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Tian W, Zhao X, Xu H, Sun Y, Zhu M. Application of the Hammersmith Infant Neurological Examination in the developmental follow-up of high-risk infants. Dev Med Child Neurol 2024; 66:1181-1189. [PMID: 38308400 DOI: 10.1111/dmcn.15855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 02/04/2024]
Abstract
AIM To investigate the independent influences affecting the global score of the Hammersmith Infant Neurological Examination (HINE) in the early life of high-risk infants and to provide evidence for early effective screening and for evaluating interventions. METHOD We conducted a prospective cohort study of 258 high-risk infants assessed by the HINE and Gesell Developmental Diagnosis Schedule at 3, 6, 9, and 12 months corrected age. A multiple linear regression model was developed to investigate independent influences on HINE global score at 3 months corrected age. The accuracy of the HINE global score was analysed by calculating the discriminant, concurrent, and predictive validities according to ages. RESULTS There were nine independent influences affecting the HINE global score at 3 months corrected age in high-risk infants. The discriminant, concurrent, and predictive validities of the HINE for gross motor developmental delays at 12 months corrected age were all statistically significant (p < 0.05). INTERPRETATION Different neonatal clinical settings are related to the HINE global score of high-risk infants early in life. The HINE can be used for longitudinal monitoring of neurological development in the first year of life in a typical Chinese clinical setting and the findings at all four ages tested relate to neuromotor outcomes at 12 months corrected age.
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Affiliation(s)
- Weiwei Tian
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
- Department of Child Health Care, Qinhuai Maternal and Child Health Care Institution of Nanjing, Nanjing, China
| | - Xiaoke Zhao
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hong Xu
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yaojin Sun
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Min Zhu
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
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巍 田, 科 赵, 红 徐, 金 孙, 敏 朱. Hammersmith. Dev Med Child Neurol 2024; 66:e173-e179. [PMID: 38282292 DOI: 10.1111/dmcn.15856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
摘要目的探讨影响高危儿生命早期Hammersmith婴儿神经学检查(HINE)总分的独立影响因素,并为早期有效筛查和评估干预疗效提供证据。方法我们对258名高危儿进行了前瞻性队列研究,分别在矫正3、6、9 和12月龄时接受了 HINE和Gesell发育诊断表的评估。一个多元线性回归模型被建立以探究矫正3月龄时HINE总分的独立影响因素。通过计算不同年龄段的区分效度、同时效度和预测效度,分析HINE 总分的准确性。结果高危儿HINE总分在矫正3月龄时有9个独立影响因素。在矫正2月龄时,HINE总分对粗大运动发育迟缓的区分效度、同时效度和预测效度均有统计学意义(P < 0.05)。结果不同的新生儿临床状况与其生命早期HINE总分有关。在典型的中国临床环境中,HINE可用于纵向监测高危儿出生后第一年的神经系统发育情况,而且四个年龄段的筛查结果都与矫正12月龄时的神经运动发育结果有关。
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Störbeck C. Early Childhood Development Is Not Enough: In Defense of Children with Developmental Delays and Disabilities and Their Right to Family-Centered Early Childhood Intervention (In the Global South). CHILDREN (BASEL, SWITZERLAND) 2024; 11:606. [PMID: 38790601 PMCID: PMC11119497 DOI: 10.3390/children11050606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/10/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
The international recognition of the critical importance of the early childhood phase has been firmly established through decades of rigorous research, evidence-based practices, and undeniable evidence of the returns on investment made during this formative period. Consequently, early childhood development has emerged as a top priority on both national and international agendas. This momentum reached a pinnacle in 2015 with the unanimous adoption of the 17 Sustainable Development Goals (SDGs) by the United Nations, which placed a particular emphasis on children under the age of five within the education-focused SDG 4, notably target 4.2, centered on ensuring that all girls and boys are ready for primary education through the provision of accessible "quality early childhood development, care and pre-primary education". However, the Global South reflects the glaring omission of addressing the needs of children at risk of poor development due to disabilities. This paper underscores the imperative for specialized early childhood intervention tailored to young children with disabilities and their families, commencing as early as possible following birth. It advocates for Early Childhood Intervention (ECI) as a service distinct from general Early Childhood Development (ECD), emphasizing the crucial role of families as active partners from the outset. Furthermore, the paper strengthens the case for Family-Centered Early Childhood Intervention (Fc-ECI) through the integration of evidence-based practices and an in-depth description of one such program in South Africa with specific reference to deaf and hard-of-hearing infants and their families. This model will be guided by core concepts outlined in WHO and UNICEF Early Childhood Intervention frameworks. Through this exploration, the paper aims to shed light on the urgent need for inclusive approaches to early childhood development, particularly for children with disabilities, and to advocate for the adoption of Family-Centered Early Childhood Intervention as a cornerstone of global efforts to ensure the holistic well-being and development of all children.
