorder, Recurrent; Psychotic Disorders; Parent-Child Relations

  8. Overview of Play: Its Uses and Importance in Early Intervention/Early Childhood Special Education

    Science.gov (United States)

    Lifter, Karin; Foster-Sanda, Suzanne; Arzamarski, Caley; Briesch, Jacquelyn; McClure, Ellen

    2011-01-01

    Play is a natural activity of early childhood, which has great relevance to the fields of early intervention, early childhood special education, and early childhood education. Within these fields, ongoing tensions persist in how play is described and used. These tensions compromise activities of assessment, intervention, and curriculum development…

  9. Cumulative Effects of Nutrient Enrichment and Elevated Temperature Compromise the Early Life History Stages of the Coral Acropora tenuis.

    Science.gov (United States)

    Humanes, Adriana; Noonan, Sam H C; Willis, Bette L; Fabricius, Katharina E; Negri, Andrew P

    2016-01-01

    Inshore coral reefs are experiencing the combined pressures of excess nutrient availability associated with coastal activities and warming seawater temperatures. Both pressures are known to have detrimental effects on the early life history stages of hard corals, but studies of their combined effects on early demographic stages are lacking. We conducted a series of experiments to test the combined effects of nutrient enrichment (three levels) and elevated seawater temperature (up to five levels) on early life history stages of the inshore coral Acropora tenuis, a common species in the Indo-Pacific and Red Sea. Gamete fertilization, larval survivorship and larval settlement were all significantly reduced as temperature increased, but only fertilization was further affected by simultaneous nutrient enrichment. Combined high temperatures and nutrient enrichment affected fertilization in an additive manner, whereas embryo abnormalities increased synergistically. Higher than normal temperatures (32°C) increased coral juvenile growth rates 1.6-fold, but mortality also increased by 50%. The co-occurrence of nutrient enrichment with high temperatures reduced juvenile mortality to 36%, ameliorating temperature stress (antagonistic interaction). Overall, the types of effect (additive vs synergistic or antagonistic) and their magnitude varied among life stages. Gamete and embryo stages were more affected by temperature stress and, in some cases, also by nutrient enrichment than juveniles. The data suggest that coastal runoff events might exacerbate the impacts of warming temperatures on fertilization if these events co-occur during corals spawning. The cumulative impacts of simultaneous exposure to nutrient enrichment and elevated temperatures over all early life history stages increases the likelihood for failure of larval supply and recruitment for this coral species. Our results suggest that improving the water quality of river discharges into coastal areas might help to

  10. Cumulative Effects of Nutrient Enrichment and Elevated Temperature Compromise the Early Life History Stages of the Coral Acropora tenuis

    Science.gov (United States)

    Noonan, Sam H. C.; Willis, Bette L.; Fabricius, Katharina E.; Negri, Andrew P.

    2016-01-01

    Inshore coral reefs are experiencing the combined pressures of excess nutrient availability associated with coastal activities and warming seawater temperatures. Both pressures are known to have detrimental effects on the early life history stages of hard corals, but studies of their combined effects on early demographic stages are lacking. We conducted a series of experiments to test the combined effects of nutrient enrichment (three levels) and elevated seawater temperature (up to five levels) on early life history stages of the inshore coral Acropora tenuis, a common species in the Indo-Pacific and Red Sea. Gamete fertilization, larval survivorship and larval settlement were all significantly reduced as temperature increased, but only fertilization was further affected by simultaneous nutrient enrichment. Combined high temperatures and nutrient enrichment affected fertilization in an additive manner, whereas embryo abnormalities increased synergistically. Higher than normal temperatures (32°C) increased coral juvenile growth rates 1.6-fold, but mortality also increased by 50%. The co-occurrence of nutrient enrichment with high temperatures reduced juvenile mortality to 36%, ameliorating temperature stress (antagonistic interaction). Overall, the types of effect (additive vs synergistic or antagonistic) and their magnitude varied among life stages. Gamete and embryo stages were more affected by temperature stress and, in some cases, also by nutrient enrichment than juveniles. The data suggest that coastal runoff events might exacerbate the impacts of warming temperatures on fertilization if these events co-occur during corals spawning. The cumulative impacts of simultaneous exposure to nutrient enrichment and elevated temperatures over all early life history stages increases the likelihood for failure of larval supply and recruitment for this coral species. Our results suggest that improving the water quality of river discharges into coastal areas might help to

  11. Early Intervention Practices in China: Present Situation and Future Directions

    Science.gov (United States)

    Hu, Xiaoyi; Yang, Xijie

    2013-01-01

    Early intervention services to young children with developmental delays in China have experienced significant growth since 1978, the beginning of the period of Reform and Opening. This article described the present situation of early intervention practices in mainland China, framed around the key components and guiding principles of Guralnick's…

  12. Student Preparation for Professional Practice in Early Intervention

    Science.gov (United States)

    Francois, Jennifer R.; Coufal, Kathy L.; Subramanian, Anu

    2015-01-01

    The preparation of students for professional practice in the field of early intervention has changed as a result of mandates through Part C, Individuals With Disabilities Education Act (IDEA). The purpose of this survey research was to describe the knowledge and skill areas, specific to early intervention, included in pre-professional curricula…

  13. Effects of Critical Thinking Intervention for Early Childhood Teacher Candidates

    Science.gov (United States)

    Han, Heejeong Sophia; Brown, E. Todd

    2013-01-01

    This study is based on an intervention designed to enhance early childhood teacher candidates' critical thinking abilities. The concept, elements, standards, and traits of critical thinking were integrated into the main course contents, and the effects of the intervention were examined. The results indicated that early childhood teacher…

  14. Early Intervention for Families and Children Experiencing Homelessness

    Science.gov (United States)

    Hurley, Jennifer J.; Looby, Winnie; Goodrum, Ashley R.; Campbell, Elizabeth M.; Bonti, Gregg K.; Raymon, Becca A.; Condon, Rebecca; Schwaeber, Sami E.; Mauceri, Melina E.; Bourne, Erin M.; Callahan, Elizabeth D.; Hardy, Danielle L.; Mathews, Pamela

    2018-01-01

    Early intervention (EI) services are provided for families and children at risk for or with developmental delays. Early intervention includes services that are provided in the natural environment as mandated by the Individuals with Disabilities Education Act (IDEA; 2004). The natural environment is where children and families would naturally spend…

  15. Mapping the Early Intervention System in Ontario, Canada

    Science.gov (United States)

    Underwood, Kathryn

    2012-01-01

    This study documents the wide range of early intervention services across the province of Ontario. The services are mapped across the province showing geographic information as well as the scope of services (clinical, family-based, resource support, etc.), the range of early intervention professionals, sources of funding and the populations served…

  16. The rationale for early intervention in schizophrenia and related disorders

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Jeppesen, Pia; Petersen, Lone

    2009-01-01

    , adherence to treatment, comorbid drug abuse, relapse and readmission. Some benefits persist after cessation of the intervention. Conclusions: Early intervention in schizophrenia is justified to reduce the negative personal and social impact of prolonged periods of untreated symptoms. Furthermore, phase......Abstract Aim: To examine the rationale and evidence supporting an early intervention approach in schizophrenia. Methods: A selective literature review was conducted. Results: During the onset of schizophrenia, there is often a significant delay between the emergence of psychotic symptoms...

  17. Early psychosocial intervention in Alzheimer's disease

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Sørensen, Jan; Waldorff, Frans B

    2014-01-01

    in five Danish districts. PARTICIPANTS: 330 community-dwelling patients and their primary caregivers. INTERVENTION: Psychosocial counselling and support lasting 8-12 months after diagnosis and follow-up at 3, 6, 12 and 36 months in the intervention group or follow-up only in the control group. MAIN...... and the caregiver before aggregation for the main analysis. RESULTS: None of the observed cost and QALY measures were significantly different between the intervention and control groups, although a tendency was noted for psychosocial care leading to cost increases with informal care that was not outweighed...

  18. Promoting equity through integrated early child development and nutrition interventions.

    Science.gov (United States)

    Black, Maureen M; Dewey, Kathryn G

    2014-01-01

    Sustainable development, a foundation of the post-2015 global agenda, depends on healthy and productive citizens. The origins of adult health begin early in life, stemming from genetic-environmental interactions that include adequate nutrition and opportunities for responsive learning. Inequities associated with inadequate nutrition and early learning opportunities can undermine children's health and development, thereby compromising their productivity and societal contributions. Transactional theory serves as a useful framework for examining the associations that link early child development and nutrition because it emphasizes the interplay that occurs between children and the environment, mediated through caregiver interactions. Although single interventions targeting early child development or nutrition can be effective, there is limited evidence on the development, implementation, evaluation, and scaling up of integrated interventions. This manuscript introduces a special edition of papers on six topics central to integrated child development/nutrition interventions: (1) review of integrated interventions; (2) methods and topics in designing integrated interventions; (3) economic considerations related to integrated interventions; (4) capacity-building considerations; (5) examples of integrated interventions; and (6) policy implications of integrated interventions. Ensuring the health and development of infants and young children through integrated child development/nutrition interventions promotes equity, a critical component of sustainable development. © 2014 New York Academy of Sciences.

  19. Ethnic variations in pathways into early intervention services for psychosis.

    Science.gov (United States)

    Ghali, Sharif; Fisher, Helen L; Joyce, John; Major, Barnaby; Hobbs, Lorna; Soni, Sujata; Chisholm, Brock; Rahaman, Nikola; Papada, Peggy; Lawrence, Jo; Bloy, Sally; Marlowe, Karl; Aitchison, Katherine J; Power, Paddy; Johnson, Sonia

    2013-04-01

    Ethnic variations have previously been identified in the duration of untreated psychosis (DUP) and pathways into psychiatric services. These have not been examined in the context of early intervention services, which may alter these trajectories. To explore ethnic differences in the nature and duration of pathways into early intervention services. In a naturalistic cohort study, data were collected for 1024 individuals with psychotic disorders accepted for case management by eight London early intervention services. Duration of untreated psychosis was prolonged in the White British group compared with most other ethnic groups. White British individuals were more likely to make contact with their general practitioner and less likely to be seen within emergency medical services. All Black patient groups were more likely than their White British counterparts to experience involvement of criminal justice agencies. Variations continue to exist in how and when individuals from different ethnic groups access early intervention services. These may account for disparities in DUP.

  20. Early Interventions for At-Risk Students.

    Science.gov (United States)

    Huxman, Frankie; Klassen, Eydie; Koontz, Barbara; Nottingham, Cheryl; Vierthaler, Charlene

    This is a report on a school-wide ethnographic study of intervention strategies for at-risk students in kindergarten through second grade. A group of 5 teachers from an elementary school of approximately 250 students in a Midwest community of about 18,000 people (2 first-grade teachers, 2 second-grade teachers, and 1 music teacher) comprised the…

  1. An Approach to Bilingualism in Early Intervention.

    Science.gov (United States)

    McCradle, Peggy; And Others

    1995-01-01

    This article discusses the concepts, principles, and practical application of serving children who live in bilingual/bicultural households; explores possible reasons for delays identified in these children; and offers a population-based approach to intervention, using a case study of bicultural South Korean children and proposing a solution that…

  2. Early identification and interventions for dyslexia: a contemporary view

    OpenAIRE

    Snowling, Margaret J.

    2013-01-01

    This paper reviews current proposals concerning the definition of dyslexia and contrasts it with reading comprehension impairment. We then discuss methods for early identification and review evidence that teacher assessments and ratings may be valid screening tools. Finally, we argue that interventions should be theoretically motivated and evidence based. We conclude that early identification of children at risk of dyslexia followed by the implementation of intervention is a realistic aim for...

  3. Social marketing approaches to nutrition and physical activity interventions in early care and education centres: a systematic review.

    Science.gov (United States)

    Luecking, C T; Hennink-Kaminski, H; Ihekweazu, C; Vaughn, A; Mazzucca, S; Ward, D S

    2017-12-01

    Social marketing is a promising planning approach for influencing voluntary lifestyle behaviours, but its application to nutrition and physical activity interventions in the early care and education setting remains unknown. PubMed, ISI Web of Science, PsycInfo and the Cumulative Index of Nursing and Allied Health were systematically searched to identify interventions targeting nutrition and/or physical activity behaviours of children enrolled in early care centres between 1994 and 2016. Content analysis methods were used to capture information reflecting eight social marketing benchmark criteria. The review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one-third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child-level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used. This review highlights opportunities to apply social marketing to obesity prevention interventions in early care centres. Social marketing could be an important strategy for early childhood obesity prevention efforts, and future research investigations into its effects are warranted. © 2017 World Obesity Federation.

  4. Early intervention for post-traumatic stress disorder.

    Science.gov (United States)

    Bryant, Richard A

    2007-02-01

    The potentially debilitating effect of posttraumatic stress disorder (PTSD) has created much interest in early intervention strategies that can reduce PTSD. This review critiques the evidence for psychological debriefing approaches and alternate early intervention strategies. The review critiques the randomized controlled trials of psychological debriefing, and early provision of cognitive behavior therapy. The latter approach involves therapy attention on acutely traumatized individuals who are high risk for PTSD development, and particularly in people with acute stress disorder (ASD). Psychological debriefing does not prevent PTSD. Cognitive behaviour therapy strategies have proven efficacy in reducing subsequent PTSD in ASD populations. Despite the promising evidence for early provision of CBT, many people do not benefit from CBT. This review concludes with consideration of major challenges facing early intervention approaches in the context of terrorist attacks and mass disasters.

  5. Cost Analysis of Early Psychosocial Intervention in Alzheimer's Disease

    DEFF Research Database (Denmark)

    Søgaard, R.; Sørensen, J.; Waldorff, F.B.

    2014-01-01

    BACKGROUND/AIM: To investigate the impact of early psychosocial intervention aimed at patients with Alzheimer's disease (AD) and their caregivers on resource use and costs from a societal perspective. METHODS: Dyads of patients and their primary caregiver were randomised to intervention (n = 163...

  6. Early Intervention Services: Effectively Supporting Maori Children and their Families

    Science.gov (United States)

    Berryman, Mere; Woller, Paul

    2011-01-01

    This paper examines Early Intervention (EI) service provision from within one Ministry of Education region in New Zealand. It does this in order to better understand what works well and what needs to change if children from Maori families, of Early Childhood age, are to be provided with the most effective EI services. By engaging with Maori…

  7. [Basics of early intervention in children with autism spectrum disorders].

    Science.gov (United States)

    Zalaquett, Daniela F; Schönstedt, Marianne G; Angeli, Milagros; Herrrera, Claudia C; Moyano, Andrea C

    2015-01-01

    Autism Spectrum Disorders (ASD) are characterized by impairments in communication and social interaction, as well as restricted and repetitive patterns of behavior. They have a prevalence of 0.6% in the general population, although there are no national statistics. Even though their evolution is variable, it has been observed that early intervention is an important factor determining prognosis. The aim of this study is to update concepts regarding the current available evidence on the importance of early intervention. After analyzing the collected information, the importance of early intervention programs for children with ASD is confirmed, as well as the role of pediatricians and other health professionals in the early detection of these disorders. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  8. Do young adults with bipolar disorder benefit from early intervention?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Hansen, Hanne Vibe; Christensen, Ellen Margrethe

    2014-01-01

    BACKGROUND: It is unknown whether young adults with bipolar disorder are able to benefit from early intervention combining optimised pharmacological treatment and group psychoeducation. The aim of the present report was to compare the effects of early intervention among patients with bipolar...... disorder aged 18-25 years to that of patients aged 26 years or older. METHODS: Patients were randomised to early treatment in a specialised outpatient mood disorder clinic versus standard care. The primary outcome was risk of psychiatric re-hospitalisation. RESULTS: A total of 158 patients with mania/bipolar...... different, the observed differences of the point estimates was surprisingly larger for young adults suggesting that young adults with bipolar disorder may benefit even more than older adults from early intervention combining pharmacological treatment and group psychoeducation....

  9. ATTITUDE PARENTS TO EARLY INTERVENTION OF VISUALLY IMPAIRED CHILDREN

    Directory of Open Access Journals (Sweden)

    Mira CVETKOVA

    1997-06-01

    Full Text Available For centuries Visually Impaired children have been educated within the high walls of special schools (Loots ET al., 1992. It is only during the last decades that more and more Visually Impaired children were brought up in their own environment:· the integrated education is not a trend anymore, but an educational policy;· The Early Intervention has transferred into approach to young Visually Impaired children.Early Intervention is crucial because the Visually Impairment affects the early development of a child in several ways:· motor functioning;· concept development;· social skills;· range of experience;· ability to move independently;· play etc.All these obstacles in early development create the necessity of Early Intervention programs which should start immediately after child’s is diagnosed.As it was said above the best approach to involve parents in early Intervention programs is to develop strategies, which fit individual family needs. This means to take into account many factors important for each family. Some of them are:· future believes and expectations;· educational background and culture;· religion;· financial situation.

  10. The rationale for early intervention in schizophrenia and related disorders

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Jeppesen, Pia; Petersen, Lone

    2009-01-01

    and this relationship holds even after controlling for the potential confounding variable of premorbid functioning. In Norway, the early Treatment and Intervention in PSychosis study demonstrated that duration of untreated psychosis is amenable to intervention with the combination of educational campaigns...... and the initiation of treatment. The average duration of untreated psychosis is around 1–2 years. During this period, brain function may continue to deteriorate and social networks can be irreversibly damaged. Studies have consistently linked longer duration of untreated psychosis with poorer outcomes......, adherence to treatment, comorbid drug abuse, relapse and readmission. Some benefits persist after cessation of the intervention. Conclusions: Early intervention in schizophrenia is justified to reduce the negative personal and social impact of prolonged periods of untreated symptoms. Furthermore, phase...

  11. Interventions aiming to reduce early retirement due to rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Pedro Almeida Laires

    2017-07-01

    Full Text Available Introduction: Aging of the population and early retirement translates into productivity losses to society. Persistence of working life is crucial to counteract this sustainability issue faced by western countries. Musculoskeletal and rheumatic diseases (RD may cause work disability and early exit from work, including early retirement. The objective of this article is to review the current knowledge about interventions aiming to reduce early retirement due to RD. Methods: We searched PubMed and The Cochrane Library for studies either in English or Portuguese between January 2000 and June 2016 that evaluated the impact of interventions targeting early retirement in RD patients still at work. We also searched for grey literature from Portuguese institutional repositories. Results: We identified several published studies testing pharmacologic and non-pharmacologic vocational rehabilitation interventions. None was specifically identified for Portugal. The general low quality of the literature and its inconsistency makes it unfeasible to draw definitive conclusions. However, some broad recommendations might be outlined. An effective intervention must: 1 act upon different levels (e.g. RD patient, workplace, involving several stakeholders (e.g. rheumatologists, occupational physicians, employers; 2 prioritize the right patients (e.g. more disabling RD; and 3 consider the patients’ role, for instance by including an element of patient education and support. Despite the lack of good quality evidence on this field, there seems to be a growing interest in the international scientific community with several ongoing studies promoting such interventions. This promising data will be very useful to set up effective policies. Conclusions: This article summarizes the current knowledge about the impact of interventions to avoid or mitigate early retirement in RD patients. It highlights the demand for further research and it also contributes to aware decision

  12. Interventions to Promote Cancer Awareness and Early Presentation: Systematic Review

    OpenAIRE

    J Austoker; C Bankhead; Lindsay J. L. Forbes; L Atkins; F Martin; K Robb; J Wardle; A J. Ramirez

    2009-01-01

    Background: Low cancer awareness contributes to delay in presentation for cancer symptoms and may lead to delay in cancer diagnosis. The aim of this study was to review the evidence for the effectiveness of interventions to raise cancer awareness and promote early presentation in cancer to inform policy and future research. Methods: We searched bibliographic databases and reference lists for randomised controlled trials of interventions delivered to individuals, and controlled or uncontrolled...

  13. Ethics of the early intervention in the treatment of schizophrenia.

    Science.gov (United States)

    Filaković, Pavo; Degmecić, Dunja; Koić, Elvira; Benić, Domagoj

    2007-09-01

    When second generation antipsychotics were introduced in the mid 1990-s they offered the possibility of early psychopharmacological interventions in the treatment of schizophrenia. The idea applying antipsychotics in the prodromal phase of schizophrenia today is an realistic option. However ethical dilemmas about offering antipsychotics to the adolescents with at risk mental states, of whom only a few are real prodromes of schizophrenia remain for clinicians. In the literature about the ethics of the early interventions in psychiatry there are still many ethical questions which call for caution because of the low predictive value of at risk mental states, of which only 40% turn out to be a real prodrome of schizophrenia. These ethical questions can be addressed in three categories: - how to best identify who should receive early pharmacological intervention? - what this intervention should consist of? - how to evaluate treatment efficacy in the absence of illness base rates in the adolescents with a real prodrome of schizophrenia? Besides, arguing against the concept of early psychopharmacological interventions in the adolescent population are the fact of the unknown effect of antipsychotics on the developing brain as well as negative effects of stigma on those adolescents who receive them. The authors in the article analyse these ethical questions and take the side of those clinicians who think that caution and careful ethical judgment are needed before the prescribing of antipsychotics to adolescents with at risk mental states.

  14. Patient exposure: description of cumulative irradiation of patients treated in interventional cardiology; Exposition des patients: description de l'irradiation cumulee des patients traites en cardiologie interventionnelle

    Energy Technology Data Exchange (ETDEWEB)

    Odile Bernier, M.O. [Institut de Radioprotection et de Surete Nucleaire, Laboratoire d ' Epidemiologie, 92 - Fontenay aux Roses (France)

    2009-07-01

    Despite its clinical benefits, interventional cardiology induces cumulative exposure to ionizing radiation and may entail an important irradiation of the patient at the cutaneous level as well as for organs at the vicinity of the heart. The author briefly reports a study performed on a sample of 1591 patients who have been submitted to at least one corono-graphy or one angioplasty during 2005. Based on clinical characteristics and dose-area-product measurements, the doses received by lung, oesophagus, bone medulla and breast have been computed

  15. Early Interventions Following the Death of a Parent: Protocol of a Mixed Methods Systematic Review.

    Science.gov (United States)

    Pereira, Mariana; Johnsen, Iren; Hauken, May Aa; Kristensen, Pål; Dyregrov, Atle

    2017-06-29

    Previous meta-analyses examined the effectiveness of interventions for bereaved children showing small to moderate effect sizes. However, no mixed methods systematic review was conducted on bereavement interventions following the loss of a parent focusing on the time since death in regard to the prevention of grief complications. The overall purpose of the review is to provide a rigorous synthesis of early intervention after parental death in childhood. Specifically, the aims are twofold: (1) to determine the rationales, contents, timeframes, and outcomes of early bereavement care interventions for children and/or their parents and (2) to assess the quality of current early intervention studies. Quantitative, qualitative, and mixed methods intervention studies that start intervention with parentally bereaved children (and/or their parents) up to 6 months postloss will be included in the review. The search strategy was based on the Population, Interventions, Comparator, Outcomes, and Study Designs (PICOS) approach, and it was devised together with a university librarian. The literature searches will be carried out in the Medical Literature Analysis and Retrieval System Online (MEDLINE), PsycINFO, Excerpta Medica Database (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The Mixed Methods Appraisal Tool will be used to appraise the quality of eligible studies. All data will be narratively synthetized following the Guidance on the Conduct of Narrative Synthesis in Systematic Reviews. The systematic review is ongoing and the data search has started. The review is expected to be completed by the end of 2017. Findings will be submitted to leading journals for publication. In accordance with the current diagnostic criteria for prolonged grief as well as the users' perspectives literature, this systematic review outlines a possible sensitive period for early intervention following the death of a parent. The hereby presented protocol ensures

  16. Serious, Minor, and Non-Delinquents in Early Adolescence: The Impact of Cumulative Risk and Promotive Factors. The TRAILS Study

    Science.gov (United States)

    van der Laan, Andre M.; Veenstra, Rene; Bogaerts, Stefan; Verhulst, Frank C.; Ormel, Johan

    2010-01-01

    This study uses a social-ecological approach to the development of delinquency. The authors emphasize that a balance between eliminating risk and enhancing protection across domains is essential in reducing problems and promoting competence. The cumulative risk and promotive effects of temperament, family and school factors in preadolescence were…

  17. Serious, Minor, and Non-Delinquents in Early Adolescence : The Impact of Cumulative Risk and Promotive Factors. The TRAILS Study

    NARCIS (Netherlands)

    van der Laan, A.M.; Veenstra, R.; Bogaerts, S.; Verhulst, F.C.; Ormel, J.

    This study uses a social-ecological approach to the development of delinquency. The authors emphasize that a balance between eliminating risk and enhancing protection across domains is essential in reducing problems and promoting competence. The cumulative risk and promotive effects of temperament,

  18. Serious, minor, and non-delinquents in early adolescence: The impact of cumulative risk and promotive factors. The TRAILS study

    NARCIS (Netherlands)

    A.M. van der Laan (André); R. Veenstra (René); S. Bogaerts (Stefan); F.C. Verhulst (Frank); J. Ormel (Johan Hans)

    2010-01-01

    textabstractThis study uses a social-ecological approach to the development of delinquency. The authors emphasize that a balance between eliminating risk and enhancing protection across domains is essential in reducing problems and promoting competence. The cumulative risk and promotive effects of

  19. THINGS THAT CAN BE CHANGED IN EARLY INTERVENTION IN CHILDHOOD.

    Science.gov (United States)

    Golubović, Špela; Marković, Jasminka; Perović, Lidija

    2015-01-01

    Early intervention implies a model of support focused on a child, family and a broader community from early childhood. The aim of this study was to analyze the elements of the successful early intervention in childhood, as well as to assess the role of a special educator and rehabilitator and level of their involvement in implementing the program on the territory of Novi Sad. The study sample included 100 parents of children with disabilities (aged 3-7), who completed the questionnaire designed for the purposes of this research, based on a similar questionnaire design. Speech delay is one of the most common reasons (over 50%) why parents seek professional help. By the end of the first year of life of their child, 43% of parents responded that they had noticed the first problems, that is, a problem was identified in 25% of children of this age group, and the same number was included in the treatment. About 55% of children were involved in organized treatment from 3 years of age onwards. Special educators and rehabilitators are usually involved in treatment when the team consists of three or more professionals. It is necessary to improve early intervention services, to educate staff, and provide conditions which would make it possible to overcome the existing disadvantages in treating children from an early age. In addition, the involvement of special education and rehabilitation professionals in treatment teams since children's early age is vital.

  20. Employment and educational outcomes in early intervention programmes for early psychosis: a systematic review.

    Science.gov (United States)

    Bond, G R; Drake, R E; Luciano, A

    2015-10-01

    Young adults with early psychosis want to pursue normal roles - education and employment. This paper summarises the empirical literature on the effectiveness of early intervention programmes for employment and education outcomes. We conducted a systematic review of employment/education outcomes for early intervention programmes, distinguishing three programme types: (1) those providing supported employment, (2) those providing unspecified vocational services and (3) those without vocational services. We summarised findings for 28 studies. Eleven studies evaluated early intervention programmes providing supported employment. In eight studies that reported employment outcomes separately from education outcomes, the employment rate during follow-up for supported employment patients was 49%, compared with 29% for patients receiving usual services. The two groups did not differ on enrolment in education. In four controlled studies, meta-analysis showed that the employment rate for supported employment participants was significantly higher than for control participants, odds ratio = 3.66 [1.93-6.93], p < 0.0001. Five studies (four descriptive and one quasi-experimental) of early intervention programmes evaluating unspecified vocational services were inconclusive. Twelve studies of early intervention programmes without vocational services were methodologically heterogeneous, using diverse methods for evaluating vocational/educational outcomes and precluding a satisfactory meta-analytic synthesis. Among studies with comparison groups, 7 of 11 (64%) reported significant vocational/education outcomes favouring early intervention over usual services. In early intervention programmes, supported employment moderately increases employment rates but not rates of enrolment in education. These improvements are in addition to the modest effects early programmes alone have on vocational/educational outcomes compared with usual services.

  1. Effects of delayed psychosocial interventions versus early psychosocial interventions for women with early stage breast cancer

    NARCIS (Netherlands)

    Vos, Petra J.; Visser, Adriaan P.; Garssen, Bert; Duivenvoorden, Hugo J.; de Haes, Hanneke C. J. M.

    2006-01-01

    The importance of psychosocial counselling after a diagnosis of cancer has been acknowledged and many intervention studies have been carried out, with the aim to find out which types of intervention are most effective in enhancing quality of life in cancer patients. A factor which could be part of

  2. Long-Term Outcomes of Early Reading Intervention

    Science.gov (United States)

    Hurry, Jane; Sylva, Kathy

    2007-01-01

    This study explores the long-term effectiveness of two differing models of early intervention for children with reading difficulties: Reading Recovery and a specific phonological training. Approximately 400 children were pre-tested, 95 were assigned to Reading Recovery, 97 to Phonological Training and the remainder acted as controls. In the short…

  3. The Underutilization of Occupational Therapy in Transdisciplinary Early Intervention Services

    Science.gov (United States)

    Minard, Carey

    2018-01-01

    Early intervention (EI) services are mandated by Part C of The Individuals with Disabilities Education Act (IDEA, 2004). The EI team, a multidisciplinary team overseen by individual states, is charged with providing family-centered services to support child development in the natural environment. This article examines the use of occupational…

  4. Early Identification and Interventions for Dyslexia: A Contemporary View

    Science.gov (United States)

    Snowling, Margaret J.

    2013-01-01

    This paper reviews current proposals concerning the definition of dyslexia and contrasts it with reading comprehension impairment. We then discuss methods for early identification and review evidence that teacher assessments and ratings may be valid screening tools. Finally, we argue that interventions should be theoretically motivated and…

  5. Early Hearing Detection and Intervention: Can Your Baby Hear?

    Centers for Disease Control (CDC) Podcasts

    This podcast discusses how important it is that every child receives a hearing screening as soon as possible after birth. It also gives specific ways that parents and health providers can find out if a child has a possible hearing loss and where to get further information. (Created 6/5/2007 by the Early Hearing Detection and Intervention Program, NCBDDD).

  6. Mystery in Milwaukee: Early Intervention, IQ, and Psychology Textbooks.

    Science.gov (United States)

    Sommer, Robert; Sommer, Barbara A.

    1983-01-01

    Textbooks in developmental and abnormal psychology were examined for references to the Milwaukee study of the effects of early intervention on intelligence. The absence of citations to articles in refereed journals shows how research data of questionable validity can seep into the research literature without going through the journal review…

  7. Culture and Early Language Development: Implications for Assessment and Intervention

    Science.gov (United States)

    Parada, Patricia M.

    2013-01-01

    The purpose of this qualitative study--"Culture and Early Language Development: Implications for Assessment and Intervention"--was to explore and describe the perceptions and beliefs of Salvadoran mothers of low socioeconomic status regarding the language development of their young children in order to identify cultural variations in…

  8. 75 FR 68613 - Part C Early Intervention Services Grant

    Science.gov (United States)

    2010-11-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Part C Early Intervention Services Grant AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of non-competitive transfer of Part C funds from North General Hospital to the Institute for Family...

  9. Measuring prerequisites and effects of preventive intervention in early infancy

    NARCIS (Netherlands)

    Pillhofer, M.; Schoellhorn, A.; Jungmann, T.; Eickhorst, A.; Schuengel, C.

    2012-01-01

    In Germany early intervention has not been systematically implemented in the regular service delivery and the existing programs have not been profoundly evaluated. Due to serious child protection cases the German Federal Ministry for Family Affairs, Senior Citizens, Women and Youth participated in a

  10. Early Childhood Education as a Resilience Intervention for Maltreated Children

    Science.gov (United States)

    Ellenbogen, Stephen; Klein, Benjamin; Wekerle, Christine

    2014-01-01

    The profound injuries caused by child maltreatment are well documented in the neurological, attachment, cognitive, and developmental literature. In this review paper, we explore the potential of early childhood education (ECE) as a community-based resilience intervention for mitigating the impacts of child abuse and neglect and supporting families…

  11. HIV Infection: Transmission, Effects on Early Development, and Interventions.

    Science.gov (United States)

    Lowenthal, Barbara

    1997-01-01

    Describes the modes of transmission of HIV and the course of the disease in infants and toddlers. Information is provided on its effects on early development, medical screening and treatments, therapies, psychosocial assistance, and interventions, including nutritional therapy, occupational and physical therapies, and speech and language therapy.…

  12. Early Childhood Intervention in China from the Families' Perspective

    Science.gov (United States)

    Zheng, Yuzhu; Maude, Susan P.; Brotherson, Mary Jane; Merritts, Ashley

    2016-01-01

    Research highlights the importance of early childhood intervention (ECI) for children with disabilities, and there is an increasing interest in China with respect to research on ECI. However, little research exists exploring the experience of families of young children with disabilities receiving ECI services and supports in China. The purpose of…

  13. Synthesis of IES Research on Early Intervention and Early Childhood Education. NCSER 2013-3001

    Science.gov (United States)

    Diamond, Karen E.; Justice, Laura M.; Siegler, Robert S.; Snyder, Patricia A.

    2013-01-01

    A primary purpose of early childhood education and interventions is to promote children's acquisition of knowledge and skills linked to later social competence and academic success. In this report, special attention is given to summarizing what has been learned about early childhood classrooms as contexts for development and learning, the kinds of…

  14. Integrating Early Intervention for Borderline Personality Disorder and Mood Disorders.

    Science.gov (United States)

    Chanen, Andrew M; Berk, Michael; Thompson, Katherine

    2016-01-01

    Borderline personality disorder (BPD) has been demonstrated to be a reliable and valid construct in young people (adolescents and young adults). Both borderline- and mood-related psychopathology become clinically apparent from puberty through to young adulthood, frequently co-occur, can reinforce one another, and can be difficult to differentiate clinically. This Gordian knot of overlapping clinical features, common risk factors, and precursors to both BPD and mood disorders complicates clinical assessment, prevention, and treatment. Regardless of whether an individual crosses an arbitrary diagnostic threshold, a considerable proportion of young people with borderline- and mood-related psychopathology will develop significant and persistent functional, vocational, and interpersonal impairment and disability during this critical risk and developmental period. There is a clear need for early intervention, but spurious diagnostic certainty risks stigma, misapplication of diagnostic labels, inappropriate treatment, and unfavorable outcomes. This article aims to integrate early intervention for BPD and mood disorders in the clinical context of developmental and phenomenological change and evolution. "Clinical staging," similar to disease staging in general medicine, is presented as a pragmatic, heuristic, and trans-diagnostic framework to guide prevention and intervention. It acknowledges that the early stages of these disorders cannot be disentangled sufficiently to allow for disorder-specific preventive measures and early interventions. Clinical staging defines an individual's location along the continuum of the evolving temporal course of a disorder. Such staging aids differentiation of early or milder clinical phenomena from those that accompany illness progression and chronicity, and suggests the application of appropriate and proportionate intervention strategies.

  15. Examination of cumulative effects of early adolescent depression on cannabis and alcohol use disorder in late adolescence in a community-based cohort.

    Science.gov (United States)

    Rhew, Isaac C; Fleming, Charles B; Vander Stoep, Ann; Nicodimos, Semret; Zheng, Cheng; McCauley, Elizabeth

    2017-11-01

    Although they often co-occur, the longitudinal relationship between depression and substance use disorders during adolescence remains unclear. This study estimated the effects of cumulative depression during early adolescence (ages 13-15 years) on the likelihood of cannabis use disorder (CUD) and alcohol use disorder (AUD) at age 18. Prospective cohort study of youth assessed at least annually between 6th and 9th grades (~ age 12-15) and again at age 18. Marginal structural models based on a counterfactual framework that accounted for both potential fixed and time-varying confounders were used to estimate cumulative effects of depressive symptoms over early adolescence. The sample originated from four public middle schools in Seattle, Washington, USA. The sample consisted of 521 youth (48.4% female; 44.5% were non-Hispanic White). Structured in-person interviews with youth and their parents were conducted to assess diagnostic symptom counts of depression during early adolescence; diagnoses of CUD and AUD at age 18 was based the Voice-Diagnostic Interview Schedule for Children. Cumulative depression was defined as the sum of depression symptom counts from grades 7-9. The past-year prevalence of cannabis and alcohol use disorder at the age 18 study wave was 20.9 and 19.8%, respectively. A 1 standard deviation increase in cumulative depression during early adolescence was associated with a 50% higher likelihood of CUD [prevalence ratio (PR) = 1.50; 95% confidence interval (CI) = 1.07, 2.10]. Although similar in direction, there was no statistically significant association between depression and AUD (PR = 1.41; 95% CI = 0.94, 2.11). Further, there were no differences in associations according to gender. Youth with more chronic or severe forms of depression during early adolescence may be at elevated risk for developing cannabis use disorder compared with otherwise similar youth who experience fewer depressive symptoms during early adolescence. © 2017 Society

  16. The early history of ideas on brief interventions for alcohol.

    Science.gov (United States)

    McCambridge, Jim; Cunningham, John A

    2014-04-01

    This study explores the early development of brief interventions for alcohol using a history of ideas approach with a particular focus on intervention content. The source publications of the key primary studies published from approximately 1962 to 1992 were examined, followed by a brief review of the earliest reviews in this field. These studies were placed in the context of developments in alcohol research and in public health. After early pioneering work on brief interventions, further advances were not made until thinking about alcohol problems and their treatment, most notably on controlled drinking, along with wider changes in public health, created new conditions for progress. There was then a golden era of rapid advance in the late 1980s and early 1990s, when preventing the development of problem drinking became important for public health reasons, in addition to helping already problematic drinkers. Many research challenges identified at that time remain to be met. The content of brief interventions changed over the period of study, although not in ways well informed by research advances, and there were also obvious continuities, with a renewed emphasis on the facilitation of self-change being one important consequence of the development of internet applications. Ideas about brief interventions have changed in important ways. Brief interventions have been studied with different populations of drinkers, with aims embracing both individual and population-level perspectives, and without well-specified contents. The brief intervention field is an appropriate target for further historical investigations, which may help thinking about addressing alcohol and other problems. © 2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  17. Early hearing detection and intervention: 2010 CODEPEH recommendation.

    Science.gov (United States)

    Trinidad-Ramos, Germán; de Aguilar, Valentín Alzina; Jaudenes-Casaubón, Carmen; Núñez-Batalla, Faustino; Sequí-Canet, José Miguel

    2010-01-01

    Newborn hearing screening is currently performed routinely in many regional health-care systems in Spain. Despite the remarkable expansion in newborn hearing screening since 2000, its feasibility and the benefits of early identification and intervention, many major challenges still remain. In this article, the Committee for the Early Detection of Hearing Loss (Comisión para la Detección Precoz de la Hipoacusia, CODEPEH) updates the recommendations that are considered important for the future development of early hearing detection and intervention (EDHI) systems in the following points: 1. Screening protocols: Separate protocols are recommended for NICU (Neonatal Intensive Care Units) and well-infant nurseries. 2. Diagnostic audiology evaluation. Professionals with skills and expertise in evaluating newborn and young infants should provide diagnosis, selection and fitting of amplification devices. 3. Medical evaluation. Risk factors for congenital and acquired hearing loss have been combined in a single list rather than grouped by time of onset. A stepwise diagnostic paradigm is diagnostically more efficient and cost-effective than a simultaneous testing approach. 4. Early intervention and surveillance. All individuals providing services to infants with hearing loss should have specialized training and expertise in the development of audition, speech and language. Regular surveillance should be performed on developmental milestones, auditory skills, parental concerns, and middle ear status. 5. Quality control. Data management as part of an integrated system is important to monitor and improve the quality of EDHI services. 2009 Elsevier España, S.L. All rights reserved.

  18. Labeling and Cumulative Disadvantage: The Impact of Formal Police Intervention on Life Chances and Crime during Emerging Adulthood

    Science.gov (United States)

    Lopes, Giza; Krohn, Marvin D.; Lizotte, Alan J.; Schmidt, Nicole M.; Vasquez, Bob Edward; Bernburg, Jon Gunnar

    2012-01-01

    Research in labeling theory has been revived recently, particularly in relation to the effect of labeling on critical noncriminal outcomes that potentially exacerbate involvement in crime. This study partakes in that revitalization by examining direct and indirect effects of police intervention in the lives of adolescents who were followed into…

  19. Equitable service provision for inclusive education and effective early intervention.

    Science.gov (United States)

    Wicks, K M

    1998-01-01

    This paper illustrates one model of providing an integrated paediatric speech and language therapy service which attempts to meet the demands of both inclusive education and effective early intervention. A move has been made from location-oriented therapy provision to offering children and their families equal opportunities to have appropriate intervention according to need. The model incorporates the philosophy of inclusive education and supports the development of current specialist educational establishments into resource bases of expertise for children with special needs in mainstream schools.

  20. Use of cumulative mortality data in patients with acute myocardial infarction for early detection of variation in clinical practice: observational study.

    Science.gov (United States)

    Lawrance, R A; Dorsch, M F; Sapsford, R J; Mackintosh, A F; Greenwood, D C; Jackson, B M; Morrell, C; Robinson, M B; Hall, A S

    2001-08-11

    Use of cumulative mortality adjusted for case mix in patients with acute myocardial infarction for early detection of variation in clinical practice. Observational study. 20 hospitals across the former Yorkshire region. All 2153 consecutive patients with confirmed acute myocardial infarction identified during three months. Variable life-adjusted displays showing cumulative differences between observed and expected mortality of patients; expected mortality calculated from risk model based on admission characteristics of age, heart rate, and systolic blood pressure. The performance of two individual hospitals over three months was examined as an example. One, the smallest district hospital in the region, had a series of 30 consecutive patients but had five more deaths than predicted. The variable life-adjusted display showed minimal variation from that predicted for the first 15 patients followed by a run of unexpectedly high mortality. The second example was the main tertiary referral centre for the region, which admitted 188 consecutive patients. The display showed a period of apparently poor performance followed by substantial improvement, where the plot rose steadily from a cumulative net lives saved of -4 to 7. These variations in patient outcome are unlikely to have been revealed during conventional audit practice. Variable life-adjusted display has been integrated into surgical care as a graphical display of risk-adjusted survival for individual surgeons or centres. In combination with a simple risk model, it may have a role in monitoring performance and outcome in patients with acute myocardial infarction.

  1. Knowledge and Use of Intervention Practices by Community-Based Early Intervention Service Providers

    Science.gov (United States)

    Paynter, Jessica M.; Keen, Deb

    2015-01-01

    This study investigated staff attitudes, knowledge and use of evidence-based practices (EBP) and links to organisational culture in a community-based autism early intervention service. An EBP questionnaire was completed by 99 metropolitan and regionally-based professional and paraprofessional staff. Participants reported greater knowledge and use…

  2. Early intervention to improve hand function in hemiplegic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Anna Purna Basu

    2015-01-01

    Full Text Available Children with hemiplegic cerebral palsy often have marked hand involvement with excessive thumb adduction and flexion and limited active wrist extension from infancy. Post-lesional aberrant plasticity can lead to progressive abnormalities of the developing motor system. Disturbances of somatosensory and visual function and developmental disregard contribute to difficulties with hand use. Progressive soft tissue and bony changes may occur, leading to contractures which further limit function in a vicious cycle. Early intervention might help to break this cycle: however, the precise nature and appropriateness of the intervention must be carefully considered. Traditional approaches to the hemiplegic upper limb include medications and botulinum toxin injections to manage abnormalities of tone, and surgical interventions. Therapist input, including provision of orthoses, remains a mainstay although many therapies have not been well evaluated. There has been a recent increase in interventions for the hemiplegic upper limb, mostly aimed outside the period of infancy. These include trials of constraint-induced movement therapy and bimanual therapy as well as the use of virtual reality and robot-assisted therapy. In future, non-invasive brain stimulation may be combined with therapy. Interventions under investigation in the infant age group include modified constraint-induced movement therapy and action observation therapy. A further approach which may be suited to the infant with thumb-in-palm deformity, but which requires evaluation, is the use of elastic taping. Enhanced cutaneous feedback through mechanical stimulation to the skin provided by the tape during movement has been postulated to modulate ongoing muscle activity. If effective, this would represent a low-cost, safe, widely applicable early intervention.

  3. Practices for Parent Participation in Early Intervention/ Early Childhood Special Education

    OpenAIRE

    Acar, Serra; Akamoğlu, Yusuf

    2014-01-01

    The authors examined the extent to which practices for parent participation in early intervention/ early childhood special education (EI/ECSE) programs. The role of parents in the EI/ECSE is important and supported through the literature. The changing traditional family picture in the classrooms, the importance of evolving laws and regulations and recommended practices regarding parent participation are highlighted. The conceptual framework is based on the children, parents, and practitioners...

  4. Early marriage in Africa--trends, harmful effects and interventions.

    Science.gov (United States)

    Walker, Judith-Ann

    2012-06-01

    This article explores the pattern of early marriage in Africa. It focuses on the sub-Saharan region as an area with the highest rates of early marriage in the world. The harmful effects of early marriage are explored in terms of impact on the health, education and economic well-being of young girls. The paper outlines a framework for analyzing global, regional and local initiatives to curb early marriage and examines the application of these interventions in sub-Saharan countries. Regional patterns are then examined and countries which have made progress in reducing age of marriage are compared to countries in which age of marriage amongst girls has reminded low. The paper concludes on the note that countries with the highest rates of early marriage are also the countries with the highest rates of poverty and highest population growth rates. The paper argues for a sub-regional strategy to address the problem of early marriage in the zone with the highest incidence.

  5. Gender comparisons in children with ASD entering early intervention.

    Science.gov (United States)

    Fulton, Alexandra M; Paynter, Jessica M; Trembath, David

    2017-09-01

    Males are diagnosed with Autism Spectrum Disorder (ASD) approximately four times as often as females. This has led to interest in recent years of potential under-diagnosis of females, as well as negative consequences for females with ASD due to under-identification. A number of potential explanations for gender bias in diagnosis are discussed including that females and males may present differently despite showing the same core symptoms. Previous research has shown inconsistent findings in comparisons between genders in young children with ASD for whom early intervention is vital. Thus, the aim of the present study was to investigate the social, communication, and cognitive functioning, as well as level of ASD symptoms, in a cohort of children who presented for early intervention to inform understanding of gender differences in this population, as well as to inform understanding of the mechanisms by which gender bias may occur. Participants included 254 children (42 females) aged 29-74 months who completed measures of cognition, communication skills, adaptive behaviour, and ASD symptoms on entry to early intervention. Consistent with hypotheses, no significant gender differences were found both overall, and when split by functioning level. However, a similar ratio of males and females was found in both high- and low-functioning groups contrary to predictions. These results are consistent with some of the previous research that suggests gender differences may not be apparent in clinical samples at this young age. We highlight a need for further research that may use universal screening or longitudinal methods to understand the trajectory of development for females with ASD specifically. Such research could better inform timely and tailored intervention from the preschool years onwards. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Sleep Problems and Early Developmental Delay: Implications for Early Intervention Programs

    Science.gov (United States)

    Bonuck, Karen; Grant, Roy

    2012-01-01

    Sleep disorders negatively impact behavior, cognition, and growth--the same areas targeted by early intervention. Conversely, developmental delays and disabilities may themselves precipitate sleep disorders. Young children with developmental delays experience sleep disorders at a higher rate than do typically developing children; the most common…

  7. Cumulative risk effect of household dysfunction for child maltreatment after intensive intervention of the child protection system in Japan: a longitudinal analysis.

    Science.gov (United States)

    Ohashi, Hirotsuna; Wada, Ichiro; Yamaoka, Yui; Nakajima-Yamaguchi, Ryoko; Ogai, Yasukazu; Morita, Nobuaki

    2018-04-20

    Building an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare. The sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model. About half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference). Greater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be

  8. Early and delayed cardioprotective intervention with dexrazoxane each show different potential for prevention of chronic anthracycline cardiotoxicity in rabbits

    International Nuclear Information System (INIS)

    Jirkovský, Eduard; Lenčová-Popelová, Olga; Hroch, Miloš; Adamcová, Michaela; Mazurová, Yvona; Vávrová, Jaroslava

    2013-01-01

    Despite incomplete understanding to its mechanism of action, dexrazoxane (DEX) is still the only clearly effective cardioprotectant against chronic anthracycline (ANT) cardiotoxicity. However, its clinical use is currently restricted to patients exceeding significant ANT cumulative dose (300 mg/m 2 ), although each ANT cycle may induce certain potentially irreversible myocardial damage. Therefore, the aim of this study was to compare early and delayed DEX intervention against chronic ANT cardiotoxicity and study the molecular events involved. The cardiotoxicity was induced in rabbits with daunorubicin (DAU; 3 mg/kg/week for 10 weeks); DEX (60 mg/kg) was administered either before the 1st or 7th DAU dose (i.e. after ≈300 mg/m 2 cumulative dose). While both DEX administration schedules prevented DAU-induced premature deaths and severe congestive heart failure, only the early intervention completely prevented the left ventricular dysfunction, myocardial morphological changes and mitochondrial damage. Further molecular analyses did not support the assumption that DEX cardioprotection is based and directly proportional to protection from DAU-induced oxidative damage and/or deletions in mtDNA. Nevertheless, DAU induced significant up-regulation of heme oxygenase 1 pathway while heme synthesis was inversely regulated and both changes were schedule-of-administration preventable by DEX. Early and delayed DEX interventions also differed in ability to prevent DAU-induced down-regulation of expression of mitochondrial proteins encoded by both nuclear and mitochondrial genome. Hence, the present functional, morphological as well as the molecular data highlights the enormous cardioprotective effects of DEX and provides novel insights into the molecular events involved. Furthermore, the data suggests that currently recommended delayed intervention may not be able to take advantage of the full cardioprotective potential of the drug

  9. Family Involvement in Early Intervention Service Planning: Links to Parental Satisfaction and Self-Efficacy

    Science.gov (United States)

    Popp, Tierney K.; You, Hyun-Kyung

    2016-01-01

    The mediating role of parental satisfaction in the relation between family involvement in early intervention service planning and parental self-efficacy was explored. Participants included families of children with disability or delay involved in early intervention (n = 2586). Data were examined upon entry into early intervention (T1) and at…

  10. Theoretical constructs for early intervention programs in mathematics:

    DEFF Research Database (Denmark)

    Lindenskov, Lena; Kirsted, Katrine

    2017-01-01

    . It is not a straightforward endeavour. One reason is that the term theory as well as the term practice may very well be given different meanings by different agents. This variation is in our view to be considered in “implementation research” and Lewin’s statement ought to be qualified by two questions “Who cares for a good...... theory?” and “What makes a good theory good for whom?” This paper explores this variation of how theory is perceived by mathematics teachers and by mathematics researchers involved in a developmental project on early intervention in mathematics education in Denmark. The paper exemplifies how agents...

  11. Music-caring within the framework of early intervention

    DEFF Research Database (Denmark)

    Jonsdottir, Valgerdur

    2011-01-01

    Despite developments in the field of early intervention, and an increase in the variety of available services and number of specialists equipped to assist, the needs of caretakers of children with disabilities in times of crisis have not received enough attention. It seems that too often caretakers...... themselves get lost in the role given to them as their infants‟ best specialists, and in the emphasis which is placed on their children‟s developmental milestones. The caretakers and the potential psychological distress they experience having a disabled child are more often than not the forgotten component...

  12. Early Hearing Detection and Intervention: Can Your Baby Hear?

    Centers for Disease Control (CDC) Podcasts

    2007-06-15

    This podcast discusses how important it is that every child receives a hearing screening as soon as possible after birth. It also gives specific ways that parents and health providers can find out if a child has a possible hearing loss and where to get further information. (Created 6/5/2007 by the Early Hearing Detection and Intervention Program, NCBDDD).  Created: 6/15/2007 by National Center on Birth Defects and Developmental Disabilities.   Date Released: 6/25/2007.

