Early Intervention Approaches Research Articles

Evolution of myeloproliferative neoplasms from normal blood stem cells.

Over the course of the last decade, genomic studies in the context of normal human hematopoiesis have provided new insights into the early pathogenesis of myeloproliferative neoplasms (MPN). A preclinical phase of MPN, termed clonal hematopoiesis (CH) was identified and subsequent lineage tracing studies revealed a multi-decade long time interval from acquisition of an MPN phenotypic driver mutation in a hematopoietic stem cell (HSC) to the development of overt MPN. Multiple germline variants associated with MPN risk have been identified through genome-wide association studies (GWAS) and in some cases functional interrogation of the impact of the variant has uncovered new insights into HSC biology and MPN development. Increasingly sophisticated methods to study clonal contributions to human hematopoiesis and measure HSC fitness have helped discern the biology underlying the tremendous clinical heterogeneity observed in MPN. Despite these advances, significant knowledge gaps remain particularly with respect to germline genetic contributors to both MPN pathogenesis and phenotypic diversity, as well as limitations in the ability to prospectively quantify rates of clonal expansion in individual MPN patients. Ultimately, we envisage a personalized approach to MPN care in the future, where an individualized genetic assessment can predict MPN trajectory and this information will be used to inform and guide therapy. MPN is particularly amenable to precision medicine strategies and our increased understanding of the evolution of MPN from normal blood stem cells provides a unique opportunity for early therapeutic intervention approaches and potentially MPN prevention strategies.

Developing a data-driven predictive model for substance abuse prevention among youth using behavioral analytics

Substance abuse among youth presents a critical public health challenge, necessitating innovative approaches for early intervention and prevention. This study proposes the development of a data-driven predictive model that leverages behavioral analytics to identify youth at risk of substance abuse. The model utilizes data from multiple sources, including social media activity, school performance records, and mental health screenings, to analyze behavioral patterns that may indicate a predisposition toward substance misuse. The core methodology integrates machine learning algorithms to process and analyze large datasets, uncovering correlations between specific behaviors and the likelihood of substance abuse. Predictive features such as changes in social engagement, academic performance fluctuations, and indicators of emotional distress are identified and incorporated into the model to enhance its accuracy. By applying supervised learning techniques, the model is trained to recognize patterns in historical data, allowing it to make predictions about future substance use risks. Furthermore, the model's design emphasizes real-time monitoring and adaptability, enabling health professionals and educators to receive timely alerts and intervene early when behavioral warning signs are detected. The application of behavioral analytics in this context offers a more proactive, personalized approach to prevention, targeting at-risk individuals before they develop harmful substance use habits. In addition to its predictive capabilities, the model also provides actionable insights into effective intervention strategies. By identifying the most influential behavioral factors, it informs tailored prevention programs that address specific risk behaviors among youth. These findings can support policymakers and healthcare providers in developing data-driven, evidence-based prevention initiatives that better allocate resources to high-risk populations.

Advances and Challenges in Machine Learning for Diabetes Prediction: A Comprehensive Review

Abstract. Diabetes mellitus is a prevalent and severe metabolic disorder disease that poses significant health risks globally, leading to substantial healthcare burdens. Recent days, advancements in artificial intelligence (AI) have markedly enhanced the accuracy and efficiency of diabetes outcome predicted by machine learning (ML), offering a promising approach for early intervention and treatment. This paper evaluates several advanced ML models, including Random Forest (RF), Support Vector Machine (SVM), and Neural Networks techniques based on neural networks. Each model's strengths and limitations are discussed, highlighting the improvements in predictive performance and diagnostic precision. Despite these advancements, the field faces ongoing challenges related to ethical considerations and data scale, which impact ML application in healthcare from both technical and moral aspects. Future efforts should focus on these challenges by promoting data sharing and integration while safeguarding privacy. Through these endeavors, we aim to advance the field of diabetes prediction and improve patient care.

Aberrant intrinsic brain activities in functional gastrointestinal disorders revealed by seed-based d mapping with permutation of subject images.