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Affiliation(s)
- Claudine Störbeck
- The Wits Centre for Deaf Studies, School of Education, Faculty of Humanities, University of the Witwatersrand, Johannesburg 2000, South Africa
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Mulqueeney A, Battin M, McKillop A, Stott NS, Allermo-Fletcher A, Williams SA. A prospective assessment of readiness to implement an early detection of cerebral palsy pathway in a neonatal intensive care setting using the PARIHS framework. Implement Sci Commun 2024; 5:46. [PMID: 38654322 PMCID: PMC11036598 DOI: 10.1186/s43058-024-00581-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/06/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Early detection of cerebral palsy (CP) is possible through targeted use of assessment tools. Changes in practice are needed to facilitate this shift towards earlier diagnosis of CP in New Zealand. The aim of this study was to prospectively evaluate readiness to implement an early detection of CP pathway within a level 3 neonatal intensive care unit (NICU) setting prior to any implementation taking place. The PARIHS (Promoting Action on Research Implementation in Health Services) framework was engaged to assess readiness by highlighting determinants that influence implementation outcomes as either barriers or enablers. METHODS A mixed methods approach was used. Firstly, an online staff survey assessed PARIHS sub-elements using Likert scores and free text with the intent to develop a baseline understanding of staff views. Secondly, focus groups were conducted to gain deeper understanding of barriers and enablers to implementation. Participants included health professionals involved in the first 6 months of life. Data were analysed to outline the barriers and enablers of implementation under the Evidence and Context constructs of the PARIHS framework. RESULTS Twenty-seven participants completed the survey, and 20 participants participated in eight focus groups and two individual interviews. Quantitative (survey) findings found 65% agreement around the usefulness of research evidence on early CP detection; however, ≤ 45% felt current resources (i.e. human, financial and IT) were sufficient for implementation. Qualitative findings (survey and focus groups) highlighted key staff concerns around resources, family impact (creating unnecessary stress), and equity (barriers to participation). Staff wanted information regarding how international evidence translates to the local context and availability of timely follow-up services. Sub-elements within the Evidence and Context constructs were rated as either mixed or low (except for Evidence - Research, rated as high), overall indicating that Auckland NICU is at the early stages of readiness to implement the early CP detection pathway. CONCLUSION This work may resonate with other neonatal services preparing to implement CP early detection pathways. Resourcing has a major role in facilitating implementation of pathways and uncertainty about resources is a barrier to implementation. Ongoing focus on building consensus and funding is required to ensure optimal uptake.
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Affiliation(s)
- Amy Mulqueeney
- Newborn Services, Starship Child Health, Te Toka Tumai - Auckland, Te Whatu Ora, Auckland, New Zealand
| | - Malcolm Battin
- Newborn Services, Starship Child Health, Te Toka Tumai - Auckland, Te Whatu Ora, Auckland, New Zealand.
- Faculty of Medical and Health Sciences, Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand.
| | - Ann McKillop
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - N Susan Stott
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | | | - Sîan A Williams
- School of Allied Health, Curtin University, Perth, Australia
- Liggins Institute, University of Auckland, Auckland, New Zealand
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农 绍, 余 卫, 李 翠, 周 晓. [Preventive early intervention strategies for neurodevelopmental disorders of high-risk infants]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:297-301. [PMID: 38557383 PMCID: PMC10986381 DOI: 10.7499/j.issn.1008-8830.2310107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/16/2024] [Indexed: 04/04/2024]
Abstract
Neurodevelopmental disorders in children have become a significant global public health concern, impacting child health worldwide. In China, the current intervention model for high-risk infants involves early diagnosis and early treatment. However, in recent years, overseas studies have explored novel preventive early intervention strategies for neurodevelopmental disorders in high-risk infants, achieving promising results. This article provides a comprehensive review of the optimal timing, methods, and intervention models of the preventive early intervention strategies for neurodevelopmental disorders in high-risk infants. The aim is to enhance the awareness and knowledge of healthcare professionals regarding preventive early intervention strategies for neurodevelopmental disorders in high-risk infants, facilitate clinical research and application of such interventions in China, and ultimately reduce the incidence of neurodevelopmental disorders in this high-risk population.
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Affiliation(s)
| | - 卫红 余
- 云南省文山壮族苗族自治州人民医院新生儿科,云南文山663000
| | - 翠红 李
- 云南省文山壮族苗族自治州人民医院新生儿科,云南文山663000
| | - 晓光 周
- 中山大学附属第八医院新生儿科, 广东深圳518033
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Ekman AT, Sengeh PA, Webber N, Jalloh MB, Hollander AC, Newby H, Cappa C, Orsini N, Alfvén T, Frielingsdorf H. Prevalence of children under five with disabilities in Sierra Leone in 2017: Insights from a population-based multiple indicator cluster survey. Disabil Health J 2023; 16:101481. [PMID: 37316393 DOI: 10.1016/j.dhjo.2023.101481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/16/2023] [Accepted: 04/27/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Children with disabilities have been low on the agenda of child health, including in Sierra Leone, and there are still many gaps in our knowledge and understanding of the issue. OBJECTIVE To estimate the prevalence of children with disabilities in Sierra Leone using functional difficulty as a proxy and to understand the factors associated with disabilities among children two to four years living in Sierra Leone. METHODS We used cross-sectional data from the Sierra Leone 2017 Multiple Indicator Cluster Survey. Disability was defined using a functional difficulty definition with additional thresholds used to define children with severe functional difficulty and multiple disabilities. Logistic regression models estimated odds ratios (ORs) of childhood disability and how they were associated with socioeconomic factors and living conditions. RESULTS Prevalence of children with disabilities was 6.6% (95% confidence interval (CI) 5.8-7.6%) and there was a high risk of comorbidity between different functional difficulties. Children with disabilities were less likely to be girls (adjusted odds ratio (AOR) 0.8 (CI 0.7-1.0) and older (AOR 0.3 (CI 0.2-0.4)), but more prone to be stunted (AOR 1.4 (CI 1.1-1.7)) and have younger caregivers (AOR 1.3 (CI 0.7-2.3)). CONCLUSION The prevalence of disabilities in young Sierra Leonean children was comparable to other countries in West and Central Africa when using the same measure of disability. Preventive as well as early detection and intervention efforts are recommended to be integrated with other programs, e.g vaccinations, nutrition, and poverty reducing programs.
