These documents were presented by Dr. NATHAN A. FOX, UNIVERSITY OF MARYLAND at the session sponsored by The Nippon Foundation, Tokyo, Japan, in the international society for the prevention of child abuse and neglect conference in Nagoya, Japan, on September 14, 2014.
A presentation given by Nick Kowalenko at The Journey, CHA Conference 2012, in the 'Innovations in Mental Health Care for Children and Young People' stream.
The information in these slides was shared by Kamna Seth and Gauri Shirali-Deo of The Source for Learning, Inc's Early Childhood team, during VAECE's 2017 Annual Conference in Hampton Roads, VA on April 1, 2017.
PRESENTATION OVERVIEW
This session focused on the definition and scope of early intervention; reflected on the urgency and importance of early diagnoses of developmental delays; and provided techniques to meaningfully use information gathered through observational data and to connect child progress to educational decisions.
ABOUT EARLY CHILDHOOD AT THE SOURCE FOR LEARNING
SFL’s Early Childhood Education Division includes PreschoolFirst--a research-based, online child assessment system that has proven effective in early childhood classrooms -- as well as a wide range of professional development and management services for the early childhood community. The Division’s PD webinar series features cutting-edge and trending topics presented in a one-hour format by SFL’s early childhood education team, with guest appearances by ECE industry experts.
A presentation given by Nick Kowalenko at The Journey, CHA Conference 2012, in the 'Innovations in Mental Health Care for Children and Young People' stream.
The information in these slides was shared by Kamna Seth and Gauri Shirali-Deo of The Source for Learning, Inc's Early Childhood team, during VAECE's 2017 Annual Conference in Hampton Roads, VA on April 1, 2017.
PRESENTATION OVERVIEW
This session focused on the definition and scope of early intervention; reflected on the urgency and importance of early diagnoses of developmental delays; and provided techniques to meaningfully use information gathered through observational data and to connect child progress to educational decisions.
ABOUT EARLY CHILDHOOD AT THE SOURCE FOR LEARNING
SFL’s Early Childhood Education Division includes PreschoolFirst--a research-based, online child assessment system that has proven effective in early childhood classrooms -- as well as a wide range of professional development and management services for the early childhood community. The Division’s PD webinar series features cutting-edge and trending topics presented in a one-hour format by SFL’s early childhood education team, with guest appearances by ECE industry experts.
The information contained in these slides was shared during NAEYC's 2016 Institute for Professional Development conference held in Baltimore, Maryland June 5-8, 2016. These slides consolidate much of the early intervention information shared by SFL's Director of Early Childhood Education Initiatives, Kamna Seth, and Senior Manager, Gauri Shirali-Deo. The topic presented, Understanding Early Intervention: Reflecting on the Scope, Need for Early Diagnosis, and Implementation of Early Intervention, underscores the importance of identifying developmental delays and developing educational strategies to address the needs of diverse learners.
Jenny Roe - Natural Solutions to Tackling Behavior & Performance in Urban Sch...youth_nex
The talk highlights the benefits of green space access in school settings for behavioral and performance outcomes. It presents two studies both carried out in deprived schools in Central Scotland; the first compares the effect of indoor versus outdoor education (delivered in a forest setting) on a range of wellbeing outcomes in teenagers; the second study explores the benefits to memory recall in early years pupils from curriculum tasks carried out indoors versus outdoors in a range of playground settings.
Professor Frank Oberklaid, Director of the Centre for Community Child Health at The Royal Children's Hospital Melbourne, shares a presentation about the evidence for early action/intervention. See also: www.rch.org/ccch and www.benevolent.org.au
Effects of preterm birth on school readiness part iOzella Brundidge
Preterm and low birth-weight born school-age children experience difficulties with complex language functions which can negatively effect social skills, communication abilities, and academic performance. Children born very low birth-weight (VLBW) from lower socioeconomic status (SES) households performed significantly poorer on intellectual ability and academic achievement. However, VLBW first grade children from higher SES households performed similar to their siblings. Parents, pediatricians, and early childcare providers play a critical role in obtaining critical early intervention for this heterogeneous cohort. Preschool enrollment improved verbal and nonverbal cognitive school readiness skills from socially disadvantaged families. Preschool enrollment had no significant effect on cognitive and behavioral skills for moderate preterm (MPT) and very preterm (VPT) born children by family SES. Although preschool enrollment did not moderate the relationship between premature birth and school readiness, enrollment did moderate the relationship between small for gestational age (SGA) and school readiness. Preschool enrollment has a positive effect on language skills and verbal school readiness outcome.