Functional gastrointestinal disorders (FGIDs) are characterized by complex interactions between the gut and brain, leading to altered brain function and symptom manifestation. We used neuroimaging meta-analytic techniques in order to analyze the correlation between FGIDs and aberrant brain activity. A systematic review was performed to ascertain resting-state functional magnetic resonance imaging (rs-fMRI) studies examining brain function in FGIDs. Pooled meta-analyses by seed-based d mapping with permutation of subject images (SDM-PSI) were performed to assess variations in regional brain activity, and sensitivity analyses were applied to evaluate the robustness of findings. Meta-regression analyses were then carried out to examine possible links between demographic factors and neuroimaging changes. Our meta-analysis revealed significant changes in regional brain activities among FGIDs patients compared to healthy controls (HC). Increased brain activation was observed in several regions including the postcentral gyrus, calcarine fissure/surrounding cortex, superior frontal gyrus, and insula, while decreased activity was noted in the left posterior cingulate gyrus, right median cingulate/paracingulate gyri, and the left caudate nucleus. Furthermore, meta-regression analyses indicated negative associations between disease duration and alterations in specific brain regions. These findings underscored the intricate interplay between gut dysfunction and aberrant brain activity in FGIDs. Early intervention and multidisciplinary approaches addressing both gastrointestinal symptoms and associated emotional distress are crucial for improving the quality of life of the patients.

Considerations for effective dissemination of evidence-based early intervention approaches.

Dissemination, or the widespread sharing of information, is important for moving research evidence into community practice. Early intervention programs for young autistic children have not yet been widely disseminated to the early childhood workforce. This letter describes factors that may support or prevent dissemination to community-based settings, such as packaging and branding early intervention approaches. We argue that an increased focus on dissemination research is needed.

Relationship between autonomic and peripheral neuropathies and cardiovascular outcomes in diabetes

This review explores the complex relationship between diabetic neuropathy and cardiovascular disease (CVD). Neuropathy, a common complication of type 1 and type 2 diabetes, is divided into autonomic and peripheral types, each impacting cardiovascular health. Cardiovascular autonomic neuropathy, a form of autonomic neuropathy, is associated with various CVD complications, including arrhythmias, impaired nocturnal blood pressure regulation, and increased mortality. The prevalence of cardiovascular autonomic neuropathy varies depending on the type and duration of diabetes and is influenced by factors like glycemic control and metabolic stress. Peripheral polyneuropathy, which is often linked to diabetic foot disease, is also correlated with elevated CVD risk; research suggests shared pathophysiological mechanisms between peripheral neuropathy and cardiovascular conditions. Screening for neuropathies using tools like the Michigan Neuropathy Screening Instrument and heart rate variability analyses can facilitate early detection of CVD risk. Additionally, emerging technologies, like deep learning models, have demonstrated promise in detecting early cardiovascular patterns associated with autonomic neuropathy through electrocardiogram analysis. These findings underscore the value of integrating novel diagnostic approaches for early intervention. As CVD represents a leading cause of death among patients with diabetes, this article emphasizes the need for thorough assessment and proactive management of neuropathy to mitigate cardiovascular risk. The review recommends a multidisciplinary approach to diabetes care, including early screening, accurate risk stratification, and targeted therapeutic strategies to prevent or slow the progression of CVD in patients with autonomic and peripheral neuropathies. Further research is warranted to clarify the optimal intervention strategies for reducing CVD risk in these populations.

Alleviation of alcoholic liver injury through composite postbiotics regulation of intestinal flora and promotion of bile acid metabolism

Alcoholic liver disease (ALD) arises from chronic alcohol consumption, leading to liver damage and gut microbiota disruption. Current clinical treatments, including pharmacological interventions, are often inadequate for early-stage ALD, highlighting the urgent need for novel therapeutic approaches. In this study, we explored the therapeutic potential of composite postbiotics, combined with ursodeoxycholic acid (UDCA) as a farnesoid X receptor (FXR) agonist, to alleviate ALD by modulating gut microbiota and bile acid metabolism. Using a murine model of ALD, composite postbiotics were found to restore intestinal barrier integrity, promote bile acid metabolism, and reduce liver inflammation. The treatment increased beneficial gut microbes such as Firmicutes and Bacteroidetes, while reducing pathogenic Proteobacteria, which enhanced bile acid metabolism and activated the FXR pathway. This activation led to a reduction in pro-inflammatory cytokines, restoration of lipid metabolism, and overall alleviation of liver injury. The addition of UDCA further enhanced the activation of the FXR pathway, providing additional protection against liver damage. Our findings suggest that composite postbiotics, particularly when combined with FXR agonists like UDCA, represent a promising therapeutic strategy for ALD by targeting the gut-liver axis and optimizing bile acid metabolism. Future research should investigate the clinical application of these treatments to offer a non-invasive and effective approach for early ALD intervention.

Part C Early Intervention Procedural Safeguard Notices: Are They Supporting Parents to Understand Their Rights?