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Affiliation(s)
- Anna-Theresia Ekman
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Paul A Sengeh
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Nance Webber
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Mohammad Bailor Jalloh
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Anna-Clara Hollander
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Global Public Health Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | | | - Claudia Cappa
- Data & Analytics Section, UNICEF, New York City, USA.
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
| | - Helena Frielingsdorf
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
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Beare NAV. Cerebral malaria-using the retina to study the brain. Eye (Lond) 2023; 37:2379-2384. [PMID: 36788363 PMCID: PMC10397347 DOI: 10.1038/s41433-023-02432-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/14/2023] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Cerebral malaria (CM) remains a common cause of death of children in Africa with annual mortality of 400 000. Malarial retinopathy is a unique set of fundus signs which has diagnostic and prognostic value in CM. Assessment of malarial retinopathy is now widely utilised in clinical care, and routinely incorporated into clinical studies to refine entry criteria. As a visible part of the central nervous system, the retina provides insights into the pathophysiology of this infectious small-vessel vasculitis with adherent parasitised red blood cells. Fluorescein angiography and optical coherence tomography (OCT) have shown that patchy capillary non-perfusion is common and causes ischaemic changes in the retina in CM. It is likely this is mirrored in the brain and may cause global neurological impairments evident on developmental follow up. Three types of blood-retina barrier breakdown are evident: large focal, punctate, and vessel leak. Punctate and large focal leak (haemorrhage in formation) are associated with severe brain swelling and fatal outcome. Vessel leak and capillary non-perfusion are associated with moderate brain swelling and neurological sequelae. These findings imply that death and neurological sequelae have separate mechanisms and are not a continuum of severity. Each haemorrhage causes a temporary uncontrolled outflow of fluid into the tissue. The rapid accumulation of haemorrhages, as evidenced by multiple focal leaks, is a proposed mechanism of severe brain swelling, and death. Current studies aim to use optic nerve head OCT to identify patients with severe brain swelling, and macula OCT to identify those at risk of neurological sequelae.
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Affiliation(s)
- Nicholas A V Beare
- Department of Eye and Vision Science, University of Liverpool, Liverpool, L7 8TX, UK.
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Wilson KJ, Tu Z, Mbale E, Mhango PP, Kayange P, Gladstone MJ, Harding S, Gottlob I, Garcia-Finana M, Shen Y, Taylor TE, Seydel KB, Zheng Y, Beare NAV. Predicting Acute and Post-Recovery Outcomes in Cerebral Malaria and Other Comas by Optical Coherence Tomography (OCT in CM) - A protocol for an observational cohort study of Malawian children. Wellcome Open Res 2023; 8:172. [PMID: 37663790 PMCID: PMC10468659 DOI: 10.12688/wellcomeopenres.19166.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 09/05/2023] Open
Abstract
Cerebral malaria (CM) remains a significant global health challenge with high morbidity and mortality. Malarial retinopathy has been shown to be diagnostically and prognostically significant in the assessment of CM. The major mechanism of death in paediatric CM is brain swelling. Long term morbidity is typically characterised by neurological and neurodevelopmental sequelae. Optical coherence tomography can be used to quantify papilloedema and macular ischaemia, identified as hyperreflectivity. Here we describe a protocol to test the hypotheses that quantification of optic nerve head swelling using optical coherence tomography can identify severe brain swelling in CM, and that quantification of hyperreflectivity in the macula predicts neurodevelopmental outcomes post-recovery. Additionally, our protocol includes the development of a novel, low-cost, handheld optical coherence tomography machine and artificial intelligence tools to assist in image analysis.