子ども虐待防止世界会議in 名古屋 日本財団スポンサードセッション資料(メリーランド大学 ネイザン A. フォックス教授)happy-yurikago
子ども虐待防止世界会議in 名古屋 2014年9月14日~9月17日
日本財団スポンサードセッション資料
「TIMING MATTERS: HOW TO THINK
ABOUT THE EFFECTS OF EARLY
EXPERIENCE ON BRAIN AND
BEHAVIORAL DEVELOPMENT」(日本語訳)
Dr.NATHAN A. FOX
UNIVERSITY OF MARYLAND
(メリーランド大学 ネイザン A. フォックス教授)
The information contained in these slides was shared during NAEYC's 2016 Institute for Professional Development conference held in Baltimore, Maryland June 5-8, 2016. These slides consolidate much of the early intervention information shared by SFL's Director of Early Childhood Education Initiatives, Kamna Seth, and Senior Manager, Gauri Shirali-Deo. The topic presented, Understanding Early Intervention: Reflecting on the Scope, Need for Early Diagnosis, and Implementation of Early Intervention, underscores the importance of identifying developmental delays and developing educational strategies to address the needs of diverse learners.
Jenny Roe - Natural Solutions to Tackling Behavior & Performance in Urban Sch...youth_nex
The talk highlights the benefits of green space access in school settings for behavioral and performance outcomes. It presents two studies both carried out in deprived schools in Central Scotland; the first compares the effect of indoor versus outdoor education (delivered in a forest setting) on a range of wellbeing outcomes in teenagers; the second study explores the benefits to memory recall in early years pupils from curriculum tasks carried out indoors versus outdoors in a range of playground settings.
Professor Frank Oberklaid, Director of the Centre for Community Child Health at The Royal Children's Hospital Melbourne, shares a presentation about the evidence for early action/intervention. See also: www.rch.org/ccch and www.benevolent.org.au
Effects of preterm birth on school readiness part iOzella Brundidge
Preterm and low birth-weight born school-age children experience difficulties with complex language functions which can negatively effect social skills, communication abilities, and academic performance. Children born very low birth-weight (VLBW) from lower socioeconomic status (SES) households performed significantly poorer on intellectual ability and academic achievement. However, VLBW first grade children from higher SES households performed similar to their siblings. Parents, pediatricians, and early childcare providers play a critical role in obtaining critical early intervention for this heterogeneous cohort. Preschool enrollment improved verbal and nonverbal cognitive school readiness skills from socially disadvantaged families. Preschool enrollment had no significant effect on cognitive and behavioral skills for moderate preterm (MPT) and very preterm (VPT) born children by family SES. Although preschool enrollment did not moderate the relationship between premature birth and school readiness, enrollment did moderate the relationship between small for gestational age (SGA) and school readiness. Preschool enrollment has a positive effect on language skills and verbal school readiness outcome.
子ども虐待防止世界会議in 名古屋 日本財団スポンサードセッション資料(メリーランド大学 ネイザン A. フォックス教授)happy-yurikago
子ども虐待防止世界会議in 名古屋 2014年9月14日~9月17日
日本財団スポンサードセッション資料
「TIMING MATTERS: HOW TO THINK
ABOUT THE EFFECTS OF EARLY
EXPERIENCE ON BRAIN AND
BEHAVIORAL DEVELOPMENT」(日本語訳)
Dr.NATHAN A. FOX
UNIVERSITY OF MARYLAND
(メリーランド大学 ネイザン A. フォックス教授)
Automation & amp ; industrial prepared by mohamed abd el ghaffar
Similar to TIMING MATTERS: HOW TO THINK ABOUT THE EFFECTS OF EARLY EXPERIENCE ON BRAIN AND BEHAVIORAL DEVELOPMENT by Dr. NATHAN A. FOX, UNIVERSITY OF MARYLAND
Autism challenges the individual, their family, the community and the practitioner. The complexity and variety of symptoms that define Autism Spectrum Disorders (ASD) require service providers to constantly update their knowledge and skills to best serve these individuals. Sensorimotor synchronization training with Interactive Metronome (IM), as part of a comprehensive treatment plan, has the potential to directly and positively influence the person’s ability to learn and engage with the world around him. This course will introduce practitioners to new advances in our understanding of ASD, including the pivotal role of timing & rhythm for speech, language, pragmatic, cognitive, motor and sensory processing skills. Participants will learn strategies to evaluate the unique strengths and needs of each individual with ASD as well as how to develop and implement effective IM training with consideration for communication, sensory, motor & behavioral challenges. The expert presenter will incorporate several videos and real examples to illustrate techniques. Take the course at https://secure.interactivemetronome.com/NetSite/IM/CEU/SimpleRegistration.aspx?course_id=2778
John Bruer Presentation to The Uses and Abuses of Biology: Neuroscience, Pare...ParentingCultureStudies
Presentation by Professor John T. Bruer, entitled 'Distortions of Neuroscience', to the conference The Uses and Abuses of Biology: Neuroscience, Parenting and British Family Policy, Friday 28 March 2014, Birkbeck, London University. Event organised by the Centre for Parenting Culture Studies, the University of Kent.
To highlight the importance of Early Brain & Child Development (EBCD).
To recognize some valuable nutritive materials for the development of children’s brains.
Pat Levitt: Neurodevelopmental Disorder Heterogeneity, Brain Development and ...Beitissie1
In his lecture, Prof. Pat Levitt describes the great heterogeneity of the brain, which makes people different from each other and is a significant challenge to treating people with disabilities.
CAPHC Concurrent Symposium
Sleep Disorders in Canadian Children: What Can We Do to Ensure Better Nights and Better Days for Children and their Families?
