scholarly journals Grow Smart: An Integrated Nutrition and Early Child Development Intervention Among Infants Improves Expressive Language and Reduces Anemia and Iron Deficiency in Rural India (FS08-03-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kristen Hurley ◽  
Sylvia Fernandez-Rao ◽  
K Madhavan Nair ◽  
Nangalla Balakrishna ◽  
Kankipati Radhakrishna ◽  
...  
Keyword(s):  
Child Development ◽  
Repeated Measures ◽  
Expressive Language ◽  
Early Learning ◽  
Emotional Behavior ◽  
Rural India ◽  
York Academy ◽  
Developmental Potential ◽  
Visual Reception ◽  
Main Effects

Abstract Objectives Nutritional deficiency and lack of early learning opportunities contribute to the loss of developmental potential. The objective is to evaluate the effects of an integrated nutrition and early learning intervention (ELI) on micronutrient status and the development of infants in rural India. Methods 513 infants (6–12mo) were enrolled from 26 villages in rural India and randomized using a 2 × 2 design to receive multiple micronutrient powders (MNP containing iron, zinc, vitamins A, B2, B12, C and folic acid) vs. placebo (B2) and EL vs. control. The ELI was based on the UNICEF-developed Care for Child Development. Baseline (BL), post-intervention (6 mo) and follow-up (12 mo) evaluations included Mullens Scales of Early Learning, anthropometry, and 2 ml venous blood (BL & 12 mo). Data were analyzed using linear mixed effects regression models with random village/subject intercepts accounting for site of recruitment and repeated measures. For biomarker outcomes, main effects of MNP was assessed. P-values of <0.05 considered statistically significant. For child development outcomes, main effects of MNP and ELI were analyzed separately, and three-way interactions (MNP*ELI*midline or MNP*ELI*end line) were tested. Results At baseline, the mean age of mothers was 22.9y (SD = 2.9) and 99.6% were married. Most mothers (84.2%) had attended some schooling. Mean infant age was 8.6 mo (SD = 2.2); 53.0% were male. Anemia prevalence was 66.4%. No significant baseline differences were found. At end line, infants in the MNP group had significantly higher hemoglobin (11 g/dl vs.10 g/dl) and ferritin (18.2ug/l vs.11.5 ug/l) values compared to infants in the placebo groups, respectively. Infants in the MNP group (mean = 39.5; SE = 0.6) versus placebo group (mean = 37.7; SE = 0.6) also scored significantly higher in expressive language and marginally higher in visual reception (mean = 42.5; SE = 0.5; P = 0.06) and social-emotional behavior (mean = 24.1; SE = 0.2; P = 0.052), compared to the placebo (mean = 41.1; E = 0.6, mean = 23.5; SE = 0.2, respectively). Significant interactions in visual reception and expressive language performance showed that children who received either or both interventions had better scores than children who received neither. Conclusions Home MNP and EL interventions can improve infant MN status and development. Funding Sources Mathile Institute for the Advancement of Human Nutrition, Nutrition International, Sackler Institute for Nutrition Science of the New York Academy of Science.

scholarly journals Beyond Stunting: Mechanisms Linking Length to Early Child Development Among Infants in Rural India (P10-003-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Maureen Black ◽  
Doris Yimgang ◽  
Kristen Hurley ◽  
Kimberly Harding ◽  
Silvia Fernandez-Rao ◽  
...  
Keyword(s):  
Child Development ◽  
Maternal Education ◽  
Expressive Language ◽  
Receptive Language ◽  
Rural India ◽  
Fine Motor ◽  
Early Child Development ◽  
Blood Draw ◽  
Early Child ◽  
Visual Reception