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Affiliation(s)
- Kyle J Wilson
- Eye & Vision Science, University of Liverpool, Liverpool, England, L69 7TX, UK
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, PO Box 30096, Malawi
| | - Zhanhan Tu
- Ulverscroft Eye Unit, University of Leicester, Leicester, England, LE2 7LX, UK
| | - Emmie Mbale
- Department of Paediatrics, Kamuzu University of Health Sciences, Blantyre, Southern Region, P/Bag 360, Malawi
| | - Priscilla P Mhango
- Department of Ophthalmology, Kamuzu University of Health Sciences, Blantyre, Southern Region, P/Bag 360, Malawi
| | - Petros Kayange
- Department of Ophthalmology, Kamuzu University of Health Sciences, Blantyre, Southern Region, P/Bag 360, Malawi
| | - Melissa J. Gladstone
- Women’s and Children’s Health, University of Liverpool, Liverpool, England, L69 7TX, UK
| | - Simon Harding
- Eye & Vision Science, University of Liverpool, Liverpool, England, L69 7TX, UK
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, L7 8YA, UK
| | - Irene Gottlob
- Cooper Neurological Institute, Cherry Hill, New Jersey, 08002, USA
| | - Marta Garcia-Finana
- Department of Health Data Science, University of Liverpool, Liverpool, England, L69 3GF, UK
| | - Yaochun Shen
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool, England, L69 3GJ, UK
| | - Terrie E Taylor
- College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, 4882, USA
- Blantyre Malaria Project, Blantyre, Southern Region, P/Bag 360, Malawi
| | - Karl B Seydel
- College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, 4882, USA
- Blantyre Malaria Project, Blantyre, Southern Region, P/Bag 360, Malawi
| | - Yalin Zheng
- Eye & Vision Science, University of Liverpool, Liverpool, England, L69 7TX, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, England, L69 7TX, UK
| | - Nicholas AV Beare
- Eye & Vision Science, University of Liverpool, Liverpool, England, L69 7TX, UK
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, L7 8YA, UK
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Botes M, van der Linde J, Swanepoel DW. A multiphased cultural and contextual adaptation of the Parents' Evaluation of Developmental Status tools for a low-income community: A South African case study. Child Care Health Dev 2022. [PMID: 36422854 DOI: 10.1111/cch.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/15/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Culturally relevant developmental screening is one of the best ways to appropriately identify developmental delays and disabilities in children as early as possible across diverse cultural backgrounds. This study aimed to adapt the Parents' Evaluation of Developmental Status (PEDS) tools for a low-income community in South Africa by using a detailed multiphased cultural and contextual adaption process. METHOD AND RESULTS A three-phase mixed-method design relying on triangulation of data was used. Data were collected at an immunization clinic in a low-income community in Mamelodi, South Africa. Phase 1 was a focus group discussion with 11 community participants. The topics explored the possible changes to the PEDS tools to make them more relevant to the community. Phase 1 informed Phase 2 where 12 early childhood development experts achieved consensus through a two-round survey on a modified Delphi method. In Phase 3, a draft of the PEDS tools-SA was presented to the authors of the PEDS tools for final approval. Of 55 questions that were adapted for the PEDS tools-SA, two original questions (3.6%), 14 questions from the expert suggestions (25.4%) and 39 from the community participant's suggestions (71%) were included. A final version of the PEDS tools-SA was created. CONCLUSION This study used a systematic method to adapt the PEDS tools to create the culturally appropriate PEDS tool-SA for a low-income community in South Africa, informed by community stakeholders' views from the first step. This resulted in a high-quality adaptation process that is more likely to result in a tool that is more acceptable to caregivers from a low-income South African community.
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Affiliation(s)
- Mignon Botes
- Department of Speech-Language Pathology, University of Pretoria, Pretoria, South Africa
| | - Jeannie van der Linde
- Department of Speech-Language Pathology, University of Pretoria, Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology, University of Pretoria, Pretoria, South Africa
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Pietruszewski L, Moore-Clingenpeel M, Moellering GCJ, Lewandowski D, Batterson N, Maitre NL. Predictive value of the test of infant motor performance and the Hammersmith infant neurological examination for cerebral palsy in infants. Early Hum Dev 2022; 174:105665. [PMID: 36126506 DOI: 10.1016/j.earlhumdev.2022.105665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Current recommendations for early detection tools for cerebral palsy (CP) include assessments that vary in feasibility and resource requirements. The predictive value of less resource-intensive tools has not been fully explored. AIMS To determine the predictive value of the Test of Infant Motor Performance (TIMP) at 3-4 months corrected age (CA) for CP, and whether administration of both the TIMP and the Hammersmith Infant Neurological Exam (HINE) improves early CP detection. STUDY DESIGN Five-year retrospective observational study of infants who received the TIMP and the HINE at 3-4 months CA in a high-risk follow-up clinic. TIMP and HINE cut-off scores (alone and in combination) were compared for CP discriminatory ability. SUBJECTS Of patients with HINE scores (n = 1389; 676 [48.7 %] female; median gestational age at birth 31 weeks [interquartile range 29-34 weeks]), 1343 had concurrent TIMP scores available. OUTCOME MEASURES Clinical diagnosis of CP. RESULTS HINE total score <57 had optimal CP predictive value (AUC = 0.815; 77 % sensitivity; 91 % specificity) compared to optimal TIMP cut-off (1 SD below the mean, AUC = 0.71; 52 % sensitivity; 94 % specificity) and all tested TIMP and HINE combinations (all p < 0.001). CONCLUSIONS HINE total score <57 at 3-4 months CA had the best CP predictive value, confirming its value absent first-line detection tools. Concurrent administration of TIMP did not improve predictive value.
