Applicability of the Denver Prescreening Developmental Questionnaire in a Low-Income Population

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 359-363
Author(s):  
Michael S. Rosenbaum ◽  
Cristina Chua-Lim ◽  
Joan Wilhite ◽  
Vipul N. Mankad
Keyword(s):  
Educational Intervention ◽  
Low Income ◽  
Predominantly Black ◽  
Low Income Population ◽  
Agreement Score ◽  
A Prospective Study ◽  
Audiovisual Presentation ◽  
And Control ◽  
Parental Responses

A prospective study was conducted to assess the applicability of the Denver Prescreening Developmental Questionnaire (DPDQ) in a predominantly black, low-income population in Mobile, Alabama. The effect of an educational intervention designed to increase the accuracy of parental responses to the DPDQ was also assessed. In a longitudinal follow-up program, 127 infants aged 2 weeks to 1 year were recruited. Parents in a randomly selected experimental group observed an audiovisual presentation describing progressive developmental behaviors, received handout materials summarizing these behaviors, and were asked to record their child's subsequent attainment of these behaviors. Mean agreement scores, obtained by comparing parental responses to the DPDQ with the corresponding items of the Denver Developmental Screening Test (DDST), did not differ between the experimental and control groups. These scores showed agreement of 93.6% (3-month visit), 91.3% (6-month visit), 91.6% (9-month visit), and 95.1% (12-month visit), resulting in an overall mean agreement score of 92.9%. The overreferral rate was low (13%) and no underreferrals were obtained. These results attest to the applicability of the DPDQ in low-income population and demonstrate the lack of effectiveness of the educational intervention in increasing the accuracy of parental responses to the DPDQ.

Abstract P186: A Randomized Preschool Trial To Promote Cardiovascular Health In Colombia: 18 Month Follow Up.

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jaime Céspedes ◽  
German Briceño ◽  
Michael Farkouh ◽  
Rajesh Vedanthan ◽  
Martha Leal ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Cardiovascular Health ◽  
Controlled Trial ◽  
Intervention Group ◽  
Educational Programs ◽  
Control Group ◽  
Active Lifestyle ◽  
And Control ◽  
The Impact

Introduction: Educational programs for children can increase uptake of healthy lifestyle behaviors. However, the impact of educational programs in preschool-aged children in low- and middle-income countries is not known. We conducted a five month educational intervention in preschool facilities (PF) in Bogota, Colombia, to assess changes in preschooler’s knowledge, attitudes and habits (KAH) towards healthy eating and living an active lifestyle. Methods: We conducted a cluster, randomized, controlled trial, and randomly assigned 14 PF in Bogota to a five-month educational intervention (7 PF) or to usual curriculum (7 PF). The intervention included classroom activities and use of printed material and videos. A total of 1216 pre-school children, 928 parents, and 120 teachers participated. A structured survey was used to evaluate changes in KAH with a weighted total score (WTS). The primary outcome was change in children's WTS, and the secondary outcomes were change in parents’ and teachers' WTS. The control PF were provided the intervention after the initial evaluation. To assess sustainability, we evaluated both intervention and control groups at 18 months. Results: At 6 months, children in the intervention group showed 10.9% increase in WTS vs. 5.3% in controls, p<0.001, after adjustment for cluster, sex, age and teachers' educational level. Among parents, the equivalent results were 8.9% and 3.1%, respectively, p< 0.001, and among teachers 9.4% and 2.5%, p=0.06. At the 18-month extended follow-up, both the intervention and control children showed a significant further increase in WTS, p<0.001 (Figure 1). In parents and teachers in the intervened group, there was no significant increase in WTS, p=0.7417, and p=0.1197. In the control group, there was an increase in WTS in teachers but not in parents, p=0.001, and p=0.4239. Conclusion: A preschool based intervention, aimed at changing KAH related to healthy diet and active lifestyle, is feasible, efficacious and sustainable up to 18 months in very young children in Colombia.

The 7th French Airborne Forward Surgical Team experience of surgical support to the population of a low-income country: a prospective study on 341 patients with short-term follow-up

2018 ◽  
Vol 164 (6) ◽  
pp. 423-427 ◽  
Author(s):  
Yvain Goudard ◽  
C Butin ◽  
C Carfantan ◽  
G Pauleau ◽  
E Soucanye de Landevoisin ◽  
...  
Keyword(s):  
Low Income ◽  
Elective Surgery ◽  
Surgical Care ◽  
Host Population ◽  
Surgical Team ◽  
Low Income Country ◽  
Operative Outcomes ◽  
Surgical Teams ◽  
A Prospective Study

