Motor skills and executive functions of 3- to 5-year old preterm children

Background and aim In the last decades mild motor problems and specific cognitive difficulties without major deficits are the most dominant neurodevelopmental sequelae in children born preterm. This study aimed to explore motor skills and executive functions (EF) and their relationship in a group of preterm children 3- to 5-year old. In addition, we considered the comparison between Very Preterm (VP), born equal or less than 32 gestational weeks (GW) and Late Preterm (LP; 33-37 GW) children in each performance domain. Method The study was conducted on 48 preterms (76.6% males; Mean GW= 31.9 weeks, SD 2.6) at preschool age (M= 48.27 months of age, SD=6.9). Developmental assessment included: Coloured Progressive Matrices (CPM); the verbal intelligence Quotient (VIQ) from WPPSI-III; Battery for the Assessment of Executive Functions (BAFE) comprising measures of cognitive, attention flexibility, inhibition control and visual-spatial working memory; Developmental Test of Visual-Motor Integration (VMI); and Movement Assessment Battery for Children-2 (MABC-2) to identify motor function impairment. Data were analysed by using independent t-test of each measure; Chi-square to determine the occurrence of delayed performances into groups; and Pearson correlations among all variables. Results In the whole sample most of children gathered performances within the normal range for cognitive, motor abilities and EF. However, we found that 17.5% of children had potential motor problems, getting an MABC-2 ”Total Score” that falls below the 16th percentile. In particular, 25%, 23.3% and 7.5% scored below the 16th percentile on ”Manual Dexterity” (MD), ”Aiming & Catching” (A&C) and ”Balance” subtests respectively. Moreover, 30% reached a low performance at the motor coordination test of VMI. There are no significant differences between VP and LP on the percentage of children with potential motor problems. Considering the mean differences, we found that VP achieved significant lower scores than LP on MABC-2 ”Total Score” (t=1.19; p=.04) and BAFE ”visual-spatial working memory” task (t=2.08; p=.04). In addition, we found the following significant correlations: CPM related negatively to A&C (r=-.38, p<.05); VMI integration test related positively to MD (r=.43, p< .05). Discussion and conclusion Children born preterm seem to be at risk for motor problems, at pre-school age, in a considerable percentage. VP performed significantly poorer than LP in MABC-2 Total Score and visual-spatial working memory, whereas they are likely to display similarly across other domains. We suggest the importance to evaluate motor skills and EF at preschool age to detect difficulties earlier than primary school entrance and to plan earlyintervention

ABILITÀ DI COORDINAZIONE MOTORIA IN BAMBINI PRETERMINE DI ETÀ PRESCOLARE: UNO STUDIO PILOTA CON IL QUESTIONARIO LITTLE DCD-Q.

Lo studio esamina le caratteristiche motorie in età prescolare (3;0-4;11 anni) di 48 bambini preterminee di 64 nati a termine. Iloro genitori hanno compilato il Little Developmental Coordination Disorder Questionnaire (L-DCDQ)che indaga le capacità di coordinazione motoria in contesti di vita quotidiana. Il questionario permette diottenere un punteggio totale (PT) e di tre sotto-scale: “Controllo durante il movimento” (CM), “Controllo fine-motorio” (FM) e “Coordinazione generale” (CG).I risultati indicano differenze significative tra i due gruppia favore dei nati a termine nel PT e nelle sotto-scale FM e CG. Suddividendo i gruppi in due classi d’età,la differenzaè osservabile solo nei bambini di 4 anni.Solo neinati a termineemergono differenze significative tra le due classi di età.I risultati indicherebberonei pretermineridotte abilità di coordinazione motoria rispetto ai bambini nati a termine,evidenti soprattutto a 4 anni

