Reversing the Effects of Early Deprivation after Infancy: Giving Children Families may not be Enough

A commentary on Effects of early psychosocial deprivation on the development of memory and executive functio

Effects of Early Psychosocial Deprivation on the Development of Memory and Executive Function

This study investigated the effects of early institutional care on memory and executive functioning. Subjects were participants in the Bucharest Early Intervention Project (BEIP) and included institutionalized children, children with a history of institutionalization who were assigned to a foster care intervention, and community children in Bucharest, Romania. Memory and executive functioning were assessed at the age of 8 years using the Cambridge Neuropsychological Test and Automated Battery (CANTAB). As expected, children with a history of early institutional care performed worse on measures of both visual memory and executive functioning compared to their peers without a history of institutional care. In comparing children randomly assigned to the foster care intervention with their peers who had continued care in the institution, initial comparisons did not show significant differences on any of the memory or executive functioning outcomes. However, for one of the measures of executive functioning, after controlling for birth weight, head circumference, and duration of time spent in early institutional care, the foster care intervention was a significant predictor of scores. These results support and extend previous findings of deficits in memory and executive functioning among school-age children with a history of early deprivation due to institutional care. This study has implications for the millions of children who continue to experience the psychosocial deprivation associated with early institutional care

Een kwalitatief onderzoek naar de begeleidingsbehoefte van mensen met een Autisme Spectrum Stoornis bij het invullen van vragenlijsten:Adviesrapport; afstudeeronderzoek Toegepaste Psychologie

Toegepast gezondheidsonderzoek (hierna te noemen TGO), onderdeel van de afdeling Gezondheidswetenschappen van het Universitair Medisch Centrum Groningen, doet onderzoek naar de effecten van de methodiek: “Bewustwording van prikkelverwerking”. Het onderzoek naar de methodiek wordt uitgevoerd onder cliënten van R95. Een voorwaarde om deel te kunnen nemen aan het onderzoek is dat men achttien jaar of ouder is, een IQ van gemiddeld of hoog heeft (>80) en gediagnosticeerd is met een Autisme Spectrum Stoornis (ASS). Om de effecten van deze methodiek te kunnen meten is door het TGO een zelfbeoordelingsvragenlijst samengesteld, deze is grotendeels niet toegespitst op de doelgroep ASS. In opdracht van de Wetenschapswinkel, meer specifiek dr. J.A. Landsman-Dijkstra van het TGO, is als afstudeeropdracht een kwalitatief onderzoek uitgevoerd. Het doel is om een advies uit te brengen waaruit blijkt hoe begeleiders kunnen aansluiten op de doelgroep om te bewerkstelligen dat de zelfbeoordelingsvragenlijst op een betrouwbare en valide wijze kan worden ingevuld. Deze scriptie brengt de begeleidingsbehoefte in kaart van mensen met ASS bij het invullen van de zelfbeoordelingsvragenlijst. De bevindingen monden uit in een adviesrapport voor de opdrachtgever, welke gebruikt kan worden gedurende haar verdere onderzoek naar de methodiek. Uit zowel desk- als fieldresearch is gebleken dat mensen met ASS moeilijkheden kunnen ervaren bij het invullen van zelfbeoordelingsvragenlijsten. In deze scriptie wordt gebruik gemaakt van drie concepten omtrent de informatieverwerking bij deze doelgroep, namelijk: Theory of Mind (TOM), Centrale Coherentie (CC) en Executief Functioneren (EF). Aan de hand van de voorgenoemde concepten wordt inzichtelijk gemaakt hoe de begeleidingsbehoefte van deze doelgroep er uit ziet gedurende het beantwoorden van de vragenlijst. Voordat de zelfbeoordelingsvragenlijst wordt ingevuld door de doelgroep, is het van belang dat de begeleider inzicht heeft in de TOM, CC en EF; dit om te kunnen beoordelen of de deelnemers de vragen goed begrijpen. De aspecten betreffende de omgeving waarin de vragenlijst wordt afgenomen, de drie concepten, het contact maken en communiceren met de doelgroep hebben gedurende de afstudeeropdracht als leidraad gefungeerd voor deze scriptie. Het kwalitatief onderzoek is uitgevoerd met behulp van semigestructureerde observaties. Uit deze observaties is gebleken dat de deelnemers daadwerkelijk moeilijkheden ervaren in het beantwoorden van bepaalde vragen uit de vragenlijst. De vragen waarbij, in het bijzonder, een appél wordt gedaan op de bovengenoemde concepten omtrent informatieverwerking blijken lastig te zijn voor de doelgroep. De begeleidingsbehoefte van de doelgroep betreffende het invullen van de vragenlijst ligt voornamelijk bij de inzicht-, dubbele- en omvangrijke vragen en uitdrukkingen. De vragen kunnen door de begeleider worden verhelderd met behulp van gespreksvaardigheden, zoals: Open vragen stellen en doorvragen. Het is van belang om de vragenlijst in te laten vullen in een ruimte waar weinig tot geen externe ruis voor komt. Daarnaast is het belangrijk dat de deelnemer wordt bijgestuurd wanneer deze dreigt af te dwalen naar een ander onderwerp; dit om het concentratieniveau op peil te houden. Vervolgens is het van belang dat de vragenlijst wordt ingevuld op een geschikt moment; op een dag wanneer de deelnemer weinig tot geen intensieve activiteiten heeft (gehad). De bevindingen in deze scriptie zijn volgens de opdrachtgever dusdanig van belang dat er in samenwerking met de opdrachtgever een artikel geschreven zal worden voor het Wetenschappelijk Tijdschrift Autisme (WTA). Het doel van dit artikel is beroepbeoefenaars die met de doelgroep ASS werken over de resultaten te informeren