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Affiliation(s)
- Lindsay Pietruszewski
- Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Research Building III, Columbus, OH 43205, USA.
| | - Melissa Moore-Clingenpeel
- Biostatistics Core, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
| | | | - Dennis Lewandowski
- Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Research Building III, Columbus, OH 43205, USA
| | - Nancy Batterson
- Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Research Building III, Columbus, OH 43205, USA
| | - Nathalie L Maitre
- Emory University School of Medicine, 1440 Clifton Rd, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1405 Clifton Rd NE, Atlanta, GA 30322, USA
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Samadi SA. The Challenges of Establishing Healthcare Services in Low- and Middle-Income Countries: The Case of Autism Spectrum Disorders (ASD) in the Kurdistan Region of Iraq-Report from the Field. Brain Sci 2022; 12:1433. [PMID: 36358360 PMCID: PMC9688601 DOI: 10.3390/brainsci12111433] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/08/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2023] Open
Abstract
The present report from the field tries to present challenges associated with establishing healthcare services for individuals with autism spectrum disorders (ASD) in a low- and middle-income area. The given case that has been highlighted is establishing daycare services focusing on rehabilitation and training services for individuals with ASD, and their caregivers and family members, in the Kurdistan Region of Iraq (KRI). Based on my experience, the associated challenges are divided into three primary levels: personal, professional, and organizational. The report highlights the importance of understanding the challenges associated with establishing healthcare services with the desire to put them under control. Plus, understanding the cultural aspects of the healthcare services for individuals with ASD experiences to address the issues at each level shared. It is concluded in the final part of the report that the key to establishing healthcare quality is to understand attitudes toward healthcare at the personal, professional, and organizational levels. This attitude determines the expectation from the services and defines assistance-seeking behaviors. Results offer insight for stakeholders in the healthcare field, allowing for a better understanding and improvement of availability and access to quality-driven healthcare services. A pre- and in-service training approach is practiced to address the associated challenges of establishing healthcare services at the personal level in KRI. A similar policy might be applicable in other LMICs, where there is a lack of professional and skillful healthcare service providers.
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Affiliation(s)
- Sayyed Ali Samadi
- Institute of Nursing and Health Research, Ulster University, Belfast BT15 1ED, UK
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Nanyunja C, Sadoo S, Kohli-Lynch M, Nalugya R, Nyonyintono J, Muhumuza A, Katumba KR, Trautner E, Magnusson B, Kabugo D, Cowan FM, Zuurmond M, Morgan C, Lester D, Seeley J, Webb EL, Otai C, Greco G, Nampijja M, Tann CJ. Early care and support for young children with developmental disabilities and their caregivers in Uganda: The Baby Ubuntu feasibility trial. Front Pediatr 2022; 10:981976. [PMID: 36177453 PMCID: PMC9513138 DOI: 10.3389/fped.2022.981976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Early care and support provision for young children with developmental disabilities is frequently lacking, yet has potential to improve child and family outcomes, and is crucial for promoting access to healthcare and early education. We evaluated the feasibility, acceptability, early evidence of impact and provider costs of the Baby Ubuntu participatory, peer-facilitated, group program for young children with developmental disabilities and their caregivers in Uganda. Materials and methods A feasibility trial, with two parallel groups, compared Baby Ubuntu with standard care. Caregivers and children, aged 6-11 months with moderate-severe neurodevelopmental impairment, were recruited and followed for 12 months. Quantitative and qualitative methods captured information on feasibility (ability to recruit), acceptability (satisfactory attendance), preliminary evidence of impact (family quality of life) and provider costs. Results One hundred twenty-six infants (median developmental quotient, 28.7) were recruited and randomized (63 per arm) over 9 months, demonstrating feasibility; 101 (80%) completed the 12-month follow-up assessment (9 died, 12 were lost to follow up, 4 withdrew). Of 63 randomized to the intervention, 59 survived (93%); of these, 51 (86%) attended ≥6 modules meeting acceptability criteria, and 49 (83%) completed the 12 month follow-up assessment. Qualitatively, Baby Ubuntu was feasible and acceptable to caregivers and facilitators. Enabling factors included community sensitization by local champions, positive and caring attitudes of facilitators toward children with disability, peer support, and the participatory approach to learning. Among 101 (86%) surviving children seen at 12 months, mixed methods evaluation provided qualitative evidence of impact on family knowledge, skills, and attitudes, however impact on a scored family quality of life tool was inconclusive. Barriers included stigma and exclusion, poverty, and the need to manage expectations around the child's progress. Total provider cost for delivering the program per participant was USD 232. Conclusion A pilot feasibility trial of the Baby Ubuntu program found it to be feasible and acceptable to children, caregivers and healthcare workers in Uganda. A mixed methods evaluation provided rich programmatic learning including qualitative, but not quantitative, evidence of impact. The cost estimate represents a feasible intervention for this vulnerable group, encouraging financial sustainability at scale. Clinical trial registration [https://doi.org/10.1186/ISRCTN44380971], identifier [ISRCTN44380971].