  13. Using Digital Media Advertising in Early Psychosis Intervention.

    Science.gov (United States)

    Birnbaum, Michael L; Garrett, Chantel; Baumel, Amit; Scovel, Maria; Rizvi, Asra F; Muscat, Whitney; Kane, John M

    2017-11-01

    Identifying and engaging youth with early-stage psychotic disorders in order to facilitate timely treatment initiation remains a major public health challenge. Although advertisers routinely use the Internet to directly target consumers, limited efforts have focused on applying available technology to proactively encourage help-seeking in the mental health community. This study explores how one might take advantage of Google AdWords in order to reach prospective patients with early psychosis. A landing page was developed with the primary goal of encouraging help-seeking individuals in New York City to contact their local early psychosis intervention clinic. In order to provide the best opportunity to reach the intended audience, Google AdWords was utilized to link more than 2,000 selected search terms to strategically placed landing page advertisements. The campaign ran for 14 weeks between April 11 and July 18, 2016 and had a total budget of $1,427. The ads appeared 191,313 times and were clicked on 4,350 times, at a per-click cost of $.33. Many users took additional help-seeking steps, including obtaining psychosis-specific information/education (44%), completing a psychosis self-screener (15%), and contacting the local early treatment program (1%). Digital ads appear to be a reasonable and cost-effective method to reach individuals who are searching for behavioral health information online. More research is needed to better understand the many complex steps between online search inquiries and making first clinical contact.

  14. Assessing Costs and Benefits of Early Childhood Intervention Programs. Overview and Applicaton to the Starting Early Starting Smart Program

    National Research Council Canada - National Science Library

    Karoly, Lynn

    2001-01-01

    Agency and program administrators and decisionmakers responsible for implementing early childhood intervention programs are becoming more interested in quantifying the costs and benefits of such programs...

  15. Early Intervention for Borderline Personality Disorder: Psychodynamic Therapy in Adolescents.

    Science.gov (United States)

    Salzer, Simone; Cropp, Carola; Streeck-Fischer, Annette

    2014-01-01

    Borderline personality disorder (BPD) should be understood as a disorder of development (Streeck-Fischer 2008, 2013) that has its first manifestation in late childhood and adolescence. There are only few treatment studies of adolescents meeting the diagnostic criteria of borderline personality disorder, although early interventions for these patients are urgently needed (see Chanen & McCutcheon 2013). We examined the effectiveness of an inpatient psychodynamic therapy (PDT). Twenty-eight adolescents fulfilling the DSM-IV diagnostic criteria of borderline personality disorder were treated with psychodynamic therapy. The mean duration of treatment was 29.87 weeks (SD = 15.88). Outcomes were remission rates, GAF, GSI, SDQ, IIP and BPI scores. Assessments were made at admission and after treatment. Pre-post comparisons and comparisons with normative data were conducted. At the end of treatment 39.29% of the patients were remitted. We found significant improvements for the GAF, GSI, SDQ, IIP (all p0.001) and the BPI (p = 0.006). These clinically relevant improvements demonstrate the effectiveness of psychodynamic therapy in adolescents with borderline personality disorder and stress the usefulness of an early intervention for these patients.

  16. Early interventions to prevent retinal vasculopathy in diabetes: a review

    Directory of Open Access Journals (Sweden)

    Harrison WW

    2015-08-01

    Full Text Available Wendy W Harrison, Vladimir YevseyenkovArizona College of Optometry, Midwestern University, Glendale, AZ, USAAbstract: Diabetic eye disease is a public health concern in all areas of the world as a leading cause of blindness in the working aged to elderly populations. Diabetes damages the lining of the microvasculature throughout the body through prolonged exposure to hyperglycemic conditions. The ocular changes are progressive with very little recourse for improvement once damage begins. Current treatments for the eye focus mainly on the late stages of the disease when neovascularization or edema threatens sight. Early interventions for diabetic vasculopathy involve metabolic therapy to improve blood glucose and blood pressure control. Technology improvements have a large part to play in advancing diagnosis of diabetic eye disease. These new technologies offer both structural and functional means for assessment of retinal health. This review focuses on current treatments for diabetic eye disease at all stages with an emphasis on new and early interventions. It also details established and emerging technologies used for earlier detection of diabetic eye disease, which is vital to the development and approval of much needed treatments targeted at earlier stages of diabetic retinopathy. Possible future treatments should be aimed to prevent retinal vasculopathy from progressing. This review will explore current research on this topic and what is needed moving forward.Keywords: diabetes, diabetic retinopathy, vascular disease

  17. The DREME Network: Research and Interventions in Early Childhood Mathematics.

    Science.gov (United States)

    Day-Hess, Crystal; Clements, Douglas H

    2017-01-01

    The DREME Network was created to advance the field of early mathematics research and improves the opportunities to develop math competencies offered to children birth through age 8 years, with an emphasis on the preschool years. All four main Network projects will have implications for interventions. Section 1 introduces the Network and its four projects. The remainder of the chapter focuses on one of these four projects, Making More of Math (MMM), in depth. MMM is directly developing an intervention for children, based on selecting high-quality instructional activities culled from the burgeoning curriculum resources. We first report a review of 457 activities from 6 research-based curricula, which describes the number of activities by content focus, type (nature), and setting of each activity. Given the interest in higher-order thinking skills and self-regulation, we then identified activities that had the potential to, develop both mathematics and executive function (EF) proficiencies. We rated these, selecting the top 10 for extensive coding by mathematics content and EF processes addressed. We find a wide divergence across curricula in all these categories and provide comprehensive reports for those interested in selecting, using, or developing early mathematics curricula. © 2017 Elsevier Inc. All rights reserved.

  18. Born in Bradford’s Better Start: an experimental birth cohort study to evaluate the impact of early life interventions

    Directory of Open Access Journals (Sweden)

    Josie Dickerson

    2016-08-01

    Full Text Available Abstract Background Early interventions are recognised as key to improving life chances for children and reducing inequalities in health and well-being, however there is a paucity of high quality research into the effectiveness of interventions to address childhood health and development outcomes. Planning and implementing standalone RCTs for multiple, individual interventions would be slow, cumbersome and expensive. This paper describes the protocol for an innovative experimental birth cohort: Born in Bradford’s Better Start (BiBBS that will simultaneously evaluate the impact of multiple early life interventions using efficient study designs. Better Start Bradford (BSB has been allocated £49 million from the Big Lottery Fund to implement 22 interventions to improve outcomes for children aged 0–3 in three key areas: social and emotional development; communication and language development; and nutrition and obesity. The interventions will be implemented in three deprived and ethnically diverse inner city areas of Bradford. Method The BiBBS study aims to recruit 5000 babies, their mothers and their mothers’ partners over 5 years from January 2016-December 2020. Demographic and socioeconomic information, physical and mental health, lifestyle factors and biological samples will be collected during pregnancy. Parents and children will be linked to their routine health and local authority (including education data throughout the children’s lives. Their participation in BSB interventions will also be tracked. BiBBS will test interventions using the Trials within Cohorts (TwiCs approach and other quasi-experimental designs where TwiCs are neither feasible nor ethical, to evaluate these early life interventions. The effects of single interventions, and the cumulative effects of stacked (multiple interventions on health and social outcomes during the critical early years will be measured. Discussion The focus of the BiBBS cohort is on

  19. Early stages of bipolar disorder: characterization and strategies for early intervention

    Directory of Open Access Journals (Sweden)

    Adiel C. Rios

    2015-12-01

    Full Text Available Objective: To characterize the early stages of bipolar disorder (BD, defined as the clinical prodrome/subsyndromal stage and first-episode phase, and strategies for their respective treatment. Methods: A selective literature search of the PubMed, Embase, PsycINFO, and ISI databases from inception until March 2014 was performed. Included in this review were articles that a characterized prodromal and first-episode stages of BD or b detailed efficacy and safety/tolerability of interventions in patients considered prodromal for BD or those with only one episode of mania/hypomania. Results: As research has only recently focused on characterization of the early phase of BD, there is little evidence for the effectiveness of any treatment option in the early phase of BD. Case management; individual, group, and family therapy; supportive therapy; and group psychoeducation programs have been proposed. Most evidence-based treatment guidelines for BD do not address treatment specifically in the context of the early stages of illness. Evidence for pharmacotherapy is usually presented in relation to illness polarity (i.e., manic/mixed or depressed or treatment phase. Conclusions: Although early recognition and treatment are critical to preventing unfavorable outcomes, there is currently little evidence for interventions in these stages of BD.

  20. Congenital heart disease in the newborn requiring early intervention

    Directory of Open Access Journals (Sweden)

    Sin Weon Yun

    2011-05-01

    Full Text Available Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA, critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS, obstructed total anomalous pulmonary venous return (TAPVR, which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth, most of the clinical and physical findings are nonspecific and vague, which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA is opened widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations, investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

  1. The Cumulative Disadvantages of Socially Toxic Family Environments: A Comparison of Early Life Experiences of Incarcerated Men and University Students

    Directory of Open Access Journals (Sweden)

    Joseph Michalski

    2017-12-01

    Full Text Available The paper examines the antecedents of criminal behavior through the process of retrospective family and life course histories in which incarcerated male inmates and male university students are compared. The main focus is on early childhood experiences and parental behaviors. The study data derive from intensive, face-to-face interviews with 38 men incarcerated for violent offences and a matched group of 66 men attending university at the same time. The interviews focus on the relative importance of adverse childhood experiences and linkages with adolescence. The interviews demonstrated that nearly four-fifths of the inmates experienced toxic family environments by the time they reached adolescence, as compared with only two of the university students. Qualitative analyses flesh out the major themes, experiences, and “risk factors” that helped shape the trajectories of both groups of men. The socially toxic family environments and sub-optimal parenting practices that most inmates endured produced long-term, adverse effects in reducing their capacities for resilience, forging healthy relationships with their peers, and remaining in school.

  2. Early interventions and lessons from Harvard Business Review.

    Science.gov (United States)

    Chong, Siow-Ann

    2007-11-01

    To describe the establishment and development of an Early Psychosis Intervention Programme in Singapore that is based on a business model and with concepts drawn from the corporate world. The author who directed this programme describes the circumstances that led to this initiative, the ideas borrowed and adapted from the corporate world, and the lessons learnt in setting up this intervention programme. The modus operandi of the programme is based on the Balanced Scorecard - a model which stresses four equally important components: customers, internal processes, financial health and learning and innovation. Other complementary actions like creating a sense of urgency, forging a vision with a core ideology, empowerment of team members, creating short-term wins, anchoring the changes and finding meaning in the work are vital for the programme to thrive. This model also emphasizes the importance of accountability through the measurability of indicators. These indicators included a significant reduction in the duration of untreated psychosis, a positive change in the referral patterns with better engagement of the primary health-care sector and an improvement in the quality of care for the patients. Much can be learnt from the business world in building and maintaining a public mental health programme. Effective change also requires effective leadership, and the successful implementation of certain strategic steps.

  3. Radial artery approach for coronary intervention - early experience

    International Nuclear Information System (INIS)

    Jan, H.; Hadi, A.; Fahim, M.; Gul, A.M.; Irfan, M.; Khan, S.B.; Hafizullah, M.

    2012-01-01

    Objective: To see the clinical outcome of patients undergoing Transradial Coronary Angioplasty with stable Angina. Methodology: This was a single center observational study with prospective data collection of 338 patients who underwent transradial coronary angioplasty from September 2009 to August 2011, at Post Graduate Medical Institute, Lady Reading Hospital, Peshawar. Patients of both genders and all ages who had transradial coronary angioplasty for chronic stable angina were included in the study. Patients were clinically examined in out patients department on first month of hospital discharge and clinical outcome data was recorded. Results: A total of 338 patients were included in the study. Male were 58.8% and 41.2% were female with mean age of 52+-7 years. All the patients had coronary intervention through right radial artery. Baseline characteristics of the patients were; 48.2% diabetic, 43.2% hypertensive, 30.5% smokers, dyslipidemia was 45.7% and mean values of serum creatinine and Hemoglobin were 1.1+-0.3 and 11.5+-1.5, respectively. The frequency of various complications were as follow; hematoma 1.3%, nausea and vomiting 2.2%, pain in hand 11.2%, re admission to hospital for chest pain 6.5%, need for revascularization 2.2%, hand ischemia 1.8%, minor bleeding 0.9%, no major bleeding and 1.9% mortality. Conclusion: The radial artery approach for coronary intervention is useful with low degree of access site vascular complications and an early mobilization. (author)

  4. Radial artery approach for coronary intervention - early experience

    Energy Technology Data Exchange (ETDEWEB)

    Jan, H; Hadi, A; Fahim, M; Gul, A M; Irfan, M; Khan, S B; Hafizullah, M [Lady Reading Hospital and Khyber Medical University, Peshawar (Pakistan). Dept. of Cardiology

    2012-01-15

    Objective: To see the clinical outcome of patients undergoing Transradial Coronary Angioplasty with stable Angina. Methodology: This was a single center observational study with prospective data collection of 338 patients who underwent transradial coronary angioplasty from September 2009 to August 2011, at Post Graduate Medical Institute, Lady Reading Hospital, Peshawar. Patients of both genders and all ages who had transradial coronary angioplasty for chronic stable angina were included in the study. Patients were clinically examined in out patients department on first month of hospital discharge and clinical outcome data was recorded. Results: A total of 338 patients were included in the study. Male were 58.8% and 41.2% were female with mean age of 52+-7 years. All the patients had coronary intervention through right radial artery. Baseline characteristics of the patients were; 48.2% diabetic, 43.2% hypertensive, 30.5% smokers, dyslipidemia was 45.7% and mean values of serum creatinine and Hemoglobin were 1.1+-0.3 and 11.5+-1.5, respectively. The frequency of various complications were as follow; hematoma 1.3%, nausea and vomiting 2.2%, pain in hand 11.2%, re admission to hospital for chest pain 6.5%, need for revascularization 2.2%, hand ischemia 1.8%, minor bleeding 0.9%, no major bleeding and 1.9% mortality. Conclusion: The radial artery approach for coronary intervention is useful with low degree of access site vascular complications and an early mobilization. (author)

  5. A Community-Based Early Intervention Program for Toddlers with Autism Spectrum Disorders

    Science.gov (United States)

    Rollins, Pamela Rosenthal; Campbell, Michelle; Hoffman, Renee Thibodeau; Self, Kayli

    2016-01-01

    This study examined Pathways Early Autism Intervention, a community-based, parent-mediated, intensive behavioral and developmental intervention program for children with autism spectrum disorders that could be used as a model for state-funded early intervention programs. A single-subject, multiple-baseline, across-participants design was used.…

  6. Responses to Struggling, K-2 Readers and Writers: Early Literacy Intervention in Three Urban Schools

    Science.gov (United States)

    Mooney, Kathleen C.

    2009-01-01

    An abundance of research on early literacy intervention indicates that struggling, K-2 readers and writers can be effectively supported through the receipt of intervention services in school; however, research in the area has not yet addressed study of the unique, contextualized design and implementation of early literacy intervention in different…

  7. Intervention of Behavioural, Cognitive and Sex on Early Childhood's Aggressive Behaviour

    Science.gov (United States)

    Purwati; Japar, Muhammad

    2015-01-01

    This study aims to find out the effect of behavioural intervention, cognitive intervention, and sex intervention toward the aggressive behaviour of early childhood. The study is conducted at two non-formal institutions of Education on Early Childhood in Magelang. This study obtains the data from two experimental groups consisting of 14 early…

  8. Race to the Top--Early Learning Challenge: An Analysis of Impact on IDEIA, Part C Early Intervention Programs

    Science.gov (United States)

    Bohjanen, Sharon L.

    2016-01-01

    Infants and toddlers who live in poverty are more likely to experience developmental delays or disabilities and less likely to access early intervention (EI) services. The federal initiative Race to the Top--Early Learning Challenge (RTT-ELC) was designed to increase access to high quality early learning programs for children at risk for…

  9. [Early Intervention and Cognitive Development: A Longitudinal Study with Psychologically Stressed Mother-Child-Dyad during Early Childhood].

    Science.gov (United States)

    Zwönitzer, Annabel; Ziegenhain, Ute; Bovenschen, Ina; Pillhofer, Melanie; Spangler, Gottfried; Gerlach, Jennifer; Gabler, Sandra; Kindler, Heinz; Fegert, Jörg M; Künster, Anne Katrin

    2016-01-01

    Early intervention programs aiming at developing parents’ relationship and parenting skills and supporting young families have become increasingly established in Germany throughout the last decade. The present longitudinal study analyzed 53 children and their mothers receiving early intervention due to their psychosocially highly challenging life situations and personal circumstances. The children were examined at birth and at an age of twelve months as well as between ages two and four. The results revealed that the child’s cognitive development could be predicted by both maternal sensitivity and mother’s psychosocial stress. However, the amount, type, and intensity of early intervention did not have any effect on the child’s development. In terms of the effectiveness of early interventions the results implicate that interventions seems to be offered in an unspecific manner and does not contribute to an improvement of the child’s developmental status.

  10. Alzheimer's disease prevention: from risk factors to early intervention.

    Science.gov (United States)

    Crous-Bou, Marta; Minguillón, Carolina; Gramunt, Nina; Molinuevo, José Luis

    2017-09-12

    Due to the progressive aging of the population, Alzheimer's disease (AD) is becoming a healthcare burden of epidemic proportions for which there is currently no cure. Disappointing results from clinical trials performed in mild-moderate AD dementia combined with clear epidemiological evidence on AD risk factors are contributing to the development of primary prevention initiatives. In addition, the characterization of the long asymptomatic stage of AD is allowing the development of intervention studies and secondary prevention programmes on asymptomatic at-risk individuals, before substantial irreversible neuronal dysfunction and loss have occurred, an approach that emerges as highly relevant.In this manuscript, we review current strategies for AD prevention, from primary prevention strategies based on identifying risk factors and risk reduction, to secondary prevention initiatives based on the early detection of the pathophysiological hallmarks and intervention at the preclinical stage of the disease. Firstly, we summarize the evidence on several AD risk factors, which are the rationale for the establishment of primary prevention programmes as well as revising current primary prevention strategies. Secondly, we review the development of public-private partnerships for disease prevention that aim to characterize the AD continuum as well as serving as platforms for secondary prevention trials. Finally, we summarize currently ongoing clinical trials recruiting participants with preclinical AD or a higher risk for the onset of AD-related cognitive impairment.The growing body of research on the risk factors for AD and its preclinical stage is favouring the development of AD prevention programmes that, by delaying the onset of Alzheimer's dementia for only a few years, would have a huge impact on public health.

  11. Longitudinal patterns of poverty and health in early childhood: exploring the influence of concurrent, previous, and cumulative poverty on child health outcomes

    Science.gov (United States)

    2012-01-01

    Background Although the links between poverty and health have often been studied , the dynamics of poverty and physical health in early childhood remain under-investigated. In particular, it is not known whether the health of young children is affected differently from that of adults by patterns of poverty unique to them. Methods We examined patterns of health from 5 to 41 months of age as a function of concurrent, lagged, and chronic exposure to insufficient income. Using data from the first four rounds of the Quebec Longitudinal Study of Child Development, we performed multilevel logistic and multilevel Poisson regressions and latent growth curve analyses to explore associations between exposure to poverty and mother-reported asthma-like attacks, and maternal perception of health status controlling for neonatal, maternal, and environmental characteristics. Results The mean number of mother-reported asthma-like attacks significantly decreased as children aged. The likelihood of being perceived in a poorer health status also decreased across time. Concurrent poverty was associated with more mother-reported asthma-like attacks and with a higher risk of being perceived in poorer health status. One-period-lagged poverty was associated with more mother-reported asthma-like attacks and this remained significant after controlling for concurrent poverty. The number of mother-reported asthma-like attacks was significantly higher among children in the chronic poverty class compared to those in the never-poor class, particularly at 17 and 29 months. Perceived health status at 5-months was significantly poorer among chronically poor children compared to never-poor children. Conclusion Exposure to poverty negatively affects two major health indicators in early childhood – maternal perception of child health and mother-reported asthma-like attacks. Patterns of the effects vary according to timing and duration of poverty exposure. Further longitudinal research is warranted

  12. Determination of preservice special education teachers’ views on early childhood intervention

    Directory of Open Access Journals (Sweden)

    Basak Baglama

    2016-12-01

    Full Text Available Abstract Experiences in early childhood have a great influence on a child's physical and mental development. Early childhood interventions are widely accepted as an effective way to prevent learning difficulties and to promote healthy development for children with special needs. For this reason, it is important for teachers who will work with children with special needs or children who are at risk to have sufficient knowledge about early childhood intervention and be competent in this area. Therefore, the present study aims to determine the views of preservice special education teachers about early childhood intervention. This study used quantitative research method and a questionnaire form was used to collect the data. The results are discussed in detail with reference to relevant literature. Implications and recommendations for further research are also provided in order to improve the quality of education policies, programs and practices related with early childhood intervention and increase awareness and knowledge related with early childhood interventions among teacher candidates.

  13. Early intervention for psychotic disorders: Real-life implementation in Hong Kong.

    Science.gov (United States)

    Wong, Gloria H Y; Hui, Christy L M; Tang, Jennifer Y M; Chang, Wing-Chung; Chan, Sherry K W; Xu, Jia-Qi; Lin, Jessie J X; Lai, Dik-Chee; Tam, Wendy; Kok, Joy; Chung, Dicky; Hung, S F; Chen, Eric Y H

    2012-03-01

    Hong Kong is among the first few cities in Asia to have implemented early intervention for psychosis in 2001. Substantial changes in psychosis service have since taken place. We reviewed available outcome data in Hong Kong, with reference to the philosophy of early intervention in psychosis, discussing experience and lessons learned from the implementation process, and future opportunities and challenges. Data accumulated in the past decade provided evidence for the benefits and significance of early intervention programmes: patients under the care of early intervention service showed improved functioning, milder symptoms, and fewer hospitalizations and suicides. Early intervention is more cost-effective compared with standard care. Stigma and misconception remains an issue, and public awareness campaigns are underway. In recent years, a critical mass is being formed, and Hong Kong has witnessed the unfolding of public service extension, new projects and organizations, and increasing interest from the community. Several major platforms are in place for coherent efforts, including the public Early Assessment Service for Young people with psychosis (EASY) programme, the Psychosis Studies and Intervention (PSI) research unit, the independent Hong Kong Early Psychosis Intervention Society (EPISO), the Jockey Club Early Psychosis (JCEP) project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. The first decade of early intervention work has been promising; consolidation and further development is needed on many fronts of research, service and education. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. A Novel Early Intervention for Preschool Depression: Findings from a Pilot Randomized Controlled Trial

    Science.gov (United States)

    Luby, Joan; Lenze, Shannon; Tillman, Rebecca

    2012-01-01

    Background: Validation for depression in preschool children has been established; however, to date no empirical investigations of interventions for the early onset disorder have been conducted. Based on this and the modest efficacy of available treatments for childhood depression, the need for novel early interventions has been emphasized. Large…

  15. Brief Report: An Evaluation of an Australian Autism-Specific, Early Intervention Programme

    Science.gov (United States)

    Paynter, Jessica M.; Riley, Emma P.; Beamish, Wendi; Scott, James G.; Heussler, Helen S.

    2015-01-01

    There is a relative paucity of evidence examining the effectiveness of early intervention for young children with Autism Spectrum Disorder, in particular those delivered through educationally-based programmes. This study aimed to evaluate the real world effectiveness of a community-based autism-specific early learning and intervention programme in…

  16. Family-Centered Early Intervention Visual Impairment Services through Matrix Session Planning

    Science.gov (United States)

    Ely, Mindy S.; Gullifor, Kateri; Hollinshead, Tara

    2017-01-01

    Early intervention visual impairment services are built on a model that values family. Matrix session planning pulls together parent priorities, family routines, and identified strategies in a way that helps families and early intervention professionals outline a plan that can both highlight long-term goals and focus on what can be done today.…

  17. Developing a Home-Based Early Intervention Personnel Training Program in Southeast China

    Science.gov (United States)

    Xie, Huichao; Chen, Ching-I; Chen, Chieh-Yu; Squires, Jane; Li, Wenge; Liu, Tian

    2017-01-01

    China is expected to have a rapid growth in specialized early intervention (EI) services for young children ages birth to 6 and their families. A major barrier in the provision of EI services in China is the shortage of well-trained EI personnel. In 2013, a Home-Based Early Intervention Program (HBEIP) was started at South China Normal University…

  18. The Role of Maternal Depression in Accessing Early Intervention Services for Children with Developmental Delay

    Science.gov (United States)

    Colgan, Siobhan Eileen

    2012-01-01

    This study investigated the relationship between maternal depression and children's access to early intervention services among a sample of children with developmental delay at age two who were determined to be eligible for early intervention services, were full term and of normal birth weight, and were not previously identified with any special…

  19. Early Child Disaster Mental Health Interventions: A Review of the Empirical Evidence

    Science.gov (United States)

    Pfefferbaum, Betty; Nitiéma, Pascal; Tucker, Phebe; Newman, Elana

    2017-01-01

    Background: The need to establish an evidence base for early child disaster interventions has been long recognized. Objective: This paper presents a descriptive analysis of the empirical research on early disaster mental health interventions delivered to children within the first 3 months post event. Methods: Characteristics and findings of the…

  20. Effect of lutein intervention on visual function in patients with early age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Chan Li

    2017-11-01

    Full Text Available AIM: To study the effect of lutein intervention on visual function of patients with early age-related macular degeneration(AMD. METHODS: Totally 200 early AMD patients were divided into lutein intervention group(20mg/dand placebo group by a randomized, double-blind, placebo-controlled trail. Questionnaire investigation, serum lutein concentration and visual function were conducted at baseline, 12, 24, 36 and 48wk respectively. RESULTS: The serum lutein concentration in lutein intervention group was higher than the baseline(PPPPP>0.05. CONCLUSION: Lutein intervention can improve the visual function of patients with early AMD.

  1. Early Intervention: A Multicultural Perspective on d/Deaf and Hard of Hearing Multilingual Learners.

    Science.gov (United States)

    Sandy, K Bowen

    2016-01-01

    Today's pluralistic society is characterized by families from many linguistic and cultural backgrounds, including families with infants and toddlers who are deaf or hard of hearing (d/Dhh). Taking a multicultural perspective, the author examines family-centered early intervention (FCEI) and the transition to school services for children who are d/Dhh. Working with d/Dhh Multilingual Learners (DMLs) and their families presents a unique challenge to early intervention professionals: ensuring that families have adequate information and resources to make informed choices, particularly regarding communication. The author presents information and research related to (a) family and professional partnerships, (b) cultural contexts for early intervention, (c) family communication decisions and linguistic diversity, (d) emerging research on DMLs, (e) considerations for early intervention providers and interpreters who work with culturally and linguistically diverse d/Dhh infants and toddlers, and (f) cultural reflections on ensuring smooth transitions from early intervention into preschool programs.

  2. Mode of entry to an early intervention service for psychotic disorders: determinants and impact on outcome.

    Science.gov (United States)

    Pira, Shamira; Durr, Georges; Pawliuk, Nicole; Joober, Ridha; Malla, Ashok

    2013-11-01

    Specialized early intervention services for first-episode psychosis should treat a proportion of patients without using inpatient beds. This study compared such service users by their initial mode of treatment before entry-inpatient (N=157) or outpatient (N=102). On entry to a Montreal early intervention service, the groups were compared on baseline clinical and functional variables and on hospitalizations during two years of treatment. Initial presentation at an emergency service, shorter duration of untreated psychosis, lower functioning level, and aggressive and bizarre behavior were associated with the inpatient entry mode to early intervention services. During follow-up, individuals entering as inpatients spent more days hospitalized than those entering as outpatients, and their time to rehospitalization was shorter. Results suggest that entry into early intervention services via the hospital emergency department and presentation with behavioral and functional disturbances were more predictive than core psychotic symptoms of hospital inpatient status on referral to an early intervention service.

  3. Moderation and Mediation in Structural Equation Modeling: Applications for Early Intervention Research

    Science.gov (United States)

    Hopwood, Christopher J.

    2007-01-01

    Second-generation early intervention research typically involves the specification of multivariate relations between interventions, outcomes, and other variables. Moderation and mediation involve variables or sets of variables that influence relations between interventions and outcomes. Following the framework of Baron and Kenny's (1986) seminal…

  4. Benefits of Early Childhood Interventions across the World: (Under) Investing in the Very Young

    Science.gov (United States)

    Nores, Milagros; Barnett, W. Steven

    2010-01-01

    This paper reviews the international (non-U.S.) evidence on the benefits of early childhood interventions. A total of 38 contrasts of 30 interventions in 23 countries were analyzed. It focuses on studies applying a quasi-experimental or random assignment. Studies were coded according to: the type of intervention (cash transfer, nutritional,…

  5. Utilisation of evidence-based practices by ASD early intervention service providers.

    Science.gov (United States)

    Paynter, Jessica M; Ferguson, Sarah; Fordyce, Kathryn; Joosten, Annette; Paku, Sofia; Stephens, Miranda; Trembath, David; Keen, Deb

    2017-02-01

    A number of autism intervention practices have been demonstrated to be effective. However, the use of unsupported practices persists in community early intervention settings. Recent research has suggested that personal, professional and workplace factors may influence intervention choices. The aim of this research was to investigate knowledge and use of strategies, organisational culture, individual attitudes, sources of information and considerations informing intervention choices by early intervention providers. An online survey was completed by 72 early intervention providers from four organisations across Australia. Providers reported high levels of trust and access of information from internal professional development, therapists and external professional development. A range of considerations including child factors, family values and research were rated as important in informing intervention choices. Participants reported greater knowledge and use of evidence-based and emerging practices than unsupported. Levels of use were linked to levels of knowledge, as well as some organisational and attitudinal factors. Areas for future research and implications are discussed.

  6. Measuring Satisfaction with Family-Professional Partnership in Early Intervention and Early Childhood Special Education Programs in Qatar

    Science.gov (United States)

    Al-Hadad, Nawal Khalil

    2010-01-01

    Family-professional partnership has been considered a recommended practice in Early Intervention/Early Childhood Special Education (EI/ECSE) programs for young children with disabilities and their families for the past two decades. The importance of establishing successful partnerships between families and professionals in educational planning has…

  7. Preterm birth-associated cost of early intervention services: an analysis by gestational age.

    Science.gov (United States)

    Clements, Karen M; Barfield, Wanda D; Ayadi, M Femi; Wilber, Nancy

    2007-04-01

    Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined. Overall, 14,033 of 76,901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

  8. Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service.

    Science.gov (United States)

    Devescovi, Raffaella; Monasta, Lorenzo; Mancini, Alice; Bin, Maura; Vellante, Valerio; Carrozzi, Marco; Colombi, Costanza

    2016-01-01

    Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System. Twenty-one toddlers at risk for autism spectrum disorders, aged 20-36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents' and teachers' active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and post-intervention (Time 1 [T1]; mean age =42 months). Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment. Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, our study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System.

  9. Making the Case for Early Identification and Intervention for Young Children at Risk for Learning Disabilities

    Science.gov (United States)

    Steele, Marcee M.

    2004-01-01

    The early identification of children with learning disabilities (LD) is difficult but can be accomplished. Observation of key behaviors which are indicators of LD by preschool and kindergarten teachers can assist in this process. This early identification facilitates the use of intervention strategies to provide a positive early experience for…

  10. Feasibility of an Online Professional Development Program for Early Intervention Practitioners

    Science.gov (United States)

    Kyzar, Kathleen B.; Chiu, Caya; Kemp, Peggy; Aldersey, Heather Michelle; Turnbull, Ann P.; Lindeman, David P.

    2014-01-01

    This article reports findings from 2 studies situated within a larger scope of design research on a professional development program, "Early Years," for Part C early intervention practitioners, working with families in home and community settings. Early Years includes online modules and onsite mentor coaching, and its development has…

  11. Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service

    Directory of Open Access Journals (Sweden)

    Devescovi R

    2016-06-01

    Full Text Available Raffaella Devescovi,1 Lorenzo Monasta,2 Alice Mancini,3 Maura Bin,1 Valerio Vellante,1 Marco Carrozzi,1 Costanza Colombi4 1Division of Child Neurology and Psychiatry, 2Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, 3Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 4Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA Background: Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM, can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System.Methods: Twenty-one toddlers at risk for autism spectrum disorders, aged 20–36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents’ and teachers’ active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months and post-intervention (Time 1 [T1]; mean age =42 months.Results: Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment.Conclusion: Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children

  12. Effects of early life stress: Opportunities for pharmacological intervention

    NARCIS (Netherlands)

    Loi, M

    2016-01-01

    Moderate acute activation of the body’s stress response system is considered an adaptive mechanism that increases the chance of survival, but severe stressors early in life may disturb brain development. In agreement, epidemiological data suggest that adverse experiences early in life, such as

  13. [Offer early attention and intervention to patients with valvular heart disease].

    Science.gov (United States)

    Jiang, Shengli; Ren, Chonglei

    2015-02-01

    As a key feature of the updates, early intervention of valvular heart disease is highlighted in the 2014 AHA/ACC guideline for the management of patients with valvular heart disease. This article reviewed the new guideline in regards to the issue of early intervention of diseases such as aortic stenosis, aortic insufficiency, mitral stenosis, mitral insufficiency, tricuspid insufficiency, and infective endocarditis, with discussion on the related topics according to the authors' understanding and practical experience in China. We conclude that valvular heart disease should receive early intervention and attention should also be paid on the progress of disease.

  14. Preventing Poor Vocational Functioning in Psychosis Through Early Intervention

    DEFF Research Database (Denmark)

    Hegelstad, Wenche Ten Velden; Bronnick, Kolbjorn S; Barder, Helene Eidsmo

    2017-01-01

    OBJECTIVE: This study tested the hypothesis that early detection of psychosis improves long-term vocational functioning through the prevention of negative symptom development. METHODS: Generalized estimating equations and mediation analysis were conducted to examine the association between...... employment and negative symptoms over ten years among patients in geographic areas characterized by usual detection (N=140) or early detection (N=141) of psychosis. RESULTS: Improved vocational outcome after ten years among patients in the early-detection area was mediated by lower levels of negative...

  15. Using Intervention Mapping for child development and wellbeing programs in early childhood education and care settings.

    Science.gov (United States)

    O'Connor, Amanda; Blewitt, Claire; Nolan, Andrea; Skouteris, Helen

    2018-06-01

    Supporting children's social and emotional learning benefits all elements of children's development and has been associated with positive mental health and wellbeing, development of values and life skills. However, literature relating to the creation of interventions designed for use within the early childhood education and care settings to support children's social and emotional skills and learning is lacking. Intervention Mapping (IM) is a systematic intervention development framework, utilising principles centred on participatory co-design methods, multiple theoretical approaches and existing literature to enable effective decision-making during the development process. Early childhood pedagogical programs are also shaped by these principles; however, educators tend to draw on implicit knowledge when working with families. IM offers this sector the opportunity to formally incorporate theoretical, evidence-based research into the development of early childhood education and care social and emotional interventions. Emerging literature indicates IM is useful for designing health and wellbeing interventions for children within early childhood education and care settings. Considering the similar underlying principles of IM, existing applications within early childhood education and care and development of interventions beyond health behaviour change, it is recommended IM be utilised to design early childhood education and care interventions focusing on supporting children's social and emotional development. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Prevention and early intervention to improve mental health in higher education students: a review.

    Science.gov (United States)

    Reavley, Nicola; Jorm, Anthony F

    2010-05-01

    The age at which most young people are in higher education is also the age of peak onset for mental and substance use disorders, with these having their first onset before age 24 in 75% of cases. In most developed countries, over 50% of young people are in higher education. To review the evidence for prevention and early intervention in mental health problems in higher education students. The review was limited to interventions targeted to anxiety, depression and alcohol misuse. Interventions to review were identified by searching PubMed, PsycINFO and the Cochrane Database of Systematic Reviews. Interventions were included if they were designed to specifically prevent or intervene early in the general (non-health professional) higher education student population, in one or more of the following areas: anxiety, depression or alcohol misuse symptoms, mental health literacy, stigma and one or more behavioural outcomes. For interventions to prevent or intervene early for alcohol misuse, evidence of effectiveness is strongest for brief motivational interventions and for personalized normative interventions delivered using computers or in individual face-to-face sessions. Few interventions to prevent or intervene early with depression or anxiety were identified. These were mostly face-to-face, cognitive-behavioural/skill-based interventions. One social marketing intervention to raise awareness of depression and treatments showed some evidence of effectiveness. There is very limited evidence that interventions are effective in preventing or intervening early with depression and anxiety disorders in higher education students. Further studies, possibly involving interventions that have shown promise in other populations, are needed.

  17. EPA guidance on the early intervention in clinical high risk states of psychoses

    DEFF Research Database (Denmark)

    Schmidt, S J; Schultze-Lutter, F; Schimmelmann, B G

    2015-01-01

    -analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples. Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses...... on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. Based on data from 15 studies (n=1394), early intervention generally produced significantly reduced conversion rates at 6- to 48-month follow-up compared to control conditions...... on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early intervention in CHR samples could have been formulated, although more...

  18. Early diagnosis and intervention for autism spectrum disorder in Africa

    African Journals Online (AJOL)

    Methods: This was a qualitative mixed method case study. Literature ... communities may provide a valuable resource to ASD intervention strategies. ... eases, and in particular mental health,9,10 have been a low .... able to become an internationally recognised scientist in ..... Research in Developmental Disabilities. 2009 ...

  19. Crisis Intervention in Early Adolescence. First Annual Report.

    Science.gov (United States)

    Adolescence Resources Center, Sumter, SC.

    The basic premise under investigation is that systematic intervention in a predictable, natural occurring stress situation for population groups: (1) can promote acquisition of competence and coping skills; and (2) minimize pathological response to stress and eventual need for treatment. This study is an exploration of preadolescent development of…

  20. "Teacher, I Can Read!" The Marvels of Early Intervention Strategies

    Science.gov (United States)

    Murphy, Jean C.; Hernandez, Leonor

    2011-01-01

    "Teacher, I can read!" exclaimed Saree, a fourth-quarter second grader who was placed in the lowest of reading groups at a southwest side elementary school in Chicago. This was her proud announcement after three weeks of intensive intervention with Ms. Gomez, a student teacher in her final semester at Chicago State University. "Ms.…

  1. Early reading intervention by means of a multicomponent reading game

    NARCIS (Netherlands)

    Ven, M.A.M. van de; Leeuw, L.C. de; Weerdenburg, M.W.C. van; Steenbeek-Planting, E.G.

    2017-01-01

    This study examined the effects of an intervention with a multicomponent reading game on the development of reading skills in 60 Dutch primary school children with special educational needs. The game contains evidence-based reading exercises and is based on principles of applied gaming. Using a

  2. The Role of Parents in Early Motor Intervention

    Science.gov (United States)

    Mahoney, Gerald; Perales, Frida

    2006-01-01

    In this article we discuss the results of a motor intervention study that we conducted with young children with Down syndrome and other disabilities (Mahoney, Robinson & Fewell, 2001). Results from this study indicated that neither of the two major treatment models that are commonly used with young children with motor impairments was effective at…

  3. Mothers' Reports of Their Involvement in Early Intensive Behavioral Intervention

    Science.gov (United States)

    Granger, Stephanie; des Rivieres-Pigeon, Catherine; Sabourin, Gabrielle; Forget, Jacques

    2012-01-01

    Although numerous studies examine the effectiveness of intensive behavioral intervention programs (EIBI) for young children with autism, few focus on the family aspect of the program. In particular, involvement of mothers in the program, which is strongly recommended, is the subject of only a small number of studies. The goal of this research is…

  4. Early Reading Intervention by Means of a Multicomponent Reading Game

    Science.gov (United States)

    van de Ven, M.; de Leeuw, L.; van Weerdenburg, M.; Steenbeek-Planting, E. G.

    2017-01-01

    This study examined the effects of an intervention with a multicomponent reading game on the development of reading skills in 60 Dutch primary school children with special educational needs. The game contains evidence-based reading exercises and is based on principles of applied gaming. Using a multiple baseline approach, we tested children's…

  5. DIAGNOSTIC GUIDANCE AND EARLY INTERVENTION IN CLASS III MALOCCLUSION

    Directory of Open Access Journals (Sweden)

    Rinandri Charea Runizar

    2015-06-01

    Full Text Available Timing of orthodontic treatment for Class III malocclusion has always been somewhat controversial. Many orthodontic pioneers like Angle, Tweed, and Graber have advocated early interception of class II malocclusion because this kind of skeletal discrepancy once established, would usually progress rapidly. What kind of early treatment would be appropriate for this malocclusion? Would this approach be effective and promises a stable result? Early orthodontic treatment is defined as a treatment that is initiated during the primary or mixed dentition stage to enhance skeletal and dental development. It is usually done in two phases. The first phase is intended to correct skeletal discrepancy by taking advantage of growth and development period. The second phase followed to improve occlusal relationship. Early treatment of Class III malocclusion is a possible alternative to improve skeletal discrepancy or at the very east may serve to prevent a worsening malocclusion. Principles of Class III early treatment depend on whether it is dental Class III, functional Class III, or skeletal Class III. Practitioners should consider positive and negative factors of a patient before initiating treatment. Likewise, they should understand factors that affect prognosis and stability of the results.

  6. Early psychological intervention in accidentally injured children ages 2–16: a randomized controlled trial

    OpenAIRE

    Kramer, Didier N.; Landolt, Markus A.

    2014-01-01

    Background: Road traffic accidents (RTA) and burns are frequent events in children. Although many children recover spontaneously, a considerable number develop long-term psychological sequelae. Evidence on early psychological interventions to prevent such long-term problems is still scarce for school-age children and completely lacking for pre-school children.Objectives: To evaluate the efficacy of an early two-session cognitive-behavioral intervention in 108 children ages 2–16 after RTAs and...

  7. Are Audiologists Directly Referring Children with Hearing Loss to Early Intervention?

    OpenAIRE

    Loyola, Natalie; Shanahan, Bridget; Shanahan, Cailin; Kawai, Kosuke; Stiles, Derek J

    2017-01-01

    This article describes the ways that pediatric audiologists are directing infants into Early Intervention, and the related barriers and facilitators. Over one hundred pediatric audiologists responded to an online survey including questions on how audiologists provide direct and indirect referrals to Early Intervention for those infants that are diagnosed with hearing loss. Most respondents agreed that audiologists are the best person to provide this referral, but many audiologists did not mak...

  8. The DEBT Project: Early Intervention for Handicapped Children and Their Parents.

    Science.gov (United States)

    Macy, Daniel J.; And Others

    Project DEBT (Developmental Education Birth through Two), an early identification and intervention program for handicapped and at risk children and their parents, is described. The Koontz Child Developmental Program, the core curriculum for instructional planning and intervention in DEBT, is reviewed, and new data are presented. It is explained…

  9. Use of early intervention for young children with autism spectrum disorder across Europe

    NARCIS (Netherlands)

    Salomone, E.; Beranova, S.; Bonnet-Brilhault, F.; Lauritsen, M.; Budisteanu, M.; Buitelaar, J.K.; Canal-Bedia, R.; Felhosi, G.; Fletcher-Watson, S.; Freitag, C.; Fuentes, J.; Gallagher, L.; Primo, P. Garcia; Gliga, F.; Gomot, M.; Green, J.; Heimann, M.; Jonsdottir, S.L.; Kaale, A.; Kawa, R.; Kylliainen, A.; Lemcke, S.; Markovska-Simoska, S.; Marschik, P.B.; McConachie, H.; Moilanen, I.; Muratori, F.; Narzisi, A.; Noterdaeme, M.; Oliveira, G.; Oosterling, I.; Pijl, M.; Pop-Jordanova, N.; Poustka, L.; Roeyers, H.; Roge, B.; Sinzig, J.; Vicente, A.; Warreyn, P.; Charman, T.

    2016-01-01

    Little is known about use of early interventions for autism spectrum disorder in Europe. Parents of children with autism spectrum disorder aged 7 years or younger (N = 1680) were recruited through parent organisations in 18 European countries and completed an online survey about the interventions

  10. Use of Early Intervention for Young Children with Autism Spectrum Disorder across Europe

    Science.gov (United States)

    Salomone, Erica; Beranová, Štepánka; Bonnet-Brilhault, Frédérique; Briciet Lauritsen, Marlene; Budisteanu, Magdalena; Buitelaar, Jan; Canal-Bedia, Ricardo; Felhosi, Gabriella; Fletcher-Watson, Sue; Freitag, Christine; Fuentes, Joaquin; Gallagher, Louise; Garcia Primo, Patricia; Gliga, Fotinica; Gomot, Marie; Green, Jonathan; Heimann, Mikael; Jónsdóttir, Sigridur Loa; Kaale, Anett; Kawa, Rafal; Kylliainen, Anneli; Lemcke, Sanne; Markovska-Simoska, Silvana; Marschik, Peter B; McConachie, Helen; Moilanen, Irma; Muratori, Filippo; Narzisi, Antonio; Noterdaeme, Michele; Oliveira, Guiomar; Oosterling, Iris; Pijl, Mirjam; Pop-Jordanova, Nada; Poustka, Luise; Roeyers, Herbert; Rogé, Bernadette; Sinzig, Judith; Vicente, Astrid; Warreyn, Petra; Charman, Tony

    2016-01-01

    Little is known about use of early interventions for autism spectrum disorder in Europe. Parents of children with autism spectrum disorder aged 7?years or younger (N?=?1680) were recruited through parent organisations in 18 European countries and completed an online survey about the interventions their child received. There was considerable…

  11. Effectiveness of a Novel Community-Based Early Intervention Model for Children with Autistic Spectrum Disorder

    Science.gov (United States)

    Smith, Isabel M.; Koegel, Robert L.; Koegel, Lynn K.; Openden, Daniel A.; Fossum, Kristin L.; Bryson, Susan E.

    2010-01-01

    The Nova Scotia early intensive behavior intervention model--NS EIBI (Bryson et al., 2007) for children with autistic spectrum disorders was designed to be feasible and sustainable in community settings. It combines parent training and naturalistic one-to-one behavior intervention employing Pivotal Response Treatment--PRT (R. Koegel & Koegel,…

  12. Future of Early Intervention with Infants and Toddlers for Whom Typical Experiences Are Not Effective

    Science.gov (United States)

    McWilliam, R. A.

    2015-01-01

    Early intervention for infants and toddlers began with high hopes, but became mired in overspecialization, bureaucracy, and turf guarding. Nevertheless, two important advances in the field have been (a) a recognition that the child's natural caregivers are in the best position to be the intervention agents and, concomitantly, (b) a rethinking…

  13. Context, Diversity and Engagement: Early Intervention with Australian Aboriginal Families in Urban and Remote Contexts

    Science.gov (United States)

    Robinson, Gary; Tyler, William; Jones, Yomei; Silburn, Sven; Zubrick, Stephen R.

    2012-01-01

    This article describes challenges met implementing an early intervention programme for Aboriginal parents and their children in the NT (Northern Territory) of Australia in the context of efforts to remediate Aboriginal disadvantage. The intervention is an adaptation of an 8- to 10-week, manualised parenting programme designed for four- to…

  14. Couple-Focused Group Intervention for Women With Early Stage Breast Cancer

    Science.gov (United States)

    Manne, Sharon L.; Ostroff, Jamie S.; Winkel, Gary; Fox, Kevin; Grana, Generosa; Miller, Eric; Ross, Stephanie; Frazier, Thomas

    2005-01-01

    This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects. Two hundred thirty-eight women were randomly assigned to receive either 6 sessions…

  15. An Intervention for Relational and Physical Aggression in Early Childhood: A Preliminary Study

    Science.gov (United States)

    Ostrov, Jamie M.; Massetti, Greta M.; Stauffacher, Kirstin; Godleski, Stephanie A.; Hart, Katie C.; Karch, Kathryn M.; Mullins, Adam D.; Ries, Emily E.

    2009-01-01

    A preventive intervention for reducing physical and relational aggression, peer victimization, and increasing prosocial behavior was developed for use in early childhood classrooms. Nine classrooms were randomly assigned to be intervention rooms (N = 202 children) and nine classrooms were control rooms (N = 201 children). Classroom was the unit of…

  16. Trends and Topics in Early Intensive Behavioral Interventions for Toddlers with Autism

    Science.gov (United States)

    Matson, Johnny L.; Tureck, Kimberly; Turygin, Nicole; Beighley, Jennifer; Rieske, Robert

    2012-01-01

    The use of applied behavior analysis (ABA) to treat persons with autism goes back several decades. Many specific target behaviors and intervention strategies have been developed. In the last two decades the most heavily studied of these methods has been Early Intensive Behavioral Interventions (EIBI). This package of ABA methods is unique in two…

  17. Developmental and Communication Disorders in Children with Intellectual Disability: The Place Early Intervention for Effective Inclusion

    Science.gov (United States)

    Jacob, Udeme Samuel; Olisaemeka, Angela Nneka; Edozie, Isioma Sitamalife

    2015-01-01

    The paper attempts to discuss the place of intervention in the developmental and communication disorders of children with intellectual disability for the purpose of providing effective inclusion programme. The definition of early intervention was stated, areas affected by children communication disorder such as language comprehension, fluency,…

  18. A Simulation Model for Designing Effective Interventions in Early Childhood Caries

    OpenAIRE

    Hirsch, Gary B.; Edelstein, Burton L.; Frosh, Marcy; Anselmo, Theresa

    2012-01-01

    Introduction Early childhood caries (ECC) — tooth decay among children younger than 6 years — is prevalent and consequential, affecting nearly half of US 5-year-olds, despite being highly preventable. Various interventions have been explored to limit caries activity leading to cavities, but little is known about the long-term effects and costs of these interventions. We developed a system dynamics model to determine which interventions, singly and in combination, could have the greatest effec...

  19. Early intervention for stuttering: similarities and differences between two programs

    OpenAIRE

    Aumont-Boucand, V.; Millard, S.; Packman, A.

    2014-01-01

    In this paper, two proponents of different approaches to early stuttering discuss how they would manage a hypothetical case of stuttering in a preschool-age girl. Two evidence-based approaches are discussed: Palin Parent-Child Interaction Therapy and the Lidcombe Program. This paper arose from an oral discussion session held at the International Fluency Association Conference in Tours, France in 2012.

  20. A Cost-Effectiveness Analysis of Early Literacy Interventions

    Science.gov (United States)

    Simon, Jessica

    2011-01-01

    Success in early literacy activities is associated with improved educational outcomes, including reduced dropout risk, in-grade retention, and special education referrals. When considering programs that will work for a particular school and context; cost-effectiveness analysis may provide useful information for decision makers. The study…

  1. Kentucky's Individualized Kindergartens: A State Network Design for Early Intervention.

    Science.gov (United States)

    Bright, B.; Cansler, D. P.

    The KIK (Kentucky Individualized Kindergartens) project, a collaborative project between Kentucky's Department of Education and the Chapel Hill (NC) Training-Outreach project, is designed to serve high risk children. KIK provides early identification of high risk kindergarteners, development of individualized education programs, and implementation…

  2. Environmental Change & Fragile States Early Warning and Intervention

    Science.gov (United States)

    2011-05-12

    Natural Resources and Ecosystem Services] Sources: Adapted from Maslow , 1943; Butts as reported by Damonte, 2006 8  Research...how positions of competing interests will evolve. Synthesizes political science, microeconomics, game theory , decision theory , and spatial...explanation of why outcomes occur (actor motivations ) Senturion Software 19 Integrated Crisis Early Warning System (ICEWS)  Developed By DARPA

  3. Families as Partners: Supporting Family Resiliency through Early Intervention

    Science.gov (United States)

    Frantz, Rebecca; Hansen, Sarah Grace; Squires, Jane; Machalicek, Wendy

    2018-01-01

    Child development occurs within the context of the child's family, neighborhood, and community environment. Early childhood providers support positive outcomes, not only for the children with whom they directly work with but also for their families. Families of children with developmental delays often experience unique challenges. A family…

  4. [The community-oriented experience of early intervention services in Taipei City].

    Science.gov (United States)

    Chu, Feng-Ying

    2007-10-01

    The purpose of this paper is to emphasize the importance of early intervention. The purpose of early intervention in Taipei City is to help child development, promote parenting skills, and reduce educational and social costs. In order to meet these goals, parenting groups and Taipei City Council have made great efforts to make early intervention work in Taipei City. In April 1995, Taipei City Government started planning and setting up the service network. To date, Taipei City has set up one reporting and referral center?, ?six community resources centers, 22 medical assessment and intervention clinics, 12 child development centers, one early intervention training center, three non-profit foundations and more than 300 inclusion schools, such as kindergartens and day care centers. With parent participation, professional devotion and Taipei City Government's commitment, the number of assisted children has increased from 98 to 2,523 /year. By the end of 2006, Taipei had already funded 25,277 children. We estimate Taipei City early intervention services to have affected at least 75,000 persons, including development-delayed and disabled children, their parents?, ?grandparents and siblings. We found that early intervention services help the children to build up self esteem, grow their potential, learn how to socialize, and receive an education, while the most important aim is to help them to reduce their level of disability or to prevent them from getting worse. At the same time, their families get support and a diverse range of services. An integrated early intervention program should include children, families, and multidisciplinary professionals. The system should therefore be more "family-centered" and "community-oriented" to provide appropriate services to children and families through a positive and aggressive attitude.