Oct 25 CAPHC Concurrent Symposium - Sleep Disorders - Dr. Penny Corkum and ...Glenna Gosewich
CAPHC Concurrent Symposium
Sleep Disorders in Canadian Children: What Can We Do to Ensure Better Nights and Better Days for Children and their Families?
Cognitive Development The last two decades .docxpickersgillkayne
Cognitive Development
“The last two decades of infancy research have seen dramatic changes in the
way developmental psychologists char
acterize the earliest stages of cognitive
development. The infant, once regarded
as an organism driven mainly by sim
ple sensorimotor schemes, is now seen
as possessing sophisticated cognitive
skills and even sophisticated concepts
that guide knowledge acquisition”
(Madole and Oakes 1999, 263).
“What we see in the crib is the great
est mind that has ever existed, the
most powerful learning machine in
the universe” (Gopnik, Meltzoff, and
Kuhl 1999, 1).
The term cognitive development
refers to the process of growth and
change in intellectual/mental abilities
such as thinking, reasoning and
understanding. It includes the acquisi
tion and consolidation of knowledge.
Infants draw on social-emotional,
language, motor, and perceptual
experiences and abilities for cognitive
development. They are attuned to
relationships between features of
objects, actions, and the physical
environment. But they are particularly
attuned to people. Parents, family
members, friends, teachers, and care
givers play a vital role in supporting
the cognitive development of infants by
providing the healthy interpersonal or
social-emotional context in which
cognitive development unfolds. Caring,
responsive adults provide the base
from which infants can fully engage in
behaviors and interactions that pro
mote learning. Such adults also serve
as a prime source of imitation.
Cultural context is important to
young children’s cognitive develop
ment. There is substantial variation
in how intelligence is defined within
different cultures (Sternberg and
Grigorenko 2004). As a result, dif
ferent aspects of cognitive function
ing or cognitive performance may be
more highly valued in some cultural
contexts than in others. For example,
whereas processing speed is an aspect
of intelligence that is highly valued
within the predominant Western con
ceptualizations of intelligence, “Ugan
dan villagers associate intelligence
with adjectives such as slow, careful,
and active” (Rogoff and Chavajay 1995,
865.). Aspects of intelligence that have
to do with social competence appear to
be seen as more important than speed
��
C
O
G
N
IT
IV
E
D
E
V
E
L
O
P
M
E
N
T
60
in some non-Western cultural contexts
(Sternberg and Grigorenko 2004). Cer
tainly, it is crucial for early childhood
professionals to recognize the role that
cultural context plays in defining and
setting the stage for children’s healthy
cognitive functioning.
Research has identified a broad
range of cognitive competencies and
described the remarkable progres
sion of cognitive development during
the early childhood years. Experts in
the field describe infants as active,
motivated, and engaged learners who
possess an impressive range of cogni
tive competencies (National Research
Council and Institute of.
Cognitive Development
“The last two decades of infancy research have seen dramatic changes in the
way developmental psychologists char
acterize the earliest stages of cognitive
development. The infant, once regarded
as an organism driven mainly by sim
ple sensorimotor schemes, is now seen
as possessing sophisticated cognitive
skills and even sophisticated concepts
that guide knowledge acquisition”
(Madole and Oakes 1999, 263).
“What we see in the crib is the great
est mind that has ever existed, the
most powerful learning machine in
the universe” (Gopnik, Meltzoff, and
Kuhl 1999, 1).
The term cognitive development
refers to the process of growth and
change in intellectual/mental abilities
such as thinking, reasoning and
understanding. It includes the acquisi
tion and consolidation of knowledge.
Infants draw on social-emotional,
language, motor, and perceptual
experiences and abilities for cognitive
development. They are attuned to
relationships between features of
objects, actions, and the physical
environment. But they are particularly
attuned to people. Parents, family
members, friends, teachers, and care
givers play a vital role in supporting
the cognitive development of infants by
providing the healthy interpersonal or
social-emotional context in which
cognitive development unfolds. Caring,
responsive adults provide the base
from which infants can fully engage in
behaviors and interactions that pro
mote learning. Such adults also serve
as a prime source of imitation.
Cultural context is important to
young children’s cognitive develop
ment. There is substantial variation
in how intelligence is defined within
different cultures (Sternberg and
Grigorenko 2004). As a result, dif
ferent aspects of cognitive function
ing or cognitive performance may be
more highly valued in some cultural
contexts than in others. For example,
whereas processing speed is an aspect
of intelligence that is highly valued
within the predominant Western con
ceptualizations of intelligence, “Ugan
dan villagers associate intelligence
with adjectives such as slow, careful,
and active” (Rogoff and Chavajay 1995,
865.). Aspects of intelligence that have
to do with social competence appear to
be seen as more important than speed
��
C
O
G
N
IT
IV
E
D
E
V
E
L
O
P
M
E
N
T
60
in some non-Western cultural contexts
(Sternberg and Grigorenko 2004). Cer
tainly, it is crucial for early childhood
professionals to recognize the role that
cultural context plays in defining and
setting the stage for children’s healthy
cognitive functioning.
