Evaluating the use of a population measure of child development in the Healthy Child Programme Two Year Review

Aims and Objectives The overall aim of this study was to inform the use of ASQ-3™ and of ASQ:SE in the Healthy Child Programme two year review which in turn is intended to contribute to overall improved outcomes for children and their families. Aim To explore the acceptability and understanding of the ASQ-3 and ASQ:SE as measures of child development as part of the Healthy Child Programme two year review among health professionals and parents. Objectives 1. To determine the acceptability of ASQ-3 and ASQ:SE among parents of children who have had a HCP a two year review. 2. To investigate parents’ understanding of ASQ-3 and ASQ:SE used as part of the 2 year review. 3. To determine the acceptability of ASQ-3 and ASQ:SE among health professionals using the measures as part of the HCP two year review. 4. To investigate health professionals’ understanding of ASQ-3 and ASQ:SE as part of the two year review. Methods Four study sites known to be currently using ASQ-3 as part of the HCP two year review were selected to reflect differences in geography and in socio-demographic characteristics of the population. A mixed methods approach was taken and data were collected from 153 parents of children who were due their HCP two year review and 126 health professionals conducting two year reviews using survey questionnaires. Twelve focus groups involving 85 health professionals were conducted, 40 parents interviewed individually and 12 HCP two year reviews observed. Findings The key findings were: ? In general, most parents and HPs accepted the ASQ-3 as a measure that provides useful information about a child’s development at two years. ? Parents and HPs were less certain that ASQ:SE could provide an accurate assessment of social and emotional development. ? Parents enjoyed and found it valuable to observe their own child and make their own observations prior to an assessment visit either in a clinic or at home. ? Parents and HPs were positive about the opportunity to work in partnership in relation to the child’s development. ? There was wide variation both across and within the areas studied as to how the ASQ-3 was used (home, clinic, with parents, put to one side, scored differently, health visitor or community nursery nurse, referrals and re-reviews etc.) ? There was considerable variation around the preparation and training for the ASQ-3 and ASQ:SE amongst HPs. ? There was some evidence of confusion about the purpose of the ASQ-3, namely whether it was for screening developmental delay or for use as an assessment tool. ? There was misunderstanding and criticism of some of the individual questions, especially where there was use of American vocabulary or activities that did not make sense to parents or HPs and also misunderstanding of the possible responses. ? There was evidence of misunderstanding of the scoring of the ASQ-3, potentially leading to over- or under- reporting of developmental delay. ? There were problems in the reporting of the scores and the assessment related to time availability, access to a suitable electronic record system such as RIO, access to computers and internet, over-reliance on hard copy and reporting scores in the Personal Child Health Record (PCHR). ? There was some evidence of variation in practice in making referrals for speech and language or paediatric assessment

Acceptability and understanding of the Ages & Stages Questionnaires®, Third Edition, as part of the Healthy Child Programme 2?year health and development review in England: Parent and professional perspectives

Background The Healthy Child Programme is the universal public health system in England to assess and monitor child health from 0 to 19. Following a review of measures for closer monitoring at age 2 years, the Department of Health for England implemented the Ages & Stages Questionnaires®, Third Edition (ASQ?3™; Hereon, ASQ?3). Aim The aim of this study was to evaluate the acceptability and understanding of the ASQ?3 in England by health professionals and parents. Method A mixed?methods approach was used. This paper reports on the qualitative data drawn from interviews with 40 parents and 12 focus groups with 85 health professionals. The data were analysed using applied thematic analysis. Findings Overall, parents and health professionals found the ASQ?3 acceptable and understandable and could use it as a measure at age 2 years. The ability to work in partnership was valued. Some limitations included potential to cause anxiety, concerns around the safety of some of the items, and use of Americanized language. Health professional's training in the use the ASQ?3 was inconsistent. Conclusion The ASQ?3 is an acceptable and understandable measure to use as part of the 2?year assessment with some adaptations to the English context and some standardized training for health professionals

The effect of local application of thymoquinone, Nigella sativa?s bioactive component, on bone healing in experimental bone defects infected with Porphyromonas gingivalis

Purpose: This study was performed to evaluate the influence of local application of thymoquinone (TQ) on bone healing in experimental bone defects infected with Porphyromonas gingivalis (PG). Methods: Forty-two female rats were randomly divided into 6 groups. A bone defect was created on the right tibia of all animals. The PG, PG/collagen membrane (COL) and PG/ TQ/COL groups were infected with PG. In the COL and PG/COL groups, the defects were covered with a COL; in the TQ/COL and PG/TQ/COL groups, the defects were covered with a TQ-containing COL. After 28 days, all animals were sacrificed. Quantitative measurements of new bone formation and osteoblast lining, as well as semiquantitative measurements of capillary density and tissue response, were analyzed. Furthermore, the presence of bacterial infections in defect areas was evaluated. Results: The new bone formation, osteoblast number, and capillary density were significantly higher in the TQ groups than in the control groups (P<0.001, P<0.001, and P<0.01, respectively). In a comparison between the TQ/COL group, with a TQ-containing COL (TQ/COL), and the PG-infected TQ-containing COL (PG/TQ/COL) group, the newly formed bone and capillary density were higher in the TQ/COL group (P<0.01). When the control group was compared to the PG, PG/COL, and PG/TQ/COL groups in terms of tissue response, the differences were statistically significant (P<0.001, P=0.02, and P=0.041, respectively). The intensity of the inflammatory cell reaction was higher in the PG, PG/COL, and PG/TQ/COL groups (P<0.05). Conclusions: Within the limitations of this study, the local application of a TQ-containing COL positively affected bone healing even if the bone defects were infected. The results suggest that TQ increased angiogenesis and showed promise for accelerating bone defect healing. Further research is warranted to support these findings and reach more definitive conclusions