  5. Early Intervention Outcomes for Toddlers with Autism Spectrum Disorder and Their Families

    Science.gov (United States)

    Noyes-Grosser, Donna M.; Elbaum, Batya; Wu, Yan; Siegenthaler, Kirsten M.; Cavalari, Rachel S.; Gillis, Jennifer M.; Romanczyk, Raymond G.

    2018-01-01

    Autism spectrum disorder (ASD) can be diagnosed as early as 18 months of age. State Early Intervention (EI) programs under Part C of the Individuals with Disabilities Education Act (IDEA) are serving increasing numbers of children with ASD; however, little is known about outcomes of these services. This study evaluated the impact of EI for…

  6. Early Intervention for Children with Autism Spectrum Disorders in China: A Family Perspective

    Science.gov (United States)

    Su, Xueyun; Long, Toby; Chen, Lianjun; Fang, Junming

    2013-01-01

    Autism spectrum disorders (ASD) were first reported in China in 1982. Since then, autism and other related disorders have been recognized by both the public and professionals. The importance of early intervention for children with ASD is becoming more accepted throughout China. A survey was designed to investigate the status of early intervention…

  7. Early intervention studies in infants and preschool children with cystic fibrosis: Are we ready?

    NARCIS (Netherlands)

    S. Stick; H.A.W.M. Tiddens (Harm); P. Aurora (Paul); P. Gustafsson (Per); S. Ranganathan (Surabhi); P. Robinson; M. Rosenfeld (Margaret); P.D. Sly; F. Ratjen (Felix)

    2013-01-01

    textabstractCystic fibrosis (CF) lung disease starts early in life and progresses even in the absence of clinical symptoms. Therefore, sensitive outcome measures to quantify and track these early abnormalities in infants and young children are needed; both for clinical care and interventional

  8. Determination of Preservice Special Education Teachers' Views on Early Childhood Intervention

    Science.gov (United States)

    Baglama, Basak; Demirok, Mukaddes Sakalli

    2016-01-01

    Experiences in early childhood have a great influence on a child's physical and mental development. Early childhood interventions are widely accepted as an effective way to prevent learning difficulties and to promote healthy development for children with special needs. For this reason, it is important for teachers who will work with children with…

  9. Early Intervention Programs: Opening the Door to Higher Education. ERIC Digest.

    Science.gov (United States)

    Fenske, Robert H.; Geranios, Christine A.; Keller, Jonathan E.; Moore, David E.

    This digest summarizes a larger document of the same title which examines early intervention programs providing services and resources to encourage low-income/minority youth to finish high school and enter college. It notes provisions of federal law which encourage such programs and the unifying mission of the National Early Intervention…

  10. Cumulative Poisson Distribution Program

    Science.gov (United States)

    Bowerman, Paul N.; Scheuer, Ernest M.; Nolty, Robert

    1990-01-01

    Overflow and underflow in sums prevented. Cumulative Poisson Distribution Program, CUMPOIS, one of two computer programs that make calculations involving cumulative Poisson distributions. Both programs, CUMPOIS (NPO-17714) and NEWTPOIS (NPO-17715), used independently of one another. CUMPOIS determines cumulative Poisson distribution, used to evaluate cumulative distribution function (cdf) for gamma distributions with integer shape parameters and cdf for X (sup2) distributions with even degrees of freedom. Used by statisticians and others concerned with probabilities of independent events occurring over specific units of time, area, or volume. Written in C.

  11. Mutually shared team competence of professionals in early childhood intervention

    OpenAIRE

    Ališauskienė, Stefanija; Kairienė, Daiva

    2011-01-01

    The article is based on theoretical study as well as on written survey. The aim of theoretical analysis to present a theoretical model of the concept of the mutually shared team competence in an interprofessional team meeting early special needs of child and family and to find out presumptions of its development. The aim of survey is to reveal ECI professionals' reflections about competences necessary for teamwork. The mutually shared team competence is analysed on the basis of the teamwork p...

  12. Early intervention and management of adrenal insufficiency in children.

    LENUS (Irish Health Repository)

    Moloney, Sinéad

    2012-09-01

    The endocrine disorder adrenal insufficiency includes inadequate production of the steroid hormone cortisol. This results in poor physiological responses to illness, trauma or other stressors and risk of adrenal crisis. Management is based on administration of hydrocortisone. It is important to avoid under- or over-treatment and increase the dosage during times of physiological stress. To reduce morbidity, hospital admissions and mortality, the education and empowerment of parents and carers, and prompt intervention when necessary are essential. A steroid therapy card for adrenal insufficiency containing personal information on a patient\\'s condition was developed for use by families and their specialist centres.

  13. Practitioner-informed improvements to early childhood intervention performance checklists and practice guides

    Directory of Open Access Journals (Sweden)

    Carl J. Dunst

    2017-08-01

    Full Text Available Results from four early childhood practitioner field tests of performance checklists and early intervention practice guides are reported. Findings from the first field test were used to make changes and improvements in the checklists and practice guides evaluated in the second and third field tests, and findings from the latter two field tests were used to improve the checklist and practice guide evaluated in the fourth field test. Results indicated that changes made in response to practitioners’ suggestions and feedback were associated with (1 progressive increases in the practitioners’ social validity judgments of the checklists, practice guides, and checklist-practice guide correspondence, and (2 progressive decreases in the number of practitioner suggestions and feedback for improving the early intervention materials. The field-test research demonstrates the importance of practitioner input, suggestions, and feedback for improving the usefulness of early childhood intervention practices.

  14. Behavioural and skill-based early interventions in children with autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Greiner, Wolfgang

    2009-07-01

    Full Text Available Introduction: Autism spectrum disorders (ASD comprise typical or infantile autism (Kanner syndrome, Asperger’s disorder and atypical autism or pervasive developmental disorder - not otherwise specified. The syndrome is characterized by deficits in (1 verbal and nonverbal communication, (2 reciprocal social interaction and (3 repetitive patterns of behaviour, interests and activities. Early behavioural interventions are based on learning theory and behaviour therapy. They take into account specific deficits in perception, emotional reactions, social interaction and communication. In Germany, these comprehensive models are not widely evaluated and implemented. Research questions: * What are the clinical effectiveness and safety of early behavioural or skills-based early interventions in autism compared to other interventions or to treatment as usual? * What are specific factors responsible for the effectiveness? * What are the cost-effectiveness and cost consequences of different early interventions in autism? * Which legal, social and ethical aspects are relevant with regard to the implementation of the respective interventions in persons with autism? Methods: Following a systematic review of the literature, controlled studies on early behavioural or skills-based interventions published since 2000 in English or German with children until the age of twelve are included and critically appraised. Studies must have at least ten participants per intervention group. Results: In total, 15 publications based on 14 studies, eight systematic reviews and one health economic study are included. Most studies evaluate early interventions based upon the Lovaas model (Early intensive behavioural treatment (EIBT, Applied behavioural analysis (ABA. Other evaluate pragmatic interventions or interventions based on other theoretical models like specific parent interventions, responsive education and prelinguistic milieu teaching, joint attention, symbolic play, and

  15. Behavioural and skill-based early interventions in children with autism spectrum disorders.

    Science.gov (United States)

    Weinmann, Stefan; Schwarzbach, Christoph; Begemann, Matthias; Roll, Stephanie; Vauth, Christoph; Willich, Stefan N; Greiner, Wolfgang

    2009-07-29

    Autism spectrum disorders (ASD) comprise typical or infantile autism (Kanner syndrome), Asperger's disorder and atypical autism or pervasive developmental disorder - not otherwise specified. The syndrome is characterized by deficits in (1) verbal and nonverbal communication, (2) reciprocal social interaction and (3) repetitive patterns of behaviour, interests and activities. Early behavioural interventions are based on learning theory and behaviour therapy. They take into account specific deficits in perception, emotional reactions, social interaction and communication. In Germany, these comprehensive models are not widely evaluated and implemented. What are the clinical effectiveness and safety of early behavioural or skills-based early interventions in autism compared to other interventions or to treatment as usual?What are specific factors responsible for the effectiveness?What are the cost-effectiveness and cost consequences of different early interventions in autism?Which legal, social and ethical aspects are relevant with regard to the implementation of the respective interventions in persons with autism? Following a systematic review of the literature, controlled studies on early behavioural or skills-based interventions published since 2000 in English or German with children until the age of twelve are included and critically appraised. Studies must have at least ten participants per intervention group. In total, 15 publications based on 14 studies, eight systematic reviews and one health economic study are included. Most studies evaluate early interventions based upon the Lovaas model (Early intensive behavioural treatment (EIBT), Applied behavioural analysis (ABA)). Other evaluate pragmatic interventions or interventions based on other theoretical models like specific parent interventions, responsive education and prelinguistic milieu teaching, joint attention, symbolic play, and picture exchange communication system. Behaviour analytic interventions

  16. Behavioural and skill-based early interventions in children with autism spectrum disorders

    Science.gov (United States)

    Weinmann, Stefan; Schwarzbach, Christoph; Begemann, Matthias; Roll, Stephanie; Vauth, Christoph; Willich, Stefan N.; Greiner, Wolfgang

    2009-01-01

    Introduction Autism spectrum disorders (ASD) comprise typical or infantile autism (Kanner syndrome), Asperger’s disorder and atypical autism or pervasive developmental disorder - not otherwise specified. The syndrome is characterized by deficits in (1) verbal and nonverbal communication, (2) reciprocal social interaction and (3) repetitive patterns of behaviour, interests and activities. Early behavioural interventions are based on learning theory and behaviour therapy. They take into account specific deficits in perception, emotional reactions, social interaction and communication. In Germany, these comprehensive models are not widely evaluated and implemented. Research questions What are the clinical effectiveness and safety of early behavioural or skills-based early interventions in autism compared to other interventions or to treatment as usual? What are specific factors responsible for the effectiveness? What are the cost-effectiveness and cost consequences of different early interventions in autism? Which legal, social and ethical aspects are relevant with regard to the implementation of the respective interventions in persons with autism? Methods Following a systematic review of the literature, controlled studies on early behavioural or skills-based interventions published since 2000 in English or German with children until the age of twelve are included and critically appraised. Studies must have at least ten participants per intervention group. Results In total, 15 publications based on 14 studies, eight systematic reviews and one health economic study are included. Most studies evaluate early interventions based upon the Lovaas model (Early intensive behavioural treatment (EIBT), Applied behavioural analysis (ABA)). Other evaluate pragmatic interventions or interventions based on other theoretical models like specific parent interventions, responsive education and prelinguistic milieu teaching, joint attention, symbolic play, and picture exchange

  17. Cumulative risk, cumulative outcome: a 20-year longitudinal study.

    Directory of Open Access Journals (Sweden)

    Leslie Atkinson

    Full Text Available Cumulative risk (CR models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO. We also predicted that early CR (assessed at age 5/6 explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20. The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a "mediated net of adversity" model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.

  18. Derived intervention levels in early stage of nuclear accident development

    Energy Technology Data Exchange (ETDEWEB)

    Vladar, M; Fojtik, M [Inst. of Preventive and Clinical Medicine, Bratislava (Slovakia); Stubna, M [Research Inst. of Nuclear Power Plants, Bohunuce (Slovakia)

    1996-12-31

    In this paper the measures for protection of health and property of public in the case of nuclear accident are discussed. They are based on optimal application of so called intervention levels. The actual flow of decision depends on: (1) prognosis of mathematical modelling of possible course of nuclear accident, and (2) results of monitoring of radiation situation.The aim of this contribution was to analyze their mutual cooperation and to suggest such procedure of monitoring or radiation situation which could be used for suggestion of protective measures. In this contribution the zones of protection planning in the accident place surrounding for the urgent measures were specified : (1) regulation of free movement of persons; (2) sheltering; (3) iodine prophylaxis; (4) temporary evacuation; (5) long term or permanent emigration. At the specification of zones of planned protection it is also coming out that regulation of movement of persons, sheltering and iodine prophylaxis were ordered in advance based on the evaluation of the crashed establishment state. In such situation the decision on protective measures in the time interval 6 to 12 hours after the beginning of accidental release is forwarding to: withdrawing the accepted orders on measures and transition from sheltering to temporary evacuation. The criterion for temporary evacuation is: (1) probability of exceeding the effective dose 100 mSv for children up to 10 years of age and pregnant women and 500 mSv for other population within 48 hours after beginning of accidental release; (2) probability of averting the effective dose 50 mSv up to 7 days, 100 mSv up to 15 days and 150 mSv up to 30 days for all population groups. In next part the intervention level, interpretation of values of kerma dose rate in air and determination of the size of planned protection zones are discussed. (J.K.) 3 tabs.

  19. Can Early Childhood Interventions Decrease Inequality of Economic Opportunity?

    Directory of Open Access Journals (Sweden)

    Katherine Magnuson

    2016-05-01

    Full Text Available This paper considers whether expanding access to center-based early childhood education (ECE will reduce economic inequality later in life. A strong evidence base indicates that ECE is effective at improving young children's academic skills and human capital development. We review evidence that children from low-income families have lower rates of preschool enrollment than their more affluent peers. Our analysis indicates that increasing enrollments for preschoolers in the year before school entry is likely to be a worthy investment that will yield economic payoffs in the form of increased adult earnings. The benefits of even a moderately effective ECE program are likely to be sufficient to offset the costs of program expansion, and increased enrollment among low-income children may reduce later economic inequality.

  20. Early intervention services of children with physical disabilities: complexity of child and family needs.

    Science.gov (United States)

    Ziviani, Jenny; Darlington, Yvonne; Feeney, Rachel; Rodger, Sylvia; Watter, Pauline

    2014-04-01

    To gain insight into the special issues confronting parents when accessing early intervention for children with physical disabilities where child and/or family characteristics indicate complex needs within the unique Australian context. Qualitative interviews with families receiving early intervention for their children with physical disabilities (N=10). Families with complex circumstances such as having children with high support needs, those from culturally and linguistically diverse backgrounds, and single-parent families were recruited to the study. Families where parents had mental or health issues, parents/other family members had an identified disability, and/or where families lived in regional or rural locations were also purposively sampled. Participants highlighted issues around (i) the nature of early intervention services provided; (ii) the ways in which services were structured; and (ii) managing their child's needs/planning into the future. Parents stressed the importance of having access to a variety of early intervention services aside from therapy. They also emphasised the need for greater clarity about what to expect from services, the intensity of therapy, other services they could access and how long they would be able to receive these. Despite their complex circumstances and needs, participants' experiences of accessing early intervention services were largely consistent with the broader research literature. Of the parents interviewed, those with health problems and single mothers expressed most apprehension about managing their child's needs and planning for the future. © 2013 Occupational Therapy Australia.

  1. Assessing Costs and Benefits of Early Childhood Intervention Programs. Overview and Application to the Starting Early Starting Smart Program. Executive Summary

    National Research Council Canada - National Science Library

    Karoly, Lynn

    2001-01-01

    Agency and program administrators and decisionmakers responsible for implementing early childhood intervention programs are becoming more interested in quantifying the costs and benefits of such programs...

  2. School Age Outcomes of Children with Autism Spectrum Disorder Who Received Community-Based Early Interventions.

    Science.gov (United States)

    Vinen, Zoe; Clark, Megan; Paynter, Jessica; Dissanayake, Cheryl

    2018-05-01

    This study followed children with Autism Spectrum Disorder (ASD) from early intervention into their early schooling years, when they were aged between 6 and 9 years, on autism symptom severity and cognitive functioning. The children, matched at pre-intervention, were compared on type of community provided service: 31 were in receipt of community-based group Early Start Denver Model and 28 had received other community provisions for ASD. Irrespective of groups, cognitive functioning was found to have significantly improved by school age compared to pre-intervention. Autism symptom severity increased during the same developmental period, seemingly driven by an increase in restricted and repetitive behaviours over time. In contrast, both groups displayed improved social affect by school age.

  3. Improving Early Identification and Intervention for Children at Risk for Autism Spectrum Disorder.

    Science.gov (United States)

    Rotholz, David A; Kinsman, Anne M; Lacy, Kathi K; Charles, Jane

    2017-02-01

    To provide an example of a successful, novel statewide effort to increase early identification of young children at risk for autism spectrum disorder (ASD) using a 2-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination. The South Carolina Act Early Team (SCAET) provided focused collaboration among leaders representing state agencies, universities, health care systems, private organizations, and families to improve quality of life for children with ASD. Specific focus was on implementing policy changes and training to result in earlier identification and home-based behavioral intervention for young children at risk for ASD. Policy changes, training, and modified state agency practices were accomplished. Presumptive eligibility, on the basis of a 2-tiered screening process was implemented by BabyNet (South Carolina's Early Intervention Program) in collaboration with the lead agency for developmental disability services. There was a fivefold increase in children eligible for early intensive behavioral intervention without waiting for a diagnosis of ASD, avoiding long waits for diagnostic evaluations. Only 16 children (2.5%) were later found not to have ASD from a comprehensive evaluation. Improvements in early identification and intervention are feasible through collaborative policy change. The South Carolina Act Early Team and its key stakeholders committed to improving outcomes for this population used existing tools and methods in new ways to improve early identification of children with ASD and to make available evidence-based intervention services. This example should be replicable in other states with key stakeholders working collaboratively for the benefit of young children with ASD. Copyright © 2017 by the American Academy of Pediatrics.

  4. A randomized controlled trial of two primary school intervention strategies to prevent early onset tobacco smoking.

    Science.gov (United States)

    Storr, Carla L; Ialongo, Nicholas S; Kellam, Sheppard G; Anthony, James C

    2002-03-01

    In this article, we examine the impact of two universal, grade 1 preventive interventions on the onset of tobacco smoking as assessed in early adolescence. The classroom-centered (CC) intervention was designed to reduce the risk for tobacco smoking by enhancing teachers' behavior management skills in first grade and, thereby, reducing child attention problems and aggressive and shy behavior-known risk behaviors for later substance use. The family-school partnership (FSP) intervention targeted these early risk behaviors via improvements in parent-teacher communication and parents' child behavior management strategies. A cohort of 678 urban, predominately African-American, public school students were randomly assigned to one of three Grade 1 classrooms at entrance to primary school (age 6). One classroom featured the CC intervention, a second the FSP intervention, and the third served as a control classroom. Six years later, 81% of the students completed audio computer-assisted self-interviews. Relative to controls, a modest attenuation in the risk of smoking initiation was found for students who had been assigned to either the CC or FSP intervention classrooms (26% versus 33%) (adjusted relative risk for CC/control contrast=0.57, 95% confidence interval (CI), 0.34-0.96; adjusted relative risk for FSP/control contrast=0.69, 95% CI, 0.50-0.97). Results lend support to targeting the early antecedent risk behaviors for tobacco smoking.

  5. Effects of early support intervention on workplace ergonomics--a two-year followup study.

    Science.gov (United States)

    Turja, Johanna; Kaleva, Simo; Kivistö, Marketta; Seitsamo, Jorma

    2012-01-01

    The purpose of the controlled longitudinal study was to determine the effect of a tailored early support intervention method on workers' workplace ergonomics. The main areas of the early support intervention were training, guidance and support for supervisors in finding weak signals of impaired ergonomics. Supervisors were also trained to bring up these weak signals in discussion with employees and to make necessary changes at the workplace. The data consisted of 301 intervention subjects and 235 control subjects working in the field of commerce. The questionnaires were carried out in 2008 and in 2010, and the response rates among both groups were 45%. We used multivariate repeated measures analysis of variance (MANOVA) to test the difference in the groups at two points of time. The main result was that in the areas of work environment, the interaction between group and time was statistically significant (p=0.0004). The work environment improved in the intervention group, but deteriorated in the control. Working methods improved due to the interventions, but physical load factors increased over time in both groups. According to the study, tailored early support intervention has a generally beneficial impact on workers' workplace ergonomics in the areas of work methods, work environment and accident factors.

  6. Early psychological intervention in accidentally injured children ages 2–16: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Didier N. Kramer

    2014-06-01

    Full Text Available Background: Road traffic accidents (RTA and burns are frequent events in children. Although many children recover spontaneously, a considerable number develop long-term psychological sequelae. Evidence on early psychological interventions to prevent such long-term problems is still scarce for school-age children and completely lacking for pre-school children. Objectives: To evaluate the efficacy of an early two-session cognitive-behavioral intervention in 108 children ages 2–16 after RTAs and burns. Methods: Children assessed at risk for the development of posttraumatic stress disorder (PTSD were randomly assigned to either a control group offered treatment as usual or an intervention group. Primary outcomes were PTSD, behavioral problems, and depression symptoms. Baseline and blinded 3- and 6-month follow-up assessments were conducted. Results: In pre-school children, no intervention effects were found. School-age children in the intervention group exhibited significantly fewer internalizing problems at 3-month follow-up relative to controls and a borderline significant time-by-group effect for PTSD intrusion symptoms was found (p=0.06. Conclusions: This is the first study examining the efficacy of an indicated, early psychological intervention among both school-age and pre-school-age children. Because the intervention was ineffective for young children, no evidence-based practice can currently be suggested. Given that parents of pre-school children perceived the intervention as helpful, brief counseling of parents in terms of psychoeducation and training in coping skills still should be provided by clinicians, despite the current lack of evidence. To prevent trauma-related disorders in school-age children, the intervention might be used in a step-wise manner, where only children at risk for long-term psychological maladjustment are provided with psychological support.

  7. Early childhood family intervention and long-term obesity prevention among high-risk minority youth.

    Science.gov (United States)

    Brotman, Laurie Miller; Dawson-McClure, Spring; Huang, Keng-Yen; Theise, Rachelle; Kamboukos, Dimitra; Wang, Jing; Petkova, Eva; Ogedegbe, Gbenga

    2012-03-01

    To test the hypothesis that family intervention to promote effective parenting in early childhood affects obesity in preadolescence. Participants were 186 minority youth at risk for behavior problems who enrolled in long-term follow-up studies after random assignment to family intervention or control condition at age 4. Follow-up Study 1 included 40 girls at familial risk for behavior problems; Follow-up Study 2 included 146 boys and girls at risk for behavior problems based on teacher ratings. Family intervention aimed to promote effective parenting and prevent behavior problems during early childhood; it did not focus on physical health. BMI and health behaviors were measured an average of 5 years after intervention in Study 1 and 3 years after intervention in Study 2. Youth randomized to intervention had significantly lower BMI at follow-up relative to controls (Study 1 P = .05; Study 2 P = .006). Clinical impact is evidenced by lower rates of obesity (BMI ≥95th percentile) among intervention girls and boys relative to controls (Study 2: 24% vs 54%, P = .002). There were significant intervention-control group differences on physical and sedentary activity, blood pressure, and diet. Two long-term follow-up studies of randomized trials show that relative to controls, youth at risk for behavior problems who received family intervention at age 4 had lower BMI and improved health behaviors as they approached adolescence. Efforts to promote effective parenting and prevent behavior problems early in life may contribute to the reduction of obesity and health disparities.

  8. Impacted Supernumerary Teeth–Early or Delayed Intervention: Decision Making Dilemma?

    OpenAIRE

    Gupta, Seema; Marwah, Nikhil

    2012-01-01

    Abstract Supernumerary teeth are considered to be one of the most significant dental anomalies affecting the primary and early mixed dentition and may cause a variety of pathological disturbances to the developing permanent dentition. Early diagnosis and prompt treatment is necessary for prevention of deleterious effects on dentoalveolar structures. However, the time of intervention is the most crucial factor governing the outcome of surgical management of hyperdontia. The aim of this case re...

  9. Divergent Cumulative Cultural Evolution

    OpenAIRE

    Marriott, Chris; Chebib, Jobran

    2016-01-01

    Divergent cumulative cultural evolution occurs when the cultural evolutionary trajectory diverges from the biological evolutionary trajectory. We consider the conditions under which divergent cumulative cultural evolution can occur. We hypothesize that two conditions are necessary. First that genetic and cultural information are stored separately in the agent. Second cultural information must be transferred horizontally between agents of different generations. We implement a model with these ...

  10. Clinical abnormalities, early intervention program of Down syndrome children: Queen Sirikit National Institute of Child Health experience.

    Science.gov (United States)

    Fuengfoo, Adidsuda; Sakulnoom, Kim

    2014-06-01

    Queen Sirikit National Institute of Child Health is a tertiary institute of children in Thailand, where early intervention programs have been provided since 1990 by multidisciplinary approach especially in Down syndrome children. This aim of the present study is to follow the impact of early intervention on the outcome of Down syndrome children. The school attendance number of Down syndrome children was compared between regular early intervention and non-regular early intervention. The present study group consists of 210 Down syndrome children who attended early intervention programs at Queen Sirikit National Institute of Child Health between June 2008 and January 2012. Data include clinical features, school attendance developmental quotient (DQ) at 3 years of age using Capute Scales Cognitive Adaptive Test/Scale (CAT/CLAMS). Developmental milestones have been recorded as to the time of appearance of gross motor, fine motor, language, personal-social development compared to those non-regular intervention patients. Of 210 Down syndrome children, 117 were boys and 93 were girls. About 87% received regular intervention, 68% attended speech training. Mean DQ at 3 years of age was 65. Of the 184 children who still did follow-up at developmental department, 124 children (59%) attended school: mainstream school children 78 (63%) and special school children 46 (37%). The mean age at entrance to school was 5.8 ± 1.4 years. The school attendance was correlated with maternal education and regular early intervention attendance. Regular early intervention starts have proven to have a positive effect on development. The school attendance number of Down syndrome children receiving regular early intervention was statistically and significantly higher than the number of Down syndrome children receiving non-regular early intervention was. School attendance correlated with maternal education and attended regularly early intervention. Regular early intervention together with maternal

  11. Early-Life Obesity Prevention: Critique of Intervention Trials During the First One Thousand Days.

    Science.gov (United States)

    Reilly, John J; Martin, Anne; Hughes, Adrienne R

    2017-06-01

    To critique the evidence from recent and ongoing obesity prevention interventions in the first 1000 days in order to identify evidence gaps and weaknesses, and to make suggestions for more informative future intervention trials. Completed and ongoing intervention trials have had fairly modest effects, have been limited largely to high-income countries, and have used relatively short-term interventions and outcomes. Comparison of the evidence from completed prevention trials with the evidence from systematic reviews of behavioral risk factors shows that some life-course stages have been neglected (pre-conception and toddlerhood), and that interventions have neglected to target some important behavioral risk factors (maternal smoking during pregnancy, infant and child sleep). Finally, while obesity prevention interventions aim to modify body composition, few intervention trials have used body composition measures as outcomes, and this has limited their sensitivity to detect intervention effects. The new WHO Healthy Lifestyles Trajectory (HeLTI) initiative should address some of these weaknesses. Future early obesity prevention trials should be much more ambitious. They should, ideally: extend their interventions over the first 1000 days; have longer-term (childhood) outcomes, and improved outcome measures (body composition measures in addition to proxies for body composition such as the BMI for age); have greater emphasis on maternal smoking and child sleep; be global.

  12. A systematic review of early intensive intervention for autism spectrum disorders.

    Science.gov (United States)

    Warren, Zachary; McPheeters, Melissa L; Sathe, Nila; Foss-Feig, Jennifer H; Glasser, Allison; Veenstra-Vanderweele, Jeremy

    2011-05-01

    Early intensive behavioral and developmental interventions for young children with autism spectrum disorders (ASDs) may enhance developmental outcomes. To systematically review evidence regarding such interventions for children aged 12 and younger with ASDs. We searched Medline, PsycINFO, and ERIC (Education Resources Information Center) from 2000 to May 2010. Two reviewers independently assessed studies against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of-evidence ratings using predetermined criteria. Thirty-four unique studies met inclusion criteria. Seventeen studies were case series; 2 were randomized controlled trials. We rated 1 study as good quality, 10 as fair quality, and 23 as poor quality. The strength of the evidence overall ranged from insufficient to low. Studies of University of California Los Angeles/Lovaas-based interventions and variants reported clinically significant gains in language and cognitive skills in some children, as did 1 randomized controlled trial of an early intensive developmental intervention approach (the Early Start Denver Model). Specific parent-training approaches yielded gains in short-term language function and some challenging behaviors. Data suggest that subgroups of children displayed more prominent gains across studies, but participant characteristics associated with greater gains are not well understood. Studies of Lovaas-based approaches and early intensive behavioral intervention variants and the Early Start Denver Model resulted in some improvements in cognitive performance, language skills, and adaptive behavior skills in some young children with ASDs, although the literature is limited by methodologic concerns.

  13. Three year follow-up of an early childhood intervention: is movement skill sustained?

    Directory of Open Access Journals (Sweden)

    Zask Avigdor

    2012-10-01

    Full Text Available Abstract Background Movement skill competence (e.g. the ability to throw, run and kick is a potentially important physical activity determinant. However, little is known about the long-term impact of interventions to improve movement skills in early childhood. This study aimed to determine whether intervention preschool children were still more skill proficient than controls three years after a 10 month movement skill focused intervention: ‘Tooty Fruity Vegie in Preschools’. Methods Children from 18 intervention and 13 control preschools in NSW, Australia were assessed at ages four (Time1, five (T2 and eight years (T3 for locomotor (run, gallop, hop, leap, horizontal jump, slide and object control proficiency (strike, bounce, catch, kick, overhand throw, underhand roll using the Test of Gross Motor Development-2. Multi-level object control and locomotor regression models were fitted with variables time, intervention (yes/no and a time*intervention interaction. Both models added sex of child and retained if significant, in which case interactions of sex of child with other variables were modelled and retained. SPSS (Version 17.0 was used. Results Overall follow-up rate was 29% (163/560. Of the 137 students used in the regression models, 53% were female (n = 73. Intervention girls maintained their object control skill advantage in comparison to controls at T3 (p = .002, but intervention boys did not (p = .591. At T3, there were no longer intervention/control differences in locomotor skill (p = .801. Conclusion Early childhood settings should implement movement skill interventions and more intensively target girls and object control skills.

  14. Three year follow-up of an early childhood intervention: is movement skill sustained?

    Science.gov (United States)

    Zask, Avigdor; Barnett, Lisa M; Rose, Lauren; Brooks, Lyndon O; Molyneux, Maxine; Hughes, Denise; Adams, Jillian; Salmon, Jo

    2012-10-22

    Movement skill competence (e.g. the ability to throw, run and kick) is a potentially important physical activity determinant. However, little is known about the long-term impact of interventions to improve movement skills in early childhood. This study aimed to determine whether intervention preschool children were still more skill proficient than controls three years after a 10 month movement skill focused intervention: 'Tooty Fruity Vegie in Preschools'. Children from 18 intervention and 13 control preschools in NSW, Australia were assessed at ages four (Time1), five (T2) and eight years (T3) for locomotor (run, gallop, hop, leap, horizontal jump, slide) and object control proficiency (strike, bounce, catch, kick, overhand throw, underhand roll) using the Test of Gross Motor Development-2. Multi-level object control and locomotor regression models were fitted with variables time, intervention (yes/no) and a time*intervention interaction. Both models added sex of child and retained if significant, in which case interactions of sex of child with other variables were modelled and retained. SPSS (Version 17.0) was used. Overall follow-up rate was 29% (163/560). Of the 137 students used in the regression models, 53% were female (n = 73). Intervention girls maintained their object control skill advantage in comparison to controls at T3 (p = .002), but intervention boys did not (p = .591). At T3, there were no longer intervention/control differences in locomotor skill (p = .801). Early childhood settings should implement movement skill interventions and more intensively target girls and object control skills.

  15. Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi.

    Science.gov (United States)

    Pitchford, Nicola J

    2015-01-01

    Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-weeks period, for the equivalent of 30-min per day. Technical support was provided from the local Voluntary Service Overseas (VSO). Children were then post-tested on the same assessments as given at pre-test. A final sample of 283 children, from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standards 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child's developmental

  16. Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi

    Directory of Open Access Journals (Sweden)

    Nicola ePitchford

    2015-04-01

    Full Text Available Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-week period, for the equivalent of 30-minutes per day. Technical support was provided from the local Voluntary Service Overseas. Children were then post-tested on the same assessments as given at pre-test.A final sample of 283 children from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standard 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child

  17. Birth-Related Posttraumatic Stress Disorder: Implications for Early Intervention Services

    Science.gov (United States)

    Pizur-Barnekow, Kris; Doering, Jennifer J.; Willett, Marjorie; Ruminski, Christine; Spring, Molly

    2014-01-01

    The positive impact of healthy relationships on child development is widely accepted. A healthy relationship between mother and child is at risk when a mother experiences symptoms of birth-related posttraumatic stress disorder (PTSD). Mothers of children with special needs are at high risk for this disorder and early intervention (EI)…

  18. Career Pathways for Related Service Paratherapists Working in Early Intervention and Other Education Settings.

    Science.gov (United States)

    Longhurst, Thomas M.

    1997-01-01

    Discusses issues in personnel training practices for paraprofessionals providing related services in early intervention and education settings. The term paratherapist is used to refer to paraprofessionals working under the supervision of professionals in physical therapy, occupational therapy, and speech-language pathology. Presents a philosophy…

  19. Conceptualizing Child and Family Outcomes of Early Intervention Services for Children with ASD and Their Families

    Science.gov (United States)

    Noyes-Grosser, Donna M.; Rosas, Scott R.; Goldman, Alyssa; Elbaum, Batya; Romanczyk, Ray; Callahan, Emily H.

    2013-01-01

    State early intervention programs (EIPs) have been encouraged to develop and implement comprehensive outcomes measurement systems. As the number of children with autism spectrum disorders (ASD) and their families receiving services in state EIPs increases, disability-specific outcomes data are needed to better understand issues of access, costs,…

  20. Omid Early Intervention Resource Kit for Children with Autism Spectrum Disorders and Their Families

    Science.gov (United States)

    Samadi, Sayyed Ali; Mahmoodizadeh, Ameneh

    2014-01-01

    Omid early intervention resource kit containing information booklets on autism spectrum disorders (ASD) and related issues, five packs of tangible selected playthings and communication facilitating aids was developed and evaluated with 65 Iranian parents. Beside a pretest before the resource kit deliverance, parents in the control group took part…

  1. Early Intervention Experiences of Families of Children with an Autism Spectrum Disorder: A Qualitative Pilot Study

    Science.gov (United States)

    Grygas Coogle, Christan; Guerette, Amy R.; Hanline, Mary Frances

    2013-01-01

    The purpose of this study was to obtain an understanding of the unique experiences of families who have a young child at risk for or identified with an autism spectrum disorder and their experiences with early intervention. Thirty-nine parents of children with or at risk for an autism spectrum disorder receiving Part C services in a state in the…

  2. Occupational Therapy Contributions in Early Intervention: Implications for Personnel Preparation and Interprofessional Practice

    Science.gov (United States)

    Muhlenhaupt, Mary; Pizur-Barnekow, Kris; Schefkind, Sandra; Chandler, Barbara; Harvison, Neil

    2015-01-01

    Occupational therapy provides a unique contribution in early intervention programs for families and their children from birth to 3 years old who are at risk for, or who have, identified disabilities. This article describes occupational therapy's distinct value and presents the profession's perspective on services to enhance families' caregiving…

  3. Battlemind Debriefing and Battlemind Training as Early Interventions with Soldiers Returning from Iraq: Randomization by Platoon

    Science.gov (United States)

    Adler, Amy B.; Bliese, Paul D.; McGurk, Dennis; Hoge, Charles W.; Castro, Carl Andrew

    2009-01-01

    Researchers have found that there is an increase in mental heath problems as a result of military-related traumatic events, and such problems increase in the months following return from combat. Nevertheless, researchers have not assessed the impact of early intervention efforts with this at-risk population. In the present study, the authors…

  4. Early Behavioral Intervention Is Associated with Normalized Brain Activity in Young Children with Autism

    Science.gov (United States)

    Dawson, Geraldine; Jones, Emily J. H.; Merkle, Kristen; Venema, Kaitlin; Lowy, Rachel; Faja, Susan; Kamara, Dana; Murias, Michael; Greenson, Jessica; Winter, Jamie; Smith, Milani; Rogers, Sally J.; Webb, Sara J.

    2012-01-01

    Objective: A previously published randomized clinical trial indicated that a developmental behavioral intervention, the Early Start Denver Model (ESDM), resulted in gains in IQ, language, and adaptive behavior of children with autism spectrum disorder. This report describes a secondary outcome measurement from this trial, EEG activity. Method:…

  5. Dyslexia and early intervention: what did we learn from the Dutch Dyslexia Programme?

    NARCIS (Netherlands)

    van der Leij, A.

    2013-01-01

    Part of the Dutch Dyslexia Programme has been dedicated to early intervention. The question of whether the genetically affected learning mechanism of children who are at familial risk (FR) of developing dyslexia could be influenced by training phoneme awareness and letter-sound associations in the

  6. Accuracy of Knowledge of Child Development in Mothers of Children Receiving Early Intervention Services

    Science.gov (United States)

    Zand, Debra H.; Pierce, Katherine J.; Bultas, Margaret W.; McMillin, Stephen Edward; Gott, Rolanda Maxim; Wilmott, Jennifer

    2015-01-01

    Parents' involvement in early intervention (EI) services fosters positive developmental trajectories in young children. Although EI research on parenting skills has been abundant, fewer data are available on parents' knowledge of normative child development. Sixty-seven mothers of children participating in a Midwestern city's EI program completed…

  7. A Study of Early Fine Motor Intervention in Down's Syndrome Children

    Science.gov (United States)

    Aparicio, Teresa Sanz; Balana, Javier Menendez

    2009-01-01

    The marked delay in acquisition of fine motor skills in trisomic-21/Down's syndrome children is undeniable. In this study, we began with an affirmation that the cause of this deficit could be found in a different environment for which early intervention is essential. A sample of 30 Down's syndrome children was used to study at different ages: six…

  8. Knowledge Translation: Supports, Challenges, and Opportunities for Change in Early Intervention

    Science.gov (United States)

    Rabinowicz, Susan; Ray, Sharon

    2018-01-01

    Knowledge translation (KT) provides a lens to examine the process of moving research-informed knowledge into early intervention practice (P. Sudsawad, 2007). The process of KT entails cognitive, affective, and behavioral stages that are mediated by factors intrinsic and extrinsic to the practitioner. Facilitators and barriers to this process may…

  9. Obesity Prevention Interventions in Early Childhood Education and Care Settings with Parental Involvement: A Systematic Review

    Science.gov (United States)

    Morris, Heather; Skouteris, Helen; Edwards, Susan; Rutherford, Leonie

    2015-01-01

    Partnering early childhood education and care (ECEC) and the home together may be more effective in combating obesogenic risk factors in preschool children. Thus, an evaluation of ECEC obesity prevention interventions with a parental component was conducted, exploring parental engagement and its effect on obesity and healthy lifestyle outcomes. A…

  10. Family Quality of Life for Families in Early Intervention in Spain

    Science.gov (United States)

    Mas, Joana M.; Baqués, Natasha; Balcells-Balcells, Anna; Dalmau, Mariona; Giné, Climent; Gràcia, Marta; Vilaseca, Rosa

    2016-01-01

    Early intervention (EI) has been shown to be an essential resource for meeting the needs and priorities of children with intellectual and developmental disability and their families. The objective of this study was to examine (a) the perceived quality of life of families attending EI centers in Spain and (b) its relationship with characteristics…

  11. Family Quality of Life: A Key Outcome in Early Childhood Intervention Services--A Scoping Review

    Science.gov (United States)

    Bhopti, Anoo; Brown, Ted; Lentin, Primrose

    2016-01-01

    A scoping review was conducted to identify factors influencing the quality of life of families of children with disability. The review also explored the scales used to measure family quality of life (FQOL) as an outcome in early childhood intervention services (ECIS). Multiple databases were searched from 2000 to 2013 to include studies pertinent…

  12. First Consensus on Primary Prevention and Early Intervention in Aesthetic Medicine.

    Science.gov (United States)

    Landau, Marina; Anand, Chytra V; Besins, Thierry; Chao, Yates Yen Yu; Fabi, Sabrina Guillen; Gout, Uliana; Kerscher, Martina; Pavicic, Tatjana; Peng, Peter Hsien Li; Rzany, Berthold; Sattler, Gerhard; Tiryaki, Tunk; Waldorf, Heidi A; Braz, Andre

    2017-09-01

    Facial aging is a complex interplay of extrinsic and intrinsic factors leading to progressive changes in the skin, subcutaneous tissue, and bone. Clinical experience suggests that early aesthetic intervention may slow the signs of aging, but treatment in the absence of symptoms or with minimal signs of aging has not yet been properly addressed. To provide treatment recommendations for primary prevention and early intervention in individuals with no or minimal signs of aging. Fourteen specialists in aesthetic medicine convened over a full-day meeting under the guidance of a certified moderator. Tailored treatment recommendations have been provided for prevention and early intervention of fine wrinkles, static lines and folds, irregular pigmentation, laxity, and subcutaneous volume loss by protecting the epidermis, stimulating neocollagenesis, reducing hyperkinetic musculature, and reinforcing supporting structures. Preventive measures and early therapeutic interventions that may alter the course of facial aging were defined. Further studies are needed to support these recommendations with the best possible evidence. J Drugs Dermatol. 2017;16(9):846-854..

  13. Caregiver Coaching Strategies for Early Intervention Providers: Moving toward Operational Definitions

    Science.gov (United States)

    Friedman, Mollie; Woods, Juliann; Salisbury, Christine

    2012-01-01

    Early intervention (EI) providers increasingly coach and collaborate with caregivers to strengthen and support caregiver-child interactions. The EI providers learning to coach other adults benefit from knowing what, exactly, they should do to support caregivers. This article serves two purposes. First, it proposes an operationally defined,…

  14. Staff supported parental involvement in effective early interventions for at-risk children

    DEFF Research Database (Denmark)

    Larsen, Michael Søgaard; Holm, Anders; Jensen, Bente

    The article presents a review of international research on the effect of early interventions with parental involvement. Ten international and national databases were searched. Hits were supplemented with references from the review group. The search process found 1933 unique references, which were...

  15. Child/Youth Homelessness: housing affordability, early intervention, and preventive care in Australia

    OpenAIRE

    Shiga, Fumiya

    2009-01-01

    The purpose of this paper is to explore the child/youth homelessness including its preventive care.This paper explores the housing support program implemented across Australia in brief at first, and then profile child/youth homelessness and housing policy. Based on that, it discusses early intervention and preventive methods followed by the conclusion.

  16. Early Intervention for Children with Hearing Loss: Information Parents Receive about Supporting Children's Language

    Science.gov (United States)

    Decker, Kalli B.; Vallotton, Claire D.

    2016-01-01

    Family-centered early intervention for children with hearing loss is intended to strengthen families' interactions with their children to support children's language development, and should include providing parents with information they can use as part of their everyday routines. However, little is known about the information received by families…

  17. Current Provision, Recent Developments, and Future Directions for Early Childhood Intervention in Singapore

    Science.gov (United States)

    Poon, Kenneth K.; Lim, Ai-Keow

    2012-01-01

    Singapore is a young island nation with a diverse population. Its support for young children at risk has its roots in the 1950s, but early childhood intervention (ECI) programs for young children with disabilities emerged only in the 1980s. ECI programs have proliferated in the subsequent years, offering an increasing range of service delivery…

  18. Developmental Phenotypes and Causal Pathways in Attention Deficit/Hyperactivity Disorder: Potential Targets for Early Intervention?

    Science.gov (United States)

    Sonuga-Barke, Edmund J. S.; Halperin, Jeffrey M.

    2010-01-01

    Early intervention approaches have rarely been implemented for the prevention of attention deficit/hyperactivity disorder (ADHD). In this paper we explore whether such an approach may represent an important new direction for therapeutic innovation. We propose that such an approach is most likely to be of value when grounded in and informed by…

  19. Parenting Interventions in Early Head Start: The Buffering Toxic Stress Consortium

    Science.gov (United States)

    Berlin, Lisa; Blair, Clancy; Boyd, Misty L.; Constantino, John N.; Hallam, Rena A.; Han, Myae; Hustedt, Jason; Harden, Brenda Jones; Raver, C. Cybele; Sarche, Michelle; Vu, Jennifer A.; Watamura, Sarah Enos; Meyer, Aleta; Fortunato, Christine

    2013-01-01

    The Buffering Toxic Stress Consortium was created by the Office of Planning, Research and Evaluation within the Administration for Children and Families to test preventive interventions for Early Head Start families facing toxic stress, as conceptualized by Shonkoff, Boyce, and McEwen in their influential 2009 article. Because relationships…

  20. The Emergence of Early Intervention for Children with Hearing Loss in China

    Science.gov (United States)

    Shenglin, Liu; Raver, Sharon A.

    2011-01-01

    In the last decade, China began developing early intervention services for very young children with hearing loss, and their families. This article presents a broad description of some of these programs, including the national rehabilitation networks for speech and hearing training, increased attention on the development of professionals, the…

  1. Early Childhood Education Intervention Programs in the Netherlands: Still Searching for Empirical Evidence

    Science.gov (United States)

    Driessen, Geert

    2018-01-01

    Early childhood education (ECE) intervention programs nowadays are the core of the educational disadvantage policy in the Netherlands. They offer institutional compensatory activities to young children who lack educational stimulation in the home environment. Target groups mainly comprise children from deprived socioeconomic backgrounds and of…

  2. Nuestras Voces: (Our Voices): A Phenomenological Study of Latino Parents' Perceptions of Early Intervention

    Science.gov (United States)

    Murphy, Kathleen Mary

    2013-01-01

    There is a rise in the Latino population, a growing need to close the achievement gap, and yet there exists a paucity of research on Latino infant and child development. This phenomenological study of Latino parents explores the thoughts and feelings of a representative sample of parents pertaining to the early intervention services that their…

  3. School Rampage Shootings and Other Youth Disturbances: Early Preventative Interventions. Psychosocial Stress Series

    Science.gov (United States)

    Nader, Kathleen, Ed.

    2012-01-01

    Together, "School Rampage Shootings and Other Youth Disturbances" and its accompanying CD provide a complete toolkit for using early preventative interventions with elementary-school age children. In ten thoughtful, clearly written chapters, both new and experienced practitioners will find a wealth of research- and evidence-based…

  4. Medical Complications of the Critically Ill Newborn: A Review for Early Intervention Professionals.

    Science.gov (United States)

    McNab, Theresa C.; Blackman, James A.

    1998-01-01

    Provides early-intervention professionals with a basic familiarity and understanding of some of the newest technologies employed in the neonatal intensive care units for neonates with respiratory distress syndrome, persistent fetal circulation, retinopathy of prematurity, intraventricular hemorrhage, and periventricular leukomalacia. Early…

  5. 75 FR 3746 - Ryan White HIV/AIDS Part C Early Intervention Services (EIS) Program

    Science.gov (United States)

    2010-01-22

    ... HIV/AIDS Part C Early Intervention Services (EIS) Program AGENCY: Health Resources and Services...: Critical funding for HIV/AIDS care and treatment to the target populations in Orange County, Orlando..., 2010). The Orange County Health Department is known Statewide as an exceptional site for HIV/AIDS care...

  6. An Intervention Including an Online Game to Improve Grade 6 Students' Performance in Early Algebra

    Science.gov (United States)

    Kolovou, Angeliki; van den Heuvel-Panhuizen, Marja; Koller, Olaf

    2013-01-01

    This study investigated whether an intervention including an online game contributed to 236 Grade 6 students' performance in early algebra, that is, solving problems with covarying quantities. An exploratory quasi-experimental study was conducted with a pretest-posttest-control-group design. Students in the experimental group were asked to solve…

  7. Early language intervention for children with intellectual disabilities: A neurocognitive perspective

    NARCIS (Netherlands)

    Schuit, M. van der; Segers, P.C.J.; Balkom, L.J.M. van; Verhoeven, L.T.W.

    2011-01-01

    For children with intellectual disabilities (ID), stimulation of their language and communication is often not a priority. Advancements in brain research provide guidelines for early interventions aimed at the stimulation of language and communication skills. In the present study, the effectiveness

  8. Early identification and intervention in children at risk for reading difficulties

    NARCIS (Netherlands)

    Regtvoort, A.G.F.M.

    2014-01-01

    In pre-readers, a familial background of dyslexia and/or delayed emergent literacy should be considered a not-to-ignore risk signalling problems with learning to read. This thesis aims to study early identification and intervention in at-risk children shortly before or after the start of formal

  9. Essential elements of an early intervention service for psychosis: the opinions of expert clinicians

    Directory of Open Access Journals (Sweden)

    Lewis Shôn

    2004-07-01

    Full Text Available Abstract Background Early intervention teams attempt to improve outcome in schizophrenia through earlier detection and the provision of phase-specific treatments. Whilst the number of early intervention teams is growing, there is a lack of clarity over their essential structural and functional elements. Methods A 'Delphi' exercise was carried out to identify how far there was consensus on the essential elements of early intervention teams in a group of 21 UK expert clinicians. Using published guidelines, an initial list was constructed containing 151 elements from ten categories of team structure and function. Results Overall there was expert consensus on the importance of 136 (90% of these elements. Of the items on which there was consensus, 106 (70.2% were rated essential, meaning that in their absence the functioning of the team would be severely impaired. Conclusion This degree of consensus over essential elements suggests that it is reasonable to define a model for UK early intervention teams, from which a measure of fidelity could be derived.

  10. Contributions to clinical Occupational Therapy in the area of early intervention in interdisciplinary team

    Directory of Open Access Journals (Sweden)

    Dani Laura Peruzzolo

    2015-07-01

    Full Text Available Introduction: Specialized care for infants considers that the sooner the intervention in risk and symptoms occurs, the greater the possibility of obtaining better results. Aims: To describe the process of early intervention provided by an extension program of graduate studies in Occupational Therapy and Hearing, Speech and Languages Science courses and also discuss the theoretical and practical paths in the care for infants and in the Occupational Therapy area. Method: Case report with convenience sample. The study was carried out through an assessment interpreted in light of psychomotor, occupational therapeutic, and speech, hearing and language contributions. The intervention was under the responsibility of an occupational therapist supported by an interdisciplinary team. It occurred once a week from August 2011 to January 2012 and from March 2012 to July 2012. Data analysis was carried out by comparing the entry assessment test and the final assessment test. Results: The boy had not developed concepts of body schema and body image that could sustain his relationship with objects, space and other persons. He presented little linguistic evolution. Considering the contributions of occupational therapy in psychomotor clinic, the boy reconstructed his family place in early intervention. The possibility of language functioning connected to the boy’s demands allowed access to symbolism. Conclusion: The proposal of early occupational therapy intervention with a single therapist supported by an interdisciplinary team was able to overcome the structural and instrumental obstacles to the boy’s development.

  11. The importance of context in early autism intervention: A qualitative South African study.

    Science.gov (United States)

    Guler, Jessy; de Vries, Petrus J; Seris, Noleen; Shabalala, Nokuthula; Franz, Lauren

    2017-09-01

    The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.

  12. Informing early intervention: preschool predictors of anxiety disorders in middle childhood.

    Directory of Open Access Journals (Sweden)

    Jennifer L Hudson

    Full Text Available BACKGROUND: To inform early intervention practice, the present research examines how child anxiety, behavioural inhibition, maternal overinvolvement, maternal negativity, mother-child attachment and maternal anxiety, as assessed at age four, predict anxiety at age nine. METHOD: 202 children (102 behaviourally inhibited and 100 behaviourally uninhibited aged 3-4 years were initially recruited and the predictors outlined above were assessed. Diagnostic assessments, using the Anxiety Disorders Interview Schedule, were then conducted five years later. RESULTS: Behavioural inhibition, maternal anxiety, and maternal overinvolvement were significant predictors of clinical anxiety, even after controlling for baseline anxiety (p.1. CONCLUSIONS: Preschool children who show anxiety, are inhibited, have overinvolved mothers and mothers with anxiety disorders are at increased risk for anxiety in middle childhood. These factors can be used to identify suitable participants for early intervention and can be targeted within intervention programs.