A family-centered early intervention (EI) approach mandated by the Individuals with Disabilities Education Act (IDEA) Part C, means involving parents fully in EI and ensuring they know their legal rights and responsibilities for participating. However, many parents report difficulty accessing information and decision-making in EI. IDEA mandates all jurisdictions provide parents with a procedural safeguard notice (PSN) outlining parents’ rights and advocacy processes. Yet, it is unclear to what extent PSNs are accessible, particularly to parents with marginalized identities. This study analyzed PSNs from 56 Part C jurisdictions for the components required by law, understandability to the general public, and availability in multiple languages. The PSNs generally did not include all required information, necessitated grade-levels above high school, minimally attended to plain language, and were infrequently available in non-English languages, suggesting that many parents are prevented from information about EI. PSNs, therefore, are a source of bias in Part C.

Communication Intervention in South Africa: Advocating for the Listening and Spoken Language Approach.

Adhering to Early Hearing Detection and Intervention (EHDI) guidelines is critical for the timely identification and management of infants with hearing impairment. Early intervention specifically focusses on family-centred communication interventions, of which the Listening and Spoken Language-South Africa (LSL-SA) approach is available for children with hearing impairment in South Africa. Studies have evidenced significant benefits for children with hearing impairment enrolled in LSL-SA compared to those enrolled in Traditional Speech-Language Therapy (TSLT), that is, age-equivalent communication outcomes, shorter duration of therapy until discharge, meritorious academic performance and integration into a hearing society. Despite these positive outcomes related to the LSL-SA approach, significant contextual barriers hinder effective implementation nationwide.Contribution:The successful implementation of EHDI guidelines in South Africa hinges on overcoming barriers through tailored healthcare strategies and contextualised delivery. Adapting frameworks such as LSL-SA to fit the local context is crucial for advancing equitable access to EHDI services, positively impacting children with hearing impairment and their families. This article highlights the systemic challenges in South Africa in optimising resources by adopting linguistically appropriate and culturally responsive early intervention approaches to champion hearing healthcare initiatives. Effective collaboration among diverse stakeholders is essential for enhancing the uptake of EHDI guidelines and translating policy into impactful communication interventions. Implementing the core principles of the LSL-SA approach will not only ensure access to this specialised service for suitable candidates but may also alleviate specific barriers to EHDI implementation within TSLT approaches.

Barriers Perceived by Professionals in Family-Centered Early Intervention Services: A Systematic Review of the Current Evidence

AbstractFamily-centered services are the recommended early intervention approach to develop and deliver services for children with disabilities and their families. This systematic review aims to identify and highlight what barriers service providers in family-centered early intervention perceive that prevent them from providing high-quality services focused on the family and the child's overall well-being. We identified 37 articles that met the selection criteria of the first initial search of 1858 articles. These studies provided insights from both service providers and families. The identified barriers were categorized into eight dimensions: family, child, knowledge, and application of the approach/model, professional beliefs, natural environment, service coordination, working conditions, and current legislation. The main barriers identified were family barriers, insecurities perceived by professionals and difficulties in their ability to provide services, changes in their attitudes and behaviors when they perceive that they are losing their role as experts, lack of knowledge and application of specific practices, and lack of skills needed to engage primary caregivers in natural settings. These findings should inform policy implementation at local and state levels in countries where family-centered service is established in early childhood programs.

GRP75 triggers white adipose tissue browning to promote cancer-associated cachexia

Cachexia, which affects 50–80% of cancer patients, is a debilitating syndrome that leads to 20% of cancer-related deaths. A key feature of cachexia is adipose tissue atrophy, but how it contributes to the development of cachexia is poorly understood. Here, we demonstrate in mouse models of cancer cachexia that white adipose tissue browning, which can be a characteristic early-onset manifestation, occurs prior to the loss of body weight and skeletal muscle wasting. By analysing the proteins differentially expressed in extracellular vesicles derived from cachexia-inducing tumours, we identified a molecular chaperone, Glucose-regulated protein 75 (GRP75), as a critical mediator of adipocyte browning. Mechanistically, GRP75 binds adenine nucleotide translocase 2 (ANT2) to form a GRP75–ANT2 complex. Strikingly, stabilized ANT2 enhances its interaction with uncoupling protein 1, leading to elevated expression of the latter, which, in turn, promotes adipocyte browning. Treatment with withanone, a GRP75 inhibitor, can reverse this browning and alleviate cachectic phenotypes in vivo. Overall, our findings reveal a novel mechanism by which tumour-derived GRP75 regulates white adipose tissue browning during cachexia development and suggest a potential white adipose tissue-centred targeting approach for early cachexia intervention.

