scholarly journals Feasibility and Outcomes of the Early Start Denver Model Delivered within the Public Health System of the Friuli Venezia Giulia Italian Region

2021 ◽  
Vol 11 (9) ◽  
pp. 1191
Author(s):  
Raffaella Devescovi ◽  
Vissia Colonna ◽  
Andrea Dissegna ◽  
Giulia Bresciani ◽  
Marco Carrozzi ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Retention Rate ◽  
Treatment Fidelity ◽  
Parent Satisfaction ◽  
Autism Spectrum ◽  
Control Group ◽  
Early Start ◽  
Early Start Denver Model

The Early Start Denver Model (ESDM) is an evidence-based early intervention model for young children with autism spectrum disorder (ASD). It is crucial to investigate the feasibility of the ESDM in community settings in contexts that are culturally different from American universities in which the model was originally developed. The aim was to further evaluate the effectiveness of the ESDM delivered within the Italian community setting at low intensity. We compared a group aged 19 to 43 months receiving the ESDM for 2 h per week over the course of 1 year with a concurrent, comparable, non-randomized control group receiving treatment as usual (TAU). Children were evaluated at baseline (T0) and after 6 months (T1) and 12 months (T2) of intervention. Feasibility was evaluated by parent and therapist questionnaires, retention rate, and therapist treatment fidelity. Both groups made similar gains in cognition and language abilities. The ESDM group made larger improvement in domains measured by the ESDM Curriculum Checklist, including communication, social skills, and maladaptive behaviors. Feasibility seemed well supported by retentions, therapists and parent satisfaction, and treatment fidelity. Our study further supports the feasibility of the ESDM implemented within the Italian public health system and suggests a better response in the ESDM-treated group than in the control group.

Preliminary clinical outcomes of a short-term low-intensity Early Start Denver Model implemented in the Taiwanese public health system

Autism ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1300-1306
Author(s):  
Tzu-Ling Lin ◽  
Chung-Hsin Chiang ◽  
Suk Yin Ho ◽  
Hsin-Chi Wu ◽  
Ching-Ching Wong
Keyword(s):  
Autism Spectrum Disorder ◽  
Young Children ◽  
Public Health System ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Early Start ◽  
Early Start Denver Model ◽  
Young Children With Autism

The Early Start Denver Model is an evidence-based, comprehensive naturalistic developmental behavioral intervention. Randomized controlled studies indicate that long-term, high-intensity Early Start Denver Model in home-based settings can positively impact the clinical outcomes of young children with autism spectrum disorder. However, it is difficult to deliver high-intensity early intervention in an under-resourced country such as Taiwan. This study evaluated the effects of implementing the Early Start Denver Model with adaptations (including low intensity, shorter duration, and delivery in general hospitals by multidisciplinary professionals) within the Taiwanese public health system. A pre- and post-intervention study was conducted. Sixteen children with autism spectrum disorder (mean age of 33.5 months) received 6 months of one-on-one Early Start Denver Model intervention (approximately 8 h per week). The children showed significant post-intervention improvements in language and overall cognitive functioning and reduced symptom severity in communication and play. This study suggests that delivering the Early Start Denver Model in community-based hospitals may be an effective intervention, with a wider reach, for young children with autism spectrum disorder in Taiwan. The next steps in Taiwan are to incorporate a control group and assess the long-term effects of the adapted Taiwanese Early Start Denver Model program. Lay Abstract The Early Start Denver Model is a comprehensive naturalistic developmental behavioral intervention for young children with autism spectrum disorder. Rigorous studies indicate that long-term, high-intensity Early Start Denver Model in home-based settings can help young children with autism spectrum disorder have great progress in language, cognitive development, and adaptive skills and reduce overall symptom severity. In accordance with the current limitations in resourcing for early intervention in Taiwan, this study evaluated the effects of implementing the Early Start Denver Model in the Taiwanese public health system with some adaptations, including lower intensity, shorter duration, and delivery in general hospitals. A total of 16 children with autism spectrum disorder, aged between 25 and 46 months, received approximately 8 h per week one-on-one Early Start Denver Model intervention. After 6 months of intervention, the children showed great improvements in language and overall cognitive functioning and reduced symptom severity in communication and play. This study suggests that directly delivering the Early Start Denver Model in community-based hospitals may be an effective intervention, which can make more young children with autism spectrum disorder in Taiwan access the Early Start Denver Model service.