  13. Early intervention for vulnerable infants and their families: an emerging agenda.

    Science.gov (United States)

    Kruskal, M O; Thomasgard, M C; Shonkoff, J P

    1989-12-01

    Early childhood development is a complex dynamic process that begins at birth and unfolds in a transactional manner as infants interact with their environment. Children are highly adaptive organisms with powerful homeostatic mechanisms; consequently, most high-risk infants do well. Environmental factors are powerful mediators in this process, and a supportive and responsive environment may alleviate many early developmental insults, while a deficient environment can exacerbate developmental weaknesses. Available data suggest that appropriately designed early intervention services can be effective in facilitating both child and family adaptation for a variety of target groups. However, many important questions remain unanswered. For example, although interventions have been shown to improve cognitive function, effects in other important areas such as social and emotional functioning and family coping have not been well studied. Information about the impact of family variables is also incomplete as is our knowledge about which services work best for which children and families. Finally, the influence of protective factors in the child and in the environment requires further exploration. The perinatologist can make several critical contributions to the comprehensive care of high risk infants beyond their medical management. He or she can play a pivotal role in identifying those neonates who need early intervention on the basis of their biologic vulnerability, their environmental risk factors, or both. Perinatologists are also in the best position to facilitate early entry into an appropriate service system and can be important collaborators in providing comprehensive services and long-term follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Promoting language and social communication development in babies through an early storybook reading intervention.

    Science.gov (United States)

    Brown, Michelle I; Westerveld, Marleen F; Trembath, David; Gillon, Gail T

    2017-12-15

    This study examined the effectiveness of low- and high-intensity early storybook reading (ESR) intervention workshops delivered to parents for promoting their babies language and social communication development. These workshops educated parents on how to provide a stimulating home reading environment and engage in parent-child interactions during ESR. Parent-child dyads (n = 32); child age: 3-12 months, were assigned into two intervention conditions: low and high intensity (LI versus HI) groups. Both groups received the same ESR strategies; however, the HI group received additional intervention time, demonstrations and support. Outcome measures were assessed pre-intervention, one and three months post-intervention and when the child turned 2 years of age. A significant time-group interaction with increased performance in the HI group was observed for language scores immediately post-intervention (p = 0.007) and at 2-years-of-age (p = 0.022). Significantly higher broader social communication scores were associated with the HI group at each of the time points (p = 0.018, p = 0.001 and p = 0.021, respectively). Simple main effect revealed that both groups demonstrated a significant improvement in language, broader social communication and home reading practices scores. ESR intervention workshops may promote language and broader social communication skills. The HI ESR intervention workshop was associated with significantly higher language and broader social communication scores.

  15. The uses of outcome measures within multidisciplinary early childhood intervention services: a systematic review.

    Science.gov (United States)

    Calder, Samuel; Ward, Roslyn; Jones, Megan; Johnston, Jenelle; Claessen, Mary

    2017-07-18

    Purpose of the article: To review the use of outcome measures, across the domains of activity, participation, and environment, within multidisciplinary early childhood intervention services. A systematic literature search was undertaken that included four electronic databases: Medline, CINAHL, EMBASE, and the Cochrane Library and Cochrane Database of Systematic Review. Inclusion criteria were age 0-24 months, having or at risk of a developmental disability, in receipt of multidisciplinary early childhood intervention services, and included outcome measures across all domains of the International Classification of Functioning-Child & Youth (ICF-CY). Only peer-reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale for randomised controlled trials and the QualSyst for non-randomised control trials. Of the total of 5764 records identified, 10 were considered to meet inclusion criteria. Fourteen outcome measures were identified, addressing the domains of activity, participation, and environment. Of these, eight have been recommended in the early intervention literature. While the methodological quality of the 10 studies varied, these papers make a contribution to the body of research that acknowledges the role of routine and enriched environments. Implications for Rehabilitation Core practice elements of multidisciplinary early childhood intervention services indicate it is necessary to select outcome measures framed within the International Classification of Functioning-Child & Youth to inform clinical decision-making for measuring intervention effectiveness across the domains of activity, participation and environment. Of the identified measures, three (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory, and Goal Attainment Scaling) are well-established and identified in the literature as

  16. Paediatric Early Warning Score - A multi-center randomized controlled intervention study

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Aagaard, Hanne; Olesen, Hanne Vebert

    Paediatric Early Warning System on evolving critical illness and intervention in hospitalised children; a regional multicentre study on implementation of a Paediatric Early Warning System Background: Critical illness in the patient and death can potentially be predicted and prevented. Deterioration...... is critically ill are related to the child’s symptoms of serious illness often being uncharacteristic. Children can seem relatively unaffected until a short time before circulatory insufficiency and cardiac arrest. Thus, there is a need for developing and investigating if an Paediatric Early Warning System...... of the intervention and evaluation. The study involves all paediatric departments and some acute departments in Central Denmark Region. The project both includes quantitative studies and a qualitative evaluation study. The studies will have different designs: • Registry study - exploring and describing life...

  17. Early intervention

    African Journals Online (AJOL)

    Mental Health, Department of Psychology, Stellenbosch University. Catherine Ward is with ... engage in violent behaviour, rape and intimate partner violence during later ... This evidence suggests that primary prevention initiatives for violence ...

  18. Community-based interventions to optimize early childhood development in low resource settings.

    Science.gov (United States)

    Maulik, P K; Darmstadt, G L

    2009-08-01

    Interventions targeting the early childhood period (0 to 3 years) help to improve neuro-cognitive functioning throughout life. Some of the more low cost, low resource-intensive community practices for this age-group are play, reading, music and tactile stimulation. This research was conducted to summarize the evidence regarding the effectiveness of such strategies on child development, with particular focus on techniques that may be transferable to developing countries and to children at risk of developing secondary impairments. PubMed, PsycInfo, Embase, ERIC, CINAHL and Cochrane were searched for studies involving the above strategies for early intervention. Reference lists of these studies were scanned and other studies were incorporated based on snow-balling. Overall, 76 articles corresponding to 53 studies, 24 of which were randomized controlled trials, were identified. Sixteen of those studies were from low- and middle-income countries. Play and reading were the two commonest interventions and showed positive impact on intellectual development of the child. Music was evaluated primarily in intensive care settings. Kangaroo Mother Care, and to a lesser extent massage, also showed beneficial effects. Improvement in parent-child interaction was common to all the interventions. Play and reading were effective interventions for early childhood interventions in low- and middle-income countries. More research is needed to judge the effectiveness of music. Kangaroo Mother Care is effective for low birth weight babies in resource poor settings, but further research is needed in community settings. Massage is useful, but needs more rigorous research prior to being advocated for community-level interventions.

  19. Promoting Early Child Development With Interventions in Health and Nutrition: A Systematic Review.

    Science.gov (United States)

    Vaivada, Tyler; Gaffey, Michelle F; Bhutta, Zulfiqar A

    2017-08-01

    Although effective health and nutrition interventions for reducing child mortality and morbidity exist, direct evidence of effects on cognitive, motor, and psychosocial development is lacking. To review existing evidence for health and nutrition interventions affecting direct measures of (and pathways to) early child development. Reviews and recent overviews of interventions across the continuum of care and component studies. We selected systematic reviews detailing the effectiveness of health or nutrition interventions that have plausible links to child development and/or contain direct measures of cognitive, motor, and psychosocial development. A team of reviewers independently extracted data and assessed their quality. Sixty systematic reviews contained the outcomes of interest. Various interventions reduced morbidity and improved child growth, but few had direct measures of child development. Of particular benefit were food and micronutrient supplementation for mothers to reduce the risk of small for gestational age and iodine deficiency, strategies to reduce iron deficiency anemia in infancy, and early neonatal care (appropriate resuscitation, delayed cord clamping, and Kangaroo Mother Care). Neuroprotective interventions for imminent preterm birth showed the largest effect sizes (antenatal corticosteroids for developmental delay: risk ratio 0.49, 95% confidence interval 0.24 to 1.00; magnesium sulfate for gross motor dysfunction: risk ratio 0.61, 95% confidence interval 0.44 to 0.85). Given the focus on high-quality studies captured in leading systematic reviews, only effects reported within studies included in systematic reviews were captured. These findings should guide the prioritization and scale-up of interventions within critical periods of early infancy and childhood, and encourage research into their implementation at scale. Copyright © 2017 by the American Academy of Pediatrics.

  20. Combining child social skills training with a parent early intervention program for inhibited preschool children.

    Science.gov (United States)

    Lau, Elizabeth X; Rapee, Ronald M; Coplan, Robert J

    2017-10-01

    Previous studies have demonstrated the efficacy of early intervention for anxiety in preschoolers through parent-education. The current study evaluated a six-session early intervention program for preschoolers at high risk of anxiety disorders in which a standard educational program for parents was supplemented by direct training of social skills to the children. Seventy-two children aged 3-5 years were selected based on high behavioural inhibition levels and concurrently having a parent with high emotional distress. Families were randomly assigned to either the intervention group, which consisted of six parent-education group sessions and six child social skills training sessions, or waitlist. After six months, families on waitlist were offered treatment consisting of parent-education only. Relative to waitlist, children in the combined condition showed significantly fewer clinician-rated anxiety disorders and diagnostic severity and maternal (but not paternal) reported anxiety symptoms and life interference at six months. Mothers also reported less overprotection. These gains were maintained at 12-month follow-up. Parent only education following waitlist produced similar improvements among children. Quasi-experimental comparison between combined and parent-only interventions indicated greater reductions from combined intervention according to clinician reports, but no significant differences on maternal reports. Results suggest that this brief early intervention program for preschoolers with both parent and child components significantly reduces risk and disorder in vulnerable children. The inclusion of a child component might have the potential to increase effects over parent-only intervention. However, future support for this conclusion through long-term, randomised controlled trials is needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. T42. WHEN SHOULD EARLY INTERVENTION START, AND FOR HOW LONG SHOULD IT LAST?

    Science.gov (United States)

    Albert, Nikolai; Melau, Marianne; Jensen, Heidi; Hastrup, Lene Halling; Hjorthøj, Carsten; Nordentoft, Merete

    2018-01-01

    Abstract Background Early intervention in psychosis facilities have often failed to integrate the two main elements of early intervention. While some facilities have focused on early, and have had Duration of Untreated Psychosis (DUP) as their main target, others have focused on the intervention and the treatment provided when patients were diagnosed. As both DUP reduction and specialized early intervention (SEI) has proved to have an effect on the treatment of patients with first-episode psychosis one could hope of a synergetic effect if the two strategies were integrated. In this study, we use data from a randomized clinical trial testing the effect of prolonged early intervention (5 years) compared to standard specialized early intervention (2 years). Overall the study found that both treatment groups remained stable or improved in psychopathology, functioning and cognition and that there was no further beneficial effect of the prolonged the treatment. Participants had a long DUP (median 52 weeks). For this specific sub-study we hypothesized that patients who were treated early in their course of illness would have a beneficial effect of the prolonged treatment compared to those who only received 2 years of specialized treatment. Methods 296 participants with a psychotic diagnosis within the schizophrenia spectrum (ICD 10 – F2x, excluding F21) were included. DUP start was assessed from first psychotic symptom equivalent to 3 or above on a global SAPS item. DUP stop was when patients started antipsychotic treatment or specialized early intervention treatment. To assess if there were a delay within the mental health referral system we used the national register to identify when participants first were diagnosed with a schizophrenia spectrum diagnosis and calculated the time until they started SEI treatment. Finally, we added the DUP and the treatment delay together to assess the time from first psychotic symptom until the start of adequate treatment (both

  2. Clinopyroxenite dikes crosscutting banded peridotites just above the metamorphic sole in the Oman ophiolite: early cumulates from the primary V3 lava

    Science.gov (United States)

    Ishimaru, Satoko; Arai, Shoji; Tamura, Akihiro

    2013-04-01

    .2-0.7, respectively. Garnets, both andradite and glossular, contain high amounts of TiO2 (up to 18 wt%). The TiO2 content should be higher in the primary CPX if we consider the formation of secondary Ti-rich garnet and titanite. The La/Yb ratio, normalized to C1 chondrite (subscript CN) (McDonough and Sun, 1995), of CPX in the dikes is high (1.1-2.0) and (La/Yb)CN of calculated melt in equilibrium with the CPX is 6.0-9.6. The REE patterns differ completely from those of diopsidite dikes, (La/Yb)CN < 1, related with hydrothermal fluid (Python et al., 2007), but are similar to those of V3 lava, (La/Yb)CN ≈ 5, (Godard et al., 2003). We can judge the CPXITE dikes are cumulates from alkaline basalt based on the mineral assemblages and mineral chemistry of the dikes. Based on the similarity of the REE pattern between this CPXITE dike and V3 lava, the CPXITE dike thought to be cumulates from the primary or closely related V3 lava, filling its conduit. These dikes are the clear evidence for that the V3 magma came from outside of the Oman ophiolite after its obduction.

  3. Training radiographers to deliver an intervention to promote early presentation of breast cancer

    International Nuclear Information System (INIS)

    Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

    2012-01-01

    Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

  4. A simulation model for designing effective interventions in early childhood caries.

    Science.gov (United States)

    Hirsch, Gary B; Edelstein, Burton L; Frosh, Marcy; Anselmo, Theresa

    2012-01-01

    Early childhood caries (ECC)--tooth decay among children younger than 6 years--is prevalent and consequential, affecting nearly half of US 5-year-olds, despite being highly preventable. Various interventions have been explored to limit caries activity leading to cavities, but little is known about the long-term effects and costs of these interventions. We developed a system dynamics model to determine which interventions, singly and in combination, could have the greatest effect in reducing caries experience and cost in a population of children aged birth to 5 years. System dynamics is a computer simulation technique useful to policy makers in choosing the most appropriate interventions for their populations. This study of Colorado preschool children models 6 categories of ECC intervention--applying fluorides, limiting cariogenic bacterial transmission from mothers to children, using xylitol directly with children, clinical treatment, motivational interviewing, and combinations of these--to compare their relative effect and cost. The model projects 10-year intervention costs ranging from $6 million to $245 million and relative reductions in cavity prevalence ranging from none to 79.1% from the baseline. Interventions targeting the youngest children take 2 to 4 years longer to affect the entire population of preschool-age children but ultimately exert a greater benefit in reducing ECC; interventions targeting the highest-risk children provide the greatest return on investment, and combined interventions that target ECC at several stages of its natural history have the greatest potential for cavity reduction. Some interventions save more in dental repair than their cost; all produce substantial reductions in repair cost. By using data relevant to any geographic area, this system model can provide policy makers with information to maximize the return on public health and clinical care investments.

  5. [Effects of an early psychological intervention on parents of children with cleft lip/palate].

    Science.gov (United States)

    Wang, Yangyang; Xin, Yanhua; Ma, Jian; Xin, Xiuhong; Shi, Bing; Huang, Yongqing

    2013-08-01

    To provide basis for effects of an early psychological intervention on parents of children with cleft lip/palate, and investigate the effects of an early psychological intervention to them. One self-administered questionnaire (SCL-90) was applied in 102 parents of children with cleft lip/palate, compared to 126 parents of healthy individuals on the day of admission. They were given the psychological intervention during hospitalization and 3 months after discharge. The questionnaire (SCL-90) was again applied to them on the day of discharge and 3 months after discharge. Using the questionnaire (SCL-90), the answer scores of somatization, obsessive-compulsive, depression and anxiety etc. were significantly higher than those of the control group (P 0.05). There were no statistical differences on the day of admission and on the day of discharge (P > 0.05), but there were statistical difference on the day of admission and 3 months after discharge (P palate is poor. It's important and greatly significant that we conduct early psychological intervention to parents of children with cleft lip/palate and to the children's psychosomatic health.

  6. Dyslexia and early intervention: what did we learn from the Dutch Dyslexia Programme?

    Science.gov (United States)

    van der Leij, Aryan

    2013-11-01

    Part of the Dutch Dyslexia Programme has been dedicated to early intervention. The question of whether the genetically affected learning mechanism of children who are at familial risk (FR) of developing dyslexia could be influenced by training phoneme awareness and letter-sound associations in the prereading phase was investigated. The rationale was that intervention studies reveal insights about the weaknesses of the learning mechanisms of FR children. In addition, the studies aimed to gather practical insights to be used in the development of a system of early diagnosis and prevention. Focused on the last period of kindergarten before formal reading instruction starts in Grade 1, intervention methods with comparable samples and designs but differences in delivery mode (use of computer or manual), tutor (semi-professional or parent), location (at school or at home), and additional practices (serial rapid naming or simple word reading) have been executed to test the hypothesis that the incidence and degree of dyslexia can be reduced. The present position paper summarizes the Dutch Dyslexia Programme findings and relates them to findings of other studies. It is discussed that the Dutch studies provide evidence on why prevention of dyslexia is hard to accomplish. It is argued that effective intervention should not only start early but also be adapted to the individual and often long-lasting educational needs of children at risk of reading failure. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions.

    Science.gov (United States)

    Hurley, Kristen M; Yousafzai, Aisha K; Lopez-Boo, Florencia

    2016-03-01

    Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged early child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions. © 2016 American Society for Nutrition.

  8. Maternal sensitivity and mental health: does an early childhood intervention programme have an impact?

    Science.gov (United States)

    Brahm, Paulina; Cortázar, Alejandra; Fillol, María Paz; Mingo, María Verónica; Vielma, Constanza; Aránguiz, María Consuelo

    2016-06-01

    Maternal sensitivity (MS) and mental health influence mother-child attachment and the child's mental health. Early interventions may promote resilience and facilitate healthy development of the children through an impact on mothers' outcomes such as their sensitivity and mental health. Play with Our Children (POC) is an early intervention programme aiming to promote a positive mother-child interaction for children who attend three family health centres of deprived areas of Santiago de Chile. To estimate the effect of the programme POC on MS and mental health. A quasi-experimental design with propensity score matching estimations was employed. MS was measured with the Q-Sort of Maternal Sensitivity, and maternal mental health was assessed with the Patient Health Questionnaire and the Parenting Stress Index. Mean-difference comparison and difference-in-difference method were used as statistical strategies. The sample included 102 children from 2 to 23 months of age, 54 of them participated in the intervention and 48 children were the comparison group. Estimates showed that participation in POC was positively associated with less stress in mothers of children younger than 12 months (P early intervention POC may influence mother's mental health and indirectly impact children's well-being during critical stages of their development by strengthening their mother's sensitivity towards them. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Early intervention for preventing posttraumatic stress disorder: an Internet-based virtual reality treatment

    Directory of Open Access Journals (Sweden)

    Sara A. Freedman

    2015-04-01

    Full Text Available Background: Posttraumatic stress disorder (PTSD develops in approximately 20% of people exposed to a traumatic event, and studies have shown that cognitive-behavioral therapy (CBT is effective as a treatment for chronic PTSD. It has also been shown to prevent PTSD when delivered early after a traumatic event. However, studies have shown that uptake of early treatment is generally low, and therefore, the need to provide interventions through other mediums has been identified. The use of technology may overcome barriers to treatment. Objective: This paper describes a randomized controlled trial that will examine an early CBT intervention for PTSD. The treatment incorporates virtual reality (VR as a method for delivering exposure-based elements of the treatment. The intervention is Internet based, such that the therapist and patient will “meet” in a secure online site. This site will also include multi-media components of the treatment (such as videos, audios, VR that can be accessed by the patient between sessions. Method: Two hundred patients arriving to a Level 1 emergency department following a motor vehicle accident will be randomly assigned to either treatment or control groups. Inclusion criteria are age 18–65, PTSD symptoms 2 weeks posttrauma related to current trauma, no suicidality, no psychosis. Patients will be assessed by telephone by a team blind to the study group, on four occasions: before and after treatment, and 6 and 12 months posttreatment. The primary outcome is PTSD symptoms at follow up. Secondary outcomes include depression and cost effectiveness. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions, in general, and Internet-based early interventions, in particular, on PTSD, in an injured population, during the acute phase after trauma. We will discuss possible strengths and limitations.

  10. The motivation for very early intervention for infants at high risk for autism spectrum disorders.

    Science.gov (United States)

    Webb, Sara Jane; Jones, Emily J H; Kelly, Jean; Dawson, Geraldine

    2014-02-01

    The first Autism Research Matrix (IACC, 2003) listed the identification of behavioural and biological markers of risk for autism as a top priority. This emphasis was based on the hypothesis that intervention with infants at-risk, at an early age when the brain is developing and before core autism symptoms have emerged, could significantly alter the developmental trajectory of children at risk for the disorder and impact long-range outcome. Research has provided support for specific models of early autism intervention (e.g., Early Start Denver Model) for improving outcomes in young children with autism, based on both behavioural and brain activity measures. Although great strides have been made in ability to identify risk markers for autism in younger infant/toddler samples, how and when to intervene during the prodromal state remains a critical question. Emerging evidence suggests that abnormal brain circuitry in autism precedes altered social behaviours; thus, an intervention designed to promote early social engagement and reciprocity potentially could steer brain development back toward the normal trajectory and remit or reduce the expression of symptoms.

  11. The gains from early intervention in Europe: Fiscal surveillance and fiscal planning using cash data

    Directory of Open Access Journals (Sweden)

    Andrew Hughes Hallett

    2012-06-01

    Full Text Available The use of real-time cash data allows us to make accurate intra-annual forecasts of an economy’s fiscal position, and to issue early warning signals for the need to correct fiscal imbalances. This paper shows how those signals can be used to design the necessary fiscal corrections, and discusses the gains that can be achieved from such interventions. Examples from Germany and Italy show that large corrections are often necessary early on to make adjustments later on acceptable and to keep debt ratios from escalating. There is a credibility issue here; we find the difference between front-loaded and back-loaded adjustment schemes is likely to be vital for the time consistency of fiscal policymaking. We also show that, without early interventions, the later deficit reductions typically double in size – meaning governments become subject to the excessive deficit procedure and significant improve-ment tests more often. Thus the budget savings from early intervention and the use of cash data are significant; in our examples they are similar in size to the operating budget of the department of housing and urban development in Germany. Similar results apply in other Eurozone countries.

  12. Integrating nutrition and early child-development interventions among infants and preschoolers in rural India.

    Science.gov (United States)

    Fernandez-Rao, Sylvia; Hurley, Kristen M; Nair, Krishnapillai Madhavan; Balakrishna, Nagalla; Radhakrishna, Kankipati V; Ravinder, Punjal; Tilton, Nicholas; Harding, Kimberly B; Reinhart, Greg A; Black, Maureen M

    2014-01-01

    This article describes the development, design, and implementation of an integrated randomized double-masked placebo-controlled trial (Project Grow Smart) that examines how home/preschool fortification with multiple micronutrient powder (MNP) combined with an early child-development intervention affects child development, growth, and micronutrient status among infants and preschoolers in rural India. The 1-year trial has an infant phase (enrollment age: 6-12 months) and a preschool phase (enrollment age: 36-48 months). Infants are individually randomized into one of four groups: placebo, placebo plus early learning, MNP alone, and MNP plus early learning (integrated intervention), conducted through home visits. The preschool phase is a cluster-randomized trial conducted in Anganwadi centers (AWCs), government-run preschools sponsored by the Integrated Child Development System of India. AWCs are randomized into MNP or placebo, with the MNP or placebo mixed into the children's food. The evaluation examines whether the effects of the MNP intervention vary by the quality of the early learning opportunities and communication within the AWCs. Study outcomes include child development, growth, and micronutrient status. Lessons learned during the development, design, and implementation of the integrated trial can be used to guide large-scale policy and programs designed to promote the developmental, educational, and economic potential of children in developing countries. © 2013 New York Academy of Sciences.

  13. The Development of Children's Algebraic Thinking: The Impact of a Comprehensive Early Algebra Intervention in Third Grade

    Science.gov (United States)

    Blanton, Maria; Stephens, Ana; Knuth, Eric; Gardiner, Angela Murphy; Isler, Isil; Kim, Jee-Seon

    2015-01-01

    This article reports results from a study investigating the impact of a sustained, comprehensive early algebra intervention in third grade. Participants included 106 students; 39 received the early algebra intervention, and 67 received their district's regularly planned mathematics instruction. We share and discuss students' responses to a written…

  14. Early Intervention and Maltreated Children: A Current Look at the Child Abuse Prevention and Treatment Act and Part C

    Science.gov (United States)

    Moxley, Kathleen M.; Squires, Jane; Lindstrom, Lauren

    2012-01-01

    Current literature regarding the prevalence of child abuse and neglect, resulting developmental impacts on children, and early intervention services for children and families involved in the child welfare system is summarized. While early intervention eligibility referrals are mandated for this population under the Child Abuse Prevention and…

  15. 78 FR 75997 - Provision of Early Intervention and Special Education Services to Eligible DoD Dependents

    Science.gov (United States)

    2013-12-13

    ... 32 CFR Part 57 Provision of Early Intervention and Special Education Services to Eligible DoD...-2011-OS-0095] RIN 0790-AI77 Provision of Early Intervention and Special Education Services to Eligible... (EIS) to infants and toddlers with disabilities and their families, as well as special education and...

  16. 32 CFR Appendix E to Part 57 - DoD-CC on Early Intervention, Special Education, and Related Services

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false DoD-CC on Early Intervention, Special Education... SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN PROVISION OF EARLY INTERVENTION AND SPECIAL EDUCATION..., Special Education, and Related Services A. Committee Membership The DoD-CC shall meet at least yearly to...

  17. 78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Science.gov (United States)

    2013-02-13

    ... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive... care services for persons living with HIV/AIDS, HRSA will provide one-time noncompetitive Ryan White...

  18. 78 FR 18989 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Science.gov (United States)

    2013-03-28

    ... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive... care services for persons living with HIV/AIDS, HRSA will provide a one-time noncompetitive Part C...

  19. 78 FR 78976 - Ryan White HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV...

    Science.gov (United States)

    2013-12-27

    ... HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY...: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive Award To... services for persons living with HIV/AIDS, HRSA will provide a one-time noncompetitive Ryan White HIV/AIDS...

  20. 78 FR 31568 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Science.gov (United States)

    2013-05-24

    ... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive... care services for persons living with HIV/AIDS, HRSA will provide a one-time noncompetitive Ryan White...

  1. 78 FR 10182 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Science.gov (United States)

    2013-02-13

    ... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program (Part C) Early Intervention Services One-Time... primary care services for persons living with HIV/AIDS, HRSA will provide one-time noncompetitive Part C...

  2. Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

    Science.gov (United States)

    Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

    2017-04-01

    For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. 2014 CODEPEH recommendations: Early detection of late onset deafness, audiological diagnosis, hearing aid fitting and early intervention.

    Science.gov (United States)

    Núñez-Batalla, Faustino; Jáudenes-Casaubón, Carmen; Sequí-Canet, Jose Miguel; Vivanco-Allende, Ana; Zubicaray-Ugarteche, Jose

    2016-01-01

    The latest scientific literature considers early diagnosis of deafness as the key element to define the educational and inclusive prognosis of the deaf child, because it allows taking advantage of the critical period of development (0-4 years). Highly significant differences exist between deaf people who have been stimulated early and those who have received late or improper intervention. Early identification of late-onset disorders requires special attention and knowledge on the part of every childcare professional. Programs and additional actions beyond neonatal screening should be designed and planed to ensure that every child with a significant hearing loss is detected early. For this purpose, the CODEPEH would like to highlight the need for continuous monitoring of children's auditory health. Consequently, CODEPEH has drafted the recommendations included in the present document. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  4. Become Related: FIAS, an Intensive Early Intervention for Young Children with Autism Spectrum Disorders.

    Science.gov (United States)

    Herbrecht, Evelyn; Kievit, Esther; Spiegel, René; Dima, Diana; Goth, Kirstin; Schmeck, Klaus

    2015-01-01

    In autism spectrum disorders (ASDs), impairments in fundamental social abilities and a lack of interest in social stimuli become apparent early in life. These impairments are thought to negatively affect further brain and behavioural development. Early intensive interventions can help to attenuate social-development and other risk factors and, thus, to ameliorate the deficits associated with ASDs. We present FIAS, an intensive early intervention approach for young children with ASD, which aims at developing children's social motivation. During 18 days, therapists work continuously for 6 h a day with the affected child, involving the whole family in a day care setting. Follow-up care at home over 1 year as well as fresh-up interventions and inclusion in kindergarten or a play group should stabilise the effects and help to respond to further challenges. Here, we present observations from the first 12 patients (25-48 months of age) treated according to the FIAS approach. We evaluated changes in core autistic symptoms and level of functioning after the 18 days of intensive intervention. Beyond standardised assessment, two innovative video-based instruments (Autism Behaviour Coding System and Evaluationsfragebogen) have been developed to assess autistic symptoms and interaction parameters during intervention. Improvements were noted in most core autistic symptom domains, with the highest effect sizes in domains like eye contact, communication, repetitive behaviour, imitation, motivation and reciprocity. In addition, the level of functioning significantly improved. The first evaluation of the FIAS approach shows promising results, as the FIAS intervention appears to improve core autistic symptom domains as well as the level of everyday functioning. Limitations of this study are the small sample size and the lack of a control group. A more comprehensive and longitudinal evaluation is in progress; this will focus on the stability of the observed effects and will attempt to

  5. A National Early Intervention System as a Strategy to Promote Inclusion and Academic Achievement in Portugal

    Directory of Open Access Journals (Sweden)

    Vitor Franco

    2017-07-01

    Full Text Available Early intervention with children at risk or facing developmental problems is a practice defined by three fundamental characteristics: being family-centered, being based on the community and on the child’s life context, and being conducted by a team with transdisciplinary practice. In this paper we wish to present how the SNIPI-National System of Early Intervention, implemented in Portugal over the past 15 years, contributes to promote maximum development and the full inclusion of children up to 6 years of age and works to prevent school failure. The SNIPI covers the entire territory and intends to respond to the needs of children with developmental disorders or those in at risk situations. This community-based early intervention model is linked to the health, education and social care systems, involving the three responsible Ministries. In the present community case study, we present the implementation of this program in the Alentejo region, involving 31 local teams and almost 2500 children. Through the regional structure’s reports and the responses of parents and professionals in impact studies, we demonstrate how the system is established and how it tackles school failure and improves the educational inclusion of these children. The impact of this Early Intervention model has been significant not only on children’s developmental outcomes, but also for the health, education and social care professionals who work in a transdisciplinary perspective, as well as for the families who became more skilled at evaluating the children’s needs and the support provided. This approach to implementing a family-centered Early Intervention program can contribute to full inclusion. It facilitates the transition to schooling based on a non-discriminatory approach and educational achievement by aiding development and an adapted contextualization in pre-school education. This program system introduces significant innovation within the framework of existing

  6. A National Early Intervention System as a Strategy to Promote Inclusion and Academic Achievement in Portugal.

    Science.gov (United States)

    Franco, Vitor; Melo, Madalena; Santos, Graça; Apolónio, Ana; Amaral, Leonor

    2017-01-01

    Early intervention with children at risk or facing developmental problems is a practice defined by three fundamental characteristics: being family-centered, being based on the community and on the child's life context, and being conducted by a team with transdisciplinary practice. In this paper we wish to present how the SNIPI-National System of Early Intervention, implemented in Portugal over the past 15 years, contributes to promote maximum development and the full inclusion of children up to 6 years of age and works to prevent school failure. The SNIPI covers the entire territory and intends to respond to the needs of children with developmental disorders or those in at risk situations. This community-based early intervention model is linked to the health, education and social care systems, involving the three responsible Ministries. In the present community case study, we present the implementation of this program in the Alentejo region, involving 31 local teams and almost 2500 children. Through the regional structure's reports and the responses of parents and professionals in impact studies, we demonstrate how the system is established and how it tackles school failure and improves the educational inclusion of these children. The impact of this Early Intervention model has been significant not only on children's developmental outcomes, but also for the health, education and social care professionals who work in a transdisciplinary perspective, as well as for the families who became more skilled at evaluating the children's needs and the support provided. This approach to implementing a family-centered Early Intervention program can contribute to full inclusion. It facilitates the transition to schooling based on a non-discriminatory approach and educational achievement by aiding development and an adapted contextualization in pre-school education. This program system introduces significant innovation within the framework of existing educational policies that

  7. Paying for Early Interventions in Psychoses: A Three-Part Model.

    Science.gov (United States)

    Frank, Richard G; Glied, Sherry A; McGuire, Thomas G

    2015-07-01

    Widespread dissemination of early interventions for psychosis, such as the intervention offered in the RAISE study (Recovery After an Initial Schizophrenia Episode), requires a funding mechanism that is both compatible with approaches already used by payers and generates incentives for providers that promote the desired behaviors. The authors propose a funding model with three components: a prospective per-case payment made conditional on patient engagement in treatment, a per-service component to cover the costs of clinical services, and an outcome-based component conditional on achieving measurable outcome milestones. The authors describe the components and how such a payment mechanism might be implemented.

  8. Internet-based early intervention to prevent posttraumatic stress disorder in injury patients: randomized controlled trial.

    Science.gov (United States)

    Mouthaan, Joanne; Sijbrandij, Marit; de Vries, Giel-Jan; Reitsma, Johannes B; van de Schoot, Rens; Goslings, J Carel; Luitse, Jan S K; Bakker, Fred C; Gersons, Berthold P R; Olff, Miranda

    2013-08-13

    Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients. Adult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale-Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented. The mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (PInternet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high

  9. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.

    Science.gov (United States)

    Dawson, Geraldine; Rogers, Sally; Munson, Jeffrey; Smith, Milani; Winter, Jamie; Greenson, Jessica; Donaldson, Amy; Varley, Jennifer

    2010-01-01

    To conduct a randomized, controlled trial to evaluate the efficacy of the Early Start Denver Model (ESDM), a comprehensive developmental behavioral intervention, for improving outcomes of toddlers diagnosed with autism spectrum disorder (ASD). Forty-eight children diagnosed with ASD between 18 and 30 months of age were randomly assigned to 1 of 2 groups: (1) ESDM intervention, which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and parents for 2 years; or (2) referral to community providers for intervention commonly available in the community. Compared with children who received community-intervention, children who received ESDM showed significant improvements in IQ, adaptive behavior, and autism diagnosis. Two years after entering intervention, the ESDM group on average improved 17.6 standard score points (1 SD: 15 points) compared with 7.0 points in the comparison group relative to baseline scores. The ESDM group maintained its rate of growth in adaptive behavior compared with a normative sample of typically developing children. In contrast, over the 2-year span, the comparison group showed greater delays in adaptive behavior. Children who received ESDM also were more likely to experience a change in diagnosis from autism to pervasive developmental disorder, not otherwise specified, than the comparison group. This is the first randomized, controlled trial to demonstrate the efficacy of a comprehensive developmental behavioral intervention for toddlers with ASD for improving cognitive and adaptive behavior and reducing severity of ASD diagnosis. Results of this study underscore the importance of early detection of and intervention in autism.

  10. Early intervention in panic: randomized controlled trial and cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    van Balkom Anton

    2008-11-01

    Full Text Available Abstract Background Panic disorder (PD is a common, severe and persistent mental disorder, associated with a high degree of distress and occupational and social disability. A substantial proportion of the population experiences subthreshold and mild PD and is at risk of developing a chronic PD. A promising intervention, aimed at preventing panic disorder onset and reducing panic symptoms, is the 'Don't Panic' course. It consists of eight sessions of two hours each. The purpose of this study is to evaluate the effectiveness of this early intervention – based on cognitive behavioural principles – on the reduction of panic disorder symptomatology. We predict that the experimental condition show superior clinical and economic outcomes relative to a waitlisted control group. Methods/design A pragmatic, pre-post, two-group, multi-site, randomized controlled trial of the intervention will be conducted with a naturalistic follow-up at six months in the intervention group. The participants are recruited from the general population and are randomized to the intervention or a waitlist control group. The intervention is offered by community mental health centres. Included are people over 18 years of age with subthreshold or mild panic disorder, defined as having symptoms of PD falling below the cut-off of 13 on the Panic Disorder Severity Scale-Self Report (PDSS-SR. Primary outcomes are panic disorder and panic symptoms. Secondary outcomes are symptoms of agoraphobia, anxiety, cognitive aspects of panic disorder, depressive symptoms, mastery, health-related quality of life, and cost-effectiveness. We will examine the following variables as potential mediators: cognitive aspects of panic disorder, symptoms of agoraphobia, anxiety and mastery. Potential moderating variables are: socio-demographic characteristics, panic disorder, agoraphobia, treatment credibility and mastery. Discussion This study was designed to evaluate the (cost effectiveness of an

  11. Early rigorous control interventions can largely reduce dengue outbreak magnitude: experience from Chaozhou, China.

    Science.gov (United States)

    Liu, Tao; Zhu, Guanghu; He, Jianfeng; Song, Tie; Zhang, Meng; Lin, Hualiang; Xiao, Jianpeng; Zeng, Weilin; Li, Xing; Li, Zhihao; Xie, Runsheng; Zhong, Haojie; Wu, Xiaocheng; Hu, Wenbiao; Zhang, Yonghui; Ma, Wenjun

    2017-08-02

    Dengue fever is a severe public heath challenge in south China. A dengue outbreak was reported in Chaozhou city, China in 2015. Intensified interventions were implemented by the government to control the epidemic. However, it is still unknown the degree to which intensified control measures reduced the size of the epidemics, and when should such measures be initiated to reduce the risk of large dengue outbreaks developing? We selected Xiangqiao district as study setting because the majority of the indigenous cases (90.6%) in Chaozhou city were from this district. The numbers of daily indigenous dengue cases in 2015 were collected through the national infectious diseases and vectors surveillance system, and daily Breteau Index (BI) data were reported by local public health department. We used a compartmental dynamic SEIR (Susceptible, Exposed, Infected and Removed) model to assess the effectiveness of control interventions, and evaluate the control effect of intervention timing on dengue epidemic. A total of 1250 indigenous dengue cases was reported from Xiangqiao district. The results of SEIR modeling using BI as an indicator of actual control interventions showed a total of 1255 dengue cases, which is close to the reported number (n = 1250). The size and duration of the outbreak were highly sensitive to the intensity and timing of interventions. The more rigorous and earlier the control interventions implemented, the more effective it yielded. Even if the interventions were initiated several weeks after the onset of the dengue outbreak, the interventions were shown to greatly impact the prevalence and duration of dengue outbreak. This study suggests that early implementation of rigorous dengue interventions can effectively reduce the epidemic size and shorten the epidemic duration.

  12. Early rigorous control interventions can largely reduce dengue outbreak magnitude: experience from Chaozhou, China

    Directory of Open Access Journals (Sweden)

    Tao Liu

    2017-08-01

    Full Text Available Abstract Background Dengue fever is a severe public heath challenge in south China. A dengue outbreak was reported in Chaozhou city, China in 2015. Intensified interventions were implemented by the government to control the epidemic. However, it is still unknown the degree to which intensified control measures reduced the size of the epidemics, and when should such measures be initiated to reduce the risk of large dengue outbreaks developing? Methods We selected Xiangqiao district as study setting because the majority of the indigenous cases (90.6% in Chaozhou city were from this district. The numbers of daily indigenous dengue cases in 2015 were collected through the national infectious diseases and vectors surveillance system, and daily Breteau Index (BI data were reported by local public health department. We used a compartmental dynamic SEIR (Susceptible, Exposed, Infected and Removed model to assess the effectiveness of control interventions, and evaluate the control effect of intervention timing on dengue epidemic. Results A total of 1250 indigenous dengue cases was reported from Xiangqiao district. The results of SEIR modeling using BI as an indicator of actual control interventions showed a total of 1255 dengue cases, which is close to the reported number (n = 1250. The size and duration of the outbreak were highly sensitive to the intensity and timing of interventions. The more rigorous and earlier the control interventions implemented, the more effective it yielded. Even if the interventions were initiated several weeks after the onset of the dengue outbreak, the interventions were shown to greatly impact the prevalence and duration of dengue outbreak. Conclusions This study suggests that early implementation of rigorous dengue interventions can effectively reduce the epidemic size and shorten the epidemic duration.

  13. Cost-effectiveness of early intervention in first-episode psychosis

    DEFF Research Database (Denmark)

    Hastrup, Lene Halling; Kronborg, C; Bertelsen, M

    2013-01-01

    Background Information about the cost-effectiveness of early intervention programmes for first-episode psychosis is limited. Aims To evaluate the cost-effectiveness of an intensive early-intervention programme (called OPUS) (trial registration NCT00157313) consisting of enriched assertive community...... treatment, psychoeducational family treatment and social skills training for individuals with first-episode psychosis compared with standard treatment. Method An incremental cost-effectiveness analysis of a randomised controlled trial, adopting a public sector perspective was undertaken. Results The mean...... treatment group (51.13, s.d. = 15.92). However, the mean GAF did not differ significantly between the groups at 5-year follow-up (55.35 (s.d. = 18.28) and 54.16 (s.d. = 18.41), respectively). Cost-effectiveness planes based on non-parametric bootstrapping showed that OPUS was less costly and more effective...

  14. Children's parasympathetic reactivity to specific emotions moderates response to intervention for early-onset aggression.

    Science.gov (United States)

    Gatzke-Kopp, Lisa M; Greenberg, Mark; Bierman, Karen

    2015-01-01

    Following theories that individual differences in respiratory sinus arrhythmia (RSA) denote differential sensitivity to environmental influences, this study examines whether differences in RSA reactivity to specific emotional challenges predict differential response to intervention. We present data from a randomized clinical trial of a targeted intervention for early onset aggression. In collaboration with a high-risk urban school district, 207 kindergarten children (73% African American, 66% male), identified by their teachers as having high levels of aggressive and disruptive behavior, were recruited. All children received a universal social-emotional curriculum. One hundred children were randomly assigned to an additional intervention consisting of weekly peer-based social skills training. Complete RSA data were available for 139 of the children. Teacher-reported externalizing symptoms and emotion regulation in 1st grade (post intervention) were examined controlling for baseline levels. First-grade peer nominations of aggressive behavior, controlling for baseline nominations, were also examined as outcomes. No effect of resting RSA was found. However, greater reactivity to anger was associated with higher externalizing symptoms and lower emotion regulation skills in 1st grade relative to low reactive children. Lower reactivity to fear was associated with greater improvement over time, an effect that was enhanced in the targeted intervention condition. Results suggest that measures of affective reactivity may provide insight into children's capacity to benefit from different types of interventions.

  15. Overall outcomes following early interventions for intracranial arteriovenous malformations with hematomas.

    Science.gov (United States)

    Bir, Shyamal C; Maiti, Tanmoy Kumar; Konar, Subhas; Nanda, Anil

    2016-01-01

    We evaluated the timing and predictors of surgical intervention for intracranial arteriovenous malformations (AVM) with hematoma. A ruptured intracranial AVM with hematoma is an emergency condition, and the optimal timing for surgical intervention is not well understood. In addition, the outcome predictors of surgical intervention have rarely been reported. We identified and analyzed 78 patients treated with microsurgical resection for pathologically proven AVM at Louisiana State University Health in Shreveport from February 1992 to December 2004. All 78 patients were diagnosed with ruptured AVM before surgery. The independent variables, including patient demographics, timing of surgery, location of the AVM and comorbidities were analyzed to assess outcome. The results of this series revealed that surgical intervention after 48hours resulted in poor outcomes for patients with hematoma, following a ruptured AVM. Several other prognostic factors, including younger age (11-40years), Spetzler-Martin Grade I and II, and AVM in a supratentorial location, had significant positive effects on outcomes. However, hypertension, smoking, and a prior embolization showed significant negative effects on outcomes after surgery. The multiple logistic regression analyses also revealed that the timing of surgical intervention had a significant effect on outcomes in patients with hematoma following ruptured AVM. Early intervention is the key to success in these patients. Published by Elsevier Ltd.

  16. Can early intervention policies improve wellbeing? Evidence from a randomized controlled trial

    OpenAIRE

    Michael Daly; Liam Delaney; Orla Doyle; Nick Fitzpatrick; Christine O'Farrelly

    2014-01-01

    Many authors have proposed incorporating measures of well-being into evaluations of public policy. Yet few evaluations use experimental design or examine multiple aspects of well-being, thus the causal impact of public policies on well-being is largely unknown. In this paper we examine the effect of an intensive early intervention program on maternal well-being in a targeted disadvantaged community. Using a randomized controlled trial design we estimate and compare treatment effects on global...

  17. Can Early Intervention Policies Improve Well-being? Evidence from a randomized controlled trial

    OpenAIRE

    Daly, Michael; Delaney, Liam; Doyle, Orla; Fitzpatrick, Nick; O'Farrelly, Christine

    2014-01-01

    Many authors have proposed incorporating measures of well-being into evaluations of public policy. Yet few evaluations use experimental design or examine multiple aspects of wellbeing, thus the causal impact of public policies on well-being is largely unknown. In this paper we examine the effect of an intensive early intervention program on maternal wellbeing in a targeted disadvantaged community. Using a randomized controlled trial design we estimate and compare treatment effects on global w...

  18. Mental health: early intervention and prevention in children and young people.

    Science.gov (United States)

    Membride, Heather

    It is estimated that 10% of children and young people have mental health problems so significant that they impact not only on their day-to-day life but, if left untreated, they will continue into adulthood. In this article, the author discusses mental health issues affecting children and young people and examines evidence-based early intervention and prevention programmes that have been shown to support better outcomes for children, young people and their families.

  19. Informing early intervention: preschool predictors of anxiety disorders in middle childhood

    OpenAIRE

    Hudson, J. L.; Dodd, Helen F.

    2012-01-01

    Background: To inform early intervention practice, the present research examines how child anxiety, behavioural inhibition, maternal overinvolvement, maternal negativity, mother-child attachment and maternal anxiety, as assessed at age four, predict anxiety at age nine.\\ud \\ud Method: 202 children (102 behaviourally inhibited and 100 behaviourally uninhibited) aged 3–4 years were initially recruited and the predictors outlined above were assessed. Diagnostic assessments, using the Anxiety Dis...

  20. Monumental Misjudgements? Early Conservative Interventions and their Impact on Orcadian Neolithic Sites

    OpenAIRE

    Ritchie, Georgina

    2014-01-01

    The contemporary experience of visiting many Neolithic sites in Orkney is dominated by the physical manifestations of early conservative interventions; the most striking of these being a series of cover-houses, installed over chambered tombs to ensure their protection from the elements. These shelters range in scale from small concrete domes enclosing the interior of the monuments (such as that over the Knowe of Yarso, depicted in the cover image), to a vast free-standing steel enclosure (see...

  1. Early interventions for youths at high risk for bipolar disorder: a developmental approach.

    Science.gov (United States)

    Benarous, Xavier; Consoli, Angèle; Milhiet, Vanessa; Cohen, David

    2016-03-01

    In recent decades, ongoing research programmes on primary prevention and early identification of bipolar disorder (BD) have been developed. The aim of this article is to review the principal forms of evidence that support preventive interventions for BD in children and adolescents and the main challenges associated with these programmes. We performed a literature review of the main computerised databases (MEDLINE, PUBMED) and a manual search of the literature relevant to prospective and retrospective studies of prodromal symptoms, premorbid stages, risk factors, and early intervention programmes for BD. Genetic and environmental risk factors of BD were identified. Most of the algorithms used to measure the risk of developing BD and the early interventions programmes focused on the familial risk. The prodromal signs varied greatly and were age dependent. During adolescence, depressive episodes associated with genetic or environmental risk factors predicted the onset of hypomanic/manic episodes over subsequent years. In prepubertal children, the lack of specificity of clinical markers and difficulties in mood assessment were seen as impeding preventive interventions at these ages. Despite encouraging results, biomarkers have not thus far been sufficiently validated in youth samples to serve as screening tools for prevention. Additional longitudinal studies in youths at high risk of developing BD should include repeated measures of putative biomarkers. Staging models have been developed as an integrative approach to specify the individual level of risk based on clinical (e.g. prodromal symptoms and familial history of BD) and non-clinical (e.g. biomarkers and neuroimaging) data. However, there is still a lack of empirically validated studies that measure the benefits of using these models to design preventive intervention programmes.

  2. WHO global consultation on public health intervention against early childhood caries

    DEFF Research Database (Denmark)

    Phantumvanit, Prathip; Makino, Yuka; Ogawa, Hiroshi

    2018-01-01

    of caries in their primary teeth (usually extractions), and this has considerable cost and social implications. A WHO Global Consultation with oral health experts on "Public Health Intervention against Early Childhood Caries" was held on 26-28 January 2016 in Bangkok (Thailand) to identify public health...... solutions and to highlight their applicability to low- and middle-income countries. After a 3-day consultation, participants agreed on specific recommendations for further action. National health authorities should develop strategies and implement interventions aimed at preventing and controlling ECC......-directed and individual fluoride administration for the prevention and control of ECC is essential. Surveillance and research, including cost-effectiveness studies, should be conducted to evaluate interventions aimed at preventing ECC in different population groups....

  3. The Lidcombe Program of early stuttering intervention for Malaysian families: Four case studies.

    Science.gov (United States)

    Vong, Etain; Wilson, Linda; Lincoln, Michelle

    2016-09-01

    This study investigated the outcomes of implementing the Lidcombe Program, an evidence-based early intervention for stuttering, with four preschool children in Malaysia. Early stuttering intervention is currently underdeveloped in Malaysia, where stuttering treatment is often more assertion-based than evidence-based. Therefore, introducing an evidence-based early stuttering intervention is an important milestone for Malaysian preschoolers who stutter. The participants ranged from 3 years 3 months to 4 years 9 months at the start of the study. Beyond-clinic speech samples were obtained at 1 month and 1 week pretreatment and immediately post-Stage 1, and at 1 month, 3 months, 6 months and 12 months post-Stage 1. Two participants, who were bilingual, achieved near-zero levels of stuttering at 12 months posttreatment. Near zero levels of stuttering were also present in their untreated languages. One participant withdrew due to reasons not connected with the research or treatment. The remaining participant, who presented with severe stuttering, completed Stage 1 but had some relapse in Stage 2 and demonstrated mild stuttering 12 months post-Stage 1. The outcomes were achieved without the need to significantly adapt Lidcombe Program procedures to Malaysian culture. Further research to continue evaluation of the Lidcombe Program with Malaysian families and to estimate proportion of those who will respond is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Long-term consequences of nutrition and growth in early childhood and possible preventive interventions.

    Science.gov (United States)

    Adair, Linda S

    2014-01-01

    Maternal nutritional deficiencies and excesses during pregnancy, and faster infant weight gain in the first 2 years of life are associated with increased risk of noncommunicable diseases (NCDs) in adulthood. The first 1,000 days of life (from conception until the child reaches age 2 years) represent a vulnerable period for programming of NCD risk, and are an important target for prevention of adult disease. This paper takes a developmental perspective to identify periconception, pregnancy, and infancy nutritional stressors, and to discuss mechanisms through which they influence later disease risk with the goal of informing age-specific interventions. Low- and middle-income countries need to address the dual burden of under- and overnutrition by implementing interventions to promote growth and enhance survival and intellectual development without increasing chronic disease risk. In the absence of good evidence from long-term follow-up of early life interventions, current recommendations for early life prevention of adult disease presume that interventions designed to optimize pregnancy outcomes and promote healthy infant growth and development will also reduce chronic disease risk. These include an emphasis on optimizing maternal nutrition prior to pregnancy, micronutrient adequacy in the preconception period and during pregnancy, promotion of breastfeeding and high-quality complementary foods, and prevention of obesity in childhood and adolescence. © 2014 Nestec Ltd., Vevey/S. Karger AG, Basel.

  5. Engaging Urban Parents of Early Adolescents in Parenting Interventions: Home Visits vs. Group Sessions.

    Science.gov (United States)

    Finigan-Carr, Nadine M; Copeland-Linder, Nikeea; Haynie, Denise L; Cheng, Tina L

    2014-01-01

    Interventions targeting parents of young children have shown effectiveness, but research is lacking about best practices for engaging parents of early adolescents. Low levels of enrollment and attendance in parenting interventions present major problems for researchers and clinicians. Effective and efficient ways to engage and collaborate with parents to strengthen parenting practices and to promote healthy development of early adolescents are needed. This exploratory mixed methods study examined the feasibility of three methods of engaging parents in positive parenting activities. Participants were parents of youth ages 11-13 enrolled in three urban, public middle schools in neighborhoods characterized by high rates of community violence. Families ( N = 144) were randomized into one of three interventions: six home sessions, two home sessions followed by four group sessions, or six group sessions. The majority of parents were single, non-Hispanic, African American mothers. Urban parents of middle school students were more likely to participate in home visits than in group sessions; offering a combination did not increase participation in the group sessions. As only 34% of those who consented participated in the intervention, qualitative data were examined to explain the reasons for non-participation.