Research has identified a broad
range of cognitive competencies and
described the remarkable progres
sion of cognitive development during
the early childhood years. Experts in
the field describe infants as active,
motivated, and engaged learners who
possess an impressive range of cogni
tive competencies (National Research
Council and Institute of ...
April 3, 2014-Trauma in Young Children Under 4-Years of Age: Attachment, Neur...MFLNFamilyDevelopmnt
The PowerPoint presentation for a 2 hour webinar exploring how young children are particularly vulnerable to the effects of trauma, especially when their relationships with their caregivers are affected. (Find the live recording of this webinar @ https://learn.extension.org/events/1416) This presentation examines the characteristics of trauma in young children who are 4-years of age and younger, formal diagnostic criteria as well as other signs and symptoms of trauma, the neurobiological underpinnings of traumatic experiences for children, and evidence-based interventions that may be useful for remediating the effects of trauma for young children and their families.
· In the methodology you should not say that you are going to look.docxLynellBull52
· In the methodology you should not say that you are going to look for the data, but only identify them, name them and establish how you are going to use them and why.
· In the methodology there is a lack of explanation about what method is going to be used for the research and development (objective 2, hip n°1 and 3).
· Furthermore you don ‘t explain how you are going to study and analyze the economic growth and its relation with the ethanol and which data are going to be used for the research .
· If you mention an interview, you need to insert a copy of the list of question that will be ask and how you will use them in you investigation.
38 ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007
The Hope Connection A therapeutic summer day
camp for adopted and at-risk children with special
socio-emotional needs
Large numbers of North American and Western
European families are adopting children with serious
socio-emotional needs. Other children experience
similar deficits as a result of neglect and abuse by
carers. Often these children are diagnosed with
psychopathology and receive drug treatments that
can be ineffective and even detrimental. Karyn B
Purvis, David R Cross, Ron Federici, Dana
Johnson and L Brooks McKenzie report on The
Hope Connection, a project designed to meet the
needs of these at-risk children and their families. The
core of this project is a theoretically integrated
summer day camp offering activities that are attach-
ment rich, sensory stimulating and behaviourally
structured. Pre-test and post-test data indicate that
summer camp had a significant impact on the
children’s behaviour (n = 19), as indicated by parent-
report measures of child behaviour problems and
attachment. These findings are discussed with
regard to possible future directions of programme
implementation and evaluation.
Introduction
The purpose of this article is to explore a
camp structure that was developed to
address the enduring effects of early
deprivation upon the development of
adopted and other at-risk children.
Originally, internationally adopted child-
ren with histories of severe deprivation
and commensurate behavioural diff icul-
ties were the target population for this
intervention. However, a small number of
domestically adopted children were
included due to the urgent needs of these
families and the background similarities
of deprivation (Purvis, Cross and
Sunshine, 2007).
Although most adopted children do
not present serious problems in these
areas, many children from deprived
backgrounds do, and there is an undeter-
mined number of families who need
support addressing them. As noted in two
recent meta-analyses by Juffer and van
IJzendoorn (2005) and Meese (2005),
there is a scarcity of research on interven-
tions in these areas.
Specifically, three areas of psycholo-
gical development are likely to be
affected when inadequate care is pro-
vided: attachment, pro-social behaviour
and sensory processing. By integrating
these three as.
early intervention in high risk infants.pptxibtesaam huma
Early Intervention in High Risk Infants
-Dr. Quazi Ibtesaam Huma (MPT)
Dr. Suvarna Ganvir (Phd, Prof & HOD)
Dept. of Neurophysiotherapy
DVVPF’s College of Physiotherapy
Objectives
By the end of the seminar one would know
What is high risk infants?
Determinants of high risk infants
Monthwise neurodevelopment of infants in gestational age
Early intervention
General NICU guidelines for high risk infants
Recent advances
What is High Risk Infant?
A High risk infant is broadly defined as one who requires more than the standard monitoring and care offered to a healthy term newborn infant.
According to American Academy of Pediatrics, High risk infant may be defined as
Preterm Infant
Infant with special healthcare needs or dependence on technology
Infant at risk because of family issues.
Infant with anticipated early death.
High-Risk Clinical Signs
At 4 months of age, hypertonicity of the trunk or extremities is recognized as a high-risk clinical sign.
Less alternate kicking movement compared with typically developing LBW infant.
Abnormalities of kicking described by Prechtl as “cramped-synchronized,” that is, limited in variety and characterized by “rigid movement with all limbs and the trunk contracting and relaxing almost simultaneously,”
Preterm Infant
Preterm infant is the infant which is born before 36 weeks of gestation
Usually preterm infant have low birth weight i.e. less than 2.5 kgs
Determinants of High Risk Infant
Biological Risk
Attributed to medical/physical condition presence of
Asphyxia
Neonatal seizures
Prenatal exposure to drugs or alcohol
Brain-lesions
Low birth weight
Established Risk
Associated with diagnosis that is clearly established like,
Congenital malformation
Chromosomal abnormalities
CNS disorders
Metabolic disease.