Abstract Objectives In low and middle-income countries, early child development (ECD) is associated with stunting, but the association with length-for-age z-scores (LAZ) is understudied. The objective is to examine whether the association with ECD among infants extends beyond stunting to LAZ and whether it is altered by nurturance or inflammation. Methods Sample: 513 infants (mean age 8.6 months, SD 2.2), 20% stunted (LAZ < -2) participated in a randomized controlled trial of micronutrient powder (MNP) in rural India. Following baseline, infants were re-evaluated at 6- and 12-months. LAZ was calculated from measured length, inflammation (C-reactive protein, CRP) from blood draw; nurturance from home observation (HOME Inventory), and ECD from Mullens Early Learning Scale (visual reception, fine/gross motor and receptive/expressive language). Linear mixed effects models were conducted, accounting for repeated measures and clustering, adjusted for child age, anemia, maternal education, household assets, and intervention. LAZ interactions with CRP and HOME scores were tested. Results LAZ was significantly positively associated with all ECD domains over time. HOME was positively associated with visual reception and expressive language (Table 1). HOME interactions were marginal for fine motor (P = 0.058) and significant for receptive language (P = 0.015). For HOME scores < -1 SD, LAZ was positively related to fine motor and receptive language, for HOME scores >1 SD, LAZ was not related to ECD (Figure 1). CRP was not related to ECD and CRP interaction was not significant. Conclusions The positive association between LAZ and ECD illustrates vulnerability prior to the threshold of stunting. Maternal nurturance is positively associated with multiple domains of infants’ ECD and attenuates relations between LAZ and receptive language and fine motor. Inflammation (measured by CRP) is not associated with ECD. Linear growth within normal and nurturant caregiving are needed to promote ECD. Funding Sources Mathile Institute for the Advancement of Human Nutrition, Nutrition International, Sackler Institute for Nutrition Science of the New York Academy of Sciences.

scholarly journals Mullen Scales of Early Learning Adaptation for Assessment of Indian Children and Application to Tuberculous Meningitis

2020 ◽  
Author(s):  
Smita Nimkar ◽  
Suvarna Joshi ◽  
Aarti Kinikar ◽  
Chhaya Valvi ◽  
D Bella Devaleenal ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
Expressive Language ◽  
Early Learning ◽  
Receptive Language ◽  
Cultural Bias ◽  
Fine Motor ◽  
Indian Children ◽  
Language And Culture ◽  
Culturally Adapted ◽  
Visual Reception

Abstract Introduction Tuberculous meningitis (TBM) results in significant morbidity and mortality among children worldwide. Associated neurocognitive complications are common but not well characterized. The Mullen Scales of Early Learning (MSEL), a well-established measure for assessment of neurodevelopment, has not yet been adapted for use in India. This study’s goal was to adapt the MSEL for local language and culture to assess neurocognition among children in India, and apply the adapted measure for assessment of children with TBM. Methods Administration of MSEL domains was culturally adapted. Robust translation procedures for instructions took place for three local languages: Marathi, Hindi and Tamil. Multilingual staff compared instructions against the original version for accuracy. The MSEL stimuli and instructions were reviewed by psychologists and pediatricians in India to identify items concerning for cultural bias. Results MSEL stimuli unfamiliar to children in this setting were identified and modified within Visual Reception, Fine-Motor, Receptive Language and Expressive Language Scales. Item category was maintained for adaptations of items visually or linguistically different from those observed in daily life. Adjusted items were administered to six typically developing children to determine modification utility. Two children diagnosed with confirmed TBM (ages 11 and 29 months) were evaluated with the adapted MSEL before receiving study medications. Skills were below age-expectation across visual reception, fine motor and expressive language domains. Conclusions This is the first study to assess children with TBM using the MSEL adapted for use in India. Future studies in larger groups of Indian children are warranted to validate the adapted measure.

