scholarly journals Working with Families Using a Family-Centered Approach for Improved Development Outcomes in High-Risk Children

2021 ◽  
Vol 14 (1) ◽  
pp. 9-17
Author(s):  
Aarti Nair ◽  
◽  
Ajay Sharma ◽  
Sandeep Kumar ◽  
Manish Jha ◽  
...  
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Birth Asphyxia ◽  
Structured Learning ◽  
Intervention Programme ◽  
Development Outcomes ◽  
High Risk Infants ◽  
The Impact ◽  
Family Centered ◽  
High Risk Children

Introduction: Around the world, almost half of all deaths in children under five occur in the newborn period. Ninety-nine percent of newborn deaths are in low- and middle-income countries and prematurity, intrapartumrelated neonatal deaths (‘birth asphyxia’), sepsis and meningitis account for 75% of these1. Developmental disability is a diverse group of chronic conditions that are due to mental or physical impairments that arise before adulthood. Developmental disabilities cause individuals living with them many difficulties in certain areas of life, especially in “language, mobility, learning, self-help, and independent living”2. Aim of Study: To analyze the impact of family centered-approach on child’s development outcomes. To quantify and validate the advantages of family-centered- approach for parents and children. Method: A low-cost, family-centered intervention programme to promote child and family wellbeing is provided at an Early Intervention Centre in Latika Roy Foundation, Dehradun, India. It follows a familycentered approach of empowering families through respect, collaboration, information, training and support. The effectiveness of this methodology is evaluated in this study. Discussion: This study evaluates the effectiveness of this family-centred interventions programme, provided by early intervention Centre, for improving development outcomes of high-risk infants. This study explores, for the first time in a resource limited country, the relationship between the reduction of family stress achieved through a family empowerment programme and improvement in development outcomes of high-risk children. Families of High-risk infants enrolled at the Centre during January 2015 through July 2017, who were in NICU for 5 or >5 days are partners in the study. Conclusion: The importance of family-centred care cannot be over-emphasized. Early intervention services and support to families can significantly improve quality of life of high-risk children. Intervention studies for children with disability state that the best way of improving children’s outcomes is by empowering parents through a structured learning programme. Given the scope and potential of such programs, this study quantifies and validates the advantages of the family-centred approach.

High-Risk Children Referred to an Early-Intervention Developmental Program

1995 ◽  
Vol 34 (12) ◽  
pp. 635-641 ◽  
Author(s):  
Lee Ann Britain ◽  
Grace E. Holmes ◽  
Ruth S. Hassanein
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Developmental Program ◽  
High Risk Children

Prevention in High Risk Children of Depressed Parents

1986 ◽  
Vol 31 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Catherine Laroche
Keyword(s):  
High Risk ◽  
Adult Patient ◽  
Family Members ◽  
Clinical Findings ◽  
Therapeutic Interventions ◽  
Children And Families ◽  
The Family ◽  
The Impact ◽  
Depressed Parents ◽  
High Risk Children

Opportunities for prevention of psychopathology in children and families are often overlooked in the treatment of the depressed adult patient. Research and clinical findings are reviewed which highlight the impact on children and the family of depressed parents. They range from illness serious enough to require hospitalization to cases in which depression has not yet been diagnosed. These findings are used as guidelines for the development of preventive and therapeutic interventions for all family members.

Design of a Web-Based Supporting System for Home-Centered Infant early Intervention Program

2013 ◽  
Vol 380-384 ◽  
pp. 2054-2057
Author(s):  
Chun Hua Liu ◽  
Kai Yan Wang
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Intervention Program ◽  
Early Intervention Program ◽  
Web Based ◽  
Supporting System ◽  
Early Intervention Services ◽  
Care Givers ◽  
High Risk Infants

Substantial literature indicates that it is necessary that infants receive early intervention services to improve long-term outcomes after birth. The effectiveness of parents as agents of intervention in the childs home environment is gradually realized. However, there a significant gap between the intensive service requirements for low-birth-weight (LBW) infants because the intervention requires intense one-on-one supervision by highly trained care givers. Based on web technology, we developed a supporting system to inform and teach parents in the early intervention of high risk infants. Results show the web-based training as a promising method of early intervention helps these caregivers in their practice of caring the high risk babies and may help overcome problems associated with the critical shortage of neonatal professionals.