Empowering members of a rural southern community in Nigeria to plan to take action to prevent maternal mortality: a participatory action research project

Aims and objectives. To facilitate the empowerment of members of a rural community to plan to take action to prevent maternal mortality. Background. Globally, about 300,000 maternal deaths occur yearly. Sub-Saharan Africa and Southern Asia regions account for almost all the deaths. Within those regions, India and Nigeria account for over a third of the global maternal deaths. Problem of maternal mortality in Nigeria is multifaceted. About 80% of maternal deaths are avoidable, given strategies which include skilled attendants, emergency obstetric care and community mobilization. In Part One of this article presented here, a strategy of community empowerment to plan to take action to prevent maternal mortality is discussed. Part Two examines evaluation of the actions planned in Part One. Design. Participatory action research was utilized. Methods. Volunteers were recruited as co-researchers into the study through purposive and snowball sampling. Following orientation workshop, participatory data collection was undertaken qualitatively with consequent thematic analysis which formed basis of the plan of action. Results. Community members attributed maternal morbidities and deaths to superstitious causes, delayed referrals by traditional birth attendants, poor transportation and poor resourcing of health facilities. Following critical reflection, actions were planned to empower the people to prevent maternal deaths through: community education and 2 advocacy meetings with stakeholders to improve health and transportation infrastructures; training of existing traditional birth attendants in the interim and initiating their collaboration with skilled birth attendants. Conclusion. The community is a resource which if mobilized through the process of participatory action research, can be empowered to plan to take action in collaboration with skilled birth attendants to prevent maternal mortality. Relevance to clinical practice. InterventioAims and objectives. To facilitate the empowerment of members of a rural community to plan to take action to prevent maternal mortality. Background. Globally, about 300,000 maternal deaths occur yearly. Sub-Saharan Africa and Southern Asia regions account for almost all the deaths. Within those regions, India and Nigeria account for over a third of the global maternal deaths. Problem of maternal mortality in Nigeria is multifaceted. About 80% of maternal deaths are avoidable, given strategies which include skilled attendants, emergency obstetric care and community mobilization. In Part One of this article presented here, a strategy of community empowerment to plan to take action to prevent maternal mortality is discussed. Part Two examines evaluation of the actions planned in Part One. Design. Participatory action research was utilized. Methods. Volunteers were recruited as co-researchers into the study through purposive and snowball sampling. Following orientation workshop, participatory data collection was undertaken qualitatively with consequent thematic analysis which formed basis of the plan of action. Results. Community members attributed maternal morbidities and deaths to superstitious causes, delayed referrals by traditional birth attendants, poor transportation and poor resourcing of health facilities. Following critical reflection, actions were planned to empower the people to prevent maternal deaths through: community education and 2 advocacy meetings with stakeholders to improve health and transportation infrastructures; training of existing traditional birth attendants in the interim and initiating their collaboration with skilled birth attendants. Conclusion. The community is a resource which if mobilized through the process of participatory action research, can be empowered to plan to take action in collaboration with skilled birth attendants to prevent maternal mortality. Relevance to clinical practice. InterventioAims and objectives. To facilitate the empowerment of members of a rural community to plan to take action to prevent maternal mortality. Background. Globally, about 300,000 maternal deaths occur yearly. Sub-Saharan Africa and Southern Asia regions account for almost all the deaths. Within those regions, India and Nigeria account for over a third of the global maternal deaths. Problem of maternal mortality in Nigeria is multifaceted. About 80% of maternal deaths are avoidable, given strategies which include skilled attendants, emergency obstetric care and community mobilization. In Part One of this article presented here, a strategy of community empowerment to plan to take action to prevent maternal mortality is discussed. Part Two examines evaluation of the actions planned in Part One. Design. Participatory action research was utilized. Methods. Volunteers were recruited as co-researchers into the study through purposive and snowball sampling. Following orientation workshop, participatory data collection was undertaken qualitatively with consequent thematic analysis which formed basis of the plan of action. Results. Community members attributed maternal morbidities and deaths to superstitious causes, delayed referrals by traditional birth attendants, poor transportation and poor resourcing of health facilities. Following critical reflection, actions were planned to empower the people to prevent maternal deaths through: community education and 2 advocacy meetings with stakeholders to improve health and transportation infrastructures; training of existing traditional birth attendants in the interim and initiating their collaboration with skilled birth attendants. Conclusion. The community is a resource which if mobilized through the process of participatory action research, can be empowered to plan to take action in collaboration with skilled birth attendants to prevent maternal mortality. Relevance to clinical practice. InterventioInterventions to prevent maternal deaths should include community empowerment to have better understanding of their circumstances as well as their collaboration with health professionals