Environmental & social risk
Refers to competency in parenting roles and factors in family dynamics
Suboptimal levels of stimulation and interaction in NICU
Inadequate parent-infant attachment
Insufficient educational preparation for caregiver roles
Meager financial resources of parents
Limited or absent family support to assist in taking care of and nurturing the infants in home environment.
The systems of infants develop in their stipulated time during gestational period prenatal or preterm results in specific injury
Commonest condition which requires early intervention
Newborn Maturity Rating—Ballard Score
Widely adopted because of the time efficiency
Ballard instrument involves only six physical and six neurological criteria, with a 0 to 5 scale and a maturity rating
designed to be used for neonates (20 to 44 weeks gestation) from birth through 3 days of age and has demonstrated concurrent validity with the Dubowitz gestational age calculation tool.
Neonatal Behavioral Assessment Scale
30- to 45-minute examination consists of observing, eliciting, and scoring 28 behavioral items on a 9-point scale and 18 reflex items on a 4-point scale
Six behavioral state categories are outlined in the NBAS: deep sleep,
Similar to TIMING MATTERS: HOW TO THINK ABOUT THE EFFECTS OF EARLY EXPERIENCE ON BRAIN AND BEHAVIORAL DEVELOPMENT by Dr. NATHAN A. FOX, UNIVERSITY OF MARYLAND (20)
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
TIMING MATTERS: HOW TO THINK ABOUT THE EFFECTS OF EARLY EXPERIENCE ON BRAIN AND BEHAVIORAL DEVELOPMENT by Dr. NATHAN A. FOX, UNIVERSITY OF MARYLAND
1. TIMING MATTERS: HOW TO THINK ABOUT THE EFFECTS OF EARLY EXPERIENCE ON BRAIN AND BEHAVIORAL DEVELOPMENT
NATHAN A. FOX
UNIVERSITY OF MARYLAND
NIPPON FOUNDATION
INTERNATIONAL SOCIETY FOR THE PREVENTION OF CHILD ABUSE AND NEGLECT CONFERENCE
NAGOYA, JAPAN
SEPTEMBER 14-17, 2014
WHITEW
2. OUTLINE OF TALK
Principles of brain and behavioral development
Sensitive periods
Using the Bucharest Early Intervention Project to illustrate these principles
Implications for policy
3. 3
Brains are built over time,
starting in the earliest years
of life. Simple skills come
first; more complex skills
build on top of them.
Brain Architecture Supports Lifelong Learning, Behavior, and Health
Cognitive, emotional, and
social capabilities are
inextricably intertwined throughout the life course.
A strong foundation in the early years improves the odds for positive outcomes and a weak foundation increases the odds of later difficulties.
4. The Ability to Change Brains
Decreases Over Time
Source: Levitt (2009)
Birth
10
20
30
Physiological “Effort”Required to Enhance Neural Connections
Normal Brain Plasticity Influenced by Experience
Age (Years)
40
50
60
70
5. Neural Circuits are Wired in a
Bottom-Up Sequence
FIRST YEAR
-8-7-6-5-4-3-2-1123456789101112345678910111213141516171819
Birth
(Months)
(Years)
Sensory Pathways
(Vision, Hearing)
Language
Higher Cognitive Function
Source: C.A. Nelson (2000)
6. birth 6 years 14 yearsExperience Shapes Brain Architecture by Over-Production Followed by Pruning(700 synapses formed per second in the early years)
8. 8
Young children naturally reach out for interaction through babbling, facial expressions, and gestures, and adults respond in kind.
Serve & Return Builds Brains and Skills
These “serve and return" interactions are essential for the development of healthy brain circuits.
Therefore, systems that support the quality of relationships in early care settings, communities, and homes also support the development of sturdy brain architecture.
9. SENSITIVE PERIODS
Are limited time periods during which the effect of experience on the brain is particularly strong
Allow experience to instruct neural circuits to process information in an adaptive way
Provide information that is essential for normal development and may alter performance permanently
12. Hubel and Weisel: Classic studies on early experience and sensitive periods
Monocular deprivation in early infancy led to deficits in brain organization in visual cortex
13. Effects of unilateral and bilateral deprivation of patterned vision (Lewis & Maurer, 2005)
Studies of infants born with bilateral cataracts—timing of surgical removal
Daphne Maurer
14. Early experience establishes the neural substrate for capabilities that emerge at a much later point in development
14 years later children whose cataracts were removed late in infancy were deficient in face processing
Sleeper effects as a function of sensitive period input
15. Janet Werker
Effects of experience on perception of language (Werker & Tees, 2005)
The timing and nature of experience with language affects perception of different languages
Before 9-10 months of age, infants can discriminate the sounds of all languages. By the end of the first year of life, they are only able to discriminate the language(s) they hear in their environment
16. Werker & Tees (2005)
Multiple sensitive periods across development for different domains
Most probably there are different sensitive periods for different skills across the first years of life
17. Sensitive Periods for Integration of Auditory and Visual Information
Eric Knudsen studies Barn Owls manipulating their early visual or auditory experience identifying sensitive periods for these inputs
18. People blind from birth hear language in their visual cortex
A sensitive period for language in the visual cortex: Distinct patterns of plasticity in congenitally versus late blind adults
Marina Bedny
19. (Hensch, 2005)
Can we reopen sensitive periods in the visual system?