  6. Evolution of care indicators after an early discharge intervention in preterm infants.

    Science.gov (United States)

    Toral-López, Isabel; González-Carrión, María Pilar; Rivas-Campos, Antonio; Lafuente-Lorca, Justa; Castillo-Vera, Josefa; de Casas, Carmen; Peña-Caballero, Manuela

    To evaluate the evolution of health outcomes in preterm infants included in an early discharge programme. Controlled, non-randomised trial with an intervention group and a control group children admitted to the Neonatal Intensive Care Unit of the University Hospital Virgen de las Nieves of Granada were included in the study. The intervention group comprised preterm infants admitted to the neonatal unit clinically stable, whose family home was located within 20km. from the hospital. They were discharged two weeks before the established time and a skilled nurse in neonatal care monitored them at home. The control group comprised infants who could not be included in home monitoring due to the distance to the hospital criterion or because their families did not give their consent and who received the usual care until their discharge. The study variables were the outcome indicators of the Nursing Outcomes Classification. Differences were found in the Nursing Outcomes Classification scores in the intervention group compared to the control group. The early discharge of preterm infants followed up at home by an expert nurse in neonatal care is a health service that achieves results in preparating parents for the care of their child, enabling them to learn about the health services, adapt to their new life, and establishbreastfeeding times. It constitutes safe intervention for children and is beneficial to parents. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  7. Mitigating the Effects of Family Poverty on Early Child Development through Parenting Interventions in Primary Care.

    Science.gov (United States)

    Cates, Carolyn Brockmeyer; Weisleder, Adriana; Mendelsohn, Alan L

    2016-04-01

    Poverty related disparities in early child development and school readiness are a major public health crisis, the prevention of which has emerged in recent years as a national priority. Interventions targeting parenting and the quality of the early home language environment are at the forefront of efforts to address these disparities. In this article we discuss the innovative use of the pediatric primary care platform as part of a comprehensive public health strategy to prevent adverse child development outcomes through the promotion of parenting. Models of interventions in the pediatric primary care setting are discussed with evidence of effectiveness reviewed. Taken together, a review of this significant body of work shows the tremendous potential to deliver evidence-based preventive interventions to families at risk for poverty related disparities in child development and school readiness at the time of pediatric primary care visits. We also addresss considerations related to scaling and maximizing the effect of pediatric primary care parenting interventions and provide key policy recommendations. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  8. Feeding and smoking habits as cumulative risk factors for early childhood caries in toddlers, after adjustment for several behavioral determinants: a retrospective study.

    Science.gov (United States)

    Majorana, Alessandra; Cagetti, Maria Grazia; Bardellini, Elena; Amadori, Francesca; Conti, Giulio; Strohmenger, Laura; Campus, Guglielmo

    2014-02-15

    Several maternal health determinants during the first period of life of the child, as feeding practice, smoking habit and socio-economic level, are involved in early childhood health problems, as caries development. The potential associations among early childhood caries, feeding practices, maternal and environmental smoking exposure, Socio-Economic Status (SES) and several behavioral determinants were investigated. Italian toddlers (n = 2395) aged 24-30 months were recruited and information on feeding practices, sweet dietary habit, maternal smoking habit, SES, and fluoride supplementation in the first year of life was obtained throughout a questionnaire administered to mothers. Caries lesions in toddlers were identified in visual/tactile examinations and classified using the International Caries Detection and Assessment System (ICDAS). Associations between toddlers' caries data and mothers' questionnaire data were assessed using chi-squared test. Ordinal logistic regression was used to analyze associations among caries severity level (ICDAS score), behavioral factors and SES (using mean housing price per square meter as a proxy). Caries prevalence and severity levels were significantly lower in toddlers who were exclusively breastfed and those who received mixed feeding with a moderate-high breast milk component, compared with toddlers who received low mixed feeding and those exclusively fed with formula (p smoked five or more cigarettes/day during pregnancy showed a higher caries severity level (p smoke. Environmental exposure to smoke during the first year of life was also significantly associated with caries severity (odds ratio =7.14, 95% confidence interval = 6.07-7.28). No association was observed between caries severity level and fluoride supplementation. More than 50% of toddlers belonging to families with a low SES, showed moderate or high severity caries levels (p smoke during pregnancy living in area with a low mean housing price per square meter.

  9. Impact of Early Intervention on Expressive and Receptive Language Development among Young Children with Permanent Hearing Loss

    Science.gov (United States)

    Meinzen-Derr, Jareen; Wiley, Susan; Choo, Daniel I.

    2011-01-01

    Along with early detection, early intervention (EI) is critical for children identified with hearing loss. Evidence indicates that many children with sensorineural hearing loss experience improved language abilities if EI services were initiated at an "early" age. The present study's objectives were to determine the impact of a state EI program on…

  10. SPIRIT advance care planning intervention in early stage dementias: An NIH stage I behavioral intervention development trial.

    Science.gov (United States)

    Song, Mi-Kyung; Ward, Sandra E; Hepburn, Kenneth; Paul, Sudeshna; Shah, Raj C; Morhardt, Darby J

    2018-06-02

    People in the early stages of Alzheimer's disease and related dementias (ADRD) are encouraged to engage in advance care planning (ACP) while they are still competent to appoint a surrogate decision maker and meaningfully participate in ACP discussions with the surrogate. In this NIH Stage I behavioral intervention development trial, we will adapt and test an efficacious ACP intervention, SPIRIT (Sharing Patient's Illness Representation to Increase Trust), with people with mild dementia and their surrogates to promote open, honest discussions while such discussions about end-of-life care are possible. We will first adapt SPIRIT (in person) to target people with mild dementia and their surrogates through a process of modification-pretesting-refinement using stakeholders (persons with mild dementia, family caregivers, and clinicians) and experts, including adapting the delivery mode to interactive web-based videoconference format (SPIRIT-remote). Then in a 3-group RCT with 120 patient-surrogate dyads, we will evaluate the feasibility and acceptability of SPIRIT in-person and SPIRIT remote, and preliminary efficacy of SPIRIT compared to usual care on preparedness outcomes for end-of-life decision making (dyad congruence on goals of care, patient decisional conflict, and surrogate decision-making confidence) shortly after the intervention. This Stage I research of SPIRIT will generate valuable insights regarding how to improve ACP for people with mild dementia who will progress to an advanced stage of the disease in the foreseeable future. ClinicalTrials.gov NCT03311711, Registered 10/12/2017. Copyright © 2018. Published by Elsevier Inc.

  11. Early renin-angiotensin system intervention is more beneficial than late intervention in delaying end-stage renal disease in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Schievink, B; Kröpelin, T; Mulder, S

    2016-01-01

    AIMS: To develop and validate a model to simulate progression of diabetic kidney disease (DKD) from early onset until end-stage renal disease (ESRD), and to assess the effect of renin-angiotensin system (RAS) intervention in early, intermediate and advanced stages of DKD. METHODS: We used data from...

  12. The efficacy of early language intervention in mainstream school settings: a randomized controlled trial.

    Science.gov (United States)

    Fricke, Silke; Burgoyne, Kelly; Bowyer-Crane, Claudine; Kyriacou, Maria; Zosimidou, Alexandra; Maxwell, Liam; Lervåg, Arne; Snowling, Margaret J; Hulme, Charles

    2017-10-01

    Oral language skills are a critical foundation for literacy and more generally for educational success. The current study shows that oral language skills can be improved by providing suitable additional help to children with language difficulties in the early stages of formal education. We conducted a randomized controlled trial with 394 children in England, comparing a 30-week oral language intervention programme starting in nursery (N = 132) with a 20-week version of the same programme starting in Reception (N = 133). The intervention groups were compared to an untreated waiting control group (N = 129). The programmes were delivered by trained teaching assistants (TAs) working in the children's schools/nurseries. All testers were blind to group allocation. Both the 20- and 30-week programmes produced improvements on primary outcome measures of oral language skill compared to the untreated control group. Effect sizes were small to moderate (20-week programme: d = .21; 30-week programme: d = .30) immediately following the intervention and were maintained at follow-up 6 months later. The difference in improvement between the 20-week and 30-week programmes was not statistically significant. Neither programme produced statistically significant improvements in children's early word reading or reading comprehension skills (secondary outcome measures). This study provides further evidence that oral language interventions can be delivered successfully by trained TAs to children with oral language difficulties in nursery and Reception classes. The methods evaluated have potentially important policy implications for early education. © 2017 Association for Child and Adolescent Mental Health.

  13. The C'JAAD: a French team for early intervention in psychosis in Paris.

    Science.gov (United States)

    Oppetit, Alice; Bourgin, Julie; Martinez, Gilles; Kazes, Mathilde; Mam-Lam-Fook, Célia; Gaillard, Raphael; Olié, Jean-Pierre; Krebs, Marie-Odile

    2018-04-01

    The aim is to describe a centre operating in Paris that pioneers the early intervention for young people at the onset and at high risk of psychosis in France. Comprehensive descriptive analysis of different clinical and service measures is used in describing the implementation of the C'JAAD (Evaluation Centre for Young Adults and Adolescents) using data from an ongoing prospective non-interventional research programme. Over a 2-year period, 151 patients were referred to the C'JAAD and included in the ICAAR research programme. After evaluation by the Comprehensive Assessment of the At-Risk Mental States Scale, 53.7% were identified at risk of developing a psychosis, 20.6% presented a full-blown psychosis and 25.7% were considered not at risk of developing a psychosis. A total of 84% of the at-risk subjects suffered from a psychiatric co-morbidity, of which anxiodepressive symptoms being the most frequent (39%). The global functioning of these at-risk subjects was seriously impaired (average Social and Occupational Functioning Assessment Scale score = 48.9). More than one third of the patients was self-referred (33.8%), 22.5% were addressed by a psychiatrist whereas 10.6% were referred by a general practitioner. In this paper, we report for the first time the activities of the C'JAAD, the pioneer unit in France for early detection and treatment of young adults with early psychosis. These observations indicate that such early intervention centre is a feasible and sustainable extension of traditional care for people with mental disorders in this country and offers promising perspective for the development of further centres. © 2016 John Wiley & Sons Australia, Ltd.

  14. Three year outcomes in an early intervention service for psychosis in a multicultural and multiethnic population.

    Science.gov (United States)

    Agius, Mark; Shah, Samir; Ramkisson, Roshelle; Persaud, Albert; Murphy, Suzanne; Zaman, Rashid

    2008-12-01

    Concern has been expressed that it may be difficult to provide certain interventions to some ethnic groups in an Early Intervention Service for Psychosis, and that as a consequence, three-year outcomes for the different Ethnic Groups may be different in different groups. To test whether there are differences between the three year outcomes of different ethnic groups represented in the patient population of an Early Intervention service for Psychosis. The three-year outcomes for the first group of 62 Patients to receive three years treatment in the Early Intervention Service in Luton, Bedfordshire were examined. This group well represented the ethnic mix of the population of Luton. It does not appear that there are major differences between the three-year outcomes of any one of the three groups studied. However the South Asian Patients appear to present earlier, with shorter DUPs, seemed more likely to marry, live with their families, and seem more likely to return to higher education after a first psychotic episode of psychosis compared to the Caucasians. Afro-Carribeans and South Asians were more likely to be unemployed, but many South Asians were employed, as were Caucasians. The fewest persons employed were in the Afro-Caribbean group. While slightly more South Asians and Afro-Carribeans were admitted compulsorily under the mental health act over the three years, 60% of each of the two non-white groups were never admitted compulsorily. This is different from the reported national trends of the Mental Health act being used excessively with the Afro-Caribbean population. No previous study has looked at the outcomes of Early Intervention Services for First Psychotic Episodes according to the Ethnic Origin of the Clients. The better outcomes seen with South Asians are probably due to cultural factors among the South Asians born in this country, rather than to issues related to the Psychotic Illness itself. These findings are important in planning services in areas

  15. Vocabulary development and intervention for English learners in the early grades.

    Science.gov (United States)

    Baker, Doris Luft; Al Otaiba, Stephanie; Ortiz, Miriam; Correa, Vivian; Cole, Ron

    2014-01-01

    The purpose of this chapter is to describe the vocabulary development and promising, evidence-based vocabulary interventions for English learners (ELs) from preschool through second grade. To achieve this purpose, we have taken six steps. First, we describe the elements of language development in the native language (L1) and a second language (L2) and how these elements relate to three phases of reading development (i.e., the prereading phase, the learning to read phase, and the reading to learn phase). We contend that in order for ELs to succeed in school, they need a strong language foundation prior to entering kindergarten. This language foundation needs to continue developing during the "learning to read" and "reading to learn" phases. Second, we describe the limitations of current practice in preschool for ELs related to vocabulary instruction and to family involvement to support children's language development. Third, we report curricular challenges faced by ELs in early elementary school, and we relate these challenges to the increase in reading and language demands outlined in the Common Core State Standards (CCSS). Specific language activities that can help meet some of the demands are provided in a table. Fourth, we synthesize the research on evidence-based vocabulary instruction and intervention and discuss implications for practice with ELs. Fifth, we describe two intervention projects under development that have the potential to improve EL vocabulary and language proficiency in the early grades. We conclude with a summary of the chapter and provide additional resources on the topic.

  16. Nurses' experience of using an application to support new parents after early discharge: an intervention study.

    Science.gov (United States)

    Boe Danbjørg, Dorthe; Wagner, Lis; Rønde Kristensen, Bjarne; Clemensen, Jane

    2015-01-01

    Background. A development towards earlier postnatal discharge presents a challenge to find new ways to provide information and support to families. A possibility is the use of telemedicine. Objective. To explore how using an app in nursing practice affects the nurses' ability to offer support and information to postnatal mothers who are discharged early and their families. Design. Participatory design. An app with a chat, a knowledgebase, and automated messages was tried out between hospital and parents at home. Settings. The intervention took place on a postnatal ward with approximately 1,000 births a year. Participants. At the onset of the intervention, 17 nurses, all women, were working on the ward. At the end of the intervention, 16 nurses were employed, all women. Methods. Participant observation and two focus group interviews. The data analysis was inspired by systematic text condensation. Results. The nurses on the postnatal ward consider that the use of the app gives families easier access to timely information and support. Conclusions. The app gives the nurses the possibility to offer support and information to the parents being early discharged. The app is experienced as a lifeline that connects the homes of the new parents with the hospital.

  17. Nurses’ Experience of Using an Application to Support New Parents after Early Discharge: An Intervention Study

    Directory of Open Access Journals (Sweden)

    Dorthe Boe Danbjørg

    2015-01-01

    Full Text Available Background. A development towards earlier postnatal discharge presents a challenge to find new ways to provide information and support to families. A possibility is the use of telemedicine. Objective. To explore how using an app in nursing practice affects the nurses’ ability to offer support and information to postnatal mothers who are discharged early and their families. Design. Participatory design. An app with a chat, a knowledgebase, and automated messages was tried out between hospital and parents at home. Settings. The intervention took place on a postnatal ward with approximately 1,000 births a year. Participants. At the onset of the intervention, 17 nurses, all women, were working on the ward. At the end of the intervention, 16 nurses were employed, all women. Methods. Participant observation and two focus group interviews. The data analysis was inspired by systematic text condensation. Results. The nurses on the postnatal ward consider that the use of the app gives families easier access to timely information and support. Conclusions. The app gives the nurses the possibility to offer support and information to the parents being early discharged. The app is experienced as a lifeline that connects the homes of the new parents with the hospital.

  18. The Role of Language Skill in Child Psychopathology: Implications for Intervention in the Early Years.

    Science.gov (United States)

    Salmon, Karen; O'Kearney, Richard; Reese, Elaine; Fortune, Clare-Ann

    2016-12-01

    In this narrative review, we suggest that children's language skill should be targeted in clinical interventions for children with emotional and behavioral difficulties in the preschool years. We propose that language skill predicts childhood emotional and behavioral problems and this relationship may be mediated by children's self-regulation and emotion understanding skills. In the first sections, we review recent high-quality longitudinal studies which together demonstrate that that children's early language skill predicts: (1) emotional and behavioral problems, and this relationship is stronger than the reverse pattern; (2) self-regulation skill; this pattern may be stronger than the reverse pattern but moderated by child age. Findings also suggest that self-regulation skill mediates the relation between early language skill and children's emotional and behavioral problems. There is insufficient evidence regarding the mediating role of emotion understanding. In subsequent sections, we review evidence demonstrating that: (1) particular kinds of developmentally targeted parent-child conversations play a vital role in the development of language skill, and (2) some current clinical interventions, directly or indirectly, have a beneficial impact on children's vocabulary and narrative skills, but most approaches are ad hoc. Targeting language via parent-child conversation has the potential to improve the outcomes of current clinical interventions in the preschool years.

  19. CUMBIN - CUMULATIVE BINOMIAL PROGRAMS

    Science.gov (United States)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CUMBIN, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), can be used independently of one another. CUMBIN can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CUMBIN calculates the probability that a system of n components has at least k operating if the probability that any one operating is p and the components are independent. Equivalently, this is the reliability of a k-out-of-n system having independent components with common reliability p. CUMBIN can evaluate the incomplete beta distribution for two positive integer arguments. CUMBIN can also evaluate the cumulative F distribution and the negative binomial distribution, and can determine the sample size in a test design. CUMBIN is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. The CUMBIN program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CUMBIN was developed in 1988.

  20. Cumulation of light nuclei

    International Nuclear Information System (INIS)

    Baldin, A.M.; Bondarev, V.K.; Golovanov, L.B.

    1977-01-01

    Limit fragmentation of light nuclei (deuterium, helium) bombarded with 8,6 GeV/c protons was investigated. Fragments (pions, protons and deuterons) were detected within the emission angle 50-150 deg with regard to primary protons and within the pulse range 150-180 MeV/c. By the kinematics of collision of a primary proton with a target at rest the fragments observed correspond to a target mass upto 3 GeV. Thus, the data obtained correspond to teh cumulation upto the third order

  1. Results from a pediatric surgical centre justify early intervention in disorders of sex development.

    Science.gov (United States)

    Crawford, Jennifer M; Warne, Garry; Grover, Sonia; Southwell, Bridget R; Hutson, John M

    2009-02-01

    Controversy persists surrounding early management of disorders of sex development. We assessed genital appearance, gender identity, and quality of life in prepubertal children who have had early surgical intervention. Children treated for disorders of sex development who were 5 to 10 years of age were eligible (n = 54). Children were scored (modified Creighton scale) for anatomical and cosmetic outcome, and both patients and parents completed PedsQL quality-of-life and gender identity questionnaires, with ethics approval. Of 54 patients, 41 presented for review. Treatment began at 13.2 (1.8-250.1) months (median; range) and were reviewed at 7.5 +/- 2.1 (mean +/- SD) years of age. Nineteen were raised as girls and 22 as boys. Girls had good (85%) or satisfactory (15%) anatomical/cosmetic outcome, whereas 52% boys had good, 38% satisfactory, and 10% poor cosmetic outcomes. On gender identity questionnaire, boys scored 3.9 +/- 0.4 (mean +/- SD) and girls 3.6 +/- 0.5; 1 of 19 boys and 3 of 19 girls had lower scores, suggesting risk of gender identity disorder. Quality-of-life scores were 80+ for physical and 65 to 80 for psychosocial scores. Early intervention is generally associated with positive outcomes for patients and parents. Girls had better anatomical outcomes than boys, and gender dysphoria risks were low in both sexes.

  2. Cell-based interventions for neurologic conditions: ethical challenges for early human trials.

    Science.gov (United States)

    Mathews, D J H; Sugarman, J; Bok, H; Blass, D M; Coyle, J T; Duggan, P; Finkel, J; Greely, H T; Hillis, A; Hoke, A; Johnson, R; Johnston, M; Kahn, J; Kerr, D; Kurtzberg, J; Liao, S M; McDonald, J W; McKhann, G; Nelson, K B; Rao, M; Regenberg, A; Siegel, A W; Smith, K; Solter, D; Song, H; Vescovi, A; Young, W; Gearhart, J D; Faden, R

    2008-07-22

    Attempts to translate basic stem cell research into treatments for neurologic diseases and injury are well under way. With a clinical trial for one such treatment approved and in progress in the United States, and additional proposals under review, we must begin to address the ethical issues raised by such early forays into human clinical trials for cell-based interventions for neurologic conditions. An interdisciplinary working group composed of experts in neuroscience, cell biology, bioethics, law, and transplantation, along with leading disease researchers, was convened twice over 2 years to identify and deliberate on the scientific and ethical issues raised by the transition from preclinical to clinical research of cell-based interventions for neurologic conditions. While the relevant ethical issues are in many respects standard challenges of human subjects research, they are heightened in complexity by the novelty of the science, the focus on the CNS, and the political climate in which the science is proceeding. Distinctive challenges confronting US scientists, administrators, institutional review boards, stem cell research oversight committees, and others who will need to make decisions about work involving stem cells and their derivatives and evaluate the ethics of early human trials include evaluating the risks, safety, and benefits of these trials, determining and evaluating cell line provenance, and determining inclusion criteria, informed consent, and the ethics of conducting early human trials in the public spotlight. Further study and deliberation by stakeholders is required to move toward professional and institutional policies and practices governing this research.

  3. Face to face interventions for informing or educating parents about early childhood vaccination.

    Science.gov (United States)

    Kaufman, Jessica; Synnot, Anneliese; Ryan, Rebecca; Hill, Sophie; Horey, Dell; Willis, Natalie; Lin, Vivian; Robinson, Priscilla

    2013-05-31

    Childhood vaccination (also described as immunisation) is an important and effective way to reduce childhood illness and death. However, there are many children who do not receive the recommended vaccines because their parents do not know why vaccination is important, do not understand how, where or when to get their children vaccinated, disagree with vaccination as a public health measure, or have concerns about vaccine safety.Face to face interventions to inform or educate parents about routine childhood vaccination may improve vaccination rates and parental knowledge or understanding of vaccination. Such interventions may describe or explain the practical and logistical factors associated with vaccination, and enable parents to understand the meaning and relevance of vaccination for their family or community. To assess the effects of face to face interventions for informing or educating parents about early childhood vaccination on immunisation uptake and parental knowledge. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7); MEDLINE (OvidSP) (1946 to July 2012); EMBASE + Embase Classic (OvidSP) (1947 to July 2012); CINAHL (EbscoHOST) (1981 to July 2012); PsycINFO (OvidSP) (1806 to July 2012); Global Health (CAB) (1910 to July 2012); Global Health Library (WHO) (searched July 2012); Google Scholar (searched September 2012), ISI Web of Science (searched September 2012) and reference lists of relevant articles. We searched for ongoing trials in The International Clinical Trials Registry Platform (ICTRP) (searched August 2012) and for grey literature in The Grey Literature Report and OpenGrey (searched August 2012). We also contacted authors of included studies and experts in the field. There were no language or date restrictions. Randomised controlled trials (RCTs) and cluster RCTs evaluating the effects of face to face interventions delivered to individual parents or groups of parents to inform or educate

  4. Can Targeted Intervention Mitigate Early Emotional and Behavioral Problems?: Generating Robust Evidence within Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Orla Doyle

    Full Text Available This study examined the impact of a targeted Irish early intervention program on children's emotional and behavioral development using multiple methods to test the robustness of the results. Data on 164 Preparing for Life participants who were randomly assigned into an intervention group, involving home visits from pregnancy onwards, or a control group, was used to test the impact of the intervention on Child Behavior Checklist scores at 24-months. Using inverse probability weighting to account for differential attrition, permutation testing to address small sample size, and quantile regression to characterize the distributional impact of the intervention, we found that the few treatment effects were largely concentrated among boys most at risk of developing emotional and behavioral problems. The average treatment effect identified a 13% reduction in the likelihood of falling into the borderline clinical threshold for Total Problems. The interaction and subgroup analysis found that this main effect was driven by boys. The distributional analysis identified a 10-point reduction in the Externalizing Problems score for boys at the 90th percentile. No effects were observed for girls or for the continuous measures of Total, Internalizing, and Externalizing problems. These findings suggest that the impact of this prenatally commencing home visiting program may be limited to boys experiencing the most difficulties. Further adoption of the statistical methods applied here may help to improve the internal validity of randomized controlled trials and contribute to the field of evaluation science more generally.ISRCTN Registry ISRCTN04631728.

  5. Youth mental health in deprived urban areas: a Delphi study on the role of the GP in early intervention.

    LENUS (Irish Health Repository)

    Schaffalitzky, E

    2014-09-06

    GPs, as healthcare professionals with whom young people commonly interact, have a central role in early intervention for mental health problems. However, successfully fulfilling this role is a challenge, and this is especially in deprived urban areas.

  6. The effect of IPS-modified, an early intervention for people with mood and anxiety disorders

    DEFF Research Database (Denmark)

    Hellström, Lone; Bech, Per; Nordentoft, Merete

    2013-01-01

    that Individual Placement and Support (IPS) has a positive effect on employment when provided to people with severe mental illness. This modified IPS intervention is aimed at supporting people with recently diagnosed anxiety or affective disorders in regaining their ability to work and facilitate their return......Anxiety and affective disorders can be disabling and have a major impact on the ability to work. In Denmark, people with a mental disorder, and mainly non-psychotic disorders, represent a substantial and increasing part of those receiving disability pensions. Previous studies have indicated...... to work or education.Aim: To investigate whether an early modified IPS intervention has an effect on employment and education when provided to people with recently diagnosed anxiety or affective disorders in a Danish context.Methods/design: The trial is a randomised, assessor-blinded, clinical superiority...

  7. Methods for evaluating a mature substance abuse prevention/early intervention program.

    Science.gov (United States)

    Becker, L R; Hall, M; Fisher, D A; Miller, T R

    2000-05-01

    The authors describe methods for work in progress to evaluate four workplace prevention and/or early intervention programs designed to change occupational norms and reduce substance abuse at a major U.S. transportation company. The four programs are an employee assistance program, random drug testing, managed behavioral health care, and a peer-led intervention program. An elaborate mixed-methods evaluation combines data collection and analysis techniques from several traditions. A process-improvement evaluation focuses on the peer-led component to describe its evolution, document the implementation process for those interested in replicating it, and provide information for program improvement. An outcome-assessment evaluation examines impacts of the four programs on job performance measures (e.g., absenteeism, turnover, injury, and disability rates) and includes a cost-offset and employer cost-savings analysis. Issues related to using archival data, combining qualitative and quantitative designs, and working in a corporate environment are discussed.

  8. CROSSER - CUMULATIVE BINOMIAL PROGRAMS

    Science.gov (United States)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CROSSER, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), can be used independently of one another. CROSSER can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CROSSER calculates the point at which the reliability of a k-out-of-n system equals the common reliability of the n components. It is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The CROSSER program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CROSSER was developed in 1988.

  9. Investigating service features to sustain engagement in early intervention mental health services.

    Science.gov (United States)

    Becker, Mackenzie; Cunningham, Charles E; Christensen, Bruce K; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Madsen, Victoria; Bieling, Peter; Chen, Yvonne; Mielko, Stephanie; Zipursky, Robert B

    2017-08-23

    To understand what service features would sustain patient engagement in early intervention mental health treatment. Mental health patients, family members of individuals with mental illness and mental health professionals completed a survey consisting of 18 choice tasks that involved 14 different service attributes. Preferences were ascertained using importance and utility scores. Latent class analysis revealed segments characterized by distinct preferences. Simulations were carried out to estimate utilization of hypothetical clinical services. Overall, 333 patients and family members and 183 professionals (N = 516) participated. Respondents were distributed between a Professional segment (53%) and a Patient segment (47%) that differed in a number of their preferences including for appointment times, individual vs group sessions and mode of after-hours support. Members of both segments shared preferences for many of the service attributes including having crisis support available 24 h per day, having a choice of different treatment modalities, being offered help for substance use problems and having a focus on improving symptoms rather than functioning. Simulations predicted that 60% of the Patient segment thought patients would remain engaged with a Hospital service, while 69% of the Professional segment thought patients would be most likely to remain engaged with an E-Health service. Patients, family members and professionals shared a number of preferences about what service characteristics will optimize patient engagement in early intervention services but diverged on others. Providing effective crisis support as well as a range of treatment options should be prioritized in the future design of early intervention services. © 2017 John Wiley & Sons Australia, Ltd.

  10. Can Early Intervention Improve Maternal Well-Being? Evidence from a Randomized Controlled Trial.

    Science.gov (United States)

    Doyle, Orla; Delaney, Liam; O'Farrelly, Christine; Fitzpatrick, Nick; Daly, Michael

    2017-01-01

    This study estimates the effect of a targeted early childhood intervention program on global and experienced measures of maternal well-being utilizing a randomized controlled trial design. The primary aim of the intervention is to improve children's school readiness skills by working directly with parents to improve their knowledge of child development and parenting behavior. One potential externality of the program is well-being benefits for parents given its direct focus on improving parental coping, self-efficacy, and problem solving skills, as well as generating an indirect effect on parental well-being by targeting child developmental problems. Participants from a socio-economically disadvantaged community are randomly assigned during pregnancy to an intensive 5-year home visiting parenting program or a control group. We estimate and compare treatment effects on multiple measures of global and experienced well-being using permutation testing to account for small sample size and a stepdown procedure to account for multiple testing. The intervention has no impact on global well-being as measured by life satisfaction and parenting stress or experienced negative affect using episodic reports derived from the Day Reconstruction Method (DRM). Treatment effects are observed on measures of experienced positive affect derived from the DRM and a measure of mood yesterday. The limited treatment effects suggest that early intervention programs may produce some improvements in experienced positive well-being, but no effects on negative aspects of well-being. Different findings across measures may result as experienced measures of well-being avoid the cognitive biases that impinge upon global assessments.

  11. WHO Global Consultation on Public Health Intervention against Early Childhood Caries.

    Science.gov (United States)

    Phantumvanit, Prathip; Makino, Yuka; Ogawa, Hiroshi; Rugg-Gunn, Andrew; Moynihan, Paula; Petersen, Poul Erik; Evans, Wendell; Feldens, Carlos Alberto; Lo, Edward; Khoshnevisan, Mohammad H; Baez, Ramon; Varenne, Benoit; Vichayanrat, Tippanart; Songpaisan, Yupin; Woodward, Margaret; Nakornchai, Siriruk; Ungchusak, Chantana

    2018-01-30

    Early Childhood Caries (ECC) is prevalent around the world, but in particular the disease is growing rapidly in low- and middle-income countries in parallel with changing diet and lifestyles. In many countries, ECC is often left untreated, a condition which leads to pain and adversely affects general health, growth and development, and quality of life of children, their families and their communities. Importantly, ECC is also a global public health burden, medically, socially and economically. In many countries, a substantial number of children require general anaesthesia for the treatment of caries in their primary teeth (usually extractions), and this has considerable cost and social implications. A WHO Global Consultation with oral health experts on "Public Health Intervention against Early Childhood Caries" was held on 26-28 January 2016 in Bangkok (Thailand) to identify public health solutions and to highlight their applicability to low- and middle-income countries. After a 3-day consultation, participants agreed on specific recommendations for further action. National health authorities should develop strategies and implement interventions aimed at preventing and controlling ECC. These should align with existing international initiatives such as the Sixtieth World Health Assembly Resolution WHA 60.17 Oral health: action plan for promotion and integrated disease prevention, WHO Guideline on Sugars and WHO breastfeeding recommendation. ECC prevention and control interventions should be integrated into existing primary healthcare systems. WHO public health principles must be considered when tackling the effect of social determinants in ECC. Initiatives aimed at modifying behaviour should focus on families and communities. The involvement of communities in health promotion, and population-directed and individual fluoride administration for the prevention and control of ECC is essential. Surveillance and research, including cost-effectiveness studies, should be

  12. Can Early Intervention Improve Maternal Well-Being? Evidence from a Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Orla Doyle

    Full Text Available This study estimates the effect of a targeted early childhood intervention program on global and experienced measures of maternal well-being utilizing a randomized controlled trial design. The primary aim of the intervention is to improve children's school readiness skills by working directly with parents to improve their knowledge of child development and parenting behavior. One potential externality of the program is well-being benefits for parents given its direct focus on improving parental coping, self-efficacy, and problem solving skills, as well as generating an indirect effect on parental well-being by targeting child developmental problems.Participants from a socio-economically disadvantaged community are randomly assigned during pregnancy to an intensive 5-year home visiting parenting program or a control group. We estimate and compare treatment effects on multiple measures of global and experienced well-being using permutation testing to account for small sample size and a stepdown procedure to account for multiple testing.The intervention has no impact on global well-being as measured by life satisfaction and parenting stress or experienced negative affect using episodic reports derived from the Day Reconstruction Method (DRM. Treatment effects are observed on measures of experienced positive affect derived from the DRM and a measure of mood yesterday.The limited treatment effects suggest that early intervention programs may produce some improvements in experienced positive well-being, but no effects on negative aspects of well-being. Different findings across measures may result as experienced measures of well-being avoid the cognitive biases that impinge upon global assessments.

  13. Brief oral health promotion intervention among parents of young children to reduce early childhood dental decay

    Science.gov (United States)

    2013-01-01

    Background Severe untreated dental decay affects a child’s growth, body weight, quality of life as well as cognitive development, and the effects extend beyond the child to the family, the community and the health care system. Early health behavioural factors, including dietary practices and eating patterns, can play a major role in the initiation and development of oral diseases, particularly dental caries. The parent/caregiver, usually the mother, has a critical role in the adoption of protective health care behaviours and parental feeding practices strongly influence children’s eating behaviours. This study will test if an early oral health promotion intervention through the use of brief motivational interviewing (MI) and anticipatory guidance (AG) approaches can reduce the incidence of early childhood dental decay and obesity. Methods The study will be a randomised controlled study with parents and their new-born child/ren who are seen at 6–12 weeks of age by a child/community health nurse. Consenting parents will complete a questionnaire on oral health knowledge, behaviours, self-efficacy, oral health fatalism, parenting stress, prenatal and peri-natal health and socio-demographic factors at study commencement and at 12 and 36 months. Each child–parent pair will be allocated to an intervention or a standard care group, using a computer-generated random blocks. The standard group will be managed through the standard early oral health screening program; “lift the lip”. The intervention group will be provided with tailored oral health counselling by oral health consultants trained in MI and AG. Participating children will be examined at 24, and 36 months for the occurrence of dental decay and have their height and weight recorded. Dietary information obtained from a food frequency chart will be used to determine food and dietary patterns. Data analysis will use intention to treat and per protocol analysis and will use tests of independent

  14. Brief oral health promotion intervention among parents of young children to reduce early childhood dental decay.

    Science.gov (United States)

    Arrow, Peter; Raheb, Joseph; Miller, Margaret

    2013-03-20

    Severe untreated dental decay affects a child's growth, body weight, quality of life as well as cognitive development, and the effects extend beyond the child to the family, the community and the health care system. Early health behavioural factors, including dietary practices and eating patterns, can play a major role in the initiation and development of oral diseases, particularly dental caries. The parent/caregiver, usually the mother, has a critical role in the adoption of protective health care behaviours and parental feeding practices strongly influence children's eating behaviours. This study will test if an early oral health promotion intervention through the use of brief motivational interviewing (MI) and anticipatory guidance (AG) approaches can reduce the incidence of early childhood dental decay and obesity. The study will be a randomised controlled study with parents and their new-born child/ren who are seen at 6-12 weeks of age by a child/community health nurse. Consenting parents will complete a questionnaire on oral health knowledge, behaviours, self-efficacy, oral health fatalism, parenting stress, prenatal and peri-natal health and socio-demographic factors at study commencement and at 12 and 36 months. Each child-parent pair will be allocated to an intervention or a standard care group, using a computer-generated random blocks. The standard group will be managed through the standard early oral health screening program; "lift the lip". The intervention group will be provided with tailored oral health counselling by oral health consultants trained in MI and AG.Participating children will be examined at 24, and 36 months for the occurrence of dental decay and have their height and weight recorded. Dietary information obtained from a food frequency chart will be used to determine food and dietary patterns. Data analysis will use intention to treat and per protocol analysis and will use tests of independent proportions and means. Multivariate

  15. [Child maltreatment and new morbidity in pediatrics : Consequences for early child support and child protective interventions].

    Science.gov (United States)

    Kindler, Heinz

    2016-10-01

    The effects of child maltreatment on children's chronic health conditions have become more visible during recent years. This is true for mental health problems as well as some chronic physical conditions, both summarized as new morbidity within pediatrics. As several Bradford Hill criteria (criteria from epidemiology for the determination of the causal nature of a statistical association) are met, the likely causal nature of underlying associations is discussed. Early family support may have the potential to modify such associations, although empirical evidence is lacking. At least for attachment-based interventions with foster carerers after child maltreatment, positive effects on child HPA axis dysregulation have been demonstrated.

  16. Baby or bathwater? Referrals of "non-cases" in a targeted early identification intervention for psychosis.

    Science.gov (United States)

    Jordan, Gerald; Kinkaid, Miriam; Iyer, Srividya N; Joober, Ridha; Goldberg, Karen; Malla, Ashok; Shah, Jai L

    2018-03-14

    To explore the unintended impact of a targeted case identification (TCI) campaign for first episode psychosis (FEP) on people not experiencing FEP ("non-cases") with respect to referral patterns and reasons for being a non-case. Sources of referral, reasons for being a non-case, and subsequent referral destinations of non-cases were examined before and after a TCI. Following the TCI, a greater proportion of non-cases lived outside the study catchment area. A smaller proportion was referred by the parent hospital's emergency room or had a substance-induced psychosis. TCIs for FEP may have unintended effects, with implications for early case identification and early intervention services.

  17. Early signs of mobility decline and physical activity counseling as a preventive intervention in older people

    DEFF Research Database (Denmark)

    Mänty, Minna Regina

    indicate that self-reported preclinical mobility limitation and fall history should be considered as important early indicators of functional decline among community-dwelling older adults. In addition, the results suggest that physical activity counseling for older adults may provide an effective means......The purpose of this study was to examine the early signs of mobility decline and falls in older people. In addition, the effects of physical activity counseling on the development of mobility limitation in an older community-dwelling population were studied. Data from two larger studies were used......: Screening and Counseling for Physical activity and Mobility among Older People, SCAMOB, a 2-year single-blinded randomized controlled trial (n=632) with a 1.5-year post-intervention follow-up, focused on 75 to 81-year-old community-dwelling people and the FITSA study, a 3-year prospective observational...

  18. Active Early: one-year policy intervention to increase physical activity among early care and education programs in Wisconsin

    Directory of Open Access Journals (Sweden)

    Tara L. LaRowe

    2016-07-01

    the EPAO; scores showing the greatest increases were the Training and Education (14.5 ± 6.5 at 12-months vs. 2.4 ± 3.8 at baseline, p < 0.01 and Physical Activity Policy (18.6 ± 4.6 at 12-months vs. 2.0 ± 4.1 at baseline, p < 0.01. Conclusions Active Early promoted improvements in providing structured (i.e. teacher-led physical activity beyond the recommended 60 daily minutes using low- to no-cost strategies along with training and environmental changes. Furthermore, it was observed that Active Early positively impacted child physical activity levels by the end of the intervention. However, resources, training, and technical assistance may be necessary for ECE programs to be successful beyond the use of the Active Early guide. Implementing local-level physical activity policies combined with support from local and statewide partners has the potential to influence higher standards for regulated ECE programs.

  19. Meta-Analysis of Studies Incorporating the Interests of Young Children with Autism Spectrum Disorders into Early Intervention Practices

    Directory of Open Access Journals (Sweden)

    Carl J. Dunst

    2012-01-01

    Full Text Available Incorporating the interests and preferences of young children with autism spectrum disorders into interventions to promote prosocial behavior and decrease behavior excesses has emerged as a promising practice for addressing the core features of autism. The efficacy of interest-based early intervention practices was examined in a meta-analysis of 24 studies including 78 children 2 to 6 years of age diagnosed with autism spectrum disorders. Effect size analyses of intervention versus nonintervention conditions and high-interest versus low-interest contrasts indicated that interest-based intervention practices were effective in terms of increasing prosocial and decreasing aberrant child behavior. Additionally, interest-based interventions that focused on two of the three core features of autism spectrum disorders (poor communication, poor interpersonal relationships were found most effective in influencing child outcomes. Implications for very early intervention are discussed in terms addressing the behavior markers of autism spectrum disorders before they become firmly established.

  20. Interventions aimed at communities to inform and/or educate about early childhood vaccination.

    Science.gov (United States)

    Saeterdal, Ingvil; Lewin, Simon; Austvoll-Dahlgren, Astrid; Glenton, Claire; Munabi-Babigumira, Susan

    2014-11-19

    -making regarding childhood vaccination (adjusted mean difference 0.043, 95% CI -0.009 to 0.097).The studies did not assess knowledge among participants of vaccine service delivery; participant confidence in the vaccination decision; intervention costs; or any unintended harms as a consequence of the intervention. We did not identify any studies that compared interventions aimed at communities to inform and/or educate with interventions directed to individual parents or caregivers, or studies that compared two interventions aimed at communities to inform and/or educate about childhood vaccination. This review provides limited evidence that interventions aimed at communities to inform and educate about early childhood vaccination may improve attitudes towards vaccination and probably increase vaccination uptake under some circumstances. However, some of these interventions may be resource intensive when implemented on a large scale and further rigorous evaluations are needed. These interventions may achieve most benefit when targeted to areas or groups that have low childhood vaccination rates.'

  1. A pilot study on early home-based intervention through an intelligent baby gym (CareToy) in preterm infants

    DEFF Research Database (Denmark)

    Sgandurra, Giuseppina; Bartalena, Laura; Cecchi, Francesca

    2016-01-01

    BACKGROUND: CareToy is an intelligent system, inspired by baby gyms, aimed to provide an intensive, individualized, home-based and family-centred early intervention (EI) program. AIMS: A pilot study was carried out to explore the feasibility of CareToy intervention in preterm infants, aged 3....... An adequately powered randomized clinical trial is warranted....

  2. Maternal Locus of Control and Perception of Family Status at Entry and Exit of Birth to Three Early Intervention

    Science.gov (United States)

    Coffaro, Ann

    2009-01-01

    Birth to three early intervention is unique time in the life of a family of a child with a disability in that confidence and competence of the parents can be addressed as part of the intervention goals and objectives. Locus of control is a quality measure of a parent's perception of their ability to be their child's teacher, advocate, and champion…

  3. Randomized Controlled Trial for Early Intervention for Autism: A Pilot Study of the Autism 1-2-3 Project

    Science.gov (United States)

    Wong, Virginia C. N.; Kwan, Queenie K.

    2010-01-01

    We piloted a 2-week "Autism-1-2-3" early intervention for children with autism and their parents immediately after diagnosis that targeted at (1) eye contact, (2) gesture and (3) vocalization/words. Seventeen children were randomized into the Intervention (n = 9) and Control (n = 8) groups. Outcome measures included the Autism Diagnostic…

  4. Early Intervention for Preschoolers at Risk for Attention-Deficit/Hyperactivity Disorder: Preschool First Step to Success

    Science.gov (United States)

    Feil, Edward G.; Small, Jason W.; Seeley, John R.; Walker, Hill M.; Golly, Annemieke; Forness, Steven R.

    2016-01-01

    This study evaluated the efficacy of the Preschool First Step (PFS) to Success early intervention for children at risk for attention deficit hyperactivity disorder (ADHD). PFS is a targeted intervention for children 3-5 years old with externalizing behavior problems and addresses secondary prevention goals and objectives. As part of a larger…

  5. 32 CFR Appendix A to Part 57 - Procedures for the Provision of Early Intervention Services for Infants and Toddlers With...

    Science.gov (United States)

    2010-07-01

    ... developmental areas: (i) Cognitive development. (ii) Physical development, including vision and hearing. (iii... Intervention Services for Infants and Toddlers With Disabilities and Their Families A Appendix A to Part 57... Appendix A to Part 57—Procedures for the Provision of Early Intervention Services for Infants and Toddlers...

  6. Meta-Analysis of Studies Incorporating the Interests of Young Children with Autism Spectrum Disorders into Early Intervention Practices

    OpenAIRE

    Dunst, Carl J.; Trivette, Carol M.; Hamby, Deborah W.

    2012-01-01

    Incorporating the interests and preferences of young children with autism spectrum disorders into interventions to promote prosocial behavior and decrease behavior excesses has emerged as a promising practice for addressing the core features of autism. The efficacy of interest-based early intervention practices was examined in a meta-analysis of 24 studies including 78 children 2 to 6 years of age diagnosed with autism spectrum disorders. Effect size analyses of intervention versus noninterve...

  7. Early Dysphagia Screening by Trained Nurses Reduces Pneumonia Rate in Stroke Patients: A Clinical Intervention Study.

    Science.gov (United States)

    Palli, Christoph; Fandler, Simon; Doppelhofer, Kathrin; Niederkorn, Kurt; Enzinger, Christian; Vetta, Christian; Trampusch, Esther; Schmidt, Reinhold; Fazekas, Franz; Gattringer, Thomas

    2017-09-01

    Dysphagia is a common stroke symptom and leads to serious complications such as aspiration and pneumonia. Early dysphagia screening can reduce these complications. In many hospitals, dysphagia screening is performed by speech-language therapists who are often not available on weekends/holidays, which results in delayed dysphagia assessment. We trained the nurses of our neurological department to perform formal dysphagia screening in every acute stroke patient by using the Gugging Swallowing Screen. The impact of a 24/7 dysphagia screening (intervention) over swallowing assessment by speech-language therapists during regular working hours only was compared in two 5-month periods with time to dysphagia screening, pneumonia rate, and length of hospitalization as outcome variables. Overall, 384 patients (mean age, 72.3±13.7 years; median National Institutes of Health Stroke Scale score of 3) were included in the study. Both groups (pre-intervention, n=198 versus post-intervention, n=186) were comparable regarding age, sex, and stroke severity. Time to dysphagia screening was significantly reduced in the intervention group (median, 7 hours; range, 1-69 hours) compared with the control group (median, 20 hours; range, 1-183; P =0.001). Patients in the intervention group had a lower rate of pneumonia (3.8% versus 11.6%; P =0.004) and also a reduced length of hospital stay (median, 8 days; range, 2-40 versus median, 9 days; range, 1-61 days; P =0.033). 24/7 dysphagia screening can be effectively performed by nurses and leads to reduced pneumonia rates. Therefore, empowering nurses to do a formal bedside screening for swallowing dysfunction in stroke patients timely after admission is warranted whenever speech-language therapists are not available. © 2017 American Heart Association, Inc.

  8. Cumulative environmental effects. Summary

    International Nuclear Information System (INIS)

    2012-01-01

    This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

  9. Cumulative environmental effects. Summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

  10. NEWTONP - CUMULATIVE BINOMIAL PROGRAMS

    Science.gov (United States)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, NEWTONP, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), can be used independently of one another. NEWTONP can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. NEWTONP calculates the probably p required to yield a given system reliability V for a k-out-of-n system. It can also be used to determine the Clopper-Pearson confidence limits (either one-sided or two-sided) for the parameter p of a Bernoulli distribution. NEWTONP can determine Bayesian probability limits for a proportion (if the beta prior has positive integer parameters). It can determine the percentiles of incomplete beta distributions with positive integer parameters. It can also determine the percentiles of F distributions and the midian plotting positions in probability plotting. NEWTONP is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. NEWTONP is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The NEWTONP program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. NEWTONP was developed in 1988.

  11. A Pilot Study of a Culturally Adapted Early Intervention for Young Children with Autism Spectrum Disorders in China

    Science.gov (United States)

    Xu, Yun; Yang, Jian; Yao, Jing; Chen, Jun; Zhuang, Xiangxiang; Wang, Wenxiang; Zhang, Xiaoli; Lee, Gabrielle T.

    2018-01-01

    The purpose of this study was to pilot test the effects of a culturally adapted early intervention influenced by the Early Start Denver Model (ESDM) on reduction of autism symptoms and severity categorization for young children with autism spectrum disorders in China. Participants were randomly assigned to either the control or intervention…

  12. A partnership model of early intervention in psychosis programme--a Canadian experience.

    Science.gov (United States)

    Oyewumi, Lamidi Kola; Savage, Troy

    2009-08-01

    To describe how a new partnership model of early intervention in psychosis, early intervention in psychosis (EIP) programme delivery in Canada attracted the interest of the community and acquired government funding. The process by which a few individuals used a conceptual framework of integrated, collaborative, flexible and recovery focused principles to engage community partners and attract government funding is described. The establishment of a small EIP programme and its expansion to a regional programme serving an area of 20,000 square kilometers and a population of approximately 500,000 people were achieved. A programme specific logic prototype was developed. A synergy of public, private and academic services emerged with an infrastructure for ongoing cohesiveness and productivity. Annual clinic visits increased from 641 in 2002 to 1904 in 2007 and annual new patients enrollments grew from 46 to 128 within the same period. Staffing grew from an interdisciplinary staff of 1.5 full-time equivalent (FTE) to the current 10.0 FTE. A carefully orchestrated programme organization that is inclusive rather than exclusive can produce a balance of evidence-based best practices in client focused service, community mental health integration and academic productivity. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.

  13. Provision of Early Intervention and Special Education Services to Eligible DoD Dependents. Final rule.

    Science.gov (United States)

    2015-06-25

    This rule reissues the current regulations and: Establishes policy, assigns responsibilities, and implements the non-funding and non-reporting provisions in DoD for: Provision of early intervention services (EIS) to infants and toddlers with disabilities and their families, as well as special education and related services to children with disabilities entitled under this part to receive education services from the DoD; implementation of a comprehensive, multidisciplinary program of EIS for infants and toddlers with disabilities and their families who, but for age, are eligible to be enrolled in DoD schools; provision of a free appropriate public education (FAPE), including special education and related services, for children with disabilities, as specified in their individualized education programs (IEP), who are eligible to enroll in DoD schools; and monitoring of DoD programs providing EIS, and special education and related services for compliance with this part. This rule also establishes a DoD Coordinating Committee to recommend policies and provide compliance oversight for early intervention and special education.

  14. Neurocognitive Functioning in Schizophrenia and during the Early Phases of Psychosis: Targeting Cognitive Remediation Interventions

    Directory of Open Access Journals (Sweden)

    Yulia Zaytseva

    2013-01-01

    Full Text Available Recent interest in the early course of schizophrenia accentuated altered cognition prior to the onset. Ultrahigh risk (UHR individuals with attenuated positive symptoms and transient psychotic episodes demonstrate neurocognitive deficits across multiple domains such as memory, executive functioning, and processing speed which are consistent with similar disturbances identified in patients with a first episode of schizophrenia. Cognitive remediation (CR approaches representing a broad set of activities are aimed to restore or improve cognitive functioning. CR proved to be effective in modulating the cognitive dysfunction in schizophrenia but is rarely used in ultrahigh risk individuals. From the clinical prospective, a better understanding of cognitive functioning in at-risk states is essential for the development of optimal early intervention models. In the review, we highlight the intervention targets, notably the specific cognitive deficits in at risk individuals which preceed the transition to psychosis and emphasize the need of the additional studies using CR approaches in UHR group aiming to enhance cognition and therefore mediate functional improvement.

  15. Case management in early psychosis intervention programme: Perspectives of clients and caregivers.

    Science.gov (United States)

    Wong, Horng Hien; Yong, Yee Huei; Shahwan, Shazana; Cetty, Laxman; Vaingankar, Janhavi; Hon, Charlene; Lee, Helen; Loh, Christopher; Abdin, Edimansyah; Subramaniam, Mythily

    2017-12-14

    This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective. Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis. There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

  16. Economic impact of a nationwide outbreak of salmonellosis: cost-benefit of early intervention.

    Science.gov (United States)

    Roberts, J A; Sockett, P N; Gill, O N

    1989-05-06

    The recognition and investigation of an outbreak of food poisoning in 1982 due to chocolate contaminated with Salmonella napoli enabled the food that carried the salmonella to be identified and four fifths of the implicated consignment of chocolate to be withdrawn. The economic benefits of prompt intervention in the outbreak have been assessed. The cost of the outbreak was over 0.5 pounds m. It is estimated that five deaths were prevented by the intervention and that 185 admissions to hospital and 29,000 cases of S napoli enteritis were avoided. This successful investigation yielded a 3.5-fold rate of return to the public sector and a 23.3-fold return to society on an investment in public health surveillance. A methodology is described that can be used to estimate the benefits of early intervention in outbreaks of foodborne illness and topics for further research are suggested. It is concluded that public health authorities and industry have much to gain by collaborating in the research into the design of cost effective programmes to prevent foodborne infections.

