Addressing implementation considerations when developing universal interventions for speech, language and communication needs in the ordinary classroom: a protocol for a scoping review

Background: Understanding the factors that influence the implementation of health interventions in the context of education is essential to improving outcomes for children and young people with speech and language needs (SLCN). Yet implementation considerations have not been adequately addressed when developing interventions for this context. The aim of this paper is to present a protocol for a scoping review of existing implementation frameworks that might guide SLCN intervention research in schools. Methods: In accordance with scoping review guidelines, the study will be conducted in six phases: (1) identification of the research question, (2) identification of potentially relevant studies of Implementation Science frameworks, (3) study screening and selection, (4) charting and extracting data from identified frameworks, (5) collating, summarising and reporting the results and (6) consultation with stakeholders. Two reviewers will conduct the screening and extraction stages independently. Identified frameworks will be collated, and described, and constructs from the IS frameworks will be categorised using domains from the Consolidated Framework for Implementation Research. A draft implementation science model will be proposed based on the findings of the scoping review. Conclusions: The findings of this review will provide guidance for researchers to begin to address implementation considerations when developing and facilitating the uptake of universal interventions for SLCN in the ordinary classroom, and ultimately can contribute towards improving outcomes for this vulnerable childhood population.

Prevalence of neurological problems in a community-based sample of paediatric coeliac disease: a cross-sectional study

BackgroundThe prevalence of and risk factors for neurological problems in childhood coeliac disease (CD) are unclear.MethodsWe performed a cross-sectional, community-based audit of CD in children diagnosed from January 2010 to December 2016 in Lothian.Results79 (28%) of 284 children with CD (201, 70.8% female) (mean age 8.3 years, range of 1–16) had neurological problems. Fifteen (5%) had headaches/migraine, 3 (1%) seizures, 32 (11%) ASD (autistic spectrum disorder), 5 (2%) ADD (attention deficit disorder) and 4 (1%) had ADHD (attention deficit hyperactivity disorder). Fifteen (5%) had anxiety (n=10, 3.5%) or low mood (n=5, 2%). Neurological problems were more common with later age at CD diagnosis (OR 1.07, 95% CI 1.01 to 1.14) and male gender (OR 1.69, 95% CI 0.96 to 2.95).ConclusionPrevalence of neurological problems in children with CD in Lothian is lower than published adult CD studies and similar or lower to the reported prevalence in the general childhood population.

Analisa Keberhasilan Program Pemberian Obat Pencegahan Massal (POPM) Filariasis Re-TAS 1 di Kabupaten Hulu Sungai Utara

District of Hulu Sungai Utara conducted an additional 2 (two) rounds of Mass Drug Administration (MDA) for filariasis prevention in 2014 and 2015 that resulted in the success of the re-Transmission Assessment Survey Phase 1 (re-TAS 1) in 2016. This study was conducted to identify factors affecting the technical aspects of the aforementioned two additional rounds of MDA. This is a descriptive qualitative study, with a cross-sectional study design. The research was performed from September to November 2017. Data was collected through in-depth interviews with some executive stakeholders (health workers, cadres, community leaders, local women group) involved in the implementation of MDA for the filariasis elimination program. The result from indepth interviews shows the presence of technical factors at the execution level which supports the smooth implementation of the two additional rounds of MDA. Those factors include communication, resources, operational standard, bureaucracy, and pharmaceutical innovation. The success of the additional MDA roundswas marked by the absence of the re-TAS sample that was tested positive of Brugia Rapid™. The pharmaceutical innovation which transforms the dosage form of the medication into powdered form with some additional sweetener that was done in 2014-2015 can improve coverage of the treatment as well as the medication adherence for the early childhood population group. Changing pharmaceutical dosage forms require additional support in the form of human resources, infrastructure as well as financing

The Role of In?uenza Vaccination and its Impact on Cardiology

Influenza is a common, but serious illness, which has a burden of disease all over the world. It is estimated that there are about 3 to 5 million severe case of the disease that may require hospital admission, and around 290,000 to 650,000 deaths in each seasonal outbreak. The whole population is at risk of becoming ill due to influenza. However, children and patients with chronic illnesses, such as those with cardiovascular diseases or multiple disorders, have a higher risk of developing complications. The prevention of infection due to influenza through vaccination is well known in the childhood population, but also has an important role in the maintenance of health and prevention of mortality and morbidity in patients with cardiovas- cular disease. This is due to known cardioprotective mechanisms, mainly in the prevention of acute myocardial infarction or heart failure. Nowadays, immunization must be included in the comprehensive secondary prevention in these patients

Socioeconomic inequalities in 29 childhood diseases: evidence from a 1,500,000 children population retrospective study