Sleep characteristics and temperament in two years old children born preterm

This study demonstrated a link between infant sleep and temperament in preterm children.Objectives Infants born preterm are at greater risk for different developmental conditions, such as language, learning and behavior disorders in respect to those born at term (Wolke, 2008). Prematurity also affect the development of the regulatory functions, in particular sleep (Kennaway, 2002). It is known that sleep in children is influenced not only by environmental factors, but also by intrinsic characteristics such as temperament (Sadeh, 2010). Few studies analyzed sleep in children born preterm and its relationship with the temperament. Therefore, our aims were to investigate in a group of two-years-old children born preterm: (1) the characteristics of sleep; (2) the temperamental dimensions; (3) the relationship between sleep pattern and temperament. Materials and methods The study included the mothers of 51 preterm (mean age 22 ± 5 months) and 57 term (mean age 21 ± 4 months) children. Mothers underwent a structured interview and filled out three questionnaires: the Italian temperament questionnaire (QUIT; Axia, 2002); Questionnaire on sleep quality (Q-sleep; Bruni) and the Brief Infant Sleep Questionnaire, Italian version (BISQ; Sadeh, 2004) that evaluates the sleep habits and patterns. To analyze the differences in the quality and sleep-related habits and in temperamental characteristics between the two groups of children chi-square tests were conducted on categorical data and a series of ANOVA on quantitative measures. Finally a correlational anaylsis has been carried out on sleep characteristics and temperament. Results Preterm children showed a higher degree of sleep problems [F (1,110) = 5.263, p <0.05] and of daytime sleepiness [F (1, 110) = 4.162, p <0.05] compared to those born at term. The temperament questionnaire analysis showed that preterm got lower scores in attention [F (1, 110) = 6.529, p <0.01] and higher scores in the negative emotionality [F (1, 110) = 6.970, p <0.01]. Finally, the correlation analysis between sleep and temperament in preterm showed that falling asleep difficulties are positively correlated with motor control and negative emotionality, and nocturnal sleep duration with the inhibition to the novelty. Conclusions Our study showed that preterm children had a high degree of problems related to sleep pattern and disturbances, and, a predominance of attention problems and negative emotionality

Sleep characteristics and temperament in preterm children at two years of age

Study Objectives: We aimed to compare 2-year-old children born preterm with children born full term regarding: (1) sleep characteristics, (2) temperament, and (3) relations between sleep pattern and habits and temperament. Methods: The study included 51 preterm children with normal cognitive, language, and motor development (mean = 20.94 months, standard deviation [SD] = 4.08) and 57 full-term children (mean = 21.19, SD = 4.32). To assess sleep-related difficulties and habits and child temperament, mothers completed the following questionnaires: the (1) Sleep Disturbance Scale for Children—adapted (SDSC); (2) Brief Infant Sleep Questionnaire (BISQ); and (3) Italian Temperament Questionnaires—version 12-36 months (QUIT). Results: Preterm children needed less support to fall asleep and fell asleep more often alone in their own bed compared to those born at full term; however, preterm children showed more frequent sleep difficulties, such as restlessness and breathing problems during the night. In addition, preterm children had lower scores in the temperamental dimension of attention and higher scores in negative emotionality than full-term children. Finally, sleep problems were correlated with higher motor activity, lower social orientation and attention, and increased negative emotionality; a shorter nocturnal sleep duration was related to higher motor activity and lower inhibition to novelty whereas an earlier rise time was associated with lower attention and social orientation. Conclusions: Preterm children showed sleep pattern problems and disturbance, predominance of attention problems, and negative emotionality related to sleep disruption

Raman spectroscopy as a PAT for pharmaceutical blending: advantages and disadvantages

Raman spectroscopy has been positively evaluated as a tool for the in-line and real-time monitoring of powder blending processes and it has been proved to be effective in the determination of the endpoint of the mixing, showing its potential role as process analytical technology (PAT). The aim of this study is to show advantages and disadvantages of Raman spectroscopy with respect to the most traditional HPLC analysis. The spectroscopic results, obtained directly on raw powders, sampled from a two-axis blender in real case conditions, were compared with the chromatographic data obtained on the same samples. The formulation blend used for the experiment consists of active pharmaceutical ingredient (API, concentrations 6.0% and 0.5%), lactose and magnesium stearate (as excipients). The first step of the monitoring process was selecting the appropriate wavenumber region where the Raman signal of API is maximal and interference from the spectral features of excipients is minimal. Blend profiles were created by plotting the area ratios of the Raman peak of API (AAPI) at 1598 cm-1 and the Raman bands of excipients (AEXC), in the spectral range between 1560 and 1630 cm-1, as a function of mixing time: the API content can be considered homogeneous when the time-dependent dispersion of the area ratio is minimized. In order to achieve a representative sampling with Raman spectroscopy, each sample was mapped in a motorized XY stage by a defocused laser beam of a micro-Raman apparatus. Good correlation between the two techniques has been found only for the composition at 6.0% (w/w). However, standard deviation analysis, applied to both HPLC and Raman data, showed that Raman results are more substantial than HPLC ones, since Raman spectroscopy enables generating data rich blend profiles. In addition, the relative standard deviation calculated from a single map (30 points) turned out to be representative of the degree of homogeneity for that blend time

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services