scholarly journals A Two-Stage Screening Approach with I-TC and Q-CHAT to Identify Toddlers at Risk for Autism Spectrum Disorder within the Italian Public Health System

2020 ◽  
Vol 10 (3) ◽  
pp. 184 ◽  
Author(s):  
Raffaella Devescovi ◽  
Lorenzo Monasta ◽  
Maura Bin ◽  
Giulia Bresciani ◽  
Alice Mancini ◽  
...  
Keyword(s):  
Public Health ◽  
Autism Spectrum Disorder ◽  
Health System ◽  
Public Health System ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Screening Tools ◽  
Two Stage ◽  
Early Signs ◽  
Screening Approach

Standardized screening programs ensure that children are monitored for early signs of autism spectrum disorder (ASD) in order to promote earlier diagnosis and intervention. The aim of this study is to identify early signs of atypical development consistent with ASD or other developmental disorders in a population of 224 low-risk toddlers through a two-stage screening approach applied at 12 and 18 months of age. We adopted two screening tools combined: 1. the Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP) Infant–Toddler Checklist (I-TC) and 2. The Quantitative Checklist for Autism in Toddlers (Q-CHAT). We assessed their sensitivity and specificity related to the diagnostic outcome at 36 months. The results showed that autistic signs can be detected as early as the first year even through a few questions extrapolated from both screeners and that our model could be used as a screening procedure in the Italian public health system.

scholarly journals Effectiveness of a Physical Therapeutic Exercise Programme for Caregivers of Dependent Patients: A Pragmatic Randomised Controlled Trial from Spanish Primary Care

2020 ◽  
Vol 17 (20) ◽  
pp. 7359
Author(s):  
Federico Montero-Cuadrado ◽  
Miguel Ángel Galán-Martín ◽  
Javier Sánchez-Sánchez ◽  
Enrique Lluch ◽  
Agustín Mayo-Iscar ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Primary Care ◽  
Health System ◽  
Public Health System ◽  
Experimental Treatment ◽  
Control Group ◽  
Therapeutic Exercise ◽  
Care Programme

Female family caregivers (FFCs) constitute one of the basic supports of socio-health care for dependence in developed countries. The care provided by FFCs may impact their physical and mental health, negatively affecting their quality of life. In order to alleviate the consequences of providing care on FFCs, the Spanish Public Health System has developed the family caregiver care programme (FCCP) to be applied in primary care (PC) centres. The effectiveness of this programme is limited. To date, the addition of a physical therapeutic exercise (PTE) programme to FCCP has not been evaluated. A randomised multicentre clinical trial was carried out in two PC centres of the Spanish Public Health System. In total, 68 FFCs were recruited. The experimental group (EG) performed the usual FCCP (4 sessions, 6 h) added to a PTE programme (36 sessions in 12 weeks) whereas the control group performed the usual FCCP performed in PC. The experimental treatment improved quality of life (d = 1.17 in physical component summary), subjective burden (d = 2.38), anxiety (d = 1.52), depression (d = 1.37) and health-related physical condition (d = 2.44 in endurance). Differences between the groups (p < 0.05) were clinically relevant in favour of the EG. The experimental treatment generates high levels of satisfaction.

Psichosocial addictions treatment based on matrix model in a public center: a pilot study / Tratamiento psicosocial de las adicciones basado en el modelo matrix en un centro público: un estudio piloto

2012 ◽  
Vol 12 (2) ◽  
Author(s):  
Jesús Martí Esquitino ◽  
José Luis Carballo Crespo ◽  
Inmaculada Cárceles Arnau ◽  
Ana María García Ruíz ◽  
Rosa María Gómez Sánchez
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Health System ◽  
Matrix Model ◽  
Public Health System ◽  
Psychosocial Treatment ◽  
Control Group ◽  
Addiction Severity ◽  
Calidad De Vida