The answer appears to be yes!!
Takao Hensch
20. GENERAL CONCLUSIONS ABOUT SENSITIVE PERIODS
Collectively, in most cases sensory/perceptual development proceed normally if such systems are “set”correctly during a sensitive period of development—(e.g. Hubel and Wiesel)
There is also evidence for sensitive periods in specific domains of language and perception
The human brain “expects” certain types of input at particular times in development.
It is not clear what aspects of cognitive or social and emotional development require experience at particular (e.g., sensitive) points in time. Inferences drawn from intervention studies suggest some advantage to early experience.
21. The Bucharest Early Intervention Project seeks to:
•Examine the effects of psychosocial deprivation on brain and behavioral development of young children
•Determine if these effects can be remediated through intervention, in this case: foster care
•Examine the issue of timing of intervention or duration of deprivation and its effects on brain and behavior with an eye towards identifying sensitive periods in cognitive and social development
23. CEAUSESCU’S LEGACY TO ROMANIA
Communist Policy:1966 decree
•Raise production by increasing population
•Establishment of the MENSTRUAL POLICE -state gynecologists who conducted monthly checks of women of childbearing age who had not borne at least 5 children
•Establishment of CELIBACY TAX - families received a stipend for having more than 2 children; were levied tax for having fewer than 5 children
•OUTLAWED all contraception and abortion
24. •Child abandonment became a national disaster, as families could not afford to keep their children, and were encouraged to turn them over to the state. This destroyed the family unit and led to thousands of children being raised in institutions.
THE RESULTS OF CEAUSESCU’S 1966 POLICY
25. •Poverty #1 reason for child abandonment
•International media brought the plight of these children to the attention of the world
•Large numbers of children adopted internationally, often by Western families unprepared for challenges that lay ahead
•And then, Romania banned international adoption
1989: The fall of the Ceausescu regimeThe aftermath….
100,000 children “warehoused”in state institutions
29. 1
2
6
3
4
5
Institutional Group
FCG
n=68
NIG
n=72
CAUG
n=68
After baseline assessment (pre-group assignment), comprehensive
follow up performed at 30, 42, 54 months, 8 and 12 years
BEIP Study design
30. DOMAINS OF ASSESSMENT IN BEIP
•Physical Development
•Language•Cognition•Language•Brain Function
•Emotional reactivity
•Caregiving Environment•Attachment
•Social competence
•Mental Health Problems
•Genetics
*Data derived from measures listed in boldand underlined
will be discussed in this talk
32. BEIP FOSTER CARE
Goal was to have foster care that was:
•Effective
•Affordable
•Replicable
•Culturally sensitive
•Informed by latest clinical and research findings
33. THE FOSTER CARE TEAM –BEIP
Comprised 3 social workers
Match families and children
Preparation of applications for foster care
Appearances before the Commission
Supervision of visits with biological family
Management of challenging child behavior
Permanency planning
34. –BUCHARESTSUPPORT SERVICES TO FOSTER PARENTS
Caseload of 18-20 families
Visits to foster parents every 10 –15 days
•Intensive phone contact
•Inquiry regarding child behavior/adjustment
Foster Parent Support Group
•Education/Support
Supplies
•Cribs, car seats, diapers, clothing
35. GENERAL HYPOTHESES OF THE BEIP STUDY
•Institutional rearing will have profound effects upon children’s socio-emotional development
•Removing children from the institution and placing them in family environments will remediate some of these deficits.
•The age or timing of placement into foster care will be a significant factor explaining intervention effects (thought this may vary by domain)
38. IQ Scores of Foster Care and Institutionalized Groups at Follow-up
Nelson et al (2007)
39. How does IQ differ for children in foster care as a function of age of placement?
Age at placement
70
75
80
85
90
95
0-18
18-24
24-30
30+
DQ/IQ
N
0-18 14
18-24 16
24-30 22
30+ 9
*
Nelson, et al (2007)
40. CHANGE IN GROUP ASSIGNMENT OVER TIME/SUBJECT ATTRITION (AS OF 96 MONTHS)
Randomized (n=136)
Assessed for Eligibility (n=187)
Excluded (n=51)
Allocated to Foster Care (n=68)
Allocated to Care as Usual (n=68)
Placement at 96 months (n=60)
-31 MacArthur Foster Care
-7 adopted
-8 Government Foster Care
-12 Returned to Bio Family
-2 Social Apartments
Discontinued Participation (n=8)
Placement at 96 months (n=56)
-15 Institutional Care
-4 adopted
-18 Government Foster Care
-18 Returned to Bio Family
-1 Family Placement
Discontinued Participation (n=12)
Analyzed (n=53)
Excluded from analysis (n=7)
-WISC data not available
Analyzed (n=50)
Excluded from analysis (n=6)
-WISC data not available
Participation
Analysis
Allocation
Enrollment
41. WISC DATA AT 96 MONTHS OF AGE
70
72
74
76
78
80
82
84
86
88
90
Verbal Perceptual Working
Memory
Processing
Speed
Full Scale
IQ
CAU (n=41)
FCG (n=48)
*
Note: *p = .05
Fox et al (2011) JCPP
42. COMPARING CURRENT PLACEMENT IN INSTITUTIONS,
GOVERNMENT FOSTER CARE AND MACARTHUR FOSTER CARE
0
20
40
60
80
100
V PR WM PS FSIQ
Institution (n=12)
Gov't FC (n=23)
Mac FC (n=28)
Note: V = Verbal Comprehension, P = Perceptual, WM = Working Memory, PS = Processing Speed,
FSIQ = Full Scale IQ; *p < .05, **p < .01.