Child Development: The Next Global Health Frontier

2018 ◽  
pp. 219-252
Author(s):  
Mei Elansary ◽  
Elizabeth Peacock-Chambers ◽  
Barry S. Zuckerman
Keyword(s):  
Early Childhood ◽  
Child Development ◽  
Child Health ◽  
Social Factors ◽  
Cultural Context ◽  
Early Childhood Development ◽  
Early Learning ◽  
Childhood Development ◽  
Developmental Potential ◽  
Use Of Technology

Recent improvements in child health have led to substantial decreases in child mortality globally.1 While progress is still needed, especially in regions afflicted by conflict and political instability,2 the next step is to promote young children’s development and early learning so they can remain healthy, take advantage of growing educational opportunities, and contribute to their communities’ economic growth. Every year, approximately 249 million children, mainly from low- and middle- income countries, fail to reach their developmental potential in the context of poverty and related health, nutrition, and social factors.3 Recessions and climate change additionally contribute to loss of developmental potential globally.4–7 While principles of early childhood development are universal, a global perspective must consider exposure to extreme poverty and high prevalence of infectious diseases, cultural context, and availability and type of resources. This chapter will describe biological and social factors that influence brain development and early learning and resilience, their cultural context, and examples of successful child development interventions globally. We also provide recommendations to rapidly accelerate the promotion of early childhood development globally with key strategies, including an emphasis on universal prevention programs rather than universal screening, multigenerational models that emphasize universal support for parents and targeted support for high-risk populations, integration of child development programs into child health and nutrition efforts, and use of technology.

The Concurrent Validity of the Minnesota Child Development Inventory as a Measure of Young Children's Language Development

1989 ◽  
Vol 54 (1) ◽  
pp. 101-105 ◽  
Author(s):  
J. Bruce Tomblin ◽  
Cynthia M. Shonrock ◽  
James C. Hardy
Keyword(s):  
Child Development ◽  
Language Development ◽  
Expressive Language ◽  
Strong Predictor ◽  
Receptive Language ◽  
Strongly Correlated ◽  
Language Measure ◽  
The Mean ◽  
Child Development Inventory ◽  
Mean Length Of Utterance

The extent to which the Minnesota Child Development Inventory (MCDI), could be used to estimate levels of language development in 2-year-old children was examined. Fifty-seven children between 23 and 28 months were given the Sequenced Inventory of Communication Development (SICD), and at the same time a parent completed the MCDI. In addition the mean length of utterance (MLU) was obtained for each child from a spontaneous speech sample. The MCDI Expressive Language scale was found to be a strong predictor of both the SICD Expressive scale and MLU. The MCDI Comprehension-Conceptual scale, presumably a receptive language measure, was moderately correlated with the SICD Receptive scale; however, it was also strongly correlated with the expressive measures. These results demonstrated that the Expressive Language scale of the MCDI was a valid predictor of expressive language for 2-year-old children. The MCDI Comprehension-Conceptual scale appeared to assess both receptive and expressive language, thus complicating its interpretation.

scholarly journals Forefoot Striking Is More Effective in Reducing Loadrates than Increasing Cadence in Runners

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0005
Author(s):  
Erin Futrell ◽  
Irene Davis
Keyword(s):  
Repeated Measures ◽  
Auditory Signal ◽  
Gait Retraining ◽  
Loading Rates ◽  
Impact Forces ◽  
Running Injuries ◽  
Main Effects ◽  
Wireless Accelerometer ◽  
One Way Anova ◽  
Vertical Impact