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Affiliation(s)
- Carol Nanyunja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Samantha Sadoo
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maya Kohli-Lynch
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Academic Child Health, Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Ruth Nalugya
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Spina Bifida and Hydrocephalus Association of Uganda (SHA-U), Mbale, Uganda
| | - James Nyonyintono
- Kiwoko Hospital, Nakaseke, Uganda
- Adara Development, Edmonds, WA, United States
| | | | | | - Emily Trautner
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Brooke Magnusson
- Kiwoko Hospital, Nakaseke, Uganda
- Adara Development, Edmonds, WA, United States
| | - Daniel Kabugo
- Kiwoko Hospital, Nakaseke, Uganda
- Adara Development, Edmonds, WA, United States
| | - Frances M Cowan
- Department of Paediatrics, Imperial College London, London, United Kingdom
| | - Maria Zuurmond
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Janet Seeley
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Emily L Webb
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Christine Otai
- Kiwoko Hospital, Nakaseke, Uganda
- Adara Development, Edmonds, WA, United States
| | - Giulia Greco
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- African Population and Health Research Center, Nairobi, Kenya
| | - Cally J Tann
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Neonatal Medicine, University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Early Interventions for Infants at Risk for Developmental Impairment: The South Asian Perspective. Indian J Pediatr 2022; 89:254-261. [PMID: 34287799 DOI: 10.1007/s12098-021-03871-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/17/2021] [Indexed: 10/20/2022]
Abstract
Majority of under-five children with developmental disabilities live in low- and middle-income countries (LMIC). A considerable proportion of disabilities results from perinatal adversities. The neonatal and infant mortality rates in India, Bangladesh, and Sri Lanka have improved over the last two decades, implying survival of infants at risk for developmental impairments. The need to thrive beyond survival is a well-recognized concept and it is imperative to establish high-risk infant follow-up (HRIF) programmes to capture these infants within the first 1000 d of life. Many challenges are present within the LMICs to identify infants at risk and to ensure early intervention (EI) during the window of optimal neural plasticity. However, it is essential to acknowledge the strengths within such systems to understand the impact of these programmes and packages on the activity and participation of these infants and their families. The International Classification of Functioning, Health and Disability for Children and Youth (ICF-CY) version is a holistic framework that will enable the families, clinicians, and policymakers to measure the impact of these interventions. Though all three countries have national policies to reach for high-risk infants, there is lack of published evidence on the successful implementation of such strategies. Therefore, it is timely to establish universally accessible, culturally appropriate and sustainable HRIF programmes. It is also recommended to measure the outcomes of such programmes based on the ICF-CY to understand the impact on the activity and participation of children in South Asia.
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Ceccarelli C, Bakolis I, Tekola B, Kinfe M, Borissov A, Girma F, Abdurahman R, Zerihun T, Hanlon C, Hoekstra RA. Validation of the Communication Profile-Adapted in Ethiopian children with neurodevelopmental disorders. Glob Ment Health (Camb) 2021; 8:e45. [PMID: 34966545 PMCID: PMC8679817 DOI: 10.1017/gmh.2021.44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/21/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neurodevelopmental disorders (NDDs) are conditions affecting a child's cognitive, behavioural, and emotional development. Appropriate and validated outcome measures for use in children with NDDs in sub-Saharan Africa are scarce. The aim of this study was to validate the Communication Profile Adapted (CP-A), a measure developed in East Africa to assess caregivers' perception of communication among children with NDDs. METHODS We adapted the CP-A for use in Ethiopia, focusing on the communicative mode (CP-A-mode) and function (CP-A-function) scales. The CP-A was administered to a representative sample of caregivers of children with NDDs and clinical controls. We performed an exploratory factor analysis and determined the internal consistency, test-retest reliability, within-scale, known-group, and convergent validity of the identified factors. RESULTS Our analysis included N = 300 participants (N = 139 cases, N = 139 clinical controls, N = 22 who did not meet criteria for either cases or controls). Within the CP-A-mode, we identified two factors (i.e. verbal and physical communication); the CP-A-function scale was unidimensional. Combining both scales into one summary variable (the CP-A-total) resulted in a scale with excellent internal consistency and test-retest reliability (Cronbach's alpha = 0.97; Kappa = 0.60-0.95, p < 0.001; ICC = 0.97, p < 0.001). Testing known-group validity, the CP-A-total scores were significantly higher for controls than cases (Δ mean = 33.93, p < 0.001). Convergent validity assessment indicated that scores were negatively and moderately correlated with clinical severity (ρ = -0.25, p = 0.04). CONCLUSION The CP-A is a valid tool for the assessment of communication among children with NDDs in Ethiopia. It holds promise as a brief, quantitative, and culturally appropriate outcome measure for use in sub-Saharan Africa.
