Assessment of Early Intervention Services to Better Child Outcomes among Part C Infants and Toddlers

Background: Early intervention services have been shown to improve child outcomes. Rapid proliferation of neural connections and circuits contribute to the rapid growth of the brain in the first three years of life. These neural circuits which create the foundation for learning are most flexible in this period and become increasingly more difficult to change thereafter. The purpose of this study is to examine the relationship between early enrollment in Georgia’s Part C birth to three early intervention program and improved child outcome ratings upon exiting the program at 3 years of age. The study used 2013 & 2014 Annual Performance Report (APR) data. Methods: This study included 6,309 participants who enrolled and received services in the Part C, Babies Can’t Wait (BCW) program. A Pearson’s correlation analysis was used to assess if there was an association between age at enrollment and improved child outcome score. One-way analysis of variance (ANOVA) was used to test the variances within the age groups for equality. Bonferroni post hoc test was used to compare the mean child outcome score across the enrollment age groups. Results: A statistically significant inverse correlation was found between enrollment age and improved child outcome score at 3 years of age. One-way ANOVA showed that the variances within the enrollment age groups were equal while the mean child outcome scores were not. Bonferroni post hoc test revealed that the mean child outcome score in the enrollment age group 0 to ≤ 6 months was significantly higher than the other age groups. Conclusions: Significantly better child outcomes were associated with enrollment in early intervention services before 6 months of age

Doxorubicin-induced chronic dilated cardiomyopathy—the apoptosis hypothesis revisited

The chemotherapeutic agent doxorubicin (DOX) has significantly increased survival rates of pediatric and adult cancer patients. However, 10% of pediatric cancer survivors will 10–20 years later develop severe dilated cardiomyopathy (DCM), whereby the exact molecular mechanisms of disease progression after this long latency time remain puzzling. We here revisit the hypothesis that elevated apoptosis signaling or its increased likelihood after DOX exposure can lead to an impairment of cardiac function and cause a cardiac dilation. Based on recent literature evidence, we first argue why a dilated phenotype can occur when little apoptosis is detected. We then review findings suggesting that mature cardiomyocytes are protected against DOX-induced apoptosis downstream, but not upstream of mitochondrial outer membrane permeabilisation (MOMP). This lack of MOMP induction is proposed to alter the metabolic phenotype, induce hypertrophic remodeling, and lead to functional cardiac impairment even in the absence of cardiomyocyte apoptosis. We discuss findings that DOX exposure can lead to increased sensitivity to further cardiomyocyte apoptosis, which may cause a gradual loss in cardiomyocytes over time and a compensatory hypertrophic remodeling after treatment, potentially explaining the long lag time in disease onset. We finally note similarities between DOX-exposed cardiomyocytes and apoptosis-primed cancer cells and propose computational system biology as a tool to predict patient individual DOX doses. In conclusion, combining recent findings in rodent hearts and cardiomyocytes exposed to DOX with insights from apoptosis signal transduction allowed us to obtain a molecularly deeper insight in this delayed and still enigmatic pathology of DC

Assessment of Early Intervention Services to Better Child Outcomes among Part C Infants and Toddlers

Background: Early intervention services have been shown to improve child outcomes. Rapid proliferation of neural connections and circuits contribute to the rapid growth of the brain in the first three years of life. These neural circuits which create the foundation for learning are most flexible in this period and become increasingly more difficult to change thereafter. The purpose of this study is to examine the relationship between early enrollment in Georgia’s Part C birth to three early intervention program and improved child outcome ratings upon exiting the program at 3 years of age. The study used 2013 & 2014 Annual Performance Report (APR) data. Methods: This study included 6,309 participants who enrolled and received services in the Part C, Babies Can’t Wait (BCW) program. A Pearson’s correlation analysis was used to assess if there was an association between age at enrollment and improved child outcome score. One-way analysis of variance (ANOVA) was used to test the variances within the age groups for equality. Bonferroni post hoc test was used to compare the mean child outcome score across the enrollment age groups. Results: A statistically significant inverse correlation was found between enrollment age and improved child outcome score at 3 years of age. One-way ANOVA showed that the variances within the enrollment age groups were equal while the mean child outcome scores were not. Bonferroni post hoc test revealed that the mean child outcome score in the enrollment age group 0 to ≤ 6 months was significantly higher than the other age groups. Conclusions: Significantly better child outcomes were associated with enrollment in early intervention services before 6 months of age