Category: Sports Introduction/Purpose: Vertical impact forces are highly influenced by the way the foot contacts the ground. These impact forces are associated with high loading rates which have been related to running injuries. As a result, clinicians have begun to use gait retraining interventions to reduce loadrates and prevent future impact-related injuries. Two types of gait retraining techniques have been promoted to reduce excessive running impacts. The first involves increasing cadence (CAD), or number of steps per minute, by 5-10%, thereby reducing stride length. The second type of gait retraining involves landing on the ball of the foot at ground contact, or using a forefoot strike (FFS). Both of these gait-retraining styles have been reported to reduce impacts, but they have not been compared with each other. Methods: 33 healthy runners (9M, 24F), running 5-15 mpw, with a rearfoot strike pattern with cadence < 170 steps/min were recruited. Subjects were randomly allocated to either FFS or CAD retraining. All subjects underwent an 8-session gait retraining program (over 2-3 wks) with auditory feedback on a treadmill. The CAD group ran to a digital metronome to increase cadence by 7.5%. The FFS group wore a wireless accelerometer that provided an auditory signal on footstrike pattern. A gait analysis was conducted at baseline, 1 wk, 1 month, and 6 months. Variables included vertical average and instantaneous load rates (VALR, VILR). A 2 x 4 repeated measures ANOVA was used to compare differences within and between the CAD and FFS groups at baseline, 1 week, 1 month and 6 months post retraining. For variables with significant interactions, simple main effects of group, as well as time were further explored using one-way ANOVA Results: There were significant interaction effects of time*group for VALR (p= 0.001), VILR (p=0.001) and foot angle (p< 0.001), but not cadence. For the simple main effects for the CAD group, VALR reduced by 14%, 7% and 16% at 1 week, 1 month, and 6 months post gait retraining respectively, compared with baseline (Figure 1). However, these reductions were not significant. For the FFS group, VALR was significantly reduced by 50%, 51% and 51% at 1 week, 1 month, and 6 months post gait retraining respectively. Interestingly, both the CAD and FFS groups increased cadence by similar amounts. Conclusion: Transitioning to a FFS pattern is significantly more effective than increasing CAD when reducing vertical loadrate (both VALR and VILR) is the goal. These changes persisted out to 6 months post gait retraining, suggesting permanence of the new pattern.

scholarly journals Supporting Child Development Through Parenting Interventions in Low- to Middle-Income Countries: An Updated Systematic Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Linlin Zhang ◽  
Derrick Ssewanyana ◽  
Marie-Claude Martin ◽  
Stephen Lye ◽  
Greg Moran ◽  
...  
Keyword(s):  
Child Development ◽  
Learning Opportunities ◽  
Population Characteristics ◽  
Effect Sizes ◽  
Parenting Interventions ◽  
Social Emotional ◽  
Middle Income ◽  
Developmental Potential ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: Over 250 million children in low- and middle-income countries are at risk of not achieving their fullest developmental potential due to co-occurring risks such as poor nutrition and inadequate learning opportunities. Early intervention programs integrating the aspects of nurturing care, that is, good health, adequate nutrition, safety and security, responsive caregiving, and learning opportunities, may ameliorate against the negative impact of these adverse conditions.Methods: This meta-analytic review updates the evidence base of parenting interventions comprising stimulation and responsive caregiving components on developmental outcomes for children under age 2 years in low- and middle-income countries. It also describes and assesses the moderation effects of population characteristics and implementation features on the intervention effectiveness. Studies were identified based on previous systematic reviews and an updated literature search in eight databases and the gray literature up to December 2020. A random-effect model was used to explore the pooled effect sizes accounted for by the intervention for developmental outcome of cognition, language, motor, and social-emotional capacities. Exploratory moderation analyses were also conducted.Results: Twenty-one randomized controlled trials representing over 10,400 children from 12 low- and middle-income countries and regions across three continents (Africa, Latin America, and Asia) were identified. The interventions showed overall small-to-moderate effects on children's cognitive development (ES = 0.44; 95% CI = [0.30, 0.57]); language development (ES = 0.33; 95% CI = [0.18, 0.49]); and motor skills (ES = 0.21; 95% CI = [0.10, 0.32]). The overall effect on social-emotional development was non-significant (ES = 0.17; 95% CI = [−0.01, 0.34]). Effect sizes (ES) varied significantly across the studies. Parenting programs that targeted vulnerable groups, including rural communities and caregivers with lower education levels, had more significant effects on children's development. Group sessions (vs. individual visits) and high program dose (≥12 sessions) were also associated with stronger effects on child development. Further research is needed to determine the effectiveness of the workforce and training on programmatic outcomes.Conclusion: The findings indicate that parenting interventions that encourage nurturing care are effective in improving the early development of children, especially among vulnerable populations. We discuss opportunities to strengthen the implementation of research-based parenting interventions in such contexts.