BackgroundThe 7th Airborne Forward Surgical Team (FST) has deployed to Chad in 2015 and 2016, in support of French military forces. Humanitarian surgical care is known to represent a significant part of the surgical activity in such missions, but to date limited data have been published on the subject.MethodsAll surgical patients from a civilian host population treated by the FST during these missions have been prospectively included. Indications, operative outcomes and postoperative outcomes were evaluated.ResultsDuring this period, the FST operated on 358 patients. Humanitarian surgical care represented 95% of the activity. Most patients (92.7%) were operated for elective surgery. Emergencies and infectious diseases represented, respectively, 7.3% and 9.1% of cases. The mean length of stay (LOS) was three days (2–4), and the median follow-up was 30 days (22–34). Mortality rate was 0.6% and morbidity was 5.6%. Parietal surgery had no significant complication and had shorter LOS (p<0.001). Emergent surgeries were more complicated (p<0.01) and required more reoperations (p<0.05). Surgical infectious cases had longer LOS (p<0.01).ConclusionsHumanitarian surgical care can be provided without compromising the primary mission of the medical forces. Close surveillance and follow-up allowed favourable outcomes with low morbidity and mortality rates. Humanitarian care is responsible for a considerable portion of the workload in such deployed surgical teams. Accounting for humanitarian care is essential in the planning and training for such future medical operations.

scholarly journals Presentation, surgery and 1-year outcomes of childhood cataract surgery in Tanzania

2020 ◽  
pp. bjophthalmol-2020-316042
Author(s):  
Furahini Godfrey Mndeme ◽  
Blandina Theophyl Mmbaga ◽  
Mchikirwa Msina ◽  
Judith Mwende ◽  
Sonia J Vaitha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Low Income ◽  
Visual Outcome ◽  
Low Income Countries ◽  
Similar Proportion ◽  
Poor Visual Outcome ◽  
A Prospective Study ◽  
Good Vision ◽  
Childhood Cataract

BackgroundRecent reports have suggested a significant change in the causes of blindness in children in low-income countries cataract becoming the leading cause. We aimed to investigate the presentations and surgical outcomes in children with cataract operated at different ages in Tanzania.MethodsWe conducted a prospective study of 228 children aged ≤192 months at three tertiary centres, 177 with bilateral cataracts and prospectively followed them for 1-year postsurgery. We collected demographic, surgical, preoperative and postoperative clinical characteristics using the standard childhood cataract surgical assessment questionnaire. Families were encouraged to return for follow-up by phone with travel reimbursement where necessary.ResultsPreoperatively, 76% bilateral children were blind in the better eye. 86% of children were followed up at 1 year and 54% bilateral children achieved visual acuity of 0.48 logMAR or better in the better eye and 5% were blind. 33% of unilateral children achieved visual acuity of 0.48 logMAR or better and 17% were blind. Preoperative blindness (adjusted OR (AOR) 14.65; 95% CI 2.21 to 97.20), preoperative nystagmus/strabismus (AOR 9.22; 95% CI 2.66 to 31.97) and aphakia (AOR, 5.32; 95% CI 1.05 to 26.97) predicted poor visual outcome in bilateral cases. 9% of 342 refracted eyes had initial postoperative cylinder of 1.5 D or more, as did a similar proportion (11%) of 315 eyes refracted 1 year after surgery. Acute fibrinous uveitis occurred in 41 (12%) eyes.ConclusionThree-quarters of children were blind preoperatively whereas over half had good vision 1-year postoperatively. Preoperative blindness, nystagmus/strabismus and aphakia predicted poor visual outcome, suggesting that cataract density determines density of amblyopia.

695 HYPERTENSION SCREENING, TREATMENT AND CONTROL IN AN ASIAN LOW-INCOME URBAN COMMUNITY- A PROSPECTIVE STUDY

2012 ◽  
Vol 30 ◽  
pp. e201
Author(s):  
Liang En Wee ◽  
Wei Xin Yeo ◽  
Run Ting Chin ◽  
Jolene Wong ◽  
Darren Chua ◽  
...  
Keyword(s):  
Prospective Study ◽  
Low Income ◽  
Urban Community ◽  
Hypertension Screening ◽  
A Prospective Study ◽  
And Control

Assessment of Physical Growth and Motor Development of Preterm Babies Based on Developmental Assessment Scale For Indian Infants (DASII)

2020 ◽  
Vol 34 (1-2) ◽  
pp. 11-14
Author(s):  
E. S. Akshara ◽  
Poorva Gohiya ◽  
Jyotsna Shrivastav
Keyword(s):  
Low Income ◽  
Motor Development ◽  
Head Circumference ◽  
Preterm Births ◽  
Physical Growth ◽  
Low Income Countries ◽  
Developmental Assessment ◽  
Preterm Babies ◽  
A Prospective Study