scholarly journals 185. Trends in Clinical Presentation and Antibiotic Resistance of Viridans Group Streptococci Bloodstream Infections in Immunocompromised Children

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S112-S113
Author(s):  
Ana M Quintero ◽  
Diego A Cruz Vidal ◽  
Monica I Ardura ◽  
Sophonie Jean
Keyword(s):  
High Risk ◽  
Antimicrobial Susceptibility ◽  
Bloodstream Infections ◽  
Severe Neutropenia ◽  
Underlying Malignancy ◽  
Significant Difference ◽  
Viridans Group Streptococci ◽  
The Impact ◽  
Over Time ◽  
High Risk Children

Abstract Background Levofloxacin prophylaxis (LVXp) is recommended in children with severe neutropenia from underlying malignancy or hematopoietic cell transplantation (HCT). The impact of LVXp on the epidemiology of viridans group streptococcus bloodstream infections (VGS-BSI) is unknown. At our center, LVXp was prescribed to high-risk children with expected prolonged neutropenia (ANC < 100, > 7 days) as part of a clinical trial (2013-17) and routinely since November 2018. We aim to describe our local epidemiology, antibiotic susceptibilities, and clinical outcomes of VGS-BSI over time. Methods VGS-BSI from 1/1/10-1/31/21 were identified via the laboratory database. Clinical data of patients followed at NCH with underlying malignancy, severe neutropenia, or HCT were extracted from the electronic health record. Available VGS isolates were subcultured, species identification confirmed by MALDI-ToF or 16s rDNA sequencing and susceptibility to penicillin (PCN), cefepime (CEF), vancomycin (VAN), and LVX performed via Etest per CLSI M100 guidelines. Non-parametric descriptive statistics were applied. Results Over a 10-yr period, 111 VGS-BSI occurred in 93 patients (Table 1); 15 (16%) patients had ≥ 2 VGS-BSI. 80 (86%) patients had fever and neutropenia (F&N); 26 (28%) required ICU care for vasopressors (N=17, 18%) or mechanical ventilation (N=10, 11%). Most VGS isolates were S. mitis/oralis group. In total, 15 (16%) patients received LVXp ≤ 6 months before VGS-BSI; 9 (10%) had breakthrough VGS-BSI while receiving LVXp and all isolates were LVX resistant. Figure 1 shows susceptibilities: overall, 24% of isolates had frank resistance to PCN, 19% CEF, 13% LVX; all were VAN susceptible. When evaluating for changes in susceptibilities over time, there was a significant difference in the proportion of LVX-resistant isolates (p=0.009, Cochran-Armitage χ 2), but not CEF (p=0.08) or PCN (p=0.86). Table 1. Demographic and Clinical Characteristics of Immunocompromised Children with Viridans Group Streptococci Bloodstream Infections (VGS-BSI) Figure 1. Antimicrobial Susceptibility Profile of Viridans Group Streptococci Bloodstream Isolates from Immunocompromised children, 2010-2021. Of 111 VGS-BSI reported during the study period from immunocompromised children, 83 (75%) were available for further testing. Antimicrobial susceptibility testing was performed by Etest and interpreted per CLSI M100. Susceptibility profiles to penicillin (PCN), cefepime (CEP) and, levofloxacin (LVX) are shown. Abbreviations: S—susceptible, I—intermediate, R—resistant. Conclusion Breakthrough, LVX-resistant VGS-BSI occurred in 10% of patients, most frequently in children with AML or HCT. Over time, there was a trend towards increased LVX resistance in the cohort. Routine antimicrobial testing and ongoing monitoring for emergence of resistance are warranted to inform local prophylaxis and empirical antibiotic strategies for high-risk children with F&N. Disclosures Monica I. Ardura, DO, MSCS, Shire (Grant/Research Support)

Early Intervention for High-Risk Children: The Carolina Early Intervention Program.