  17. An Online Change of Activity in Energy Spectrum for Detection on an Early Intervention Robot

    Energy Technology Data Exchange (ETDEWEB)

    Boudergui, K.; Laine, F. [CEA, LIST, Laboratoire Capteurs et Architectures Electroniques, F-91191 Gif Sur Yvette (France); Montagu, T. [CEA, LIST, Laboratoire de Modelisation et de Simulation des Systemes, 91191 Gif-sur-Yvette (France); Blanc, P. [IMS, Innovation and Measurement Systems, 94100 Saint-Maur-des-Fosses (France); Deltour, A. [ECA Robotics, 91892 Orsay Cedex (France); Mozziconacci, S. [SDIS13, 13110 Port de Bouc (France)

    2015-07-01

    With the growth of industrial risks and the multiplication of CBRNe (Chemical Biological Radiological and explosive) attacks through toxic chemicals, biological or radiological threats, public services and military authorities face with increasingly critical situations, whose management is strongly conditioned by fast and reliable establishment of an informative diagnostic. Right after an attack, the five first minutes are crucial to define the various scenarios and the most dangerous for a human intervention. Therefore the use of robots is considered essential by all stakeholders of security. In this context, the SISPEO project (Systeme d'Intervention Sapeurs Pompiers Robotise) aims to create/build/design a robust response through a robotic platform for early intervention services such as civil and military security in hostile environments. CEA LIST has proposed an adapted solution to detect and characterize nuclear and radiological risks online and in motion, using a miniature embedded CdZnTe (CZT) crystal Gamma-ray spectrometer. This paper presents experimental results for this miniature embedded CZT spectrometer and its associated mathematical method to detect and characterize radiological threats online and in motion. (authors)

  18. An Online Change of Activity in Energy Spectrum for Detection on an Early Intervention Robot

    International Nuclear Information System (INIS)

    Boudergui, K.; Laine, F.; Montagu, T.; Blanc, P.; Deltour, A.; Mozziconacci, S.

    2015-01-01

    With the growth of industrial risks and the multiplication of CBRNe (Chemical Biological Radiological and explosive) attacks through toxic chemicals, biological or radiological threats, public services and military authorities face with increasingly critical situations, whose management is strongly conditioned by fast and reliable establishment of an informative diagnostic. Right after an attack, the five first minutes are crucial to define the various scenarios and the most dangerous for a human intervention. Therefore the use of robots is considered essential by all stakeholders of security. In this context, the SISPEO project (Systeme d'Intervention Sapeurs Pompiers Robotise) aims to create/build/design a robust response through a robotic platform for early intervention services such as civil and military security in hostile environments. CEA LIST has proposed an adapted solution to detect and characterize nuclear and radiological risks online and in motion, using a miniature embedded CdZnTe (CZT) crystal Gamma-ray spectrometer. This paper presents experimental results for this miniature embedded CZT spectrometer and its associated mathematical method to detect and characterize radiological threats online and in motion. (authors)

  19. Issues regarding the delivery of early intervention psychiatric services to the South Asian population in England.

    Science.gov (United States)

    Agius, Mark; Talwar, A; Murphy, S; Zaman, Rashid

    2010-06-01

    Little research has been done to ascertain how patients and families of South Asian origin access and use early intervention mental health services today. The aim of this retrospective study is to gain a better understanding of how well South Asian patients engage with standard psycho-social interventions. In June 2003 an audit was conducted amongst 75 patients from different ethnic groups in Luton. Measures of engagement with mental health services included; number of missed outpatient appointments over one year and compliance with medication regimes. The results of this audit showed that South Asian patients are more likely to miss appointments and refuse to take medication in comparison to their Caucasian or Afro- Caribbean counter-parts. Further analysis revealed that the Bangladeshi subgroup had missed more appointments and had a greater proportion of medication refusal in comparison to the other Asian subgroups. These results support the pioneering work by Dr Robin Pinto in the 1970s he observed that Asian patients perceive and utilise mental health services in a different way compared to the Caucasian population. The observations from our study depict the difficulties in engaging ethnic minority patients into existing services. Hence we argue that future interventions should be adapted and tailored to overcome cultural and language barriers with patients and their families.

  20. [A survey of Local Physicians and Psychotherapists on Cooperation in Regional Networks for Early Child Interventions in Saxony-Anhalt].

    Science.gov (United States)

    Clauß, D; Fleischer, S; Mattern, E; Ayerle, G

    2016-07-01

    Early childhood interventions positively contribute to health related child development. For these interventions, networks are a necessary prerequisite as they promote interdisciplinary and interprofessional cooperation. This holds especially true for the integration of health system protagonists. In a cross-sectional survey local paediatrists, gynaecologists, general practitioners, and psychotherapists were asked about their knowledge, experiences, desires, and reservations regarding cooperation in early childhood intervention networks. 64 out of 1747 (3.7%) eligible clinicians answered the survey. On average they estimated that 10.1% of the families they are treating would benefit from early childhood interventions. Participants rated themselves as competent to offer appropriate early childhood interventions. The youth welfare service was judged as the most important institution for their own professional practice by 84.4%. Additionally to an applicable agenda, a fair group moderation of network meetings was seen as a substantial requirement in order to take part in network meetings. Health professionals are important protagonists in early childhood interventions. Clinicians should assess relevant problems in families and offer appropriate support on a regular basis. Alongside clearly defined regional contacts, interprofessional continuing education seems mandatory. © Georg Thieme Verlag KG Stuttgart · New York.

  1. POSTSURGICAL RECURRENT CUSHING DISEASE: CLINICAL BENEFIT OF EARLY INTERVENTION IN PATIENTS WITH NORMAL URINARY FREE CORTISOL.

    Science.gov (United States)

    Carroll, Ty B; Javorsky, Bradley R; Findling, James W

    2016-10-01

    To assess the performance of biochemical markers in the detection of recurrent Cushing disease (CD), as well as the potential benefit of early intervention in recurrent CD patients with elevated late-night salivary cortisol (LNSC) and normal urinary free cortisol (UFC). The design was a single-center, retrospective chart review. Patients treated by the authors from 2008-2013 were included. Recurrence was defined by postsurgical remission of CD with subsequent abnormal LNSC, UFC, or dexamethasone suppression test (DST). We identified 15 patients with postsurgical recurrent CD after initial remission; all but one underwent testing with LNSC, DST, and UFC. Although 12 of 15 patients had normal UFC at time of recurrence, DST was abnormal in 11 of 15, and all 14 patients with LNSC results had ≥1 elevated measurement. Nine patients (7 with normal UFC) showed radiologic evidence of a pituitary tumor at time of recurrence. Among the 14 patients with available follow-up data, 12 have demonstrated significant improvement since receiving treatment. Five patients underwent repeat pituitary surgery and 4 achieved clinical and biochemical remission. Eight patients received mifepristone or cabergoline, and 6 showed clinical and/or biochemical improvement. Three patients (2 with prior mifepristone) underwent bilateral adrenalectomy and 2 demonstrated significant clinical improvements. LNSC is more sensitive than UFC or DST for detection of CD recurrence. Prompt intervention when LNSC is elevated, despite normal UFC, may yield significant clinical benefit for many patients with CD. Early treatment for patients with recurrent CD should be prospectively evaluated, utilizing LNSC elevation as an early biochemical marker. ACTH = adrenocorticotropic hormone CD = Cushing disease CS = Cushing syndrome CV = coefficient of variation DST = dexamethasone suppression test IPSS = inferior petrosal sinus sampling LNSC = late-night salivary cortisol QoL = quality of life TSS = transsphenoidal

  2. Research Paper: Production of A Protocol on Early Intervention for Speech and Language Delays in Early Childhood: An Novice Experience in Iran

    Directory of Open Access Journals (Sweden)

    Roshanak Vameghi

    2016-01-01

    Results The result of this study is presented as 7 intervention packages, including the following domains of disorders: prelingual lingual speech and language hearing impairment, speech sound, dysphagia, stuttering, and dysarthria  Conclusion Most studies have confirmed the effectiveness and need for early interventions for children with speech and language impairment. However, most do not explain the details of these interventions. Before the present study, no systematic and evidence-based protocol existed for early intervention in childhood speech and language impairments, in Iran; and due to language differences, as well as possible differences in the speech and language developmental process of children of different communities, making direct use of non-Persian references was not possible and effective. Thus, there was a clear demand for the production of such a protocol.

  3. A systematic review evaluating the role of nurses and processes for delivering early mobility interventions in the intensive care unit.

    Science.gov (United States)

    Krupp, Anna; Steege, Linsey; King, Barbara

    2018-04-19

    To investigate processes for delivering early mobility interventions in adult intensive care unit patients used in research and quality improvement studies and the role of nurses in early mobility interventions. A systematic review was conducted. Electronic databases PubMED, CINAHL, PEDro, and Cochrane were searched for studies published from 2000 to June 2017 that implemented an early mobility intervention in adult intensive care units. Included studies involved progression to ambulation as a component of the intervention, included the role of the nurse in preparing for or delivering the intervention, and reported at least one patient or organisational outcome measure. The System Engineering Initiative for Patient Safety (SEIPS) model, a framework for understanding structure, processes, and healthcare outcomes, was used to evaluate studies. 25 studies were included in the final review. Studies consisted of randomised control trials, prospective, retrospective, or mixed designs. A range of processes to support the delivery of early mobility were found. These processes include forming interdisciplinary teams, increasing mobility staff, mobility protocols, interdisciplinary education, champions, communication, and feedback. Variation exists in the process of delivering early mobility in the intensive care unit. In particular, further rigorous studies are needed to better understand the role of nurses in implementing early mobility to maintain a patient's functional status. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Can very early music interventions promote at-risk infants' development?

    Science.gov (United States)

    Virtala, Paula; Partanen, Eino

    2018-04-30

    Music and musical activities are often a natural part of parenting. As accumulating evidence shows, music can promote auditory and language development in infancy and early childhood. It may even help to support auditory and language skills in infants whose development is compromised by heritable conditions, like the reading deficit dyslexia, or by environmental factors, such as premature birth. For example, infants born to dyslexic parents can have atypical brain responses to speech sounds and subsequent challenges in language development. Children born very preterm, in turn, have an increased likelihood of sensory, cognitive, and motor deficits. To ameliorate these deficits, we have developed early interventions focusing on music. Preliminary results of our ongoing longitudinal studies suggest that music making and parental singing promote infants' early language development and auditory neural processing. Together with previous findings in the field, the present studies highlight the role of active, social music making in supporting auditory and language development in at-risk children and infants. Once completed, the studies will illuminate both risk and protective factors in development and offer a comprehensive model of understanding the promises of music activities in promoting positive developmental outcomes during the first years of life. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.

  5. The role of early surgical intervention in civilian gunshot wounds to the head.

    Science.gov (United States)

    Helling, T S; McNabney, W K; Whittaker, C K; Schultz, C C; Watkins, M

    1992-03-01

    Surgical management of gunshot wounds of the head has remained a controversial issue in the care of civilian patients. In an attempt to determine who might benefit from aggressive surgical intervention, we examined 89 patients over a 3-year period who had suffered cranial gunshot wounds and had at least one computed tomographic scan of the head after admission. Patients were divided into those receiving early (less than 24 hours) surgical intervention (ES, n = 27), late (greater than 24 hours) surgical intervention (LS, n = 6) or no surgical intervention (NS, n = 56). Overall mortality was 63%. Ten of 27 patients (37%) in the ES group died compared with 46 of 56 patients (82%) in the NS group (p less than 0.0001). Glasgow Coma Scale (GCS) scores in the ES group averaged 7.86 +/- 4.72 and in the NS group 5.59 +/- 4.42 (p less than 0.05). The GCS scores in the LS group (all of whom survived) were significantly higher than those of the other two groups, 12.17 +/- 4.10. The number of patients with GCS scores of 3 or 4 on admission was significantly less in the ES (41%) than in the NS group (66%, p = 0.035) and survival was better with surgery (36%) than without (3%, p = 0.007). Patients with mass lesions (clot, ventricular blood) were more often found in the ES group (17/27) than in the NS group (18/56) (p = 0.008). Patients with bihemispheric injuries fared better with surgery (7 of 14 survivors) than without (2 of 33 survivors, p = 0.0003). Only one infectious complication (brain abscess) was encountered in the LS group. No delayed intracranial complications in survivors in the NS group were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Effects of healthcare professional delivered early feeding interventions on feeding practices and dietary intake: A systematic review.

    Science.gov (United States)

    Matvienko-Sikar, Karen; Toomey, Elaine; Delaney, Lisa; Harrington, Janas; Byrne, Molly; Kearney, Patricia M

    2018-04-01

    Childhood obesity is a global public health challenge. Parental feeding practices, such as responsive feeding, are implicated in the etiology of childhood obesity. This systematic review aimed to examine of effects of healthcare professional-delivered early feeding interventions, on parental feeding practices, dietary intake, and weight outcomes for children up to 2 years. The role of responsive feeding interventions was also specifically examined. Databases searched included: CINAHL, the Cochrane Library, EMBASE, Medline, PubMed, PsycINFO, and Maternity and Infant Care. participants are parents of children ≤2 years; intervention includes focus on early child feeding to prevent overweight and obesity; intervention delivered by healthcare professionals. Sixteen papers, representing 10 trials, met inclusion criteria for review. Six interventions included responsive feeding components. Interventions demonstrated inconsistent effects on feeding practices, dietary intake, and weight outcomes. Findings suggest some reductions in pressure to eat and infant consumption of non-core beverages. Responsive feeding based interventions demonstrate greater improvements in feeding approaches, and weight outcomes. The findings of this review highlight the importance of incorporating responsive feeding in healthcare professional delivered early feeding interventions to prevent childhood obesity. Observed inconsistencies across trials may be explained by methodological limitations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. The Impact of an Early Eclectic Rehabilitative Intervention on Symptoms in First Episode Depression among Employed People

    Directory of Open Access Journals (Sweden)

    Tero Raiskila

    2013-01-01

    Full Text Available Objective. To evaluate the effect of an early vocational-orientated eclectic intervention on beck depression inventory (BDI scores compared to treatment as usual in first ever depressive episode among employed people. Design. A randomized controlled trial comparing the rehabilitative intervention and the conventional treatment. Subjects. The subjects came from occupational health care units. Methods. Employees were sent to a rehabilitation center after being screened for depression using the BDI. They were diagnosed using the structured clinical interview for DSM-IV. The participating subjects (N=283 were randomized into intervention and control groups. The intervention group received eclectic early depression intervention treatment (N=134 and the control group was treated in the conventional way (N=100. They were followed for one year. Results. The mean decrease in BDI scores within the intervention group was from 20.8 to 11.6 and within the control group from 19.3 to 10.8. BDI score decreased by 10 or more points in 64% of the participants in the intervention group and in 53% of the control group (P=0.013. Conclusions. There was some evidence that early eclectic intervention in first ever episode depression may be more effective than conventional treatments among working age people in employment.

  8. The impact of indicated prevention and early intervention on co-morbid eating disorder and depressive symptoms: a systematic review.

    Science.gov (United States)

    Rodgers, Rachel F; Paxton, Susan J

    2014-01-01

    Depressive and eating disorder symptoms are highly comorbid. To date, however, little is known regarding the efficacy of existing programs in decreasing concurrent eating disorder and depressive symptoms. We conducted a systematic review of selective and indicated controlled prevention and early intervention programs that assessed both eating disorder and depressive symptoms. We identified a total of 26 studies. The large majority of identified interventions (92%) were successful in decreasing eating disorder symptoms. However fewer than half (42%) were successful in decreasing both eating disorder and depressive symptoms. Intervention and participant characteristics did not predict success in decreasing depressive symptoms. Indicated prevention and early intervention programs targeting eating disorder symptoms are limited in their success in decreasing concurrent depressive symptoms. Further efforts to develop more efficient interventions that are successful in decreasing both eating disorder and depressive symptoms are warranted.

  9. Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder.

    Science.gov (United States)

    Estes, Annette; Munson, Jeffrey; Rogers, Sally J; Greenson, Jessica; Winter, Jamie; Dawson, Geraldine

    2015-07-01

    We prospectively examined evidence for the sustained effects of early intervention based on a follow-up study of 39 children with ASD who began participation in a randomized clinical trial testing the effectiveness of the Early Start Denver Model (ESDM) at age 18 to 30 months. The intervention, conducted at a high level of intensity in-home for 2 years, showed evidence of efficacy immediately posttreatment. This group of children was assessed at age 6 years, 2 years after the intervention ended, across multiple domains of functioning by clinicians naive to previous intervention group status. The ESDM group, on average, maintained gains made in early intervention during the 2-year follow-up period in overall intellectual ability, adaptive behavior, symptom severity, and challenging behavior. No group differences in core autism symptoms were found immediately posttreatment; however, 2 years later, the ESDM group demonstrated improved core autism symptoms and adaptive behavior as compared with the community-intervention-as-usual (COM) group. The 2 groups were not significantly different in terms of intellectual functioning at age 6 years. Both groups received equivalent intervention hours during the original study, but the ESDM group received fewer hours during the follow-up period. These results provide evidence that gains from early intensive intervention are maintained 2 years later. Notably, core autism symptoms improved in the ESDM group over the follow-up period relative to the COM group. This improvement occurred at the same time that the ESDM group received significantly fewer services. This is the first study to examine the role of early ESDM behavioral intervention initiated at less than 30 months of age in altering the longer-term developmental course of autism. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. Vers un modele d'intervention precoce en lecture en actualisation linguistique (Towards a Model of Early Intervention in Reading Readiness).

    Science.gov (United States)

    Berger, Marie Josee

    1999-01-01

    Argues that in Ontario's French-medium schools, reading is often a challenge, particularly for those in readiness classes who speak little or no French. A model for early intervention in reading is recommended, combining reading and writing to address the linguistic challenges of students in a minority-language community. (Author/MSE)

  11. A Comparison of Equine-Assisted Intervention and Conventional Play-Based Early Intervention for Mother-Child Dyads with Insecure Attachment

    Science.gov (United States)

    Beetz, Andrea; Winkler, Nora; Julius, Henri; Uvnäs-Moberg, Kerstin; Kotrschal, Kurt

    2015-01-01

    Early interventions aim at promoting a good mother-child relationship as basis for a good socio-emotional development, especially in high-risk populations, and at correcting already unfavorable patterns of interaction and are common today. Insecure attachment, both of the child and of the mother, has been identified as a risk factor for early…

  12. Cumulative radiation effect

    International Nuclear Information System (INIS)

    Kirk, J.; Gray, W.M.; Watson, E.R.

    1977-01-01

    In five previous papers, the concept of Cumulative Radiation Effect (CRE) has been presented as a scale of accumulative sub-tolerance radiation damage, with a unique value of the CRE describing a specific level of radiation effect. Simple nomographic and tabular methods for the solution of practical problems in radiotherapy are now described. An essential feature of solving a CRE problem is firstly to present it in a concise and readily appreciated form, and, to do this, nomenclature has been introduced to describe schedules and regimes as compactly as possible. Simple algebraic equations have been derived to describe the CRE achieved by multi-schedule regimes. In these equations, the equivalence conditions existing at the junctions between schedules are not explicit and the equations are based on the CREs of the constituent schedules assessed individually without reference to their context in the regime as a whole. This independent evaluation of CREs for each schedule has resulted in a considerable simplification in the calculation of complex problems. The calculations are further simplified by the use of suitable tables and nomograms, so that the mathematics involved is reduced to simple arithmetical operations which require at the most the use of a slide rule but can be done by hand. The order of procedure in the presentation and calculation of CRE problems can be summarised in an evaluation procedure sheet. The resulting simple methods for solving practical problems of any complexity on the CRE-system are demonstrated by a number of examples. (author)

  13. Early Antenatal Prediction of Gestational Diabetes in Obese Women: Development of Prediction Tools for Targeted Intervention.

    Directory of Open Access Journals (Sweden)

    Sara L White

    Full Text Available All obese women are categorised as being of equally high risk of gestational diabetes (GDM whereas the majority do not develop the disorder. Lifestyle and pharmacological interventions in unselected obese pregnant women have been unsuccessful in preventing GDM. Our aim was to develop a prediction tool for early identification of obese women at high risk of GDM to facilitate targeted interventions in those most likely to benefit. Clinical and anthropometric data and non-fasting blood samples were obtained at 15+0-18+6 weeks' gestation in 1303 obese pregnant women from UPBEAT, a randomised controlled trial of a behavioural intervention. Twenty one candidate biomarkers associated with insulin resistance, and a targeted nuclear magnetic resonance (NMR metabolome were measured. Prediction models were constructed using stepwise logistic regression. Twenty six percent of women (n = 337 developed GDM (International Association of Diabetes and Pregnancy Study Groups criteria. A model based on clinical and anthropometric variables (age, previous GDM, family history of type 2 diabetes, systolic blood pressure, sum of skinfold thicknesses, waist:height and neck:thigh ratios provided an area under the curve of 0.71 (95%CI 0.68-0.74. This increased to 0.77 (95%CI 0.73-0.80 with addition of candidate biomarkers (random glucose, haemoglobin A1c (HbA1c, fructosamine, adiponectin, sex hormone binding globulin, triglycerides, but was not improved by addition of NMR metabolites (0.77; 95%CI 0.74-0.81. Clinically translatable models for GDM prediction including readily measurable variables e.g. mid-arm circumference, age, systolic blood pressure, HbA1c and adiponectin are described. Using a ≥35% risk threshold, all models identified a group of high risk obese women of whom approximately 50% (positive predictive value later developed GDM, with a negative predictive value of 80%. Tools for early pregnancy identification of obese women at risk of GDM are described

  14. Early intervention for adolescents with Patellofemoral Pain Syndrome - a pragmatic cluster randomised controlled trial

    Science.gov (United States)

    2012-01-01

    Background Self-reported knee pain is highly prevalent among adolescents. As much as 50% of the non-specific knee pain may be attributed to Patellofemoral Pain Syndrome (PFPS). In the short term, exercise therapy appears to have a better effect than patient education consisting of written information and general advice on exercise or compared with placebo treatment. But the long-term effect of exercise therapy compared with patient education is conflicting. The purpose of this study is to examine the short- and long-term effectiveness of patient education compared with patient education and multimodal physiotherapy applied at a very early stage of the condition among adolescents. Methods/Design This study is a single blind pragmatic cluster randomised controlled trial. Four upper secondary schools have been invited to participate in the study (approximately 2500 students, aged 15-19 years). Students are asked to answer an online questionnaire regarding musculoskeletal pain. The students who report knee pain are contacted by telephone and offered a clinical examination by a rheumatologist. Subjects who fit the inclusion criteria and are diagnosed with PFPS are invited to participate in the study. A minimum of 102 students with PFPS are then cluster-randomised into two intervention groups based on which school they attend. Both intervention groups receive written information and education. In addition to patient education, one group receives multimodal physiotherapy consisting primarily of neuromuscular training of the muscles around the foot, knee and hip and home exercises. The students with PFPS fill out self-reported questionnaires at baseline, 3, 6, 12 and 24 months after inclusion in the study. The primary outcome measure is perception of recovery measured on a 7-point Likert scale ranging from "completely recovered" to "worse than ever" at 12 months. Discussion This study is designed to investigate the effectiveness of patient education compared with patient

  15. Implementation of early intensive behavioural intervention for children with autism in Switzerland

    DEFF Research Database (Denmark)

    Studer, Nadja; Gundelfinger, Ronnie; Schenker, Tanja

    2017-01-01

    BACKGROUND: There is a major gap between the US and most European countries regarding the implementation of early intensive behavioural intervention (EIBI) for children with autism. The present paper reports on the current status of EIBI in Switzerland and on the effectiveness of EIBI under...... clinical conditions in a Swiss pilot project. METHODS: The paper combines a narrative report of the care system for children with autism in Switzerland and an initial evaluation of EIBI as implemented in the Department of Child and Adolescent Psychiatry, University of Zurich. RESULTS: The current situation...... of the implementation of EIBI for children with autism in Switzerland is characterized by marked deficits in its acceptance. Major reasons include insufficient governmental approval and lacking legal and financial support. In addition, ignorance among health care providers and educational professionals has contributed...

  16. Multisensory-Based Rehabilitation Approach: Translational Insights from Animal Models to Early Intervention

    Directory of Open Access Journals (Sweden)

    Giulia Purpura

    2017-07-01

    Full Text Available Multisensory processes permit combinations of several inputs, coming from different sensory systems, allowing for a coherent representation of biological events and facilitating adaptation to environment. For these reasons, their application in neurological and neuropsychological rehabilitation has been enhanced in the last decades. Recent studies on animals and human models have indicated that, on one hand multisensory integration matures gradually during post-natal life and development is closely linked to environment and experience and, on the other hand, that modality-specific information seems to do not benefit by redundancy across multiple sense modalities and is more readily perceived in unimodal than in multimodal stimulation. In this review, multisensory process development is analyzed, highlighting clinical effects in animal and human models of its manipulation for rehabilitation of sensory disorders. In addition, new methods of early intervention based on multisensory-based rehabilitation approach and their applications on different infant populations at risk of neurodevelopmental disabilities are discussed.

  17. Development of a fidelity scale for Danish specialized early interventions service

    DEFF Research Database (Denmark)

    Melau, Marianne; Albert, Nikolai; Nordentoft, Merete

    2017-01-01

    positive effects along with creating new teams and preserving critical components is to ensure fidelity to the model. Currently there is no Danish fidelity scale for SEI services. AIM: To establish a fidelity scale for SEI teams, in a brief and easily manageable form, for the use of evaluating......BACKGROUND: The efficacy of the Specialized Early Intervention (SEI) treatment in Denmark, the OPUS treatment, has in a randomized clinical trial proved to be very effective compared to treatment as usual, and the dissemination of SEI services is increasing in Denmark. A prerequisite for upholding...... and assessing the critical components in Danish SEI services. METHOD: We identified essential evidence-based components of SEI services internationally and interviewed experts from five Danish SEI teams, using an adapted version of the Delphi Consensus method. RESULTS: An 18-point fidelity scale was constructed...

  18. Multiple magnet ingestion: is there a role for early surgical intervention?

    Science.gov (United States)

    Salimi, Amrollah; Kooraki, Soheil; Esfahani, Shadi Abdar; Mehdizadeh, Mehrzad

    2012-01-01

    Children often swallow foreign bodies. Multiple magnet ingestion is rare, but can result in serious complications. This study presents three unique cases of multiple magnet ingestion: one case an 8-year-old boy with multiple magnet ingestion resulting in gastric obstruction and the other two cases with intestinal perforations due to multiple magnet intake. History and physical examination are unreliable in children who swallow multiple magnets. Sometimes radiological findings are not conclusive, whether one magnet is swallowed or more. If magnets are not moved in sequential radiology images, we recommend early surgical intervention before gastrointestinal complications develop. Toy companies, parents, physicians, and radiologists should be warned about the potential complications of such toys.

  19. Effectiveness of a single-session early psychological intervention for children after road traffic accidents: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Meuli Martin

    2010-02-01

    Full Text Available Abstract Background Road traffic accidents (RTAs are the leading health threat to children in Europe, resulting in 355 000 injuries annually. Because children can suffer significant and long-term mental health problems following RTAs, there is considerable interest in the development of early psychological interventions. To date, the research in this field is scarce, and currently no evidence-based recommendations can be made. Methods To evaluate the effectiveness of a single-session early psychological intervention, 99 children age 7-16 were randomly assigned to an intervention or control group. The manualised intervention was provided to the child and at least one parent around 10 days after the child's involvement in an RTA. It included reconstruction of the accident using drawings and accident-related toys, and psychoeducation. All of the children were interviewed at 10 days, 2 months and 6 months after the accident. Parents filled in questionnaires. Standardised instruments were used to assess acute stress disorder (ASD, posttraumatic stress disorder (PTSD, depressive symptoms and behavioural problems. Results The children of the two study groups showed no significant differences concerning posttraumatic symptoms and other outcome variables at 2 or at 6 months. Interestingly, analyses showed a significant intervention × age-group effect, indicating that for preadolescent children the intervention was effective in decreasing depressive symptoms and behavioural problems. Conclusions This study is the first to show a beneficial effect of a single-session early psychological intervention after RTA in preadolescent children. Therefore, an age-specific approach in an early stage after RTAs may be a promising way for further research. Younger children can benefit from the intervention evaluated here. However, these results have to be interpreted with caution, because of small subgroup sizes. Future studies are needed to examine specific

  20. Modeling determinants of medication attitudes and poor adherence in early nonaffective psychosis: implications for intervention.

    Science.gov (United States)

    Drake, Richard J; Nordentoft, Merete; Haddock, Gillian; Arango, Celso; Fleischhacker, W Wolfgang; Glenthøj, Birte; Leboyer, Marion; Leucht, Stefan; Leweke, Markus; McGuire, Phillip; Meyer-Lindenberg, Andreas; Rujescu, Dan; Sommer, Iris E; Kahn, René S; Lewis, Shon W

    2015-05-01

    We aimed to design a multimodal intervention to improve adherence following first episode psychosis, consistent with current evidence. Existing literature identified medication attitudes, insight, and characteristics of support as important determinants of adherence to medication: we examined medication attitudes, self-esteem, and insight in an early psychosis cohort better to understand their relationships. Existing longitudinal data from 309 patients with early Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nonaffective psychosis (83% first episode) were analyzed to test the hypothesis that medication attitudes, while meaningfully different from "insight," correlated with insight and self-esteem, and change in each influenced the others. Rosenberg Self-Esteem Scale, Birchwood Insight Scale, and Positive and Negative Syndrome Scale insight were assessed at presentation, after 6 weeks and 3 and 18 months. Drug Attitudes Inventory (DAI) and treatment satisfaction were rated from 6 weeks onward. Structural equation models of their relationships were compared. Insight measures' and DAI's predictive validity were compared against relapse, readmission, and remission. Analysis found five latent constructs best fitted the data: medication attitudes, self-esteem, accepting need for treatment, self-rated insight, and objective insight. All were related and each affected the others as it changed, except self-esteem and medication attitudes. Low self-reported insight at presentation predicted readmission. Good 6-week insight (unlike drug attitudes) predicted remission. Literature review and data modeling indicated that a multimodal intervention using motivational interviewing, online psychoeducation, and SMS text medication reminders to enhance adherence without damaging self-concept was feasible and appropriate. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For

  1. Early interdisciplinary hospital intervention for elderly patients with hip fractures : functional outcome and mortality

    Directory of Open Access Journals (Sweden)

    Francisco José Tarazona-Santabalbina

    2012-01-01

    Full Text Available OBJECTIVES: Hip fractures are associated with high levels of co-morbidity and mortality. Orthogeriatric units have been shown to be effective with respect to functional recovery and mortality reduction. The aim of this study is to document the natural history of early multidisciplinary intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge. METHODS: This observational, retrospective study was performed in an orthogeriatric care unit on patients aged >70 years with a diagnosis of hip fracture between 2004 and 2008. This study included 1363 patients with a mean age of 82.7 + 6.4 years. RESULTS: On admission to the unit, the average Barthel score of these patients was 77.2 + 27.8 points, and the average Charlson index score was 2.14 + 2.05. The mean length of stay was 8.9 + 4.26 days, and the readmission rate was 2.3%. The in-hospital mortality rate was 4.7%, and the mortality rates at one, six, and 12 months after discharge were 8.7%, 16.9%, and 25.9%, respectively. The Cox proportional hazards model estimated that male sex, Barthel scale, heart failure, and cognitive impairment were associated with an increased risk of death. With regard to functionality, 63.7% of the patients were able to walk at the time of discharge, whereas 77.4% and 80.1% were able to walk at one month and six months post-discharge, respectively. The factors associated with a worse functional recovery included cognitive impairment, performance status, age, stroke, Charlson score, and delirium during the hospital stay. CONCLUSIONS: Early multidisciplinary intervention appears to be effective for the management of hip fracture. Age, male sex, baseline function, cognitive impairment and previous comorbidities are associated with a higher mortality rate and worse functional recovery.

  2. Estimating the Cost and Effect of Early Intervention on In-Patient Admission in First Episode Psychosis.

    Science.gov (United States)

    Behan, Caragh; Cullinan, John; Kennelly, Brendan; Turner, Niall; Owens, Elizabeth; Lau, Adam; Kinsella, Anthony; Clarke, Mary

    2015-06-01

    Early intervention in psychosis is an accepted policy internationally. When 'A Vision for Change', the national blueprint for mental health policy in Ireland, was published in 2007 there was one Irish pilot service for early intervention in psychosis. The National Clinical Mental Health Programme Plan (2011) identified early intervention in psychosis as one of three areas for roll out nationally. There is limited economic evaluation in the field of mental health in Ireland to guide service development. This is in part due to lack of robust patient level data. The aim of the study was to investigate whether the introduction of an early intervention service in psychosis resulted in any change to the number and duration of admissions in people with first-episode psychosis. We examined two prospective epidemiological cohorts of individuals presenting with first-episode psychosis to an urban community mental health service (population 172,000). The historical cohort comprised of individuals presenting from 1995 to 1998 and received treatment as usual (n=132). The early intervention cohort presented to the same catchment area between 2008 and 2011 (n=97) following the introduction of an early intervention service in 2005. We found significant reductions in the rates admitted for treatment across the two time periods. Reduction in the rate of admission was larger in this catchment than the reduction in the rate of admission in the country as a whole. There were significant reductions in the duration of untreated psychosis arising from the early intervention programme. Significant reductions in length of stay were accounted for by differences in baseline age and marital status. The average cost of admission declined from 15,821 to 9,398 in the early intervention cohort. The comparison pre and post early intervention service showed cost savings consistent with other studies internationally. Key issues are whether changes in the admission pattern were due to the

  3. Cumulative trauma disorders: A review.

    Science.gov (United States)

    Iqbal, Zaheen A; Alghadir, Ahmad H

    2017-08-03

    Cumulative trauma disorder (CTD) is a term for various injuries of the musculoskeletal and nervous systems that are caused by repetitive tasks, forceful exertions, vibrations, mechanical compression or sustained postures. Although there are many studies citing incidence of CTDs, there are fewer articles about its etiology, pathology and management. The aim of our study was to discuss the etiology, pathogenesis, prevention and management of CTDs. A literature search was performed using various electronic databases. The search was limited to articles in English language pertaining to randomized clinical trials, cohort studies and systematic reviews of CTDs. A total of 180 papers were identified to be relevant published since 1959. Out of these, 125 papers reported about its incidence and 50 about its conservative treatment. Workplace environment, same task repeatability and little variability, decreased time for rest, increase in expectations are major factors for developing CTDs. Prevention of its etiology and early diagnosis can be the best to decrease its incidence and severity. For effective management of CTDs, its treatment should be divided into Primordial, Primary, Secondary and Tertiary prevention.

  4. Cumulative radiation effect

    International Nuclear Information System (INIS)

    Kirk, J.; Cain, O.; Gray, W.M.

    1977-01-01

    Cumulative Radiation Effect (CRE) represents a scale of accumulative sub-tolerance radiation damage, with a unique value of the CRE describing a specific level of radiation effect. Computer calculations have been used to simplify the evaluation of problems associated with the applications of the CRE-system in radiotherapy. In a general appraisal of the applications of computers to the CRE-system, the various problems encountered in clinical radiotherapy have been categorised into those involving the evaluation of a CRE at a point in tissue and those involving the calculation of CRE distributions. As a general guide, the computer techniques adopted at the Glasgow Institute of Radiotherapeutics for the solution of CRE problems are presented, and consist basically of a package of three interactive programs for point CRE calculations and a Fortran program which calculates CRE distributions for iso-effect treatment planning. Many examples are given to demonstrate the applications of these programs, and special emphasis has been laid on the problem of treating a point in tissue with different doses per fraction on alternate treatment days. The wide range of possible clinical applications of the CRE-system has been outlined and described under the categories of routine clinical applications, retrospective and prospective surveys of patient treatment, and experimental and theoretical research. Some of these applications such as the results of surveys and studies of time optimisation of treatment schedules could have far-reaching consequences and lead to significant improvements in treatment and cure rates with the minimum damage to normal tissue. (author)

  5. Development and delivery of a physiotherapy intervention for the early management of whiplash injuries: the Managing Injuries of Neck Trial (MINT) Intervention.

    Science.gov (United States)

    Williamson, Esther; Williams, Mark; Hansen, Zara; Joseph, Stephen; Lamb, Sarah E

    2009-03-01

    This paper describes the development and implementation of a physiotherapy intervention for a large multicentred randomised controlled trial of the early management of whiplash injuries in a National Health Service setting. Participants were eligible if they were classified as having whiplash-associated disorder grades I to III and self-referred for treatment within 6 weeks of injury. The intervention development was informed through a variety of methods including the current evidence base, published guidelines, clinician opinion, a pilot study and expert opinion. The intervention was targeted at known, potentially modifiable risk factors for poor recovery, and utilised manual therapy, exercises and psychological strategies. The treatment was individually tailored, with a maximum of six treatments allowed within the trial protocol over an 8-week period. The intervention was delivered to 300 participants. The amount and types of treatments delivered are described.

  6. Need for Early Interventions in the Prevention of Pediatric Overweight: A Review and Upcoming Directions

    Directory of Open Access Journals (Sweden)

    Anne M. Dattilo

    2012-01-01

    Full Text Available Childhood obesity is currently one of the most prevailing and challenging public health issues among industrialized countries and of international priority. The global prevalence of obesity poses such a serious concern that the World Health Organization (WHO has described it as a “global epidemic.” Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns, dietary habits, and parental feeding practices are established. Obesity prevention evidence points to specific dietary factors, such as the promotion of breastfeeding and appropriate introduction of nutritious complementary foods, but also calls for attention to parental feeding practices, awareness of appropriate responses to infant hunger and satiety cues, physical activity/inactivity behaviors, infant sleep duration, and family meals. Interventions that begin at birth, targeting multiple factors related to healthy growth, have not been adequately studied. Due to the overwhelming importance and global significance of excess weight within pediatric populations, this narrative review was undertaken to summarize factors associated with overweight and obesity among infants and toddlers, with focus on potentially modifiable risk factors beginning at birth, and to address the need for early intervention prevention.

  7. Need for early interventions in the prevention of pediatric overweight: a review and upcoming directions.

    Science.gov (United States)

    Dattilo, Anne M; Birch, Leann; Krebs, Nancy F; Lake, Alan; Taveras, Elsie M; Saavedra, Jose M

    2012-01-01

    Childhood obesity is currently one of the most prevailing and challenging public health issues among industrialized countries and of international priority. The global prevalence of obesity poses such a serious concern that the World Health Organization (WHO) has described it as a "global epidemic." Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns, dietary habits, and parental feeding practices are established. Obesity prevention evidence points to specific dietary factors, such as the promotion of breastfeeding and appropriate introduction of nutritious complementary foods, but also calls for attention to parental feeding practices, awareness of appropriate responses to infant hunger and satiety cues, physical activity/inactivity behaviors, infant sleep duration, and family meals. Interventions that begin at birth, targeting multiple factors related to healthy growth, have not been adequately studied. Due to the overwhelming importance and global significance of excess weight within pediatric populations, this narrative review was undertaken to summarize factors associated with overweight and obesity among infants and toddlers, with focus on potentially modifiable risk factors beginning at birth, and to address the need for early intervention prevention.

  8. Social integration and substance use: assessing the effects of an early intervention programme for youth.

    Science.gov (United States)

    Brand, Amélie; Guillod, Line; Habersaat, Stéphanie; Panchaud, Evelyne; Stéphan, Philippe; Urben, Sébastien

    2018-06-01

    Appropriate social integration has been shown to be a protective factor against substance use among adolescents and associated negative consequences. Promoting social integration through early intervention with adolescents using substances is thus necessary and is the aim of the Identification, Assessment and Follow-up of Adolescents with Substance Use (in French, Dépistage - évaluation - parrainage d'adolescents consommateurs de substances (DEPART) programme. The present study aimed to describe this programme and its participants from 2009 to 2013 as well as to assess its effects on social integration. Data from 398 adolescents using substances who attended the DEPART programme were analysed. The results showed that almost 80% of the adolescents admitted to the DEPART programme were boys, with a large proportion using cannabis. Globally, social integration did not increase from admission to discharge from the programme, but a shift was observed for school and professional integration. Additionally, after the intervention, we observed that social integration was more important in younger patients. This study showed that adolescents with problematic substance use mostly consumed soft drugs and that those who were integrated into the DEPART programme at a younger age were more likely to be socially integrated at the end of the programme. © 2016 John Wiley & Sons Australia, Ltd.

  9. Implementation of early intensive behavioural intervention for children with autism in Switzerland.

    Science.gov (United States)

    Studer, Nadja; Gundelfinger, Ronnie; Schenker, Tanja; Steinhausen, Hans-Christoph

    2017-01-21

    There is a major gap between the US and most European countries regarding the implementation of early intensive behavioural intervention (EIBI) for children with autism. The present paper reports on the current status of EIBI in Switzerland and on the effectiveness of EIBI under clinical conditions in a Swiss pilot project. The paper combines a narrative report of the care system for children with autism in Switzerland and an initial evaluation of EIBI as implemented in the Department of Child and Adolescent Psychiatry, University of Zurich. The current situation of the implementation of EIBI for children with autism in Switzerland is characterized by marked deficits in its acceptance. Major reasons include insufficient governmental approval and lacking legal and financial support. In addition, ignorance among health care providers and educational professionals has contributed to this situation precluding that children with autism receive the most beneficial assistance. The authors have initiated and been working in an intervention centre offering EIBI for a decade and report on their experience with the implementation of EIBI. Based on their clinical practice, they document that EIBI also works efficiently under ordinary mental health service conditions. EIBI needs to be implemented more intensively in Switzerland. Although the effects of EIBI as implemented in Zurich are promising, the results are not as pronounced as under controlled research conditions.

  10. Outcomes of an early feeding practices intervention to prevent childhood obesity.

    Science.gov (United States)

    Daniels, Lynne Allison; Mallan, Kimberley Margaret; Nicholson, Jan Maree; Battistutta, Diana; Magarey, Anthea

    2013-07-01

    The goal of this study was to evaluate outcomes of a universal intervention to promote protective feeding practices that commenced in infancy and aimed to prevent childhood obesity. The NOURISH randomized controlled trial enrolled 698 first-time mothers (mean ± SD age: 30.1 ± 5.3 years) with healthy term infants (51% female) aged 4.3 ± 1.0 months at baseline. Mothers were randomly allocated to self-directed access to usual care or to attend two 6-session interactive group education modules that provided anticipatory guidance on early feeding practices. Outcomes were assessed 6 months after completion of the second information module, 20 months from baseline and when the children were 2 years old. Maternal feeding practices were self-reported by using validated questionnaires and study-developed items. Study-measured child height and weight were used to calculate BMI z scores. Retention at follow-up was 78%. Mothers in the intervention group reported using responsive feeding more frequently on 6 of 9 subscales and 8 of 8 items (all, P ≤ .03) and overall less controlling feeding practices (P feeding practices (3 of 4 items; all, P feeding, tailored to developmental stage, increased use by first-time mothers of "protective" feeding practices that potentially support the development of healthy eating and growth patterns in young children.

  11. [Social network analysis of interdisciplinary cooperation and networking in early prevention and intervention. A pilot study].

    Science.gov (United States)

    Künster, A K; Knorr, C; Fegert, J M; Ziegenhain, U

    2010-11-01

    Child protection can only be successfully solved by interdisciplinary cooperation and networking. The individual, heterogeneous, and complex needs of families cannot be met sufficiently by one profession alone. To guarantee efficient interdisciplinary cooperation, there should not be any gaps in the network. In addition, each actor in the network should be placed at an optimal position regarding function, responsibilities, and skills. Actors that serve as allocators, such as pediatricians or youth welfare officers, should be in key player positions within the network. Furthermore, successful child protection is preventive and starts early. Social network analysis is an adequate technique to assess network structures and to plan interventions to improve networking. In addition, it is very useful to evaluate the effectiveness of interventions like round tables. We present data from our pilot project which was part of "Guter Start ins Kinderleben" ("a good start into a child's life"). Exemplary network data from one community show that networking is already quite effective with a satisfactory mean density throughout the network. There is potential for improvement in cooperation, especially at the interface between the child welfare and health systems.

  12. Heart rate variability biofeedback intervention for reduction of psychological stress during the early postpartum period.

    Science.gov (United States)

    Kudo, Naoko; Shinohara, Hitomi; Kodama, Hideya

    2014-12-01

    This study examined the effectiveness of heart rate variability (HRV) biofeedback intervention for reduction of psychological stress in women in the early postpartum period. On postpartum day 4, 55 healthy subjects received a brief explanation about HRV biofeedback using a portable device. Among them, 25 mothers who agreed to implement HRV biofeedback at home were grouped as the biofeedback group, and other 30 mothers were grouped as the control group. At 1 month postpartum, there was a significant decrease in total Edinburgh Postnatal Depression Scale score (P biofeedback group; this change was brought about mainly by decreases in items related to anxiety or difficulty sleeping. There was also a significant increase in standard deviation of the normal heartbeat interval (P biofeedback group after adjusting for potential covariates. In conclusion, postpartum women who implemented HRV biofeedback after delivery were relatively free from anxiety and complained less of difficulties sleeping at 1 month postpartum. Although the positive effects of HRV biofeedback may be partly attributable to intervention effects, due to its clinical outcome, HRV biofeedback appears to be recommendable for many postpartum women as a feasible health-promoting measure after childbirth.

  13. The early intervention message: perspectives of parents of children with autism spectrum disorder.

    Science.gov (United States)

    Edwards, A; Brebner, C; McCormack, P; MacDougall, C

    2017-03-01

    There is strong evidence that early intervention (EI) can improve outcomes for children with autism spectrum disorder (ASD), and consequently, the importance of EI has been widely promoted to families of children with ASD. However, the perspectives of parents of children with ASD regarding the EI message have not been widely examined. This study used qualitative methods to explore parental perspectives on the EI message. Semi-structured interviews were undertaken with 14 participants from 12 family units to explore the perspectives of parents of children with ASD on the EI message. Thematic analysis was undertaken on the data. Three central themes were constructed following data analysis: (i) parents' initial perceptions of EI following their child's diagnosis with ASD; (ii) the consequences (both positive and negative) of the EI message; and (iii) parents' perspectives on life after EI. The results of this study indicated that parents were acutely aware of the importance of EI, and although this provided parents with hope immediately post-diagnosis, it also placed pressure on parental decision-making regarding which intervention approaches to access for their children with ASD. The results of this study highlight the importance of carefully considering how health messages, specifically the importance of EI, are communicated to families of children with ASD. Furthermore, the findings of this study also highlight the need for allied health professionals to communicate openly with parents about the anticipated outcomes of EI programmes. © 2016 John Wiley & Sons Ltd.

  14. Follow-Up Study of the Effects of a Supplemental Early Reading Intervention on the Reading/Disability Risk of Urban Primary Learners

    Science.gov (United States)

    Cartledge, Gwendolyn; Yurick, Amanda; Singh, Angella Harjani; Keyes, Starr E.; Kourea, Lefki

    2011-01-01

    Early intervention to mitigate special education and reading risk is especially critical for low socioeconomic and minority learners. This study examined the lasting effects of an early reading intervention package of phonemic awareness on the reading skills of 38 second-grade students one and two years after intervention ended. The participants…

  15. Data management for early hearing detection and intervention in South Africa

    Directory of Open Access Journals (Sweden)

    Selvarani Moodley

    2017-06-01

    Full Text Available Introduction: Internationally, newborn hearing screening is becoming part of standard neonatal healthcare service guidelines for the implementation of early hearing detection and intervention (EHDI initiatives, including screening, diagnosis, data management and intervention. Data management includes the processes of data collection and storage thereof, as well as analysis and interpretation of data to guide the future planning, implementation and evaluation of EHDI programmes. There have been limited studies on data management in the South African EHDI context. Methods: The aim of this study was to determine the type of data management systems in use in South Africa and whether they allow for cross-disciplinary sharing and evaluation of the EHDI processes. A survey instrument on the management of EHDI data was developed and sent to HI HOPES referral agents in both public and private sectors. Results: A return rate of 80% was achieved, with 19 (59% public sector and 13 (41% private sector audiologists participating in the study. The data revealed that there was no uniform data management system in use nationally, and no consistent shared system within the public or private sectors. The majority of respondents (44% used a paper-based system for data recording. No institutions were using data management systems that enabled sharing of information with other medical professionals. Conclusion: Data management and tracking of the pathway from screening to diagnosis to intervention is necessary to ensure quality care and outcomes for children identified with hearing loss. International studies reveal the importance of effective implementation of data management systems; however, to date these have focussed on developed country contexts. Data management challenges identified in this study reflect international challenges as well as challenges unique to a developing country context.

  16. Secant cumulants and toric geometry

    NARCIS (Netherlands)

    Michalek, M.; Oeding, L.; Zwiernik, P.W.

    2012-01-01

    We study the secant line variety of the Segre product of projective spaces using special cumulant coordinates adapted for secant varieties. We show that the secant variety is covered by open normal toric varieties. We prove that in cumulant coordinates its ideal is generated by binomial quadrics. We

  17. Transition from early intervention program to primary school in children with autism spectrum disorder.

    Science.gov (United States)

    Eapen, Valsamma; Grove, Rachel; Aylward, Elizabeth; Joosten, Annette V; Miller, Scott I; Van Der Watt, Gerdamari; Fordyce, Kathryn; Dissanayake, Cheryl; Maya, Jacqueline; Tucker, Madonna; DeBlasio, Antonia

    2017-11-08

    To evaluate the characteristics that are associated with successful transition to school outcomes in preschool aged children with autism. Twenty-one participants transitioning from an early intervention program were assessed at two time points; at the end of their preschool placement and approximately 5 mo later following their transition to school. Child characteristics were assessed using the Mullen Scales of Early Learning, Vineland Adaptive Behaviour Scales, Social Communication Questionnaire and the Repetitive Behaviour Scale. Transition outcomes were assessed using Teacher Rating Scale of School Adjustment and the Social Skills Improvement System Rating Scales to provide an understanding of each child's school adjustment. The relationship between child characteristics and school outcomes was evaluated. Cognitive ability and adaptive behaviour were shown to be associated with successful transition to school outcomes including participation in the classroom and being comfortable with the classroom teacher. These factors were also associated with social skills in the classroom including assertiveness and engagement. Supporting children on the spectrum in the domains of adaptive behaviour and cognitive ability, including language skills, is important for a successful transition to school. Providing the appropriate support within structured transition programs will assist children on the spectrum with this important transition, allowing them to maximise their learning and behavioural potential.

  18. A Systematic Review of the Effectiveness of Early Intervention and the Role of Parents in Language Development of Hearing Loss Children

    Directory of Open Access Journals (Sweden)

    Ehsan Shekari

    2017-03-01

    Discussion: Research showed the effectiveness of early intervention in the early development of language and vocabulary. In addition, early detection of hearing loss in the first 6 months of age has a positive impact on children and families interactions and consequently, on language and vocabulary development. The primary focus in the implementation of early intervention services is to reduce the negative effects of risk factors and facilitate optimum development over time. Finally, the combination of early diagnosis and early intervention for children with hearing impairment is necessary.

  19. Modulation of early stress-induced neurobiological changes: a review of behavioural and pharmacological interventions in animal models.

    Science.gov (United States)

    Harrison, E L; Baune, B T

    2014-05-13

    Childhood adversity alters the predisposition to psychiatric disorders later in life. Those with psychiatric conditions and a history of early adversity exhibit a higher incidence of treatment resistance compared with individuals with no such history. Modulation of the influence early stress exerts over neurobiology may help to prevent the development of psychiatric disorders in some cases, while attenuating the extent of treatment resistance in those with established psychiatric disorders. This review aims to critically evaluate the ability of behavioural, environmental and pharmacologic interventions to modulate neurobiological changes induced by early stress in animal models. Databases were systematically searched to locate literature relevant to this review. Early adversity was defined as stress that resulted from manipulation of the mother-infant relationship. Analysis was restricted to animal models to enable characterisation of how a given intervention altered specific neurobiological changes induced by early stress. A wide variety of changes in neurobiology due to early stress are amenable to intervention. Behavioural interventions in childhood, exercise in adolescence and administration of epigenetic-modifying drugs throughout life appear to best modulate cellar and behavioural alterations induced by childhood adversity. Other pharmacotherapies, such as endocannabinoid system modulators, anti-inflammatories and antidepressants can also influence these neurobiological and behavioural changes that result from early stress, although findings are less consistent at present and require further investigation. Further work is required to examine the influence that behavioural interventions, exercise and epigenetic-modifying drugs exert over alterations that occur following childhood stress in human studies, before possible translational into clinical practice is possible.