El Modelo Matrix (MM) está recomendado por el Instituto Nacional de Drogas y Abuso de EEUU (NIDA) como uno de los tratamientos efectivos para la adicción a cocaína, sin embargo, todavía no hay estudios en la sanidad pública española. El objetivo fue medir la efectividad del tratamiento basado en el Modelo Matrix adaptado a la sanidad pública murciana sobre la calidad de vida percibida, deseo de consumo, consumo real y autoinformado, retención y criterios de dependencia. Se trata de un estudio prospectivo pre experimental pre-post sin grupo control, llevado a cabo en el Centro de Atención a Drogodependencias (CAD) de Murcia, entre Octubre de 2011 y Mayo de 2012 con 9 pacientes consumidores de cocaína. Todos los cuestionarios mejoraron la puntuación, siendo estadísticamente significativos los cambios en criterios de dependencia y nivel de calidad de vida percibido. La retención fue muy alta y el consumo descendió, se concluye que aumenta la retención para los sujetos estudiados respecto de otros estudios, mejora el nivel de calidad percibida, se mantiene la abstinencia y disminuye el craving; así, el tratamiento mejora la gravedad del consumo y la retención en este estudio.  Abstract National Institute on Drug Abuse (NIDA) of USA recomends Matrix Model among other effective treatments on addiction to cocaine, however, there is no studies on the spanish public health system yet. The objective was to measure effectiveness of a psychosocial treatment based on Matrix Model, adapted to the murcian public health system on: quality of life, craving, reported and actual use, retention and dependence criteria. Prospective pre-experimental pre-post study with no control group was used, not linked to drug, conducted October, 2011 to May, 2012 at the Center of Attention to Drug Dependency (CAD) in Murcia, among 9 cocaine users. All questionaires improved their score, changes in dependence criteria and perceibed quality of life reached statistical significancy. Retention was high, with only one participant lost and general cocaine use decreased or ceased. Retention and quality of life have been improved, abstinence mantained and craving decreased; thus, this treatment reduces addiction severity.

scholarly journals Randomized controlled trial protocol: A quanti-quali approach for analyzing the results of an intervention on the waiting list for bariatric surgery

2019 ◽  
Vol 32 ◽  
Author(s):  
Mayara Martins EVANGELISTA ◽  
Alex Harley CRISP ◽  
Sinara Laurini ROSSATO ◽  
Carla Maria VIEIRA ◽  
Rayli BOSSA ◽  
...  
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Clinical Trial ◽  
Health System ◽  
Educational Intervention ◽  
Public Health System ◽  
Intervention Group ◽  
Waiting List ◽  
Control Group ◽  
The Public

ABSTRACT Objective This article aims to describe the protocol of a randomized clinical trial and the baseline results of the study of a one-year interdisciplinary intervention in users of the public health system in the bariatric surgery waiting list. Methods A randomized, single-blind clinical trial will be conducted including 88 participants recruited on an outpatient clinic of the public health system. Participants were randomized into the control group (n=44), receiving the usual treatment; and into the intervention group (n=44), participating in the educational intervention. Participants had their food intake, negative affectivity and physical inactivity/sedentary behavior assessed, as well as anthropometric and body composition measurements; their blood samples were collected; and also had different physical capacity tests. Results Of the 157 participants invited, 27 had severe functional limitations, one was under-age, and four declined the study due to associated diseases. Eighty-eight participants were randomized: 44 for the Control Group and 44 for the Intervention Group. When comparing the demographic and biochemical characteristics, there were no differences between groups except for serum glucose (GC=110.4±46.8mg/dL and GI93.1±16.9mg/dL, p=0.039). Conclusion This study protocol describes the methodology used in the study of educational intervention for the promotion of health care of patients on the waiting list for bariatric surgery. It shows that there is similarity between the baseline comparison groups. Registro Brasileiro de Ensaios Clínicos (Brazilian Clinical Trials Registry), RBR-775y3d.

India as a Pioneer of Innovation

2018 ◽  
Keyword(s):  
Public Health ◽  
Health System ◽  
Informal Economy ◽  
Urban Poor ◽  
Public Health System ◽  
Low Cost ◽  
Social Enterprises ◽  
Specific Context ◽  
Innovation Project ◽  
Context Specific

What does innovation mean to and in India? What are the predominant areas of innovation for India, and under what situations do they succeed or fail? This book addresses these all-important questions arising within diverse Indian contexts: informal economy, low-cost settings, large business groups, entertainment and copyright-based industries, an evolving pharma sector, a poorly organized and appallingly underfunded public health system, social enterprises for the urban poor, and innovations for the millions. It explores the issues that promote and those that hinder the country’s rise as an innovation leader. The book’s balanced perspective on India’s promises and failings makes it a valuable addition for those who believe that India’s future banks heavily on its ability to leapfrog using innovation, as well as those sceptical of the Indian state’s belief in the potential of private enterprise and innovation. It also provides critical insights on innovation in general, the most important of which being the highly context-specific, context-driven character of the innovation project.

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