1988 ◽  
pp. 32-43 ◽  
Author(s):  
Craig T. Ramey ◽  
Donna M. Bryant ◽  
Frances A. Campbell ◽  
Joseph J. Sparling ◽  
Barbara H. Wasik
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Intervention Program ◽  
Early Intervention Program ◽  
High Risk Children

Sound Level Exposure of High-Risk Infants in Different Environmental Conditions

2006 ◽  
Vol 25 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Jacqueline Byers ◽  
W. Randolph Waugh ◽  
Linda Lowman
Keyword(s):  
High Risk ◽  
Environmental Conditions ◽  
Sound Level ◽  
Outcome Variable ◽  
Improvement Program ◽  
Convenience Sample ◽  
Sound Levels ◽  
Centered Care ◽  
High Risk Infants ◽  
The Impact

Purposes: To provide descriptive information about the sound levels to which high-risk infants are exposed in various actual environmental conditions in the NICU, including the impact of physical renovation on sound levels, and to assess the contributions of various types of equipment, alarms, and activities to sound levels in simulated conditions in the NICU.Design: Descriptive and comparative design.Sample: Convenience sample of 134 infants at a southeastern quarternary children’s hospital.Main Outcome Variable: A-weighted decibel (dBA) sound levels under various actual and simulated environmental conditions.Results: The renovated NICU was, on average, 4–6 dBA quieter across all environmental conditions than a comparable nonrenovated room, representing a significant sound level reduction. Sound levels remained above consensus recommendations despite physical redesign and staff training. Respiratory therapy equipment, alarms, staff talking, and infant fussiness contributed to higher sound levels.Conclusion: Evidence-based sound-reducing strategies are proposed. Findings were used to plan environment management as part of a developmental, family-centered care, performance improvement program and in new NICU planning.

scholarly journals 4107 Implementation and evaluation of a novel protocol that uses clinical biomarkers to promote early diagnosis and treatment of Neurodevelopmental Disabilities

2020 ◽  
Vol 4 (s1) ◽  
pp. 72-73
Author(s):  
Tara Lynn Johnson ◽  
Sowmya Sivakumar ◽  
Namarta Kapil ◽  
Bittu Majmudar
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Early Diagnosis ◽  
Clinical Care ◽  
Standard Of Care ◽  
Early Intervention Services ◽  
Neurodevelopmental Disabilities ◽  
Clinical Biomarkers ◽  
High Risk Infants ◽  
New Biomarkers

OBJECTIVES/GOALS: Our objective was to establish a new protocol to evaluate new biomarkers to detect Neurodevelopmental Disabilities (NDD) in high-risk infants. As early intervention results in better outcomes, our goal was to implement the protocol to promote earlier NDD diagnosis and referral for treatment. METHODS/STUDY POPULATION: We implemented a new protocol using the General Movement Assessment (GMA), Hammersmith Infant Neurological Examination (HINE), and Capute Scales to evaluate infants who were at high risk of NDD. To determine the success of our protocol with these biomarkers, we studied former premature infants who were evaluated in follow-up clinic from 10/1/2018-10/1/2019. We defined our primary and secondary outcomes as the ages of neurodevelopmental diagnoses and referral to early intervention services before and after implementation of the new protocol, respectively. Our hypotheses were that infants who were evaluated with these biomarkers would be diagnosed with NDD and be referred for treatment at younger ages than their counterparts. RESULTS/ANTICIPATED RESULTS: Approximately 120 patients were evaluated during the time period that was defined. About half were evaluated prior to implementing the GMA and HINE, and the remainder were evaluated using GMA and other developmental measures. We anticipate that infants who underwent GMA will be diagnosed with NDD and referred for therapies at a younger age than their counterparts. DISCUSSION/SIGNIFICANCE OF IMPACT: Through our translational research, we will transform the standard of care for high-risk infants by incorporating clinical biomarkers into day-to-day clinical care for these infants. Implementation of this novel protocol will promote the early diagnosis and referral to treatment for NDD.

scholarly journals Auditory exposure of high‐risk infants discharged from the NICU and the impact of social factors

2020 ◽  
Vol 109 (10) ◽  
pp. 2049-2056 ◽  
Author(s):  
Lara Liszka ◽  
Elizabeth Heiny ◽  
Joan Smith ◽  
Bradley L. Schlaggar ◽  
Amit Mathur ◽  
...  
Keyword(s):  
High Risk ◽  
Social Factors ◽  
High Risk Infants ◽  
The Impact
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