Background Socioeconomic position (SEP) powerfully affects health status in the childhood population. However, the knowledge of which diseases are more affected by SEP and whose outcomes could be improved by having a more equitable society remains uncertain on a population basis. Methods We measured socioeconomic and gender inequalities in the pre-COVID-19 era for 29 diseases in the entire childhood population in Catalonia to identify which diseases are most impacted by inequalities. This population-based study included 1,449,816 children under 15 years old from 2014 to 2017 (48.52% girls) and each of their registered diagnoses within the Catalonia National Health System. We calculated frequency measures by SEP and their sex ratios for each disease. We estimated four regression-based inequality measures: slope index of inequality, relative index of inequality (RII), absolute population-attributable fraction, and population-attributable fraction. Results Twenty-five of the 29 diseases examined showed SEP inequalities. The diseases with the greatest inequalities in both sexes were tuberculosis, obesity, adjustment and anxiety disorders, essential hypertension, poisoning, short gestation, low birth weight, foetal growth retardation and intrauterine hypoxia and birth asphyxia and trauma (RII ≥ 2.0); only food allergy showed the opposite pattern (RII < 1.0). Overall, 80,188 (7.80%) of the disease events in boys and 74,921 (8.88%) in girls would be avoided if all children had the same disease rate as those in the medium-high SEP group, with tuberculosis, intrauterine hypoxia and birth asphyxia and trauma, obesity, and short gestation, low birth weight, foetal growth retardation being those that could be reduced the most in relative terms, and dermatitis, injuries, acute bronquitis, and being overweight those that could be reduced the most in absolute terms. Girls present higher RII than boys for respiratory allergy, asthma, dermatitis, being overweight, and obesity (p < 0.05). In contrast, boys showed higher RII compared to girls only in congenital anomalies (p < 0.05). Conclusions Socioeconomic and gender inequalities are widely present in childhood health. This indicates that SEP plays a common role in their development although it varies in magnitude according to each disease. It is also a phenomenon that comprises all SEP groups in society. Action needs to be taken to ensure a fairer start in life in terms of health.

Addressing implementation considerations when developing universal interventions for speech, language and communication needs in the ordinary classroom: a protocol for a scoping review

Background: Understanding the factors that influence the implementation of health interventions in the context of education is essential to improving outcomes for children and young people with speech and language needs (SLCN). Yet implementation considerations have not been adequately addressed when developing interventions for this context. The aim of this paper is to present a protocol for a scoping review of existing implementation frameworks that might guide SLCN intervention research in schools. Methods: In accordance with scoping review guidelines, the study will be conducted in six phases: (1) identification of the research question, (2) identification of potentially relevant studies of Implementation Science frameworks, (3) study screening and selection, (4) charting and extracting data from identified frameworks, (5) collating, summarising and reporting the results and (6) consultation with stakeholders. Two reviewers will conduct the screening and extraction stages independently. Identified frameworks will be collated, and described, and constructs from the IS frameworks will be categorised using domains from the Consolidated Framework for Implementation Research. A draft IS model will be proposed based on the findings of the scoping review. Conclusions: The findings of this review will provide guidance for researchers in addressing implementation considerations when developing universal interventions for SLCN in the ordinary classroom, and ultimately will contribute towards improving outcomes for this vulnerable childhood population.

Genotype Analysis of ABCC1, NCF4 and CBR3 Polymorphism and the Association With Childhood Acute Lymphoblastic Leukemia in Mexican Childhood Population

Background: The identification of genetic risk factors for Acute Lymphoblastic Leukemia (ALL), are increasingly urgent and necessary.Objective: The purpose of this study is to determine the association of the genetic polymorphisms ABCC1 rs3743527, NCF4 rs1883112 and CBR3 rs1056892 with ALL.Methods: DNA samples were obtained in 71 children with ALL (from 2 to 18 years) and in 71 controls without ALL, to determine the polymorphisms by real-time polymerase chain reaction (qPCR), using specific TaqMan probes in a StepOne® thermal cycler (Applied Biosystems, United States).Results: The results of the Odds Ratio analysis show that in the rs1883112 polymorphism of the NCF4 gene, the heterozygous allele has a risk effect for ALL (OR = 3.1870, CI = 1.8880–7.9383 and p = 0.0002), in turn the mutated genotype (AA) is associated with a protective effect (OR = 0.26, 0.1248 to 0.5434 and p = 0.0003). On the other hand, the CBR3 rs1056892 polymorphism shows a significant association of risk to ALL, in the presence of the HT genotype (OR = 2.77, IC = 1.3837 to 5.5651 and p = 0.004) and the mutated genotype of this polymorphism has a significant association with protection to ALL in the HM genotype (OR = 0.52, IC = 0.2639 to 1.0304 and p = 0.05). While the inheritance models of the polymorphisms let us see that of the rs1883112 polymorphism of the NCF4 polymorphism; the HT genotype of the codominant model shows a protective effect against ALL (OR = 0.4117, IC = 0.1718 to 0.9866 and p = 0.04), the recessive model shows us and confirms what we already saw in table number 3, being that there is an association with protective effect in the HM genotype (OR = 0.2604, IC = 0.1248 to 0.5434 and p = 0.0003). In the polymorphism rs1056892 of the CBR3 gene, a protection association was found in the heterozygous allele of the codominant model (OR = 0.3448, IC = 0.1375 to 0.8896 and p = 0.0274). In addition, the recessive inheritance model for the HM genotype shows a protective effect to ALL, (OR = 0.52, CI = 0.9919 to 3.8638 and p = 0.05).Conclusion: There is an evident impact of the NCF4 rs1883112 and CBR3 rs1056892 polymorphisms with an increased risk of susceptibility to ALL; Likewise, through the codominant inheritance model, the effect of the variation of the CBR3 rs1056892 gene as a protective factor against ALL was evaluated.