Transdermal delivery of carnosine into equine skeletal muscle

2021 ◽  
pp. 1-6
Author(s):  
B.P. Dieter ◽  
C.J. Macias ◽  
T.J. Sharpe ◽  
B. Roberts ◽  
M. Wille ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Transdermal Delivery ◽  
Repeated Measures ◽  
Muscle Metabolism ◽  
Enzyme Linked Immunosorbent Assay ◽  
Time To Exhaustion ◽  
Thoroughbred Racehorses ◽  
Repeated Measures Analysis ◽  
Main Effect ◽  
Main Effects

The dipeptide carnosine consists of β-alanine and L-histidine. It plays a major role in skeletal muscle metabolism, especially as an intracellular buffer and antioxidant. Increasing intramuscular carnosine has been shown to improve recovery from exercise and increase anaerobic threshold and time-to-exhaustion. Dietary supplementation with carnosine does not effectively increase intramuscular carnosine due to the presence of carnosinase in the blood. However, an effective transdermal delivery process could expediently increase intramuscular concentrations of carnosine. This study’s objective was to examine the efficacy of a transdermal system for delivering carnosine into the skeletal muscle of horses, using a randomised, placebo controlled, crossover study. Carnosine plus a proprietary transdermal delivery agent or the agent alone (placebo) were applied to the middle gluteal muscles of 10 Thoroughbred racehorses, and muscle biopsies were taken before and 30, 60, and 120 min after application. Muscle carnosine concentration was measured using an enzyme-linked immunosorbent assay. A two-way repeated measures analysis of variance was used to test for the main effects of time and treatment (placebo or carnosine) as well as an interaction between time and treatment. Independent F-tests examined the change in intramuscular carnosine levels from baseline to each time point (30, 60, and 120 min). There was a significant main effect of treatment (P=0.004), no significant main effect for time (P=0.18), and a non-significant interaction of treatment with time (P=0.08). Mean intramuscular carnosine concentrations increased from baseline to 120 min. Compared to concentrations following placebo application, carnosine was greater by ~35% at 30 min (P=0.002) and ~46% after 60 min (P=0.044), but not at 120 min (P=0.20). The results indicated that intramuscular carnosine can be increased using a transdermal delivery system within 60 min of application which could have important implications for the health of horses, and their capacity to perform and recover from physical activity.

scholarly journals Effects of Pitch and Rhythm Priming Tasks on Accuracy and Fluency During Sight-Reading

2019 ◽  
Vol 67 (3) ◽  
pp. 252-269
Author(s):  
Christine R. Russell
Keyword(s):  
Repeated Measures ◽  
Sight Reading ◽  
Exposure Condition ◽  
Pitch Accuracy ◽  
Wind Instrumentalists ◽  
Repeated Measures Design ◽  
Priming Condition ◽  
Main Effect ◽  
Main Effects ◽  
Performance Scale

The purpose of this study was to investigate the effects of pitch and rhythm priming tasks on sight-reading accuracy and fluency. High school wind instrumentalists ( N = 182) were assigned to one of four experimental groups: pre-/posttest rhythm, pre-/posttest pitch, posttest-only rhythm, or posttest-only pitch. Participants sight-read selected stimulus exercises from the Watkins-Farnum Performance Scale and completed two priming treatments and a control condition as part of a repeated-measures design. A three-way repeated-measures MANOVA, with rhythm accuracy, pitch accuracy, and fluency accuracy as dependent measures, revealed a significant main effect due to priming condition. Rhythm accuracy scores were significantly lower after both perceptual and conceptual priming than after a control condition. No significant differences in pitch accuracy or fluency existed based on priming condition. No significant differences were found in rhythm, pitch, or fluency accuracy based on treatment condition (pitch or rhythm) or exposure condition (pre-/posttest or post only). Two-way repeated-measures MANOVAs revealed significant main effects based on time. Pitch accuracy and fluency each significantly improved between pre- and posttest and from the first to third study tasks. Results suggest that performing rhythm alone or pitch alone requires different cognitive processes than does performing both together.