Background: The rate of preterm births ranges from 5% to 18% across 184 countries. Almost 12% births are preterm in low-income countries compared with 9% in high-income countries. Almost 1 million children die each year due to complications of preterm birth. Of those who survive, suffer from face developmental disabilities and undernourishment. Aims and Objectives: To assess the physical growth and its relation with the development of babies taken into study. Materials and Methods: A prospective study was conducted on 159 preterm babies of gestational age 32 to 36 weeks. All the treatments given during hospitalization, course of stay, and special procedures done were recorded. Baby’s weight, length, and head circumference were again noted at the time of discharge. Anthropometric measurements were done at every follow-up visit. Neurodevelopmental screening was performed at each follow-up. At the end of 12 months the risk factors contributing to the delayed development were analyzed. Results: 95.5% infants born as preterm had a length of more than 58 cm (– 3SD) and weight 5.6 kg at 1 year and 50% infants had a head circumference of more than 39 cm (– 3SD). Conclusion: Preterm babies when followed-up for 1 year of age did attain appropriate weight and length of their corrected age. Microcephaly was observed in 30% of babies at 1 year of age, of which 15.7% were found with developmental delay.

scholarly journals Surgical outcome following rotator cuff tear repair in a low-income population. Impact of obesity and smoking

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Christine M. M. Silva ◽  
Natália M. Mourão ◽  
Leila N. da Rocha ◽  
Joaquim I. V. D. Landim ◽  
Hermano A. L. Rocha ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Low Income ◽  
Smoking Status ◽  
Fatty Infiltration ◽  
Obese Patients ◽  
Full Thickness ◽  
Low Income Population ◽  
Cuff Tear ◽  
Tendon Retraction

Abstract Background Comorbidities and socioeconomic issues impact outcome of rotator cuff tear (RCT) repair. There are no data on RCT repair outcome from developing regions. We determined the impact of obesity and smoking following RCT repair in a low-income population. Methods This is a retrospective case series. Forty-seven shoulders of 42 patients subjected to open or arthroscopic repair of a RCT with a minimum of 2 years follow-up were cross-sectionally evaluated. Patients were seen in the Orthopaedic Service of the Hospital Geral de Fortaleza-CE, Brazil between March and September 2018. RCT were classified as partial or full-thickness lesions. Fatty infiltration (Goutallier) and tendon retraction (Patte) were recorded as well as obesity (BMI > 30), literacy [>/≤ 8 school years (SY)] and smoking status 6 months prior to surgery (present/absent). Outcomes included pain (visual analogue scale; VAS, 0–10 cm), range of motion [active forward flexion and external rotation (ER)], UCLA and ASES scoring. Results Patients were 59.9 ± 7.4 years-old, 35(74.4%) female with 19 (17.1–30.2 IQR) median of months from diagnosis to surgery and 25 median months of follow-up (26.9–34.0 IQR); over 90% declared < 900.00 US$ monthly family income and two-thirds had ≤8 SY. Forty patients (85.1%) had full-thickness tears, 7 (14.9%) had Goutallier ≥3 and over 80% had < Patte III stage. Outcomes were similar regardless of fatty infiltration or tendon retraction staging. There were 17 (36.1%) smokers and 13 (27.6%) obese patients. Outcome was similar when comparing obese vs non-obese patients. Smokers had more pain (P = 0.043) and less ER (P = 0.029) with a trend towards worse UCLA and ASES scores as compared to non-smokers though differences did not achieve minimal clinically important difference (MCID) proposed for surgical RCT treatment. After adjusting for obesity, VAS and ER values in smokers were no longer significant (P = 0.2474 and 0.4872, respectively). Conclusions Our data document outcomes following RCT repair in a low-income population. Smoking status but not obesity impacted RCT repair outcome though not reaching MCID for surgical treatment.

scholarly journals Intention to Read to Newborns Following a Brief Reading Promotion Intervention among Low-Income Pregnant Women

2019 ◽  
Vol 12 (2) ◽  
pp. 50-52
Author(s):  
Deshanett Clay ◽  
Carolyn R. Ahlers-Schmidt ◽  
Mary Benton ◽  
Matt Engel ◽  
Molly Brown
Keyword(s):  
Educational Intervention ◽  
Low Income ◽  
Word Knowledge ◽  
American Academy Of Pediatrics ◽  
Actual Reading ◽  
Post Test ◽  
Baseline Knowledge ◽  
Study Participants ◽  
Reading To Children