  20. Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting.

    Science.gov (United States)

    Eapen, Valsamma; Crnčec, Rudi; Walter, Amelia

    2013-01-07

    Available evidence indicates that early intervention programs, such as the Early Start Denver Model (ESDM), can positively affect key outcomes for children with Autism Spectrum Disorder (ASD). However, programs involving resource intensive one-to-one clinical intervention are not readily available or deliverable in the community, resulting in many children with ASD missing out on evidence-based intervention during their early and most critical preschool years. This study evaluated the effectiveness of the ESDM for preschool-aged children with ASD using a predominantly group-based intervention in a community child care setting. Participants were 26 children (21 male) with ASD with a mean age of 49.6 months. The ESDM, a comprehensive early intervention program that integrates applied behaviour analysis with developmental and relationship-based approaches, was delivered by trained therapists during the child's attendance at a child care centre for preschool-aged children with ASD. Children received 15-20 hours of group-based, and one hour of one-to-one, ESDM intervention per week. The average intervention period was ten months. Outcome measures were administered pre- and post-intervention, and comprised a developmental assessment - the Mullen Scales of Early Learning (MSEL); and two parent-report questionnaires - the Social Communication Questionnaire (SCQ) and Vineland Adaptive Behaviours Scales-Second Edition (VABS-II). Statistically significant post-intervention improvements were found in children's performance on the visual reception, receptive language and expressive language domains of the MSEL in addition to their overall intellectual functioning, as assessed by standardised developmental quotients. Parents reported significant increases in their child's receptive communication and motor skills on the VABS-II, and a significant decrease in autism-specific features on the SCQ. These effects were of around medium size, and appeared to be in excess of what may

  1. IMPLEMENTING AN ATTACHMENT-BASED PARENTING INTERVENTION WITHIN HOME-BASED EARLY HEAD START: HOME-VISITORS' PERCEPTIONS AND EXPERIENCES.

    Science.gov (United States)

    West, Allison L; Aparicio, Elizabeth M; Berlin, Lisa J; Jones Harden, Brenda

    2017-07-01

    Implementation of evidence-based interventions in "real-world" settings is enhanced when front-line staff view the intervention as acceptable, appropriate, and feasible. This qualitative study addresses Early Head Start (EHS) home visitors' perceptions and experiences of an evidence-based parenting intervention, the Attachment and Biobehavioral Catch-up program (M. Dozier, O. Lindhiem, & J. Ackerman, 2005), when added to EHS services as usual within the context of a research-practice partnership. Thematic analysis of in-depth, qualitative interviews indicates that home visitors experienced the intervention as positive and helpful for EHS families. Some challenges included scheduling and uncertainty regarding the goals of the intervention. Concerns over participation in the research centered on information exchange, confidentiality, and time limitations. © 2017 Michigan Association for Infant Mental Health.

  2. My Family-Study, Early-Onset Substance use Prevention Program: An Application of Intervention Mapping Approach

    Directory of Open Access Journals (Sweden)

    Mehdi Mirzaei-Alavijeh

    2017-03-01

    Full Text Available Background and Objectives: Based on different studies, substance use is one of the health problems in the Iranian society. The prevalence of substance use is on a growing trend; moreover, the age of the onset of substance use has declined to early adolescence and even lower. Regarding this, the present study aimed to develop a family-based early-onset substance use prevention program in children (My Family-Study by using intervention mapping approach. Materials and Methods: This study descirbes the research protocol during which the intervention mapping approach was used as a framework to develop My Family-Study. In this study, six steps of intervention mapping were completed. Interviews with experts and literature review fulfilled the need assessment. In the second step, the change objectivs were rewritten based on the intersection of the performance objectives and the determinants associated in the matrices. After designing the program and planning the implementation of the intervention, the evaluation plan of the program was accomplished. Results: The use of intervention mapping approach facilitated the develop-pment of a systematic as well as theory- and evidence-based program. Moreover, this approach was helful in the determination of outcomes, performance and change objectives, determinants, theoretical methods, practical application, intervention, dissemination, and evaluation program. Conclusions: The intervention mapping provided a systematic as well as theory- and evidence-based approach to develop a quality continuing health promotion program.

  3. Early Intervention for Post-Traumatic Stress Disorder, Depression, and Quality of Life in Mortuary Affairs Soldiers Postdeployment.

    Science.gov (United States)

    Biggs, Quinn M; Fullerton, Carol S; McCarroll, James E; Liu, Xian; Wang, Leming; Dacuyan, Nicole M; Zatzick, Douglas F; Ursano, Robert J

    2016-11-01

    U.S. Army mortuary affairs (MA) soldiers experience stressors of deployment and exposure to the dead, increasing risk for post-traumatic stress and depression. This study examines Troop Education for Army Morale, a postdeployment early intervention based on Psychological First Aid. MA soldiers (N = 126) were randomized to intervention or comparison groups 1-month postdeployment. Intervention sessions were held at 2, 3, 4, and 7 months. Assessments of post-traumatic stress disorder (PTSD), depression, and quality of life (QOL) were conducted at 1, 2, 3, 4, 7, and 10 months for both groups. At baseline, 25.0% of the total sample had probable PTSD (17-item PTSD Checklist M = 35.4, SD = 16.9) and 23.6% had probable depression (9-item Patient Health Questionnaire Depression Scale M = 7.8, SD = 6.9). Over 10 months, PTSD and depression symptoms decreased and QOL improved for the total sample. At study conclusion, intervention and comparison groups were not different. Intervention group males showed a transient symptom increase at 2 to 3 months. Males attended fewer intervention sessions than females. Lower attendance was associated with more symptoms and lower QOL. Higher attendance was associated with greater intervention benefits. Findings highlight the need for better understanding postdeployment interventions and facilitating attendance. Further intervention for MA soldiers is indicated. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  4. Preferences for Early Intervention Mental Health Services: A Discrete-Choice Conjoint Experiment.

    Science.gov (United States)

    Becker, Mackenzie P E; Christensen, Bruce K; Cunningham, Charles E; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Bieling, Peter J; Madsen, Victoria; Chen, Yvonne Y S; Mielko, Stephanie; Zipursky, Robert B

    2016-02-01

    Early intervention services (EISs) for mental illness may improve outcomes, although treatment engagement is often a problem. Incorporating patients' preferences in the design of interventions improves engagement. A discrete-choice conjoint experiment was conducted in Canada to identify EIS attributes that encourage treatment initiation. Sixteen four-level attributes were formalized into a conjoint survey, completed by patients, family members, and mental health professionals (N=562). Participants were asked which EIS option people with mental illness would contact. Latent-class analysis identified respondent classes characterized by shared preferences. Randomized first-choice simulations predicted which hypothetical options, based on attributes, would result in maximum utilization. Participants in the conventional-service class (N=241, 43%) predicted that individuals would contact traditional services (for example, hospital location and staffed by psychologists or psychiatrists). Membership was associated with being a patient or family member and being male. Participants in the convenient-service class (N=321, 57%) predicted that people would contact services promoting easy access (for example, self-referral and access from home). Membership was associated with being a professional. Both classes predicted that people would contact services that included short wait times, direct contact with professionals, patient autonomy, and psychological treatment information. The convenient-service class predicted that people would use an e-health model, whereas the conventional-service class predicted that people would use a primary care or clinic-hospital model. Provision of a range of services may maximize EIS use. Professionals may be more apt to adopt EISs in line with their beliefs regarding patient preferences. Considering several perspectives is important for service design.

  5. Using a Film Intervention in Early Addiction Treatment: a Qualitative Analysis of Process.

    Science.gov (United States)

    Bjelland, Ingerid Elgesem; Johansen, Ayna; Darnell, Farnad; Brendryen, Håvar

    2017-10-01

    There is a need for knowledge about how self-help materials can be made useful in treatment for Substance Abuse Disorders (SUD), as a supplement to ongoing treatment, or as independent tools for change. In this study, we explored the use of self-help films in early addiction treatment, taking into account both patient and therapist perspectives, as well as dyadic functions. We explored how active mechanisms might be related to intervention format and implementation context. A secondary aim was to examine the potential mechanisms related to the specific content of the intervention: mindfulness and acceptance psychoeducation. A qualitative exploratory research design, including a general inductive analytic approach, constructivist grounded theory, and source triangulation features, was used to code and analyze interview material. Emerging themes were developed into concepts, and finally an operational model. Participants included 12 patients and 22 therapists, in in-/outpatient addiction clinics, all in urban areas of Norway. The purpose of the design was empirical grounding of developed concepts, to promote different potential user perspectives (patients' and therapists') and obtain process data. The core concept constructed, "Alliance as experiential process," gives a description of the data where patients and therapists accept or reject the film as a result of an experience process conceptualized as alliance formation. The alliance process model reflects the observation that patients constructed alliances autonomously, while therapists built alliances indirectly through their patients' experiences. Use of a self-help film may be a helpful adjunct to face-to-face therapy for patients who create a personally meaningful attachment to the film. Mindfulness/acceptance may offer one basic framework for such connection to take place.

  6. Application of the Intervention Mapping protocol to develop Keys, a family child care home intervention to prevent early childhood obesity.

    Science.gov (United States)

    Mann, Courtney M; Ward, Dianne S; Vaughn, Amber; Benjamin Neelon, Sara E; Long Vidal, Lenita J; Omar, Sakinah; Namenek Brouwer, Rebecca J; Østbye, Truls

    2015-12-10

    Many families rely on child care outside the home, making these settings important influences on child development. Nearly 1.5 million children in the U.S. spend time in family child care homes (FCCHs), where providers care for children in their own residences. There is some evidence that children in FCCHs are heavier than those cared for in centers. However, few interventions have targeted FCCHs for obesity prevention. This paper will describe the application of the Intervention Mapping (IM) framework to the development of a childhood obesity prevention intervention for FCCHs Following the IM protocol, six steps were completed in the planning and development of an intervention targeting FCCHs: needs assessment, formulation of change objectives matrices, selection of theory-based methods and strategies, creation of intervention components and materials, adoption and implementation planning, and evaluation planning Application of the IM process resulted in the creation of the Keys to Healthy Family Child Care Homes program (Keys), which includes three modules: Healthy You, Healthy Home, and Healthy Business. Delivery of each module includes a workshop, educational binder and tool-kit resources, and four coaching contacts. Social Cognitive Theory and Self-Determination Theory helped guide development of change objective matrices, selection of behavior change strategies, and identification of outcome measures. The Keys program is currently being evaluated through a cluster-randomized controlled trial The IM process, while time-consuming, enabled rigorous and systematic development of intervention components that are directly tied to behavior change theory and may increase the potential for behavior change within the FCCHs.

  7. [Joint application of 7 interventional pulmonology methods in early diagnosis of lung cancer].

    Science.gov (United States)

    Jin, Fa-Guang; Li, Wang-Ping; Mu, De-Guang; Chu, Dong-Ling; Fu, En-Qing; Xie, Yong-Hong; Lu, Jing-Li; Sun, Ya-Ni

    2009-06-23

    To evaluate the combination of 7 interventional pulmonology methods in early diagnosis of lung cancer. A total of 467 patients with thoracic and pulmonary lesions (include hilum pulmonis lymphadenectasis, mediastinal lymphadenectasis, pulmonary scobination, lump, lamellar infiltration, small amount of pleural fluid and pleural scobination) had negative results via exfoliative cytology, bacteriology and routine bronchoscopy. All these patients had ultrathin bronchoscopy with biopsy and brushing. For those 155 cases whose foci were located at porta pulmonis, inner zone or median zone, the authors applied ultrathin bronchoscopy with biopsy and brushing guided by X-ray. For those 95 cases whose foci were located at median zone or outer zone and unconnected with chest wall, per cutem lung puncture needle aspiration was employed under the guidance of X-ray. For those 102 cases whose foci were tightly connected with pleural membrane, per cutem lung puncture biopsy was employed under the guidance of type-B ultrasonic. For those 59 cases with suspected central airway foci, auto-fluorescence bronchoscopic biopsy and brushing were employed. For those 67 cases with hilum pulmonis or mediastinal lymphadenectasis, endobronchial ultrasonic transbronchial needle aspiration (EBUS-TBNA) was employed. For those 23 cases with small amount of pleural fluid or pleural scobination, electronic thoracoscopic biopsy and brushing were employed. It was found that 118 cases were diagnosed by ultrathin bronchoscopic biopsy and brushing with a positive rate of 25.3% (118/467), 105 cases by ultrathin bronchoscopy with biopsy and brushing guided by X-ray with a positive rate of 67.7% (105/155), 63 cases by per cutem lung puncture needle aspiration under the guidance of X-ray with a positive rate of 66.3% (63/95), 69 cases by per cutem lung puncture biopsy under the guidance of type-B ultrasound with a positive rate of 67.6% (69/102), 18 cases by auto-fluorescence bronchoscopic biopsy and brushing

  8. Highlighting the evidence gap: how cost-effective are interventions to improve early childhood nutrition and development?

    Science.gov (United States)

    Batura, Neha; Hill, Zelee; Haghparast-Bidgoli, Hassan; Lingam, Raghu; Colbourn, Timothy; Kim, Sungwook; Sikander, Siham; Pulkki-Brannstrom, Anni-Maria; Rahman, Atif; Kirkwood, Betty; Skordis-Worrall, Jolene

    2015-07-01

    There is growing evidence of the effectiveness of early childhood interventions to improve the growth and development of children. Although, historically, nutrition and stimulation interventions may have been delivered separately, they are increasingly being tested as a package of early childhood interventions that synergistically improve outcomes over the life course. However, implementation at scale is seldom possible without first considering the relative cost and cost-effectiveness of these interventions. An evidence gap in this area may deter large-scale implementation, particularly in low- and middle-income countries. We conduct a literature review to establish what is known about the cost-effectiveness of early childhood nutrition and development interventions. A set of predefined search terms and exclusion criteria standardized the search across five databases. The search identified 15 relevant articles. Of these, nine were from studies set in high-income countries and six in low- and middle-income countries. The articles either calculated the cost-effectiveness of nutrition-specific interventions (n = 8) aimed at improving child growth, or parenting interventions (stimulation) to improve early childhood development (n = 7). No articles estimated the cost-effectiveness of combined interventions. Comparing results within nutrition or stimulation interventions, or between nutrition and stimulation interventions was largely prevented by the variety of outcome measures used in these analyses. This article highlights the need for further evidence relevant to low- and middle-income countries. To facilitate comparison of cost-effectiveness between studies, and between contexts where appropriate, a move towards a common outcome measure such as the cost per disability-adjusted life years averted is advocated. Finally, given the increasing number of combined nutrition and stimulation interventions being tested, there is a significant need for evidence of cost

  9. Effects of early comprehensive interventions on child neurodevelopment in poor rural areas of China: a moderated mediation analysis.

    Science.gov (United States)

    Liu, S; Wang, Z; Zhao, C; Huang, X; Liang, X; Wang, X; Lu, S; Scherpbier, R W

    2018-06-01

    To examine the effects of early comprehensive interventions on home environment and child neurodevelopment among children younger than 3 years in poor rural areas of China, as well as the underlying mediating and moderating mechanisms. Non-randomized intervention study was conducted among 216 children aged 0-3 years in Shanxi province of China. Based on a 2 × 2 factor design, children in Lin and Fenxi County were assigned to an intervention group with duration less than 1 year (n = 26) or an intervention group with duration longer than 1 year (n = 82), while children in Fangshan County served as a control group with duration less than 1 year (n = 30) or a control group with duration longer than 1 year (n = 78). The control group received national public health services (NPHS), while the intervention group received NPHS plus comprehensive interventions covering health, nutrition, early psychosocial stimulation, and child protection. Home environment (Infant-Toddler Home Observation for Measurement of the Environment [HOME]) and child neurodevelopment (Ages and Stages Questionnaire [ASQ]) were measured by observation and interview with mothers after the intervention program. The intervention group showed significantly higher overall HOME, organization, learning materials, and involvement than the control group, only for a duration longer than 1 year. Children in the intervention group performed better in overall ASQ, fine motor, problem-solving, and personal-social than children in the control group. Moderated mediation analyses indicated that there were significantly indirect effects of treatment on overall ASQ through overall HOME, organization, and involvement only when the duration was longer than 1 year. Early comprehensive interventions longer than 1 year improve home environment and promote child neurodevelopment among children younger than 3 years in poor rural areas. What is more, effects of early comprehensive interventions longer than 1 year on

  10. Cumulative Trauma Among Mayas Living in Southeast Florida.

    Science.gov (United States)

    Millender, Eugenia I; Lowe, John

    2017-06-01

    Mayas, having experienced genocide, exile, and severe poverty, are at high risk for the consequences of cumulative trauma that continually resurfaces through current fear of an uncertain future. Little is known about the mental health and alcohol use status of this population. This correlational study explored t/he relationship of cumulative trauma as it relates to social determinants of health (years in the United States, education, health insurance status, marital status, and employment), psychological health (depression symptoms), and health behaviors (alcohol use) of 102 Guatemalan Mayas living in Southeast Florida. The results of this study indicated that, as specific social determinants of health and cumulative trauma increased, depression symptoms (particularly among women) and the risk for harmful alcohol use (particularly among men) increased. Identifying risk factors at an early stage before serious disease or problems are manifest provides room for early screening leading to early identification, early treatment, and better outcomes.

  11. Early surgical intervention and its impact on patients presenting with necrotizing soft tissue infections: A single academic center experience

    Directory of Open Access Journals (Sweden)

    George J Hadeed

    2016-01-01

    Full Text Available Objectives: Early diagnosis and emergent surgical debridement of necrotizing soft tissue infections (NSTIs remains the cornerstone of care. We aimed to study the effect of early surgery on patients' outcomes and, in particular, on hospital length of stay (LOS and Intensive Care Unit (ICU LOS. Materials and Methods: Over a 6-year period (January 2003 through December 2008, we analyzed the records of patients with NSTIs. We divided patients into two groups based on the time of surgery (i.e., the interval from being diagnosed and surgical intervention: Early (<6 h and late (≥6 h intervention groups. For these two groups, we compared baseline demographic characteristics, symptoms, and outcomes. For our statistical analysis, we used the Student's t-test and Pearson Chi-square (χ2 test. To evaluate the clinical predictors of early diagnosis of NSTIs, we performed multivariate logistic regression analysis. Results: In the study population (n = 87; 62% males and 38% females, age, gender, wound locations, and comorbidities were comparable in the two groups. Except for higher proportion of crepitus, the clinical presentations showed no significant differences between the two groups. There were significantly shorter hospital LOS and ICU LOS in the early than late intervention group. The overall mortality rate in our study patients with NSTIs was 12.5%, but early intervention group had a mortality of 7.5%, but this did not reach statistical significance. Conclusions: Our findings show that early surgery, within the first 6 h after being diagnosed, improves in-hospital outcomes in patients with NSTIs.

  12. 75 FR 5603 - Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program

    Science.gov (United States)

    2010-02-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of noncompetitive award of Part C funds for Saint Michael's Medical...

  13. A Randomised Controlled Trial to Determine the Effectiveness of an Early Psychological Intervention with Children Involved in Road Traffic Accidents

    Science.gov (United States)

    Stallard, Paul; Velleman, Richard; Salter, Emma; Howse, Imogen; Yule, William; Taylor, Gordon

    2006-01-01

    Objective: To determine whether an early intervention using a psychological debriefing format is effective in preventing psychological distress in child road traffic accident survivors. Design: Randomised controlled trial. Setting: Accident and Emergency Department, Royal United Hospital, Bath. Subjects: 158 children aged 7-18. Follow-up…

  14. Parental Concerns Regarding a Centre-Based Early Intervention Programme for Down Syndrome in Malaysia: A Case Study

    Science.gov (United States)

    Kunagaratnam, Nagasangari; Loh, Sau Cheong

    2010-01-01

    This qualitative study provides information on the concerns faced by parents having children with Down syndrome in a centre-based Early Intervention Programme in Malaysia and how they coped with these concerns. Semi-structured interviews were conducted with a total of five parents and two special educators. The interview and observation findings…

  15. Early Intervention in Children (0–6 Years with a Rare Developmental Disability: The Occupational Therapy Role

    Directory of Open Access Journals (Sweden)

    Lucy Dall'Alba

    2014-12-01

    Conclusion: Family-centred practice, play therapy, and individually tailored programmes are identified as key practice areas for this population. The important role occupational therapists play in early intervention teams is highlighted; however, further research is needed to develop the evidence base for best practice with particular rare developmental conditions.

  16. Effectiveness of a School-Based Early Intervention CBT Group Programme for Children with Anxiety Aged 5-7 Years

    Science.gov (United States)

    Ruocco, Sylvia; Gordon, Jocelynne; McLean, Louise A.

    2016-01-01

    Early manifestations of anxiety in childhood confer significant distress and life interference. This study reports on the first controlled trial of the "Get Lost Mr. Scary" programme, a Cognitive Behavioural Therapy group intervention for children with anxiety aged 5-7 years. Participants were 134 children (65 males and 69 females) drawn…

  17. Early Intervention Programs. Opening the Door to Higher Education. ASHE-ERIC Higher Education Report Vol. 25, No. 6.

    Science.gov (United States)

    Fenske, Robert H.; Geranios, Christine A.; Keller, Jonathan E.; Moore, David E.

    This report addresses issues related to the increasing growth of early intervention programs to encourage high school graduation and college attendance among students from low-income and minority groups. It first presents a brief review of the societal goals of equality for the nation's education system. It then defines the programs "early…

  18. Fostering a Social Child with Autism: A Moment-by-Moment Sequential Analysis of an Early Social Engagement Intervention

    Science.gov (United States)

    Vernon, Ty W.

    2014-01-01

    Young children with autism often experience limited social motivation and responsiveness that restricts establishment of crucial social momentum. These characteristics can lead to decreased opportunities for parental engagement and the social learning associated with these moments. Early social interventions that capitalize on pre-existing…

  19. Supporting Language in Schools: Evaluating an Intervention for Children with Delayed Language in the Early School Years

    Science.gov (United States)

    Lee, Wendy; Pring, Tim

    2016-01-01

    Extensive evidence exists that many children who experience early socio-economic disadvantage have delayed language development. These delays have been shown to exist when children start school and appear to persist through their education. Interventions that can help these children are desirable to ease the difficulties they have in school and to…

  20. You Must Not Spank Your Children in America: Hmong Parenting Values, Corporal Punishment, and Early Childhood Intervention Programs.

    Science.gov (United States)

    Hughes, Mary Kay

    Conflicts between traditional Hmong values and traditional American parenting values are explored, drawing on the experiences of a coordinator of an Even Start program serving Hmong parents. Even Start is a state-funded early childhood intervention program with a literacy component for parents with less than an eighth grade proficiency in reading…

  1. Early Intravenous Beta-Blockers in Patients With ST-Segment Elevation Myocardial Infarction Before Primary Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    Roolvink, Vincent; Ibáñez, Borja; Ottervanger, Jan Paul; Pizarro, Gonzalo; van Royen, Niels; Mateos, Alonso; Dambrink, Jan-Henk E.; Escalera, Noemi; Lipsic, Erik; Albarran, Agustín; Fernández-Ortiz, Antonio; Fernández-Avilés, Francisco; Goicolea, Javier; Botas, Javier; Remkes, Wouter; Hernandez-Jaras, Victoria; Kedhi, Elvin; Zamorano, José L.; Navarro, Felipe; Alfonso, Fernando; García-Lledó, Alberto; Alonso, Joaquin; van Leeuwen, Maarten; Nijveldt, Robin; Postma, Sonja; Kolkman, Evelien; Gosselink, Marcel; de Smet, Bart; Rasoul, Saman; Piek, Jan J.; Fuster, Valentin; van 't Hof, Arnoud W. J.

    2016-01-01

    The impact of intravenous (IV) beta-blockers before primary percutaneous coronary intervention (PPCI) on infarct size and clinical outcomes is not well established. This study sought to conduct the first double-blind, placebo-controlled international multicenter study testing the effect of early IV

  2. Prevention of and Early Intervention for Students with Emotional and Behavioral Disorders: Systems to Support Data-Based Decision Making

    Science.gov (United States)

    Lewis, Timothy J.; Mitchell, Barbara S.

    2012-01-01

    Students with emotional and behavioral disorders are at great risk for long-term negative outcomes. Researchers and practitioners alike acknowledge the need for evidence-based, preventive, and early intervention strategies. Accordingly, in this chapter an expanded view of prevention is presented as a series of data driven decisions to guide…

  3. On Track for Success: The Use of Early Warning Indicator and Intervention Systems to Build a Grad Nation

    Science.gov (United States)

    Bruce, Mary; Bridgeland, John M.; Fox, Joanna Hornig; Balfanz, Robert

    2011-01-01

    Over the past decade, schools, districts, and states have become increasingly savvy with data collection and analysis to drive student outcomes. The development and use of Early Warning Indicator and Intervention Systems (EWS) are at the cutting edge of the data- driven, outcomes-focused, high-impact education movement. These systems can increase…

  4. Preliminary Evaluation of a Social Skills Training and Facilitated Play Early Intervention Programme for Extremely Shy Young Children in China

    Science.gov (United States)

    Li, Yan; Coplan, Robert J.; Wang, Yuemin; Yin, Jingtong; Zhu, Jingjing; Gao, Zhuqing; Li, Linhui

    2016-01-01

    The goal of this study was to provide a preliminary evaluation of a social skills and facilitated play early intervention programme to promote social interaction, prosocial behaviours and socio-communicative skills among young extremely shy children in China. Participants were a sample of n = 16 extremely shy young children attending kindergarten…

  5. 78 FR 25458 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Science.gov (United States)

    2013-05-01

    ... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of Ryan White HIV/AIDS... HIV/AIDS, HRSA will provide a one-time noncompetitive Ryan White HIV/AIDS Program Part C funds award...

  6. Banking Time in Head Start: Early Efficacy of an Intervention Designed to Promote Supportive Teacher-Child Relationships

    Science.gov (United States)

    Driscoll, Katherine C.; Pianta, Robert C.

    2010-01-01

    Research Findings: This exploratory study encompassed a collaboration to implement and evaluate the early efficacy of Banking Time, a dyadic intervention designed to promote supportive teacher-child relationships. Banking Time is a set of one-on-one meetings between a teacher and a child consisting of child-led play and teacher facilitation…

  7. Parents' Perceptions of Early Interventions and Related Services for Children with Autism Spectrum Disorder in Saudi Arabia

    Science.gov (United States)

    Alotaibi, Faihan; Almalki, Nabil

    2016-01-01

    The present study sought to examine parents' perceptions of early interventions and related services for children with autism spectrum disorder (ASD) in Saudi Arabia. In this study a survey was distributed to a sample of 80 parents with children who have ASD. Parents also were asked open-ended questions to enable them to provide suggestions. The…

  8. Rate of Language Growth in Children with Hearing Loss in an Auditory-Verbal Early Intervention Program

    Science.gov (United States)

    Jackson, Carla Wood; Schatschneider, Christopher

    2013-01-01

    This longitudinal study explored the rate of language growth of children in an early intervention program providing auditory-verbal therapy. A retrospective investigation, the study applied a linear growth model to estimate a mean growth curve and the extent of individual variation in language performance on the Preschool Language Scale, 4th ed.…

  9. Effect of Foster Care on Language Learning at Eight Years: Findings from the Bucharest Early Intervention Project

    Science.gov (United States)

    Windsor, Jennifer; Moraru, Ana; Nelson, Charles A., III.; Fox, Nathan A.; Zeanah, Charles H.

    2013-01-01

    This study reports on language outcomes at eight years from the Bucharest Early Intervention Project, a randomized controlled study of foster care. We previously have shown that children placed in foster care by age two have substantially stronger preschool language outcomes than children placed later and children remaining in institutional care.…

  10. Steps and pips in the history of the cumulative recorder.

    OpenAIRE

    Lattal, Kennon A

    2004-01-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This review traces the evolution of the cumulative recorder from Skinner's early modified kymographs through various models developed by Skinner and his co...

  11. The challenge of cumulative impacts

    Energy Technology Data Exchange (ETDEWEB)

    Masden, Elisabeth

    2011-07-01

    Full text: As governments pledge to combat climate change, wind turbines are becoming a common feature of terrestrial and marine environments. Although wind power is a renewable energy source and a means of reducing carbon emissions, there is a need to ensure that the wind farms themselves do not damage the environment. There is particular concern over the impacts of wind farms on bird populations, and with increasing numbers of wind farm proposals, the concern focuses on cumulative impacts. Individually, a wind farm, or indeed any activity/action, may have minor effects on the environment, but collectively these may be significant, potentially greater than the sum of the individual parts acting alone. Cumulative impact assessment is a legislative requirement of environmental impact assessment but such assessments are rarely adequate restricting the acquisition of basic knowledge about the cumulative impacts of wind farms on bird populations. Reasons for this are numerous but a recurring theme is the lack of clear definitions and guidance on how to perform cumulative assessments. Here we present a conceptual framework and include illustrative examples to demonstrate how the framework can be used to improve the planning and execution of cumulative impact assessments. The core concept is that explicit definitions of impacts, actions and scales of assessment are required to reduce uncertainty in the process of assessment and improve communication between stake holders. Only when it is clear what has been included within a cumulative assessment, is it possible to make comparisons between developments. Our framework requires improved legislative guidance on the actions to include in assessments, and advice on the appropriate baselines against which to assess impacts. Cumulative impacts are currently considered on restricted scales (spatial and temporal) relating to individual development assessments. We propose that benefits would be gained from elevating cumulative

  12. The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma

    DEFF Research Database (Denmark)

    Busse, William W; Pedersen, Søren; Pauwels, Romain A

    2008-01-01

    BACKGROUND: The Inhaled Steroid Treatment as Regular Therapy in Early Asthma (START) study enrolled 7241 patients aged 5 to 66 years with recent-onset, mild persistent asthma to assess early intervention with the inhaled corticosteroid budesonide on long-term asthma control. OBJECTIVE: The open......-label phase of the START study was included to determine the effect on lung function and asthma control of adding budesonide to the reference group patients who had not initially received inhaled corticosteroids. METHODS: Patients were randomized to double-blind treatment with budesonide, 200 mug (those aged...

  13. Thrombolysis in the age of Primary Percutaneous Coronary Intervention: Mini-Review and Meta-analysis of Early PCI.

    Science.gov (United States)

    Al Shammeri, O; Garcia, LA

    2013-01-01

    Primary Percutaneous Coronary Intervention (PCI) is the treatment of choice for ST-segment Elevation Myocardial Infarction (STEMI) if performed within 90 minutes from first medical contact. However, primary PCI is only available for less than 25% of patients with STEMI. Early PCI or Pharmaco-invasive strategy has evolved from facilitated PCI but with more delayed timing from thrombolysis to PCI. Assess the safety and effectiveness of Early PCI. We reviewed the data of the available therapy options for patients with STEMI. Then we performed a meta-analysis for all randomized controlled trials of early PCI versus standard therapy. Five studies fulfilled our inclusion criteria. Our meta-analysis showed improved cardiovascular events with early PCI compared to standard therapy (odd ratio of 0.54; 95% Confidence interval 0.47-0.7, pearly PCI 4 to 24 hours after successful thrombolysis. Early PCI should be done to all STEMI patients within 24 hours after successful thrombolysis.

  14. [Evaluation of quality of service in Early Intervention: A systematic review].

    Science.gov (United States)

    Jemes Campaña, Inmaculada Concepción; Romero-Galisteo, Rita Pilar; Labajos Manzanares, María Teresa; Moreno Morales, Noelia

    2018-06-07

    Early Intervention (EI), as a paediatric service, has the duty of quantifying the results and the quality of its services provided. The accessibility of valid and reliable tools allows professionals to evaluate the quality of these services. The aim of this study is to review the scientific literature on tools used to measure the methodological and service quality in EI. A search was made in different databases: Medline (from PubMed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC and Scielo. The methodological quality of the studies was tested using the COSMIN scale. A total of 13 manuscripts met the criteria to be included in this review. Ten of them received a "good" or "reasonable" score based on the COSMIN scale. Despite its importance, there is no consensus among authors on the measurement of service quality in EI. It is often the family of the children attended in EI that are considered the target to study, although the opinion of professionals carries more weight and completes the information. Copyright © 2018. Publicado por Elsevier España, S.L.U.

  15. Communication Concepts for Prevention and Early Intervention in Aesthetic Medicine: Consensus and Literature Review.

    Science.gov (United States)

    Gout, Uliana; Anand, Chytra V; Braz, Andre; Chao, Yates Yen Yu; Fabi, Sabrina Guillen; Kerscher, Martina; Landau, Marina; Pavicic, Tatjana; Peng, Peter Hsien Li; Rzany, Berthold; Sattler, Gerhard; Tiryaki, Tunk; Waldorf, Heidi A; Besins, Thierry

    2017-09-01

    Communication concepts relating to prevention and early intervention (P&E) within aesthetic medicine are poorly understood and highly underexplored. However, effective communication is a key criterion for successful outcomes. To introduce the framework for P&E communication strategies within a younger population and explore the barriers that may be encountered. A literature review on P&E communication strategies in aesthetic medicine and related topics of interest was conducted and used to construct a working framework that may be applied in clinical practice. Examination of existing literature revealed a need for a more structured communication framework for P&E encompassing up-to-date evidence-based learning and educational marketing that is tailored to individual needs and target populations. Message framing-the way in which a message is presented-is an important consideration in the dissemination of information to promote changes in health behaviour. A structured consultation is key to optimising patient engagement and ensures a tailored approach to understanding and catering to the specific needs of each patient. This is the first paper to discuss the communication concepts behind P&E within aesthetic medicine and paves the way for further research and focus in this significant field. J Drugs Dermatol. 2017;16(9):859-864..

  16. EFFECTS OF AN INTERVENTION PROGRAM (HHP) ON THE PROMOTION OF HEALTHY HABITS IN EARLY ADOLESCENCE.

    Science.gov (United States)

    Nebot Paradells, Vicente; Pablos Monzó, Ana; Elvira Macagno, Laura; Guzmán Luján, José Francisco; Pablos Abella, Carlos

    2015-12-01

    it is vital to monitor and promote healthy lifestyle habits in early adolescence, as it is a time of changes when future lifestyle habits are formed. a study was conducted to find out the effects of a Healthy Habits Program (HHP) in children between the ages of 10 and 12 years (N = 158). The study included an intervention group (IG) (n = 90), which participated in the HHP for 8 months, and a control group (CG) (n = 100). In order to assess healthy habits in these children we used the Inventory of Healthy Habits (IHH), the reliability of which was previously evaluated (N = 134). the IHH obtained good reliability, Interclass Correlation Coefficient (range .506 - 884; p eating habits initially (p = .564), but by the end of the study (p = .001) the IG showed better habits. As for the other healthy habits indicators, the CG had better habits initially (p = .047), but the score of the IG improved and there were no differences between the groups at the end of the study. it was shown that the IHH is a suitable and reliable questionnaire for studying habits in adolescents. The HHP brought about changes in the IG, which achieved better scores for eating habits and sum of health habits. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  17. Early interventional treatment with intranasal corticosteroids compared with postonset treatment in pollinosis.

    Science.gov (United States)

    Higaki, Takaya; Okano, Mitsuhiro; Makihara, Seiichiro; Fujiwara, Tazuko; Haruna, Takenori; Noda, Yohei; Kariya, Shin; Nishizaki, Kazunori

    2012-12-01

    The usefulness of early interventional treatment (EIT) with intranasal corticosteroids (INSs) compared with postonset treatment (POT) has not been clarified. To study the efficacy and safety of EIT with INSs compared with POT and placebo in Japanese cedar/cypress pollinosis. We designed a 3-armed, double-blinded, randomized, placebo-controlled trial. Patients received mometasone furoate nasal spray (EIT group: n = 25), placebo (n = 25), or 4 weeks of placebo followed by 8 weeks of mometasone (POT group: n = 25) for a 12-week period starting on February 1, 2011. The primary end point was the comparison of the total nasal symptom score (TNSS) among the 3 groups. Total ocular symptom score (TOSS), total naso-ocular symptom score (TSS), Allergic Rhinitis and Its Impact (ARIA) on Asthma classification, and safety were the main secondary end points. The placebo and POT groups, but not the EIT group, had a significant exacerbation of TNSS and TOSS soon after the start of pollen counts being high on consecutive days. The 12-week mean TSS in the EIT group (score, 2.3) was significantly lower than in the placebo (5.0; P INSs is superior to POT in controlling pollinosis. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Parents seek early intervention services for a two-year-old without autism.

    Science.gov (United States)

    Reddy, Arathi; Graves, Crista; Augustyn, Marilyn

    2011-10-01

    Sam is a 27-month-old boy who you have followed since birth. He lives with his parents in a small resort town approximately 90 miles outside a major city. Both his parents are professionals in their late 30s and have been highly involved in his care since birth. At the 12-month visit, they were concerned about his difficulty regulating. He was not sleeping through the night and had significant difficulty with baths. His physical examination and growth were normal. His eye contact was good, although it was difficult to see him smile. He had 1 or 2 words and was beginning to walk independently.At the 15-month checkup, they continued to be concerned about his poor regulation. He napped sporadically, and he was very difficult to take out on errands as he did not like his car seat. He now had approximately 10 single words, was using his fingers to point, and very clearly waved "bye bye" as soon as you entered the room.At the 18-month checkup, they state that he has not yet learned the word "no." He will follow a 1-step command when he wants to but now has 15 single words without any combinations. He points for his needs and to show them something. He has become increasingly "shy" around strangers and prefers to play with one other child as opposed to a larger group. He does not like loud noises and prefers to go barefoot constantly. His physical examination was again normal as was his growth. He is referred for a full hearing evaluation, which is also normal. The family was referred to early intervention, and he began receiving speech and language therapy and occupational therapy for his sensory challenges as well as a play group.At the 24-month checkup, his language continued to consist of single words-now approximately 30. When the parents do not understand what he wants, he will often tantrum and has started banging his head on the floor when frustrated. He has no repetitive behaviors and is starting to demonstrate imaginative play. Bath time has becoming

  19. Laying a Firm Foundation: Embedding Evidence-Based Emergent Literacy Practices Into Early Intervention and Preschool Environments.

    Science.gov (United States)

    Terrell, Pamela; Watson, Maggie

    2018-04-05

    As part of this clinical forum on curriculum-based intervention, the goal of this tutorial is to share research about the importance of language and literacy foundations in natural environments during emergent literacy skill development, from infancy through preschool. Following an overview of intervention models in schools by Powell (2018), best practices at home, in child care, and in preschool settings are discussed. Speech-language pathologists in these settings will be provided a toolbox of best emergent literacy practices. A review of published literature in speech-language pathology, early intervention, early childhood education, and literacy was completed. Subsequently, an overview of the impact of early home and preschool literacy experiences are described. Research-based implementation of best practice is supported with examples of shared book reading and child-led literacy embedded in play within the coaching model of early intervention. Finally, various aspects of emergent literacy skill development in the preschool years are discussed. These include phonemic awareness, print/alphabet awareness, oral language skills, and embedded/explicit literacy. Research indicates that rich home literacy environments and exposure to rich oral language provide an important foundation for the more structured literacy environments of school. Furthermore, there is a wealth of evidence to support a variety of direct and indirect intervention practices in the home, child care, and preschool contexts to support and enhance all aspects of oral and written literacy. Application of this "toolbox" of strategies should enable speech-language pathologists to address the prevention and intervention of literacy deficits within multiple environments during book and play activities. Additionally, clinicians will have techniques to share with parents, child care providers, and preschool teachers for evidence-based literacy instruction within all settings during typical daily

  20. Early Stent Thrombosis and Mortality After Primary Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Dangas, George D; Schoos, Mikkel M.; Steg, Philippe Gabriel

    2016-01-01

    BACKGROUND: Early stent thrombosis (ST) within 30 days after primary percutaneous coronary intervention in ST-segment-elevation myocardial infarction is a serious event. We sought to determine the predictors of and risk of mortality after early ST according to procedural antithrombotic therapy...... with bivalirudin compared with heparin±GPI because of increased ST within 4 hours after primary percutaneous coronary intervention. However, the mortality attributable to early ST was significantly lower after bivalirudin than after heparin±GPI. CLINICAL TRIAL REGISTRATION: URL: http....... METHODS AND RESULTS: In a patient-level pooled analysis from the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) and European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) trials, we examined 30-day outcomes in 4935 patients undergoing primary...

  1. Overview of States' Use of Telehealth for the Delivery of Early Intervention (IDEA Part C Services

    Directory of Open Access Journals (Sweden)

    Jana Cason

    2012-12-01

    Full Text Available Background: Early intervention (EI services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC 2011.  EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA; however, personnel shortages, particularly in rural areas, limit access for children who qualify.  Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community.  Method:  A survey sent by the National Early Childhood Technical Assistance Center (NECTAC to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs.  Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified.  Results:  Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey.  Of these, 30% (n=9 indicated that they are either currently using telehealth as an adjunct service delivery model (n=6 or plan to incorporate telehealth within the next 1-2 years (n=3.  Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH, speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters.  Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance.  Expressed barriers and concerns for

  2. Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood.

    Science.gov (United States)

    Helle, Christine; Hillesund, Elisabet Rudjord; Omholt, Mona Linge; Øverby, Nina Cecilie

    2017-09-20

    Childhood overweight and obesity is a global public health challenge. Primary prevention initiatives targeting parents have been called for to encourage a positive feeding environment and healthy eating habits that may lay a good foundation for future health. At the same time, there is a need for interventions which combine accessibility and scalability with cost effectiveness. Today's parents are extensive Internet-users, but only a few randomized controlled trials have investigated the use of Internet to promote healthy eating habits in early childhood. In Early Food for Future Health we have developed and will evaluate an Internet-based tool for parents of children between 6 and 12 months, aiming to increase knowledge about infant nutrition and foster protective feeding behavior. During springtime 2016, parents of children aged between 3 and 5 months were recruited through Norwegian child health centres and announcements on Facebook. After completing the baseline questionnaire, 718 parents were individually randomized to intervention- or control group. The intervention group received monthly emails with links to an age-appropriate web-site when their child was between 6 and 12 months. The control group received ordinary care from the child health centres. The data-collection is ongoing. All participants will be followed up at ages 12 and possibly 24 and 48 months, with questionnaires relating to eating behaviour and feeding practices, food variety and diet quality. Providing guidance and counseling to parents of infants is an important task for health authorities and the public child health services. Early Food for Future health is an intervention focusing on promoting early healthy food-habits which may prevent childhood overweight and obesity. If proven to be effective, Early Food for Future Health can be used by parents and public health nurses for supplementary guidance on feeding practices and diet. This study has the potential to provide greater

  3. Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study.

    Science.gov (United States)

    Taylor, Natalie J; Sahota, Pinki; Sargent, Judith; Barber, Sally; Loach, Jackie; Louch, Gemma; Wright, John

    2013-12-28

    Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres. HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother's diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity. We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial.

  4. Parenting and the Family Check-Up: Changes in Observed Parent-Child Interaction Following Early Childhood Intervention.

    Science.gov (United States)

    Sitnick, Stephanie L; Shaw, Daniel S; Gill, Anne; Dishion, Thomas; Winter, Charlotte; Waller, Rebecca; Gardner, Frances; Wilson, Melvin

    2015-01-01

    Coercion theory posits a cyclical relationship between harsh and coercive parent-child interactions and problem behavior beginning in early childhood. As coercive interactions have been theorized and found to facilitate the development and growth of early conduct problems, early interventions often target parenting to prevent or reduce early disruptive problem behavior. This study utilizes direct observations of parent-child interactions from the Early Steps Multisite study (N = 731; 369 boys) to examine the effect of the Family Check-Up, a family-centered intervention program, on measures of parent-child positive engagement and coercion from age 2 through 5, as well as on childhood problem behavior at age 5. Results indicate that high levels of parent-child positive engagement were associated with less parent-child coercion the following year, but dyadic coercion was unrelated to future levels of positive engagement. In addition, families assigned to the Family Check-Up showed increased levels of positive engagement at ages 3 and 5, and the association between positive engagement at age 3 and child problem behavior at age 5 was mediated by reductions in parent-child coercion at age 4. These findings provide longitudinal confirmation that increasing positive engagement in parent-child interaction can reduce the likelihood of coercive family dynamics in early childhood and growth in problem behavior.

  5. Focus on early-career GPs: qualitative evaluation of a multi-faceted educational intervention to improve antibiotic prescribing.

    Science.gov (United States)

    Deckx, Laura; Anthierens, Sibyl; Magin, Parker J; Morgan, Simon; McArthur, Lawrie; Yardley, Lucy; Dallas, Anthea; Little, Paul; van Driel, Mieke L

    2018-01-16

    We conducted an educational intervention emphasizing rational antibiotic prescribing in early-career General Practitioners (GP) in vocational training (trainees). The intervention consisted of an online introduction module, an online communication training module, face-to-face workshops, and cases to be discussed one-on-one by the trainee-supervisor dyad during regular scheduled education sessions. To explore the participants' experiences with the intervention. A qualitative study of 14 GP trainees and supervisors. Interviews followed a semi-structured interview guide, were transcribed and analysed using concurrent thematic analysis. Overall, the intervention was well received. Resources were not often used in practice, but GP trainees used the information in communicating with patients. The intervention improved trainees' confidence and provided new communication strategies, e.g. explicitly asking about patients' expectations and talking patients through the examination to form an overall clinical picture. Trainees seemed eager to learn and adapt their practice, whereas GP supervisors rather commented that the intervention was reinforcing. None of the participants reported prescribing conflicts between trainee and supervisor. However, most participants identified conflicts within the GP practice or with specialists: other doctors who prescribe more antibiotics perpetuate patients' ideas that antibiotics will fix everything, which in turn causes conflict with the patient and undermines attempts to improve antibiotic prescribing. The educational intervention was received positively. Early-career GPs thought it influenced their prescribing behaviour and improved their confidence in non-prescribing. Interventions that target teams (e.g. entire practice) could minimize conflict, ensure consistency of messages and support overall antibiotic stewardship in primary care. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please

  6. Early results of surgical intervention for elbow deformity in cerebral palsy based on degree of contracture.

    Science.gov (United States)

    Carlson, Michelle G; Hearns, Krystle A; Inkellis, Elizabeth; Leach, Michelle E

    2012-08-01

    Elbow flexion posture, caused by spasticity of the muscles on the anterior surface of the elbow, is the most common elbow deformity seen in patients with cerebral palsy. This study retrospectively evaluated early results of 2 surgical interventions for elbow flexion deformities based on degree of contracture. We hypothesized that by guiding surgical treatment to degree of preoperative contracture, elbow extension and flexion posture angle at ambulation could be improved while preserving maximum flexion. Eighty-six patients (90 elbows) were treated for elbow spasticity due to cerebral palsy. Seventy-one patients (74 elbows) were available for follow-up. Fifty-seven patients with fixed elbow contractures less than 45° were surgically treated with a partial elbow muscle lengthening, which included partial lengthening of the biceps and brachialis and proximal release of the brachioradialis. Fourteen patients (17 elbows) with fixed elbow contractures ≥ 45° had a more extensive full elbow release, with biceps z-lengthening, partial brachialis myotomy, and brachioradialis proximal release. Age at surgery averaged 10 years (range, 3-20 y) for partial lengthening and 14 years (range, 5-20 y) for full elbow release. Follow-up averaged 22 months (range, 7-144 mo) for partial lengthening and 18 months (range, 6-51 mo) for full elbow release. Both groups achieved meaningful improvement in flexion posture angle at ambulation, active and passive extension, and total range of motion. Elbow flexion posture angle at ambulation improved by 57° and active extension increased 17° in the partial lengthening group, with a 4° loss of active flexion. In the full elbow release group, elbow flexion posture angle at ambulation improved 51° and active extension improved 38°, with a loss of 19° of active flexion. Surgical treatment of spastic elbow flexion in cerebral palsy can improve deformity. We obtained excellent results by guiding the surgical intervention by the amount of

  7. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    International Nuclear Information System (INIS)

    Forbes, L. J. L.; Forster, A. S.; Dodd, R. H.; Tucker, L.; Laming, R.; Ramirez, A. J.; Sellars, S.; Patnick, J.

    2012-01-01

    Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ∼70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women.

  8. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    Science.gov (United States)

    Forbes, Lindsay J. L.; Forster, Alice S.; Dodd, Rachael H.; Tucker, Lorraine; Laming, Rachel; Sellars, Sarah; Patnick, Julietta; Ramirez, Amanda J.

    2012-01-01

    Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women. PMID:23213334

  9. Project success: A methodological and evaluative case study of the early alert program interventions

    Science.gov (United States)

    Larkins, Randy James

    environment possible in whatever form the focus group takes place. Suggestions for future research include recruiting participants from online classes and attempting to engage more disenfranchised students in other studies. Similar to new types of focus group methods due to technological advances, academic interventions for students facing failing grades are also increasing due to the internet and new methods of service delivery. The contextual aspect of this research involved asking students to participate in an initial focus group session, four weeks of email updates, and a final focus group session in which students participated in the same group as the initial session. The purpose of the focus groups was to evaluate whether or not the universities' attempts to help students succeed in a course known in the past for high failure rates through a program known as the Early Alert Project was succeeding. Interview data were analyzed using thematic coding to evaluate available support services using a comprehensive implementation evaluation model which included effort, monitoring, process, components; and treatment specification. The primary findings were although students believed the university was trying to help them succeed, Early Alert Project efforts were adversely received. In addition, participants felt that although there were enough support services to help them succeed in the course, the components of the support system were confusing and not organized in any systematic manner. Suggestions for further research included researching delivery of this type of communication that might be more amenable to the students who received it and applying this research to other courses to examine whether the same results occur. Finally, implications of the use of traditional methods and academic support services are discussed in addition to the effect of the research itself upon its participants.

  10. Early versus late surgical intervention or medical management for infective endocarditis: a systematic review and meta-analysis.

    Science.gov (United States)

    Anantha Narayanan, Mahesh; Mahfood Haddad, Toufik; Kalil, Andre C; Kanmanthareddy, Arun; Suri, Rakesh M; Mansour, George; Destache, Christopher J; Baskaran, Janani; Mooss, Aryan N; Wichman, Tammy; Morrow, Lee; Vivekanandan, Renuga

    2016-06-15

    Infective endocarditis is associated with high morbidity and mortality and optimal timing for surgical intervention is unclear. We performed a systematic review and meta-analysis to compare early surgical intervention with conservative therapy in patients with infective endocarditis. PubMed, Cochrane, EMBASE, CINAHL and Google-scholar databases were searched from January 1960 to April 2015. Randomised controlled trials, retrospective cohorts and prospective observational studies comparing outcomes between early surgery at 20 days or less and conservative management for infective endocarditis were analysed. A total of 21 studies were included. OR of all-cause mortality for early surgery was 0.61 (95% CI 0.50 to 0.74, pendocarditis between the overall unmatched cohorts. The results of our meta-analysis suggest that early surgical intervention is associated with significantly lower risk of mortality in patients with infective endocarditis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Level and Intensity of Early Intervention Services for Infants and Toddlers with Disabilities: The Impact of Child, Family, System, and Community-Level Factors on Service Provision

    Science.gov (United States)

    Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony

    2009-01-01

    Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…

  12. After Early Autism Diagnosis: Changes in Intervention and Parent-Child Interaction.

    Science.gov (United States)

    Suma, Katharine; Adamson, Lauren B; Bakeman, Roger; Robins, Diana L; Abrams, Danielle N

    2016-08-01

    This study documents the relation between an autism spectrum disorder (ASD) diagnosis, increases in intervention, and changes in parent-child interaction quality. Information about intervention and observations of interaction were collected before diagnosis and a half year after diagnosis for 79 low-risk toddlers who had screened positive for ASD risk during a well-baby checkup. Children diagnosed with ASD (n = 44) were 2.69 times more likely to increase intervention hours. After ASD diagnosis, the relation between intervention and interaction quality was complex: although increases in intervention and interaction quality were only modestly related, the overall amount of intervention after diagnosis was associated with higher quality interactions. Moreover, lower quality interactions before diagnosis significantly increased the likelihood that intervention would increase post-diagnosis.