scholarly journals Time Course and Magnitude of Tolerance to the Ergogenic Effect of Caffeine on the Second Ventilatory Threshold

Life ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 343
Author(s):  
Carlos Ruiz-Moreno ◽  
Beatriz Lara ◽  
Jorge Gutiérrez-Hellín ◽  
Jaime González-García ◽  
Juan Del Coso
Keyword(s):  
Heart Rate ◽  
Aerobic Exercise ◽  
Body Mass ◽  
Repeated Measures ◽  
Time Course ◽  
Ventilatory Threshold ◽  
Statistical Significance ◽  
Ergogenic Effect ◽  
Double Blind ◽  
Main Effects

Pre-exercise caffeine ingestion has been shown to increase the workload at ventilatory threshold, suggesting an ergogenic effect of this stimulant on submaximal aerobic exercise. However, the time course of tolerance to the effect of caffeine on ventilatory threshold is unknown. This study aimed to determine the evolution of tolerance to the ergogenic effect of caffeine on the ventilatory threshold. Methods: Eleven participants (age 32.3 ± 4.9 yrs, height 171 ± 8 cm, body mass 66.6 ± 13.6 kg, VO2max = 48.0 ± 3.8 mL/kg/min) took part in a longitudinal, double-blind, placebo-controlled, randomized, crossover experimental design. Each participant took part in two identical treatments: in one treatment, participants ingested a capsule containing 3 mg of caffeine per kg of body mass per day (mg/kg/day) for twenty consecutive days; in the other treatment, participants ingested a capsule filled with a placebo for the same duration and frequency. During these treatments, participants performed a maximal ramp test on a cycle ergometer three times per week and the second ventilatory threshold (VT2) was assessed by using the ventilatory equivalents for oxygen and carbon dioxide. Results: A two-way ANOVA with repeated measures (substance × time) revealed statistically significant main effects of caffeine (p < 0.01) and time (p = 0.04) on the wattage obtained at VT2, although there was no interaction (p = 0.09). In comparison to the placebo, caffeine increased the workload at VT2 on days 1, 4, 6 and 15 of ingestion (p < 0.05). The size of the ergogenic effect of caffeine over the placebo on the workload at VT2 was progressively reduced with the duration of the treatment. In addition, there were main effects of caffeine (p = 0.03) and time (p = 0.16) on VO2 obtained at VT2, with no interaction (p = 0.49). Specifically, caffeine increased oxygen uptake at VT2 on days 1 and 4 (p < 0.05), with no other caffeine–placebo differences afterwards. For heart rate obtained at VT2, there was a main effect of substance (p < 0.01), while the overall effect of time (p = 0.13) and the interaction (p = 0.22) did not reach statistical significance. Heart rate at VT2 was higher with caffeine than with the placebo on days 1 and 4 (p < 0.05). The size of the effect of caffeine on VO2 and heart at VT2 tended to decline over time. Conclusion: Pre-exercise intake of 3 mg/kg/day of caffeine for twenty days enhanced the wattage obtained at VT2 during cycling ramp tests for ~15 days of ingestion, while there was a progressive attenuation of the size of the ergogenic effect of caffeine on this performance variable. Therefore, habituation to caffeine through daily ingestion may reduce the ergogenic effect of this stimulant on aerobic exercise of submaximal intensity.

Sign in / Sign up

Export Citation Format

Share Document