*
*
** *
Fox et al (2011) JCPP
43. 0
20
40
60
80
100
120
VCI
PRI
WMI
PSI
Full IQ
CAUG
FCG
12-YEAR IQ COMPOSITESBY GROUP
*
**
* p<.05, **p<.01
44. INTERIM SUMMARY: IQ
Young children living in institutions show significant delays in IQ
Removal from institutions, particularly prior to 24 months of age, and placement into families remediates IQ deficits
Stability of family placement over age is an important factor in IQ outcomes
Remarkably, 10 years after the intervention began there are still positive effects on IQ
47. UTTERANCE LENGTH (42 MONTHS)
0
2
4
6
8
10
IG
FCG>24
FCG<24
NIG
Mean length of utterance
words
morphemes
48. -2
-1.5
-1
-0.5
0
z score
Reading (8years)
(Single word identification)
IG (N=47)
FCG>24 (N=31)
FCG<24 (N=24)
This figure includes all children, assigning a zero score to (mainly IG) children who could not read.
49. INTERIM SUMMARY: LANGUAGE
Young children living in institutions have significant delays in expression and receptive language
Removal from institutions, particularly before 24 months of age, is associated with remediation of language
These effects continue through age 8.
51. INSTITUTIONALIZATION & BRAIN ACTIVITY
Institution
Community
Proportion
0.58
0.46
Theta, 3-5 Hz
McLaughlin et al, 2010, Biological Psychiatry
Marshall, Fox, and BEIP (2007)
52. INSTITUTIONALIZATION & BRAIN ACTIVITY
Institution
Community
Alpha, 6-9 Hz
McLaughlin et al, 2010, Biological Psychiatry
Proportion
0.58
0.46
Marshall, Fox & BEIP group (2007)
53. 2.44μV2
3.80μV2
Brain Activity (EEG) Changes as a function of intervention and timing
(8 years of age)
CAUG
FCG > 24
NIG
FCG < 24
Vanderwert et al (2010)
54. BRAINEFFECTS OF EARLY PSYCHOSOCIAL DEPRIVATION
Initial reports on post institutionalizedchildren reported reduced metabolic activity in temporal and frontal cortex;
In one study Tottenham et al. show enlarged amygdala volumes, whereas Hanson/Pollak et al. show smaller amygdala volume. In both cases, however, must keep in mind potential for sample bias.
56. STRUCTURAL MRI
Performed in Bucharest on 1.5T Siemens machine
DTI also obtained on 80% of the children
57. STRUCTURAL MRI
•FreeSurferused to automatically detect grey/white matter borders and identify:
–Total grey matter
–Total white matter
–Hippocampus
–Amygdala
–Basal ganglia : caudate, putamen, globuspallidus, nucleus accumbens
–Corpus callosum andsubdivisions
–Thalamus
Sheridan et al, (2012) PNAS
58. TOTAL CORTICAL GREY MATTER
*
IG B= -39.9, t= -3.01, p= .004
FCG B= -38.5, t= -2.79, p= .007
Regression controlling for age and gender
*
Sheridan et al (2012), PNAS
59. TOTAL CORTICAL WHITE MATTER
*
IG B= -24.1, t= -2.17, p= .03
FCG B= -18.1, t= -1.5, p= .12
Regression controlling for age and gender
n.s.
Sheridan et al (2012), PNAS)
60. a
+
t = 1.8, p = .06
b
*
t = 2.9, p = .005
d
+
t = 1.9, p=.06
e
n.s.
t = 1.4, p = 15
c
+
t = 1.9, p = .06
Regression Analysis: Group, Age, Gender
62. MRISUMMARY
Dramatic reduction in grey and white matter among ever institutionalized children
No intervention effect for grey matter
Possible (modest) intervention effect for white matter
63.
64. STRUCTURE AND FUNCTION
•Associations between institutionalization and reductions in alpha power are fully mediated by white matter integrity
•White matter variation in typical adults accounts for individual differences in EEG alpha power1
•Damage to white matter results in decreases in EEG alpha power2
1. Valdés-Hernández et al., 2010; 2. Claudio Babiloni et al., 2006
66. INCIDENCE OF MENTAL HEALTH PROBLEMS
The caregiver was administered the Romanian version of the Preschool Age Psychiatric Assessment (Romanian PAPA) when the children in the BEIP were 54 months old
The PAPA is a comprehensive structured psychiatric interview assessing mental health symptoms and disorders in children ages 2 through 5 years old
67. PREVALENCE OF ADHD IN THE BEIP STUDY
0
5
10
15
20
25
Institution
Foster Care
Community
Prevalence of ADHD
(Zeanah et al 2009)
68. Intervention Effects on Internalizing Disorders
*
0
10
20
30
40
50
60
CAU
FC
CAU
FC
Girls
Boys
Prevalence of Internalizing Disorders
WHITEW
WHITEW
69. SUMMARY OF FINDINGS ON PSYCHIATRIC DISORDERS
In general, children raised in institutions display greater internalizing and externalizing disorders compared to community controls.