  13. Technology-based functional assessment in early childhood intervention: a pilot study.

    Science.gov (United States)

    Khetani, Mary A; McManus, Beth M; Arestad, Kristen; Richardson, Zachary; Charlifue-Smith, Renee; Rosenberg, Cordelia; Rigau, Briana

    2018-01-01

    Electronic patient-reported outcomes (e-PROs) may provide valid and feasible options for obtaining family input on their child's functioning for care planning and outcome monitoring, but they have not been adopted into early intervention (EI). The purpose of this pilot study was to evaluate the feasibility of implementing technology-based functional assessment into EI practice and to examine child, family, service, and environmental correlates of caregiver-reported child functioning in the home. In a cross-sectional design, eight individual EI providers participated in a 90-min technology-based functional assessment training to recruit participants and a 60-min semi-structured focus group post data collection. Participants completed the Young Children's Participation and Environment Measure (YC-PEM) home section online and Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) via iPad. Participants' EI service use data were obtained from administrative records. A total of 37 caregivers of children between 6 and 35 months old (mean age = 19.4, SD = 7.7) enrolled, a rate of 44% (37/84) in 2.5 months. Providers suggested expanding staff training, gathering data during scheduled evaluations, and providing caregivers and providers with access to assessment summaries. Caregivers wanted their child's participation to change in 56% of home activities. Lower caregiver education and higher EI intensity were related to less child involvement in home activities. Implementing technology-based functional assessment is feasible with modifications, and these data can be useful for highlighting child, family, and EI service correlates of caregiver-reported child functioning that merit further study. Feasibility results informed protocol modifications related to EI provider training, timing of data collection, and management of EI service use data extraction, as preparation for a subsequent scale-up study that is underway.

  14. Independent risk factors for postoperative pain in need of intervention early after awakening from general anaesthesia.

    Science.gov (United States)

    Mei, Wei; Seeling, Matthes; Franck, Martin; Radtke, Finn; Brantner, Benedikt; Wernecke, Klaus-Dieter; Spies, Claudia

    2010-02-01

    Despite advances in postoperative pain management, the proportion of patients with moderate to severe postoperative pain is still ranging 20-80%. In this retrospective study, we investigated 1736 patients to determine the incidence of postoperative pain in need of intervention (PPINI)defined as numeric rating scale >4 at rest in the post anaesthesia care unit early after awakening from general anaesthesia, and to identify possible risk factors. The proportion of patients with PPINI was 28.5%. On multivariate analysis, younger age (OR=1.300 [1.007-1.678], p=0.044), female gender (OR=1.494 [1.138-1.962], p=0.004), obesity (OR=1.683 [1.226-2.310], p=0.001), use of nitrous oxide (OR=1.621 [1.110-2.366], p=0.012), longer duration of surgery (OR=1.165 [1.050-1.292], p=0.004), location of surgery (musculoskeletal OR=2.026 [1.326-3.095], p=0.001; intraabdominal OR=1.869 [1.148-3.043], p=0.012), and ASA-PS I-II (OR=1.519 [1.131-2.039], P=0.005) were identified as independent risk factors for PPINI. Patients with PPINI experienced significantly more PONV (10.3% vs. 6.2%, p=0.003), more psychomotor agitation (5.5% vs. 2.7%, p=0.004), needed more application of opioid in PACU (62.8% vs. 24.2%, p<0.001), stayed significantly longer in PACU (89.6min [70-120] vs. 80min [60-100], p<0.001), had a longer median length of hospital stay (6.6 days [4.0-8.8] vs. 6.0 days [3.2-7.8

  15. Care for Child Development: an intervention in support of responsive caregiving and early child development.

    Science.gov (United States)

    Lucas, J E; Richter, L M; Daelmans, B

    2018-01-01

    An estimated 43% of children younger than 5 years of age are at elevated risk of failing to achieve their human potential. In response, the World Health Organization and UNICEF developed Care for Child Development (CCD), based on the science of child development, to improve sensitive and responsive caregiving and promote the psychosocial development of young children. In 2015, the World Health Organization and UNICEF identified sites where CCD has been implemented and sustained. The sites were surveyed, and responses were followed up by phone interviews. Project reports provided information on additional sites, and a review of published studies was undertaken to document the effectiveness of CCD for improving child and family outcomes, as well as its feasibility for implementation in resource-constrained communities. The inventory found that CCD had been integrated into existing services in diverse sectors in 19 countries and 23 sites, including child survival, health, nutrition, infant day care, early education, family and child protection and services for children with disabilities. Published and unpublished evaluations have found that CCD interventions can improve child development, growth and health, as well as responsive caregiving. It has also been reported to reduce maternal depression, a known risk factor for poor pregnancy outcomes and poor child health, growth and development. Although CCD has expanded beyond initial implementation sites, only three countries reported having national policy support for integrating CCD into health or other services. Strong interest exists in many countries to move beyond child survival to protect and support optimal child development. The United Nations Sustainable Development Goals depend on children realizing their potential to build healthy and emotionally, cognitively and socially competent future generations. More studies are needed to guide the integration of the CCD approach under different conditions. Nevertheless

  16. Acceptability of early infant male circumcision as an HIV prevention intervention in Zimbabwe: a qualitative perspective.

    Directory of Open Access Journals (Sweden)

    Webster Mavhu

    Full Text Available BACKGROUND: Early infant male circumcision (EIMC is simpler, safer and more cost-effective than adult circumcision. In sub-Saharan Africa, there are concerns about acceptability of EIMC which could affect uptake. In 2009 a quantitative survey of 2,746 rural Zimbabweans (aged 18-44 indicated that 60% of women and 58% of men would be willing to have their newborn son circumcised. Willingness was associated with knowledge of HIV and male circumcision. This qualitative study was conducted to better understand this issue. METHODS: In 2010, 24 group discussions were held across Zimbabwe with participants from seven ethnic groups. Additionally, key informant interviews were held with private paediatricians who offer EIMC (n = 2 plus one traditional leader. Discussions were audio-recorded, transcribed, translated into English (where necessary, coded using NVivo 8 and analysed using grounded theory principles. RESULTS: Knowledge of the procedure was poor. Despite this, acceptability of EIMC was high among parents from most ethnic groups. Discussions suggested that fathers would make the ultimate decision regarding EIMC although mothers and extended family can have (often covert influence. Participants' concerns centred on: safety, motive behind free service provision plus handling and disposal of the discarded foreskin. Older men from the dominant traditionally circumcising population strongly opposed EIMC, arguing that it separates circumcision from adolescent initiation, as well as allowing women (mothers to nurse the wound, considered taboo. CONCLUSIONS: EIMC is likely to be an acceptable HIV prevention intervention for most populations in Zimbabwe, if barriers to uptake are appropriately addressed and fathers are specifically targeted by the programme.

  17. Quantifying parental preferences for interventions designed to improve home food preparation and home food environments during early childhood.

    Science.gov (United States)

    Virudachalam, Senbagam; Chung, Paul J; Faerber, Jennifer A; Pian, Timothy M; Thomas, Karen; Feudtner, Chris

    2016-03-01

    Though preparing healthy food at home is a critical health promotion habit, few interventions have aimed to improve parental cooking skills and behaviors. We sought to understand parents' preferences and priorities regarding interventions to improve home food preparation practices and home food environments during early childhood. We administered a discrete choice experiment using maximum difference scaling. Eighty English-speaking parents of healthy 1-4 year-old children rated the relative importance of potential attributes of interventions to improve home food preparation practices and home food environments. We performed latent class analysis to identify subgroups of parents with similar preferences and tested for differences between the subgroups. Participants were mostly white or black 21-45 year-old women whose prevalence of overweight/obesity mirrored the general population. Latent class analysis revealed three distinct groups of parental preferences for intervention content: a healthy cooking group, focused on nutrition and cooking healthier food; a child persuasion group, focused on convincing toddlers to eat home-cooked food; and a creative cooking group, focused on cooking without recipes, meal planning, and time-saving strategies. Younger, lower income, 1-parent households comprised the healthy cooking group, while older, higher income, 2-parent households comprised the creative cooking group (p cooked dinner regularly, unlike the other two groups (p food preparation practices. Such interventions are important for creating healthier home food environments and preventing obesity starting from early childhood. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. The effect of a simple educational intervention on interest in early abortion training among family medicine residents.

    Science.gov (United States)

    Wu, Justine P; Bennett, Ian; Levine, Jeffrey P; Aguirre, Abigail Calkins; Bellamy, Scarlett; Fleischman, Joan

    2006-06-01

    We aimed to assess the effect of an educational intervention on the interest in and support for abortion training among family medicine residents. We conducted a cross-sectional survey before and after an educational lecture on medical and surgical abortion in primary care among 89 residents in 10 New Jersey family medicine programs. Before the lecture, there was more interest in medical abortion training than surgical abortion. Resident interest in surgical abortion and overall support for abortion training increased after the educational intervention (p<.01). Efforts to develop educational programs on early abortion care may facilitate the integration of abortion training in family medicine.

  19. A randomised controlled trial of an iPad-based application to complement early behavioural intervention in Autism Spectrum Disorder.

    Science.gov (United States)

    Whitehouse, Andrew J O; Granich, Joanna; Alvares, Gail; Busacca, Margherita; Cooper, Matthew N; Dass, Alena; Duong, Thi; Harper, Rajes; Marshall, Wendy; Richdale, Amanda; Rodwell, Tania; Trembath, David; Vellanki, Pratibha; Moore, Dennis W; Anderson, Angelika

    2017-09-01

    Technology-based interventions for Autism Spectrum Disorder (ASD) have proliferated, but few have been evaluated within the context of a randomised controlled trial (RCT). This RCT evaluated the efficacy of one technology-based early intervention programme (Therapy Outcomes By You; TOBY) in young children with ASD. TOBY is an app-based learning curriculum designed for children and parents as a complement to early behavioural intervention. Eighty children (16 female) were recruited to this RCT within 12 months of receiving a diagnosis of ASD (M age = 3.38; SD = 0.69) and randomised to receive either treatment-as-usual (community-based intervention, n = 39) or the TOBY therapy (at least 20 min/day) plus treatment-as-usual (n = 41) for a period of 6 months. Outcomes were assessed at 3 and 6 months postbaseline. (Australian New Zealand Clinical Trials Registry: ACTRN12614000738628; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365463). Children in the TOBY intervention group averaged 19 min/day engaging with the app in the first 3 months, but only 2 min/day during the second 3 months. There was no group difference in scores on the primary outcome, the Autism Treatment Evaluation Checklist, at either the 3- or 6-month follow-up. However, significant improvements at the 6-month follow-up were observed in the TOBY intervention group relative to the treatment-as-usual group on three secondary outcomes: the Fine Motor and Visual Reception subscales of the Mullen Scale of Early Learning and the Total Words Understood scale of the MacArthur-Bates Communicative Development Index. Statistical trends towards improvement in the TOBY intervention group were observed on measures of adaptive function, although these decreased in magnitude from the 3- to 6-month follow-up. This study provides evidence that technology-based interventions may provide a relatively low-cost addition to existing therapist-delivered interventions for children with ASD. However

  20. The Impact of Health Education Intervention for Prevention and Early Detection of Type 2 Diabetes in Women with Gestational Diabetes.

    Science.gov (United States)

    Tawfik, Mirella Youssef

    2017-06-01

    This study aims to investigate the impact of a health belief model (HBM)-based educational intervention on knowledge, beliefs, self-reported practices, gestational and postpartum weight in women with gestational diabetes mellitus (GDM). A cluster randomized controlled trial was performed, with randomization at the level of Primary Health Care centers in three Egyptian cities. Eligible women with GDM were enrolled at 24 weeks pregnancy. The intervention group (n = 103) received health education intervention based on the HBM construct. Control subjects (n = 98) received the usual care. The outcomes measured were: women's knowledge, beliefs, self-reported practices, gestational weight gain (GWG), and postpartum weight retention. Patients were investigated at baseline, at end of pregnancy, and at 6 weeks postpartum. After the intervention, percentages of women who had high knowledge and beliefs scores had significantly increased from less than 50 % to more than 70 % in the intervention group (p < 0.001). More women in the intervention group reported practicing exclusive breast feeding (85.4 %) and screening for T2DM (43.7 %) at 6 weeks postpartum compared to the control group (63.3 and 19.4 % respectively) (p < 0.001). More women with excessive body mass index in the intervention group (65 %) compared to the control group (11.6 %) were meeting recommended GWG (p < 0.001), and postpartum weight (37.7, and 20.3 % respectively) (p < 0.01). This intervention significantly improved knowledge, beliefs, self-reported practices, and gestational and postpartum weight in patients with GDM. Further research is needed for investigating the effectiveness of applying early, multi-phase, and longer intervention.

  1. [Effectiveness of integrated early childhood development intervention on nurturing care for children aged 0-35 months in rural China].

    Science.gov (United States)

    Shi, H F; Zhang, J X; Wang, X L; Xu, Y Y; Dong, S L; Zhao, C X; Huang, X N; Zhao, Q; Chen, X F; Zhou, Y; O'Sullivan, Margo; Pouwels, Ron; Scherpbier, Robert W

    2018-02-02

    Objective: To explore whether Integrated Early Childhood Development (IECD) program has effectively improved the nurturing care for children aged 0-35 months in rural China. Methods: IECD has been implemented by the government of China with support from the United Nations Children's Fund (UNICEF) in four poverty-stricken rural counties since 2014. The interventions targeting the five key components of nurturing care (i.e. child and caregiver health, child nutrition, early learning support, child protection and social security) were delivered through the IECD program to children aged 0 to 35 months and their caregivers. A population-based intervention trial was designed to evaluate intervention effectiveness with data collected in 2013 (baseline) and 2016 (mid-term). The changes of nurturing care in the intervention and control group were analyzed by using a difference-in-differences (DID) model. This approach provided adjustment for sociodemographic and other confounding factors. Results: The baseline and mid-term survey enrolled 1 468 and 1 384 children in the intervention group, and 1 485 and 1 361 in the control group. After two years of implementation, the prevalence of caregiver's depression in the intervention group showed a decrease of 9.1% (mid-term 34.8% (479/1 377) vs. baseline 43.9% (621/1 414)), whereas that in control group showed a decrease of 1.6% (mid-term 34.3% (464/1 353) vs. baseline 35.9% (509/1 419)). With the confounding adjusted in the difference-in-differences model, the decrease of the caregiver's depression prevalence in the intervention group was 7.0% greater than that in the control group ( P= 0.008). The qualified rate of minimum meal frequency in the intervention group showed an increase of 10.4% (mid-term 69.0% (532/771) vs. baseline 58.6% (481/821)), whereas the qualified rate in the intervention group showed an increase of 2.9% (mid-term 66.4% (469/706) vs. baseline 63.5% (508/800)). With the confounding adjusted in the difference

  2. Motor Development and Motor Resonance Difficulties in Autism: Relevance to Early Intervention for Language and Communication Skills

    Directory of Open Access Journals (Sweden)

    Joseph P. Mccleery

    2013-04-01

    Full Text Available Research suggests that a sub-set of children with autism experience notable difficulties and delays in motor skills development, and that a large percentage of children with autism experience deficits in motor resonance. These motor-related deficiencies, which evidence suggests are present from a very early age, are likely to negatively affect social-communicative and language development in this population. Here, we review evidence for delayed, impaired, and atypical motor development in infants and children with autism. We then carefully review and examine the current language and communication-based intervention research that is relevant to motor and motor resonance (i.e., neural mirroring mechanisms activated when we observe the actions of others deficits in children with autism. Finally, we describe research needs and future directions and developments for early interventions aimed at addressing the speech/language and social-communication development difficulties in autism from a motor-related perspective.

  3. International Human Rights to Early Intervention for Infants and Young Children with Disabilities: Tools for Global Advocacy

    Science.gov (United States)

    Brown, Sharan E.; Guralnick, Michael J.

    2015-01-01

    With almost universal ratification of the Convention on the Rights of the Child and the growing number of States Parties that have signed or ratified the Convention on the Rights of Persons with Disabilities, the majority of countries in the world have now committed to implementing the human rights articulated in these treaties. In this article we first provide an overview of both Conventions, highlight the articles in the treaties that are relevant to early intervention for infants and young children with disabilities, and describe the specific duties required of States Parties to ensure compliance including international cooperation. Second, a series of early intervention action principles are put forward that can help States Parties translate the underlying values of the Conventions into practice. PMID:26213446

  4. Motor development and motor resonance difficulties in autism: relevance to early intervention for language and communication skills

    Science.gov (United States)

    McCleery, Joseph P.; Elliott, Natasha A.; Sampanis, Dimitrios S.; Stefanidou, Chrysi A.

    2013-01-01

    Research suggests that a sub-set of children with autism experience notable difficulties and delays in motor skills development, and that a large percentage of children with autism experience deficits in motor resonance. These motor-related deficiencies, which evidence suggests are present from a very early age, are likely to negatively affect social-communicative and language development in this population. Here, we review evidence for delayed, impaired, and atypical motor development in infants and children with autism. We then carefully review and examine the current language and communication-based intervention research that is relevant to motor and motor resonance (i.e., neural “mirroring” mechanisms activated when we observe the actions of others) deficits in children with autism. Finally, we describe research needs and future directions and developments for early interventions aimed at addressing the speech/language and social-communication development difficulties in autism from a motor-related perspective. PMID:23630476

  5. The effect of duration of untreated psychosis and treatment delay on the outcomes of prolonged early intervention in psychotic disorders

    DEFF Research Database (Denmark)

    Albert, Nikolai; Melau, Marianne; Jensen, Heidi

    2017-01-01

    to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment......The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first-episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study, we investigate whether...... DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. For this specific study participants...

  6. Can state early intervention programs meet the increased demand of children suspected of having autism spectrum disorders?

    Science.gov (United States)

    Wise, Marissa D; Little, Alison A; Holliman, Jaime Bruce; Wise, Paul H; Wang, C Jason

    2010-01-01

    To determine whether Early Intervention programs have the capacity to accommodate the expected increase in referrals following the American Academy of Pediatrics' 2007 recommendation for universal screening of 18- and 24-month-old children for Autism Spectrum Disorders (ASD). We conducted a telephone survey of all state and territory early. Intervention coordinators about the demand for ASD evaluations, services, and program capacity. We used multivariate models to examine state-level factors associated with the capacity to serve children with ASD. Fifty-two of the 57 coordinators (91%) responded to the survey. Most states reported an increase in demand for ASD-related evaluations (65%) and services (58%) since 2007. In addition, 46% reported that their current capacity poses a challenge to meeting the 45-day time limit for creating the Individualized Family Service Plan. Many states reported that they have shortages of ASD-related personnel, including behavioral therapists (89%), speech-language pathologists (82%), and occupational therapists (79%). Among states that reported the number of service hours (n = 34) 44% indicated that children with ASD receive 5 or fewer weekly service hours. Multivariate models showed that states with a higher percentage of African-American and Latino children were more likely to have provider shortages whereas states with higher population densities were more likely to offer a greater number of service hours. Many Early Intervention programs may not have the capability to address the expected increase in demand for ASD services. Early Intervention programs will likely need enhanced resources to provide all children with suspected ASD with appropriate evaluations and services.

  7. Kindergarten stressors and cumulative adrenocortical activation: the "first straws" of allostatic load?

    Science.gov (United States)

    Bush, Nicole R; Obradović, Jelena; Adler, Nancy; Boyce, W Thomas

    2011-11-01

    Using an ethnically diverse longitudinal sample of 338 kindergarten children, this study examined the effects of cumulative contextual stressors on children's developing hypothalamic-pituitary-adrenocortical (HPA) axis regulation as an early life indicator of allostatic load. Chronic HPA axis regulation was assessed using cumulative, multiday measures of cortisol in both the fall and spring seasons of the kindergarten year. Hierarchical linear regression analyses revealed that contextual stressors related to ethnic minority status, socioeconomic status, and family adversity each uniquely predicted children's daily HPA activity and that some of those associations were curvilinear in conformation. Results showed that the quadratic, U-shaped influences of family socioeconomic status and family adversity operate in different directions to predict children's HPA axis regulation. Results further suggested that these associations differ for White and ethnic minority children. In total, this study revealed that early childhood experiences contribute to shifts in one of the principal neurobiological systems thought to generate allostatic load, confirming the importance of early prevention and intervention efforts. Moreover, findings suggested that analyses of allostatic load and developmental theories accounting for its accrual would benefit from an inclusion of curvilinear associations in tested predictive models.

  8. The effect of an attachment-oriented couple intervention for breast cancer patients and partners in the early treatment phase

    DEFF Research Database (Denmark)

    Nicolaisen, Anne; Hagedoorn, Mariët; Hansen, Dorte Gilså

    2018-01-01

    OBJECTIVE: Patients and partners both cope individually and as a dyad with challenges related to a breast cancer diagnosis. The objective of this study was to evaluate the effect of a psychological attachment-oriented couple intervention for breast cancer patients and partners in the early...... treatment phase. METHODS: A randomised controlled trial including 198 recently diagnosed breast cancer patients and their partners. Couples were randomised to the Hand in Hand (HiH) intervention in addition to usual care or to usual care only. Self-report assessments were conducted for both patients...... and partners at baseline, post-intervention (5 months) and follow-up (10 months), assessing cancer-related distress, symptoms of anxiety and depression, and dyadic adjustment. Patients' cancer-related distress was the primary outcome. RESULTS: Cancer-related distress decreased over time in both patients...

  9. A randomized, controlled trial of the effectiveness of an early-intervention program in reducing parenting stress after preterm birth.

    Science.gov (United States)

    Kaaresen, Per Ivar; Rønning, John A; Ulvund, Stein Erik; Dahl, Lauritz B

    2006-07-01

    Preterm birth has been associated with increased parenting stress in early infancy, and some reports have found this to be a risk factor for later behavioral problems. There are, however, few studies and conflicting results. Information about the fathers is scarce. Our goal was to study the effects of an early-intervention program on parenting stress after a preterm birth until 1 year corrected age. A randomized, controlled trial was conducted including infants with a birth weight effects of a modified version of the Mother-Infant Transaction Program on parenting stress measured by the Parenting Stress Index. A term control group was also recruited. The Parenting Stress Index was administered to the mothers at 6 and 12 months' corrected age and to the fathers at 12 months' corrected age. The intervention consisted of 8 sessions shortly before discharge and 4 home visits by specially trained nurses focusing on the infant's unique characteristics, temperament, and developmental potential and the interaction between the infant and the parents. Seventy-one infants were included in the preterm intervention group, and 69 were included in the preterm control group. The preterm groups were well balanced. Seventy-four infants were included in the term control group. Compared with the preterm controls, both the mothers and fathers in the preterm intervention group reported significant lower scores in child domain, parent domain, and total stress on all occasions except the mother-reported child domain at 12 months. These differences were not related to birth weight or gestational age. The level of stress among the preterm intervention group was comparable to their term peers. Both parents in the intervention group reported consistently lower scores within the distractibility/hyperactivity, reinforces parents, competence, and attachment subscales compared with the preterm control group. There were no differences in mean summary stress scores between the mothers and fathers in

  10. Barriers and facilitators to implementing family support and education in Early Psychosis Intervention programmes: A systematic review.

    Science.gov (United States)

    Selick, Avra; Durbin, Janet; Vu, Nhi; O'Connor, Karen; Volpe, Tiziana; Lin, Elizabeth

    2017-10-01

    Family support is a core component of the Early Psychosis Intervention (EPI) model, yet it continues to have relatively low rates of implementation in practice. This paper reports results of a literature review on facilitators and barriers to delivering family interventions in EPI programmes. A search was conducted of 4 electronic databases, Medline, EMBASE, PsycINFO and Joanna Briggs, from 2000 to 2015 using terms related to early onset psychosis, family work and implementation. Four thousand four hundred and two unique studies were identified, 7 of which met inclusion criteria. Barriers and facilitators were coded and aggregated to higher-level themes using a consensus approach. Five of 7 studies examined structured multifamily psychoeducation. Uptake by families was affected by: family/client interest and readiness to participate; ability to access supports; and support needs/preferences. Implementation by programmes was affected by staff access to training and resources to provide family support. A key finding across the identified studies was that families have different needs and preferences regarding the timing, length, intensity and content of the intervention. One size does not fit all and many families do not require the intensive psychoeducational programmes typically provided. The reviewed literature suggests that flexible, tiered approaches to care may better meet family needs and increase rates of uptake of family support. However, more research is needed on the effectiveness of different models of family support in early psychosis and how they can be successfully implemented. © 2017 John Wiley & Sons Australia, Ltd.

  11. The effect of duration of untreated psychosis and treatment delay on the outcomes of prolonged early intervention in psychotic disorders.

    Science.gov (United States)

    Albert, Nikolai; Melau, Marianne; Jensen, Heidi; Hastrup, Lene Halling; Hjorthøj, Carsten; Nordentoft, Merete

    2017-09-26

    The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first-episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study, we investigate whether DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. For this specific study participants were dichotomized based on DUP, treatment delay, and time from first symptom until start of SEI treatment. The groups were analyzed with regard to treatment response on psychopathology, level of functioning, and cognitive functioning. The participants with a short DUP had a tendency to respond better to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment for participants with a short total treatment delay could mean that prolonged SEI treatment is more beneficial than treatment as usual (TAU) so long as it is provided in the early years of illness and not just in the early years after diagnosis. THE EARLIER THE BETTER: The duration of untreated psychosis influences the long-term outcomes of treatment. Nikolai Albert, at the Copenhagen Mental Health Centre, and a team of Danish researchers have investigated the effects of a specialized early intervention program (OPUS) in 400 patients diagnosed with schizophrenia spectrum disorders and compared the effects of OPUS after two and five years. Their findings suggest that five years of specialized early intervention was most beneficial when the total duration from symptom start to

  12. Toward Shorter Hospitalization After Endoscopic Transsphenoidal Pituitary Surgery: Day-by-Day Analysis of Early Postoperative Complications and Interventions.

    Science.gov (United States)

    Shimanskaya, Viktoria E; Wagenmakers, Margreet A E M; Bartels, Ronald H M A; Boogaarts, Hieronymus D; Grotenhuis, J André; Hermus, Ad R M M; van de Ven, Annenienke C; van Lindert, Erik J

    2018-03-01

    It is unclear which patients have the greatest risk of developing complications in the first days after endoscopic transsphenoidal pituitary surgery (ETS) and how long patients should stay hospitalized after surgery. The objective of this study is to identify which patients are at risk for early postoperative medical and surgical reinterventions to optimize the length of hospitalization. The medical records of 146 patients who underwent ETS for a pituitary adenoma between January 2013 and July 2016 were reviewed retrospectively. Data were collected on baseline patient-related characteristics, characteristics of the pituitary adenoma, perioperative complications and interventions, and postoperative outcomes. Patients who underwent additional interventions on days 2, 3, and 4 after ETS were identified as cases, and patients who did not have any interventions after day 1 postoperatively were identified as controls. Diabetes mellitus (odds ratio [OR], 4.279; 95% confidence interval [CI], 1.149-15.933; P = 0.03), incomplete adenoma resection (OR, 2.840; 95% CI, 1.228-6.568; P = 0.02) and increased morning sodium concentration on day 2 after surgery (OR, 5.211; 95% CI, 2.158-12.579; P surgery have an increased chance on reinterventions. In addition, patients without any interventions on day 1 and 2 are at low risk for later reinterventions. These patients could be suitable candidates for early hospital discharge. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions1234

    Science.gov (United States)

    Hurley, Kristen M; Yousafzai, Aisha K; Lopez-Boo, Florencia

    2016-01-01

    Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions. PMID:26980819

  14. Early Intervention for Families Exposed to Chronic Stress and Trauma: The Attachment Vitamins Program

    Science.gov (United States)

    Hulette, Annmarie C.; Dunham, Mackenzie; Davis, Mindy; Gortney, Jason; Lieberman, Alicia F.

    2016-01-01

    This article describes the Attachment Vitamins program, a trauma-informed parent group intervention for families with young children. Attachment Vitamins is a relational psychoeducational intervention based on the principles of Child-Parent Psychotherapy (CPP). Its goal is to repair the impact of chronic stress and trauma through strengthening the…

  15. What's Possible for First-Grade At-Risk Literacy Learners Receiving Early Intervention Services

    Science.gov (United States)

    Bufalino, Janet; Wang, Chuang; Gomez-Bellenge, Francisco X.; Zalud, Garreth

    2010-01-01

    This paper summarizes a study that was conducted on data from children who received a one-on-one intervention called Reading Recovery[R] during the first half of their first-grade year in school. The purpose was to investigate the relationship between accelerated progress children made during and after receiving a Reading Recovery intervention,…

  16. Pilot European Regional Interventions for Smart Childhood Obesity Prevention in Early age

    DEFF Research Database (Denmark)

    Sansolios, Sanne; Mikkelsen, Mette Vang

    2010-01-01

    The intervention carried out in Denmark included a foodintervention in four kindergartens over at four weeks baseline period and a two weeks intervention period, also a tasteworkshop were carried out introducing a new boardgame using the Sapere method and finally a foodtale book and an activity f...

  17. An Early Social Engagement Intervention for Young Children with Autism and Their Parents

    Science.gov (United States)

    Vernon, Ty W.; Koegel, Robert L.; Dauterman, Hayley; Stolen, Kathryn

    2012-01-01

    The social vulnerabilities associated with young children with autism are recognized as important intervention targets due to their influence on subsequent development. Current research suggests that interventions that combine motivational and social components can create meaningful changes in social functioning. Simultaneously, it is hypothesized…

  18. Early Success Is Vital in Minimal Worksite Wellness Interventions at Small Worksites

    Science.gov (United States)

    Ablah, Elizabeth; Dong, Frank; Konda, Kurt; Konda, Kelly; Armbruster, Sonja; Tuttle, Becky

    2015-01-01

    Intervention: In an effort to increase physical activity, 15 workplaces participated in a minimal-contact 10,000-steps-a-day program sponsored by the Sedgwick County Health Department in 2007 and 2008. Pedometers were provided to measure participants' weekly steps for the 10-week intervention. Method: Participants were defined as those who…

  19. Firm Foundations: The Effectiveness of an Educational Psychologist Developed Intervention Targeting Early Numeracy Skills

    Science.gov (United States)

    Somerville, Ros; Ayre, Kate; Tunbridge, Daniel; Cole, Katy; Stollery, Richard; Sanders, Mary

    2015-01-01

    This study evaluates the efficacy of a mathematics intervention devised by Essex Educational Psychology Service (EPS), UK. The intervention was designed to develop understanding and skills across four key domains within arithmetical development, by applying the principles of errorless learning, distributed practice and teaching to mastery. A…

  20. A School-Based Phonological Awareness Intervention for Struggling Readers in Early French Immersion

    Science.gov (United States)

    Wise, Nancy; D'Angelo, Nadia; Chen, Xi

    2016-01-01

    The current intervention study investigated the sustained effectiveness of phonological awareness training on the reading development of 16 children in French immersion who were identified as at-risk readers based on grade 1 English measures. The intervention program provided children from three cohorts with supplemental reading in small groups on…

  1. After Early Autism Diagnosis: Changes in Intervention and Parent-Child Interaction

    Science.gov (United States)

    Suma, Katharine; Adamson, Lauren B.; Bakeman, Roger; Robins, Diana L.; Abrams, Danielle N.

    2016-01-01

    This study documents the relation between an autism spectrum disorder (ASD) diagnosis, increases in intervention, and changes in parent-child interaction quality. Information about intervention and observations of interaction were collected before diagnosis and a half year after diagnosis for 79 low-risk toddlers who had screened positive for ASD…

  2. Pilot European Regional Interventions for Smart Childhood Obesity Prevention in Early age

    DEFF Research Database (Denmark)

    Sansolios, Sanne; Storm Slumstrup, Camilla

    2010-01-01

    The intervention carried out in Denmark included a foodintervention in four kindergartens over at four weeks baseline period and a two weeks intervention period, also a tasteworkshop were carried out introducing a new boardgame using the Sapere method and finally a foodtale book and an activity...

  3. Parent-delivered early intervention in infants at risk for ASD: Effects on electrophysiological and habituation measures of social attention.

    Science.gov (United States)

    Jones, Emily J H; Dawson, Geraldine; Kelly, Jean; Estes, Annette; Jane Webb, Sara

    2017-05-01

    Prospective longitudinal studies of infants with older siblings with autism spectrum disorder (ASD) have indicated that differences in the neurocognitive systems underlying social attention may emerge prior to the child meeting ASD diagnostic criteria. Thus, targeting social attention with early intervention might have the potential to alter developmental trajectories for infants at high risk for ASD. Electrophysiological and habituation measures of social attention were collected at 6, 12, and 18 months in a group of high-risk infant siblings of children with ASD (N = 33). Between 9 and 11 months of age, infant siblings received a parent-delivered intervention, promoting first relationships (PFR), (n = 19) or on-going assessment without intervention (n = 14). PFR has been previously shown to increase parental responsivity to infant social communicative cues and infant contingent responding. Compared to infants who only received assessment and monitoring, infants who received the intervention showed improvements in neurocognitive metrics of social attention, as reflected in a greater reduction in habituation times to face versus object stimuli between 6 and 12 months, maintained at 18 months; a greater increase in frontal EEG theta power between 6 and 12 months; and a more comparable P400 response to faces and objects at 12 months. The high-risk infants who received the intervention showed a pattern of responses that appeared closer to the normative responses of two groups of age-matched low-risk control participants. Though replication is necessary, these results suggest that early parent-mediated intervention has the potential to impact the brain systems underpinning social attention in infants at familial risk for ASD. Autism Res 2017, 10: 961-972. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

  4. Economic Evaluation of PRIMROSE—A Trial-Based Analysis of an Early Childhood Intervention to Prevent Obesity

    Directory of Open Access Journals (Sweden)

    Nora Döring

    2018-03-01

    Full Text Available BackgroundChildhood obesity is a major clinical and economic health concern. Alongside the clinical understanding of obesity, there is a growing interest in designing and implementing interventions that are worth their money given the scarce resources in the health care sector. This study is one of the first efforts to provide evidence by assessing the effects and costs of a population-based primary prevention intervention targeting pre-school children attending child health centers in Sweden.MethodsThe economic evaluation is based on the PRIMROSE cluster-randomized controlled trial aiming to establish healthy eating and physical activity among pre-school children (9–48 months of age through motivational interviewing applied by trained nurses at child health centers. The cost-effectiveness is assessed over the trial period from a societal perspective. The primary outcome was BMI at age 4. Cost data was prospectively collected alongside the trial. Scenario analyses were carried out to identify uncertainty.ResultsThe estimated additional mean total costs of the PRIMROSE intervention were 342 Euro (95% CI: 334; 348 per child. During pre-school years direct costs mainly consist of training costs and costs for the additional time used by nurses to implement the intervention compared to usual care. Early indirect costs mainly consist of parents’ absence from work due to their participation in the intervention. The incremental cost-effectiveness ratio in the base case analysis was 3,109 Euro per 1 BMI unit prevented.ConclusionWe cannot provide evidence that the PRIMROSE intervention is cost-effective, given the uncertainty in the effect measure. Until further evidence is provided, we recommend resources to be spent elsewhere within the field of obesity prevention. Furthermore, to achieve valid and reliable cost-effectiveness results, the economic evaluation of obesity prevention programs in early childhood should incorporate the life time

  5. Educators’ perspectives on facilitating computer-assisted speech intervention in early childhood settings

    OpenAIRE

    Crowe, K.; Cumming, T.; McCormack, J.; McLeod, S.; Baker, E.; Wren, Y.; Roulstone, S.; Masso, S.

    2017-01-01

    Early childhood educators are frequently called on to support preschool-aged children with speech sound disorders and to engage these children in activities that target their speech production. This study explored factors that acted as facilitators and/or barriers to the provision of computer-based support for children with speech sound disorders (SSD) in early childhood centres. Participants were 23 early childhood educators at 13 centres who participated in the Sound Start Study, a randomiz...

  6. Effectiveness of a Brief Home Parenting Intervention for Reducing Early Sexual Risks Among Latino Adolescents: Salud y Éxito.

    Science.gov (United States)

    O'Donnell, Lydia; Fuxman, Shai

    2017-11-01

    Teen pregnancy rates and related risks remain elevated among Latino teens. We tested the impact on youth sexual behaviors of a brief, culturally targeted, bilingual media intervention designed for parents of young adolescents. Salud y éxito (Health & Success) uses dramatic audio stories to model positive parenting practices. After completing classroom surveys, 27 urban schools in the Northeast and Southwest serving low-income Latino communities were randomized so that all families of seventh grade students were sent either: (1) booklets on healthy eating and exercise; (2) Salud-50, where families either received booklets or the intervention, or (3) Salud-100, where all families received the intervention. Postintervention follow-up surveys were conducted at 3- and 12-months. Multilevel analyses tested intervention effects, controlling for sociodemographics. Compared with controls, at 12-months postintervention (8th grade spring), youth in Salud-100 report lower sexual risks (touching, AOR 1.46, CI 1.19-0.84, p Salud-50 results are between those from Salud-100 and control schools. Salud y éxito is an effective parenting intervention that can augment school-based health and sexuality education and help Latino parents support their children during early adolescence. © 2017, American School Health Association.

  7. A Cost-Benefit Analysis of Early Childhood Hygiene Interventions in Uzbekistan

    Directory of Open Access Journals (Sweden)

    Raushan ATANIYAZOVA

    2014-11-01

    Full Text Available This paper applies cost-benefit analysis (CBA technique to estimate the effectiveness of hand hygiene and oral health interventions in Uzbekistan for children of kindergarten age (3-6 years old. Our primary objective in this study is to apply CBA framework to investigate economic viability of hand hygiene and oral health interventions on respiratory diseases (influenza, bronchitis, pneumonia, intestinal diseases (diarrhea, hepatitis A, and helminthiasis, and dental caries and stomatitis. Though it is often difficult to attribute a specific hygiene intervention to a reduction in specific illness, our study shows that prevention of disease through hygiene promotion is cost-effective. To be the most effective, however, hygiene interventions should be accompanied by education and awareness-raising of teachers, parents and children.

  8. An early social engagement intervention for young children with autism and their parents.

    Science.gov (United States)

    Vernon, Ty W; Koegel, Robert L; Dauterman, Hayley; Stolen, Kathryn

    2012-12-01

    The social vulnerabilities associated with young children with autism are recognized as important intervention targets due to their influence on subsequent development. Current research suggests that interventions that combine motivational and social components can create meaningful changes in social functioning. Simultaneously, it is hypothesized that parent delivery of such strategies can invoke increases in these core social behaviors and parent engagement. This study examined the effects of teaching parents to implement a social engagement intervention with their children. The results indicated that the use of this parent-delivered social intervention led to (a) increases in their children's use of eye contact, directed positive affect, and verbal initiations, (b) increases in parent positive affect and synchronous engagement, and (c) generalized increases in parent and child behaviors.

  9. the Importance of an early exercise and nutrition intervention among RENAL TRANSPLANT RECIPIENTS

    Directory of Open Access Journals (Sweden)

    Andrea Mahrova

    2012-06-01

    In conclusion, the combination of an exercise and nutrition intervention was the most effective and could give each patient an opportunity to achieve an optimal physical and psychological level almost equal to their original condition.

  10. Effects of early childhood intervention on fertility and maternal employment: Evidence from a randomized controlled trial

    OpenAIRE

    Sandner, Malte

    2015-01-01

    This paper presents the results of a randomized study of a home visiting program implemented in Germany for low-income, first-time mothers. A major goal of the program is to improve the participants' economic self-sufficiency and family planning. I use administrative data from the German social security system and detailed telephone surveys to examine the effects of the intervention on maternal employment, welfare benefits, and household composition. The study reveals that the intervention un...

  11. A review of evidence-based early intervention for behavioural problems in children with autism spectrum disorder: the core components of effective programs, child-focused interventions and comprehensive treatment models.

    Science.gov (United States)

    Tonge, Bruce J; Bull, Kerry; Brereton, Avril; Wilson, Rebecca

    2014-03-01

    This article reviews recent evidence and other earlier relevant articles regarding early intervention studies for children with autism spectrum disorder (ASD). There is a well-established body of empirical evidence for the effectiveness of Early Intensive Behavioural Intervention (EIBI) with young children with ASD. The importance of parent skills training, education and positive behaviour support is also a key factor in influencing outcomes. Drug treatment is of short-term benefit for disruptive behaviour but long-term outcome and metabolic side-effects have not been studied. Few studies have measured the long-term value and effectiveness of early intervention treatments, and currently there are no articles published on effects into adulthood of such treatments. Such research would indicate whether early intervention results in reduced reliance on health services into adulthood.

  12. Minimum intervention dentistry approach to managing early childhood caries: a randomized control trial.

    Science.gov (United States)

    Arrow, Peter; Klobas, Elizabeth

    2015-12-01

    A pragmatic randomized control trial was undertaken to compare the minimum intervention dentistry (MID) approach, based on the atraumatic restorative treatment procedures (MID-ART: Test), against the standard care approach (Control) to treat early childhood caries in a primary care setting. Consenting parent/child dyads were allocated to the Test or Control group using stratified block randomization. Inclusion and exclusion criteria were applied. Participants were examined at baseline and at follow-up by two calibrated examiners blind to group allocation status (κ = 0.77), and parents completed a questionnaire at baseline and follow-up. Dental therapists trained in MID-ART provided treatment to the Test group and dentists treated the Control group using standard approaches. The primary outcome of interest was the number of children who were referred for specialist pediatric care. Secondary outcomes were the number of teeth treated, changes in child oral health-related quality of life and dental anxiety and parental perceptions of care received. Data were analyzed on an intention to treat basis; risk ratio for referral for specialist care, test of proportions, Wilcoxon rank test and logistic regression were used. Three hundred and seventy parents/carers were initially screened; 273 children were examined at baseline and 254 were randomized (Test = 127; Control = 127): mean age = 3.8 years, SD 0.90; 59% male, mean dmft = 4.9, SD 4.0. There was no statistically significant difference in age, sex, baseline caries experience or child oral health-related quality of life between the Test and Control group. At follow-up (mean interval 11.4 months, SD 3.1 months), 220 children were examined: Test = 115, Control = 105. Case-notes review of 231 children showed Test = 6 (5%) and Control = 53 (49%) were referred for specialist care, P < 0.0001. More teeth were filled in the Test group (mean = 2.93, SD 2.48) than in the Control group (mean = 1.54, SD

  13. Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD).

    Science.gov (United States)

    Reichow, Brian; Barton, Erin E; Boyd, Brian A; Hume, Kara

    2012-10-17

    The rising prevalence of autism spectrum disorders (ASD) increases the need for evidence-based behavioral treatments to lessen the impact of symptoms on children's functioning. At present, there are no curative or psychopharmacological therapies to effectively treat all symptoms of the disorder. Early intensive behavioral intervention (EIBI), a treatment based on the principles of applied behavior analysis delivered for multiple years at an intensity of 20 to 40 hours per week, is one of the more well-established treatments for ASD. To systematically review the evidence for the effectiveness of EIBI in increasing the functional behaviors and skills of young children with ASD. We searched the following databases on 22 November 2011: CENTRAL (2011 Issue 4), MEDLINE (1948 to November Week 2, 2011), EMBASE (1980 to Week 46, 2011), PsycINFO (1806 to November Week 3, 2011), CINAHL (1937 to current), ERIC (1966 to current), Sociological Abstracts (1952 to current), Social Science Citation Index (1970 to current), WorldCat, metaRegister of Controlled Trials, and Networked Digital Library of Theses and Dissertations. We also searched the reference lists of published papers. Randomized control trials (RCTs), quasi-randomized control trials, or clinical control trials (CCTs) in which EIBI was compared to a no-treatment or treatment-as-usual control condition. Participants must have been less than six years of age at treatment onset and assigned to their study condition prior to commencing treatment. Two authors independently selected and appraised studies for inclusion and assessed the risk of bias in each included study. All outcome data were continuous, from which standardized mean difference effect sizes with small sample correction were calculated. We conducted random-effects meta-analysis where possible, which means we assumed individual studies would provide different estimates of treatment effects. One RCT and four CCTs with a total of 203 participants were included

  14. Prediabetes in pregnancy, can early intervention improve outcomes? A feasibility study for a parallel randomised clinical trial.

    Science.gov (United States)

    Hughes, Ruth C E; Rowan, Janet; Williman, Jonathan

    2018-03-03

    Measurement of glycated haemoglobin (HbA1c) in early pregnancy is routine in New Zealand to identify women with diabetes and prediabetes. However, the benefit of early intervention in women with prediabetes is inconclusive. Our aim was to test the feasibility of a two-arm parallel randomised controlled trial of standard care versus early intervention in pregnancies complicated by prediabetes. Two tertiary referral centres in New Zealand. Women measured at booking, without pre-existing diabetes. Randomisation was done by remote web-based allocation into one of two groups. Women in the early intervention group attended an antenatal diabetes clinic, commenced daily home blood glucose monitoring, and medication was prescribed if lifestyle measures failed to maintain target blood glucose levels. Controls received lifestyle education, continued standard care with their midwife and/or obstetrician, and were asked to perform a 75 g oral glucose tolerance test at 24 weeks' gestation with a referral to clinic if this test was positive. Both groups received lifestyle questionnaires at recruitment and in late pregnancy. Recruitment rate, adherence to protocol and validation of potential primary outcomes. Recruitment rates were lower than expected, especially in Māori and Pacific women. Non-adherence to allocated treatment protocol was significant, 42% (95% CI 24% to 61%) in the early intervention group and 30% (95% CI 16% to 51%) in controls. Caesarean section and pre-eclampsia were signalled as potential primary outcomes, due to both the high observed incidence in the control group and ease of measurement. For a future definitive trial, extending the gestation of eligibility and stepped-wedge cluster randomisation may overcome the identified feasibility issues. Consistent with published observational data, pre-eclampsia and emergency caesarean section could be included as primary outcome measures, both of which have a significant impact on maternal and neonatal morbidity and

  15. Sleep quality and fatigue after a stress management intervention for women with early-stage breast cancer in southern Florida.

    Science.gov (United States)

    Vargas, Sara; Antoni, Michael H; Carver, Charles S; Lechner, Suzanne C; Wohlgemuth, William; Llabre, Maria; Blomberg, Bonnie B; Glück, Stefan; DerHagopian, Robert P

    2014-12-01

    Sleep disruption and fatigue are ubiquitous among cancer patients and are sources of stress that may compromise treatment outcomes. Previously, we showed that a cognitive behavioral stress management (CBSM) intervention reduced anxiety and other stress-related processes in women undergoing primary treatment for breast cancer. This study examined secondary outcomes from a CBSM intervention trial for women with early-stage breast cancer to test if CBSM would improve sleep quality and fatigue among these patients at a single site in southern Florida. CBSM-related effects have already been demonstrated for indicators of psychosocial adaptation (e.g., general and cancer-related anxiety). Patients were randomized to CBSM (n= 120) or a 1-day psychoeducation control group (n= 120). The Pittsburgh Sleep Quality Index (PSQI) and Fatigue Symptom Inventory were completed prior to randomization and 6 and 12 months after the baseline assignment. In latent growth analyses, women in CBSM reported greater improvements in PSQI sleep quality scores than controls, although there were no significant differences between conditions on PSQI total scores. Women in CBSM also reported greater reductions in fatigue-related daytime interference than controls, though there were no significant differences in changes in fatigue intensity. Changes in sleep quality were associated with changes in fatigue. Future work may consider integrating sleep and fatigue content into stress management interventions for women with early-stage breast cancer.

  16. [Clinical significance of early percutaneous coronary intervention in patients with Braunwald III-B type unstable angina pectoris].

    Science.gov (United States)

    Nozaki, Katsuhiro; Nakao, Koichi; Horiuchi, Kenji; Kasanuki, Hiroshi; Honda, Takashi

    2003-06-01

    To assess the efficacy of early invasive strategy for the treatment of Braunwald III-B type unstable angina pectoris. This study included 573 consecutive patients of whom 267 underwent percutaneous coronary intervention (PCI) (312 lesions). The patients were divided into two groups, 95 treated with the early invasive strategy of coronary angiography within 24 hr of admission (Group PCI-I) and the remaining 172 treated with the early conservative strategy of coronary angiography 24 hr after admission (Group PCI-C). No significant differences were noted in the baseline characteristics of the two groups except for ST segment elevation on electrocardiography at presentation, which occurred significantly less frequently in Group PCI-C (36.8% vs 8.1%, p strategy for unstable angina pectoris were almost equivalent to those of the early conservative strategy, despite more frequent ST segmental elevation at admission in Group PCI-I. These findings suggest that the early invasive strategy for unstable angina pectoris may be acceptable even in the current Japanese clinical setting without the use of GP IIb/IIIa receptor antagonist, low molecular weight heparin or clopidogrel.

  17. Thrombolysis in the age of Primary Percutaneous Coronary Intervention: Mini-Review and Meta-analysis of Early PCI

    Science.gov (United States)

    Al Shammeri, O; Garcia, LA

    2013-01-01

    Objective Primary Percutaneous Coronary Intervention (PCI) is the treatment of choice for ST-segment Elevation Myocardial Infarction (STEMI) if performed within 90 minutes from first medical contact. However, primary PCI is only available for less than 25% of patients with STEMI. Early PCI or Pharmaco-invasive strategy has evolved from facilitated PCI but with more delayed timing from thrombolysis to PCI. Aim Assess the safety and effectiveness of Early PCI. Patients and Method We reviewed the data of the available therapy options for patients with STEMI. Then we performed a meta-analysis for all randomized controlled trials of early PCI versus standard therapy Results Five studies fulfilled our inclusion criteria. Our meta-analysis showed improved cardiovascular events with early PCI compared to standard therapy (odd ratio of 0.54; 95% Confidence interval 0.47-0.7, pPCI 4 to 24 hours after successful thrombolysis Conclusion Early PCI should be done to all STEMI patients within 24 hours after successful thrombolysis. PMID:23559909

  18. Spelling and Meaning of Compounds in the Early School Years through Classroom Games: An Intervention Study.

    Science.gov (United States)

    Tsesmeli, Styliani N

    2017-01-01

    The study aimed to evaluate the intervention effects on spelling and meaning of compounds by Greek students via group board games in classroom settings. The sample consisted of 60 pupils, who were attending the first and second grade of two primary schools in Greece. Each grade-class was divided into an intervention ( N = 29 children) and a control group ( N = 31 children). Before intervention, groups were evaluated by standardized tests of reading words/pseudowords, spelling words, and vocabulary. Students were also assessed on compound knowledge by a word analogy task, a meaning task and a spelling task. The experimental design of the intervention included a pre-test, a training program, and a post-test. The pre- and post-assessments consisted of the spelling and the meaning tasks entailing equally morphologically transparent and opaque compounds. The training program was based on word families ( N = 10 word families, 56 trained items, 5 sessions) and aimed to offer instruction of morphological decomposition and meaning of words. The findings showed that training was effective in enhancing the spelling and most notably the meaning of compounds. A closer inspection of intervention data in terms of morphological transparency, revealed that training group of first graders improved significantly both on transparent and opaque compounds, while the degree of gains was larger on opaque items for the second graders. These findings are consistent with the experimental literature and particularly optimistic for the literacy enhancement of typically developing children in regular classrooms.

  19. Supernumerary Teeth in Primary Dentition and Early Intervention: A Series of Case Reports

    OpenAIRE

    Bahadure, Rakesh N.; Thosar, Nilima; Jain, Eesha S.; Kharabe, Vidhi; Gaikwad, Rahul

    2012-01-01

    Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stages. They are of great concern to the dentists and parents because of the eruption, occlusal, and esthetic problems they can cause. Supernumerary teeth occur more frequently in the permanent dentition but rarely in primary dentition. Mesiodens is the most common type of supernumerary teeth but rarely seen in lower arch. Early recognition and diagnosis of supernume...

  20. Randomized Controlled Evaluation of an Early Intervention to Prevent Post-Rape Psychopathology

    OpenAIRE

    Resnick, Heidi; Acierno, Ron; Waldrop, Angela E.; King, Lynda; King, Daniel; Danielson, Carla; Ruggiero, Kenneth J.; Kilpatrick, Dean

    2007-01-01

    A randomized between-group design was used to evaluate efficacy of a video intervention to reduce PTSD and other mental health problems, implemented prior to the forensic medical exam conducted within 72 hours post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) ages 15 or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and de...