Multi-Ancestry Sleep-by-SNP Interaction Analysis in 126,926 Individuals Reveals Lipid Loci Stratified by Sleep Duration

Both short and long sleep are associated with an adverse lipid profile, likely through different biological pathways. To elucidate the biology of sleep-associated adverse lipid profile, we conduct multi-ancestry genome-wide sleep-SNP interaction analyses on three lipid traits (HDL-c, LDL-c and triglycerides). In the total study sample (discovery + replication) of 126,926 individuals from 5 different ancestry groups, when considering either long or short total sleep time interactions in joint analyses, we identify 49 previously unreported lipid loci, and 10 additional previously unreported lipid loci in a restricted sample of European-ancestry cohorts. In addition, we identify new gene-sleep interactions for known lipid loci such as LPL and PCSK9. The previously unreported lipid loci have a modest explained variance in lipid levels: most notable, gene-short-sleep interactions explain 4.25% of the variance in triglyceride level. Collectively, these findings contribute to our understanding of the biological mechanisms involved in sleep-associated adverse lipid profiles

Impaired Very-Low-Density Lipoprotein catabolism links hypoglycemia to hypertriglyceridemia in Glycogen Storage Disease type Ia

International audiencePrevention of hypertriglyceridemia is one of the biomedical targets in Glycogen Storage Disease type Ia (GSD Ia) patients, yet it is unclear how hypoglycemia links to plasma triglyceride (TG) levels. We analyzed whole-body TG metabolism in normoglycemic (fed) and hypoglycemic (fasted) hepatocyte-specific glucose-6-phosphatase deficient (L-G6pc-/- ) mice. De novo fatty acid synthesis contributed substantially to hepatic TG accumulation in normoglycemic L-G6pc-/- mice. In hypoglycemic conditions, enhanced adipose tissue lipolysis was the main driver of liver steatosis, supported by elevated free fatty acid concentrations in GSD Ia mice and GSD Ia patients. Plasma very-low-density lipoprotein (VLDL) levels were increased in GSD Ia patients and in normoglycemic L-G6pc-/- mice, and further elevated in hypoglycemic L-G6pc-/- mice. VLDL-TG secretion rates were doubled in normo- and hypoglycemic L-G6pc-/- mice, while VLDL-TG catabolism was selectively inhibited in hypoglycemic L-G6pc-/- mice. In conclusion, fasting-induced hypoglycemia in L-G6pc-/- mice promotes adipose tissue lipolysis and arrests VLDL catabolism. This mechanism likely contributes to aggravated liver steatosis and dyslipidemia in GSD Ia patients with poor glycemic control and may explain clinical heterogeneity in hypertriglyceridemia between GSD Ia patients

Improving the role of River Basin Organisations in sustainable river basin governance by linking social institutional capacity and basin biophysical capacity

The river basin organisation (RBO) model has been advocated as organisational best practice for sustainable river basin management, despite scant evidence of its effectiveness to manage complex river systems. This review provides a framework which combines functional social-institutional capacities with basin biophysical indicators in a diagnostic tool to determine RBO governance performance. Each of these two capacities are represented by four groups of indicators respectively covering social learning capacity and biophysical capacity. The distance and alignment between capacity and measure of performance scores can be used to prioritise program planning and resource allocation for improving river basin governance, and to undertake periodic evaluations as part of a trajectory analysis. The diagnostic functional framework provides tangible indicators of performance around key concepts in river basin governance. It offers a first attempt to strengthen the position and effectiveness of an RBO in dealing with complex adaptive systems