But children removed from institutions and placed into foster care homes display significantly less internalizing problems compared to those randomized to remain in the institution.
•This was particularly true for girls
There was no intervention effect for externalizing problems— specifically ADHD
70. INTERIM SUMMARY
Early exposure to severe psychosocial deprivation is associated with higher slow wave and lower high frequency EEG activity and heightened internalizing and externalizing problems
Foster care intervention (particularly if it occurs early in life) remediates this pattern of EEG activity and internalizing problems. It does not remediate externalizing problems— specifically ADHD
EEG activity early in life is associated with lower internalizing problems and mediates the relation between early experience and later problems with ADHD
73. BEIP: SSP CLASSIFICATIONS
Community
•76.7% secure
•3.6% avoidant
•0.0% resistant
•19.7% disorganized
•0.0% unclassifiable
Institution
•16.8% secure
•4.7% avoidant
•0.0% resistant
•65.4% disorganized
•13.1% unclassifiable
Zeanah, et al 2005
74. CONTINUUM OF ATTACHMENT
5 --ABCD patterns of attachment
4 --Patterns of attachment with behavioral anomalies
3 --Clear preference but passive
2 --Preference discernible
1 --No attachment behaviors evident
75. DEGREE TO WHICH CHILDREN LIVING IN INSTITUTIONS HAVE
FORMED ATTACHMENTS TO THEIR CAREGIVERS
Romanian
Community
Romanian
Institution
1=No attachment
0%
9.5%
2=Some
differentiation
0%
25.3%
3=Some preference
0%
30.5%
4=Attachment with
anomalies
0%
31.6%
5=Clearly recognizable
attachment patterns
100%
3.2%
Zeanah et al (2005)
79. SUMMARY OF SSP FINDINGS
Large differences at baseline IG vs. NIG
•Security
•Organization
•Large intervention effects, but incomplete recovery
Timing effects on security and organization
•More children secure if placed before 22-24 months
•More children organized earlier they were placed
80. STRANGER AT THE DOOR
Caregiver/mother and child answer door (pre-arranged).
RA: “Come with me, I have something to show you.”
Walk out the door and around the corner to find RA from previous home visit.
82. EFFECTS ON TIMING OF PLACEMENT ON INDISCRIMINATE BEHAVIOR
Children placed into families before 24 months of age showed absence of indiscriminate behavior across follow-up
83. DOMAINS WITH SENSITIVE PERIOD
IQ
Attachment
EEG power
Social skills (teacher report)
Indiscriminate behavior
DOMAINS WITH NO SENSITIVE PERIOD (BUT INTERVENTION EFFECTS)
Psychiatric outcomes (anxiety)
Positive emotional reactivity
Peer social competence
84. DOMAINS SEEMINGLY UNAFFECTED BY EARLY ADVERSITY
Face processing
Emotion recognition
Face recognition
DOMAINS UNAFFECTED BY INTERVENTION
Externalizing problems
Executive function
85. SENSITIVE PERIODS AND BEIP
Both language and EEG activity show sensitive periods in development
Cognition (IQ) does not but does show an intervention effect even 10 years after the start of the intervention.
Early experience affects different domains and intervention has differential effects depending on timing
86. OVERALLCONCLUSIONS
Children raised in institutions during early development demonstrate significantly impaired physical, cognitive, language, social-emotional, and brain development compared to community children.
•Here we demonstrate specific cognitive deficits and neural neural compromises that may be associated with these deficits
Insofar as we have been able to look at our data, our model of foster care as an intervention appears to effectively ameliorate many of the negative sequelae of institutionalization…
Although not all…for example, we are seeing only small effects on executive functions….and only at 12 years of age
Some aspects of brain development (i.e. certain white matter tracts) are remediated in children placed into foster care, whereas others are not (i.e. total gray matter, certain white matter tracts)
87. IMPLICATIONS FOR POLICY
Brains develop as a function of expected environmental experience
In the absence of expected experience brain and behavioral develop are derailed
Children living in conditions of neglect are likely to suffer from the absence of stimulation (warm, responsive, contingent interaction)
Removing children from conditions of neglect (and the earlier the better) is good for their brain development and good for their behavioral development
88. INVESTIGATIVE TEAM
Principal Investigators
Charles Zeanah, MD, Tulane University
Nathan A. Fox, Ph.D., University of Maryland
Charles A. Nelson, Ph.D., Harvard Medical School/Children’s Hospital Boston
Funding:
•John D. and Catherine T. Macarthur Foundation
•NIMH MH091363-01