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Affiliation(s)
- Caterina Ceccarelli
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bethlehem Tekola
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mersha Kinfe
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anton Borissov
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fikirte Girma
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rehana Abdurahman
- Department of Psychiatry, Yekatit 12 Hospital and Medical College, Addis Ababa, Ethiopia
| | - Tigist Zerihun
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Department of Health Services and Population Research and WHO Collaborating Centre for Mental Health Research and Capacity-Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Global Health Institute, King's College London, London, UK
| | - Rosa A. Hoekstra
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Global Health Institute, King's College London, London, UK
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Kim HH, An JI, Park YR. A Prediction Model for Detecting Developmental Disabilities in Preschool-Age Children Through Digital Biomarker-Driven Deep Learning in Serious Games: Development Study. JMIR Serious Games 2021; 9:e23130. [PMID: 34085944 PMCID: PMC8214184 DOI: 10.2196/23130] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/15/2020] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background Early detection of developmental disabilities in children is essential because early intervention can improve the prognosis of children. Meanwhile, a growing body of evidence has indicated a relationship between developmental disability and motor skill, and thus, motor skill is considered in the early diagnosis of developmental disability. However, there are challenges to assessing motor skill in the diagnosis of developmental disorder, such as a lack of specialists and time constraints, and thus it is commonly conducted through informal questions or surveys to parents. Objective This study sought to evaluate the possibility of using drag-and-drop data as a digital biomarker and to develop a classification model based on drag-and-drop data with which to classify children with developmental disabilities. Methods We collected drag-and-drop data from children with typical development and developmental disabilities from May 1, 2018, to May 1, 2020, via a mobile application (DoBrain). We used touch coordinates and extracted kinetic variables from these coordinates. A deep learning algorithm was developed to predict potential development disabilities in children. For interpretability of the model results, we identified which coordinates contributed to the classification results by applying gradient-weighted class activation mapping. Results Of the 370 children in the study, 223 had typical development, and 147 had developmental disabilities. In all games, the number of changes in the acceleration sign based on the direction of progress both in the x- and y-axes showed significant differences between the 2 groups (P<.001; effect size >0.5). The deep learning convolutional neural network model showed that drag-and-drop data can help diagnose developmental disabilities, with an area under the receiving operating characteristics curve of 0.817. A gradient class activation map, which can interpret the results of a deep learning model, was visualized with the game results for specific children. Conclusions Through the results of the deep learning model, we confirmed that drag-and-drop data can be a new digital biomarker for the diagnosis of developmental disabilities.
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Affiliation(s)
- Ho Heon Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Il An
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Tann CJ, Kohli-Lynch M, Nalugya R, Sadoo S, Martin K, Lassman R, Nanyunja C, Musoke M, Sewagaba M, Nampijja M, Seeley J, Webb EL. Surviving and Thriving: Early Intervention for Neonatal Survivors With Developmental Disability in Uganda. INFANTS AND YOUNG CHILDREN 2021; 34:17-32. [PMID: 33790497 PMCID: PMC7983078 DOI: 10.1097/iyc.0000000000000182] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Global attention on early child development, inclusive of those with disability, has the potential to translate into improved action for the millions of children with developmental disability living in low- and middle-income countries. Nurturing care is crucial for all children, arguably even more so for children with developmental disability. A high proportion of survivors of neonatal conditions such as prematurity and neonatal encephalopathy are affected by early child developmental disability. The first thousand days of life is a critical period for neuroplasticity and an important window of opportunity for interventions, which maximize developmental potential and other outcomes. Since 2010, our group has been examining predictors, outcomes, and experiences of neonatal encephalopathy in Uganda. The need for an early child intervention program to maximize participation and improve the quality of life for children and families became apparent. In response, the "ABAaNA early intervention program," (now re-branding as 'Baby Ubuntu') a group participatory early intervention program for young children with developmental disability and their families, was developed and piloted. Piloting has provided early evidence of feasibility, acceptability, and impact and a feasibility trial is underway. Future research aims to develop programmatic capacity across diverse settings and evaluate its impact at scale.
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Affiliation(s)
- Cally J. Tann
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Maya Kohli-Lynch
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Ruth Nalugya
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Samantha Sadoo
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Karen Martin
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Rachel Lassman
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Carol Nanyunja
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Margaret Musoke
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Margaret Sewagaba
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Margaret Nampijja
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Janet Seeley
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
| | - Emily L. Webb
- Department of Infectious Disease Epidemiology, School of Hygiene and Tropical Medicine, London, England (Dr Tann and Dr Sadoo); Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda (Drs Tann, Nampijja, and Professor Seeley and Mss Nalugya, Nanyunja, Musoke, and Sewagaba); Institute for Women's Health, University College London, London, England (Dr Tann and Dr Martin); Centre for Academic Child Health, University of Bristol, Bristol, England (Dr Kohli-Lynch); Alder Hey Children's NHS Foundation Trust, Liverpool, England (Dr Martin); Kyaninga Child Development Centre, Fort Portal, Uganda (Ms Lassman); African Population and Health Research Center, Nairobi, Kenya (Dr Nampijja); Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, England (Dr Seeley); and MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, England (Dr Webb)