Introduction. Reading to children can increase word knowledge andsuccess in school. The American Academy of Pediatrics recommendsbeginning reading at birth. However, children from low-incomefamilies are exposed to less words, including reading exposure, thanchildren from high-income families.Methods.xPregnant women attending a community prenatal educationprogram targeted at high-risk and low-income populationswere recruited into this study. Participants completed a pre-survey,engaged with a brief educational intervention, then completed amatched post-survey. Surveys assessed perceived benefits, intendedbehaviors, and self-efficacy regarding reading to their child.Results. Of 61 eligible participants, 54 (89%) completed the study.Participants reported being Black (33%), White (30%), Hispanic(28%), and other race (9%). Average gestational age at enrollmentwas 27 weeks (range 13 to 38 weeks). The average age of respondentswas 26 years (SD = 7.2); 46% reported being pregnant for the firsttime. Following the intervention, no change in knowledge regardingbenefits of reading was observed, however, baseline knowledge washigh (58% - 94%). At post-test, significantly more women reported itwas important to start reading to their child at birth (83% vs 56%; p< 0.001) and that they planned to start reading to their child at birth(70% vs 50%; p = 0.001).Conclusions. A brief educational intervention showed promise inincreasing pregnant women’s intentions to read to their children andshould be considered in conjunction with other reading promotionprograms. Follow-up to assess actual reading behavior is needed.Kans J Med 2019;12(2):50-52.

Predictors of compliance in colposcopy clinic follow-up among the uninsured

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20511-e20511
Author(s):  
L. Wenzel ◽  
D. Chase ◽  
J. Hawk ◽  
K. Osann ◽  
K. Tewari
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Low Income ◽  
Pap Smear ◽  
Median Income ◽  
Screening Programs ◽  
Low Income Population ◽  
History Of ◽  
Colposcopy Clinic

e20511 Background: Despite successful screening programs for cervical cancer, ethnic disparities persist. The no-show rate for follow-up appointments after HPV-related abnormal pap smears approximates 50% in high risk populations. We sought to identify factors that may influence follow-up compliance in a multi-ethnic, low income population at risk for cervical cancer. Methods: A longitudinal cohort study was conducted by chart review for all patients identified as having had a colposcopy exam for HPV-associated cervical dysplasia at a southern California inner city clinic from 2006 to 2007. Compliance was defined as obtaining a pap smear within 3 to 14 months from the initial colposcopy. The following variables were evaluated in a multivariate logistic regression model to identify factors which predicted follow-up compliance: race, age, preferred language, insurance, income, marital status, cytology, histology, history of a LLETZ, and pregnancy status. Results: During the study period, 438 patients attended the colposcopy clinic. This approximates 52% of the 912 scheduled clinic appointments during 2006. Patients’ median age was 28 years, 41% were Spanish speaking, with an estimated median income of less than $20,000 for half of the sample. Approximately 71% of patients had temporary publically-funded insurance. Only 55% (239/438) returned for recommended follow-up pap smear. In univariate and multivariate analysis, neither language, Spanish surname, median income, age, histology, nor insurance status predicted adequate follow-up (p=ns). A history of having undergone a large loop excision of the transformation zone (LLETZ) was the only factor which significantly predicted compliance with recommended follow-up pap smear (OR=1.76; 95% CI 1.08–2.895). Conclusions: Follow-up compliance for this high-risk, low income population is very poor. Identifying factors which predict noncompliance could inform strategies to improve care. In this analysis a history of LLETZ was the only variable which predicted whether follow-up care occurred as recommended. Results suggest that intensive, culturally-sensitive colposcopy clinic-based educational interventions should be developed and evaluated. No significant financial relationships to disclose.

Neighborhood influences and child development: A prospective study of substance abusers' offspring

1999 ◽  
Vol 11 (4) ◽  
pp. 763-784 ◽  
Author(s):  
SUNIYA S. LUTHAR ◽  
GRETTA CUSHING
Keyword(s):  
Prospective Study ◽  
Low Income ◽  
Substance Abusers ◽  
Developmental Changes ◽  
Drug Abusers ◽  
Maternal Psychopathology ◽  
Behavioral Competence ◽  
High Crime ◽  
A Prospective Study

In this 2-year prospective study, psychopathology and competence among drug abusers' offspring were examined in relation to characteristics of their neighborhoods. The sample consisted of 77 children of cocaine and opioid addicts with a mean age of 12.3 years at baseline and 14.2 years at follow-up. Outcomes examined included psychiatric diagnoses, dimensional symptom indices, and aspects of everyday behavioral competence. Links involving neighborhood variables varied by gender, wherein boys reflected greater deterioration than girls when neighborhoods had high crime rates and high proportions of low-income households. Conversely, girls appeared to benefit more than boys from the presence of professional adults in the community. Overall, neighborhood indicators accounted for more variability in changes in child adjustment over time than did indices of maternal psychopathology. Findings are discussed in terms of developmental changes in the salience of exosystemic and familial forces, and implications for interventions are outlined.

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