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Resch B, Hofbauer-Krug C, Pansy J, Prechtl K, Avian A, Kurz R. Prospective Randomized Observational Pilot Trial Evaluating the Effect of Different Durations of Interdisciplinary Early Intervention and Family Support in Parents of Very Low Birth Weight Infants (Early Bird Study). Front Public Health 2020; 8:242. [PMID: 32719760 PMCID: PMC7349967 DOI: 10.3389/fpubh.2020.00242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/19/2020] [Indexed: 01/05/2023] Open
Abstract
Background: Early childhood intervention (ECI) is a holistic approach for infants with or at risk for psychomotor and/or cognitive and/or behavioral impairment. It aims to optimally support them and positively influence their neurodevelopmental outcome. The right dosage of intervention and when the intervention should start are still to be determined. Hypothesis: Parents are more satisfied when the duration of ECI is longer (120 min once a week) than the usual 90-min session. Methods: We developed a parental questionnaire (both mother and father) that evaluated the level of satisfaction of parents with the intervention. We compared 120 with 90 min of ECI per week during the school year 2017/18. Included were parents of very low birth weight infants (<1,500 g) following informed consent. ECI was initiated at the NICU at an infant age of ≥ 2 weeks. Parents were randomized (https://www.randomizer.at/) to a 120- or 90-min duration and had to answer the questionnaire to the approximate time-point of 1, 3, and 6 months. Answers were classified as strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree except for the last question, which directly rated the ECI professional. Results: Eleven fathers (55%) and 19 mothers (95%) of the 10 parents of each group participated in the study. Demographic data did not differ between groups, and the median time-points of questionnaire answers were 77, 137, and 220 days, respectively. Overall, 120-min ECI sessions were not superior to 90-min sessions for both parents regarding parental satisfaction during the study time. We found no differences between fathers and mothers and minimal changes over time. All parents were satisfied with the ECI professionals, irrespective of ECI duration. Conclusion: An ECI duration of 120 min once per week was not superior to a 9- min duration regarding parental satisfaction with ECI professionals and their work.
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Affiliation(s)
- Bernhard Resch
- University Course for Interdisciplinary Early Intervention and Family Support, Postgraduate School, Medical University of Graz, Graz, Austria.,Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.,Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Claudia Hofbauer-Krug
- University Course for Interdisciplinary Early Intervention and Family Support, Postgraduate School, Medical University of Graz, Graz, Austria.,Institute for Social and Orthopedagogic Interventions (SHFI), Graz, Austria
| | - Jasmin Pansy
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Karin Prechtl
- Institute for Social and Orthopedagogic Interventions (SHFI), Graz, Austria
| | - Alexander Avian
- Institute for Statistics, Medical University of Graz, Graz, Austria
| | - Ronald Kurz
- University Course for Interdisciplinary Early Intervention and Family Support, Postgraduate School, Medical University of Graz, Graz, Austria.,Institute for Social and Orthopedagogic Interventions (SHFI), Graz, Austria
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Ellis M, Pant PR. Global Community Child Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3331. [PMID: 32403304 PMCID: PMC7246820 DOI: 10.3390/ijerph17093331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 11/16/2022]
Abstract
This special issue of IJERPH has published a range of studies in this developing field of Global Community Child Health research. A number of manuscripts submitted in response to our invitation describing 'community-based interventions which impact on child health and wellbeing around the globe. In addition to rural community-based initiatives given that most children now live in cities we are also interested to hear about urban initiatives….' We hope this issue will of great interest to the researchers and practitioners as well as academia from the fields of Global Health as well as Global Child Health because it comprised of 14 articles representing all five continents. Physical activity appears a key component of the scientific community's current conception of child well-being judging from the four papers published addressing this area. This issue also has papers on childhood obesity to rubella vaccination. Despite of the journal's strive for reaching out to a wider global child health community, this issue missed contributions relating to child safeguarding and social determinants of urban health.
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Affiliation(s)
- Matthew Ellis
- Centre for Academic Child Health, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK
| | - Puspa Raj Pant
- Department of Nursing and Midwifery, University of the West of England (UWE Bristol), Bristol BS16 1QY, UK;
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The Inventory of Quality in Early Intervention Centres for Service Providers: Preliminary Validating Study in a Spanish Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072581. [PMID: 32283746 PMCID: PMC7177315 DOI: 10.3390/ijerph17072581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/02/2020] [Accepted: 04/08/2020] [Indexed: 11/17/2022]
Abstract
Evaluating the service quality in early intervention (EI) from the perspective of professionals with knowledge in this area is essential for the improvement of EI centres. In this study, we aimed to test the reliability and validity of the adapted Inventory of Quality in Early Intervention Centres-P (IQEIC-P) in a sample of professionals who worked in EI centres. Three hundred and twenty-four professionals of 85 EI Spanish centres were recruited for this research. Various psychometric analyses were used to evaluate the factorial structure, the internal consistency, factorial validity and construct validity. A 5-dimension structure was obtained in the exploratory factor analysis (EFA). The results showed an adequate internal consistency (Cronbach’s alpha values between 0.71 and 0.83, and composite reliability (CR) values higher than 0.70), as well as satisfactory convergent and discriminant validity (average variance extracted (AVE) values above 0.50). In the confirmatory factor analysis, good model fit indicators were observed. The IQEIC-P showed adequate psychometric properties, demonstrating to be a valid instrument for the evaluation of service quality in EI centres from the perspective of professionals. The benefits will influence the professionals themselves, and they will have a positive and direct impact on the families that are attended to in these centres.
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