The Homeostasis-Enrichment-Plasticity (HEP®) Approach for Premature Infants with Developmental Risks: A Pre-Post Feasibility Study.

Background: The environmental enrichment (EE) framework has inspired several early intervention (EI) approaches. This study evaluated the feasibility, safety, caregiver acceptance, and satisfaction of implementing the HEP Approach intervention, a novel EI model based on the EE paradigm. Outcome measures for motor development, individual functional goals, sensory functions, caregiver-provided environmental affordances, and motivation for movement were examined. Methods: A pre-post-study design examined 18 premature infants (<33 weeks six days gestation) with a corrected age of 4-10 months. A 21-item Likert scale survey assessed the feasibility, safety, acceptability, and satisfaction of implementing the HEP Approach intervention. The Peabody Developmental Motor Scales-2, Test of Sensory Functions in Infants, Affordances in the Home Environment for Motor Development, and Infant Movement Motivation Questionnaire were used for outcomes. The goal attainment scale measured progress toward parent goals. The HEP Approach consisted of 12 one-hour sessions implemented over three months. Results: Most participating parents found the HEP Approach intervention feasible, safe, acceptable, and satisfactory. GAS scores demonstrated significant gains with a mean t-score of 67.75 (SD = 2.00). Results found significant improvement (p ≤ 0.05) in all outcome measures. Conclusions: Results suggest that the HEP Approach intervention is safe, feasible, and acceptable to implement. Outcome measures were meaningful and sensitive in identifying improved motor development, individualized parental goals, sensory functions, caregivers' use of environmental opportunities, and movement motivation in premature at-risk infants. Results suggest further studies on the HEP Approach are feasible, and highlight the potential of this intervention to inspire and guide future research in this field.

Deaf role-models for Deaf children in hearing families: a scoping review.

The use of Deaf role-models (DRMs) with Deaf children born into hearing families is a practice aimed at improving outcomes for Deaf children, yet there is little peer-reviewed research available to influence future direction of such. This scoping review directs attention to available research on DRMs as a socio-linguistic and cultural viewpoint for balancing a predominantly audiological approach for early intervention for Deaf children. Systematic database searches initially yielded 132 records, of which seven articles were included in this scoping review. Findings are presented as five themes: 'Deaf Gain' and associated cultural capital, effective communication, developmental influences, family (or caregiver) attitudes to Deafness, and administration of DRM programs. Few formalized DRM programs were identified within the literature. The review concludes with recommendations for further exploration of the DRM experiences of Deaf people and their families within Australia.

Inequitable access to mental healthcare for socially excluded adolescents.

Adolescence is a critical period for mental health and social exclusion, a key social determinant of mental health. Early intervention approaches are key to mitigating the impact of mental ill-health during adolescence, however social exclusion can create additional barriers to accessing care. We aimed to better understand help-seeking experiences of adolescents facing co-occurring social exclusion and mental ill-health, including sources of support, barriers and preferences for service provision. Cross-sectional data were analysed, from the 2022 Mission Australia Youth Survey (N = 18,800). Adolescents aged 15 to 19 years were recruited from around Australia, through schools, community organisations and digital platforms. Indices of four domains of social exclusion (housing, finances, relational and education/employment) were created using existing Youth Survey variables, and supplemented with demographic characteristics, psychological distress and help-seeking behaviours (perceived need, mental health supports, barriers to access and preferences). Relationships between social exclusion domains, mental health concerns and help-seeking behaviours were explored using logistic regression models. A total of 9,743 young people reported having needed mental health support, yet only 58.1% reportedly sought support (n = 5,565). Social exclusion domains were associated with different help-seeking behaviours: housing challenges with higher help-seeking (OR = 1.28; 95% CI [1.15, 1.42]); relational difficulties and edu-employment issues with lower (OR = 0.75; 95% CI [0.68, 0.83] and OR = 0.82; 95% CI [0.75, 0.89]). Stigma, confidentiality concerns, cost and not knowing where to seek help were common barriers to help-seeking; those experiencing social exclusion more likely to report these. Participants reported a strong preference for face-to-face support. This study highlights the additional needs and challenges faced by adolescents dealing with both social exclusion and mental ill-health. With greater barriers to help-seeking, concerted efforts are needed to reduce stigma, improve mental health literacy and increase access to trusted information sources. Further initiatives should focus on structural factors that socially exclude young people and exacerbate inequitable access to mental healthcare.

Long non-coding RNA SNHG7 serves as a diagnostic biomarker for acute coronary syndrome and its predictive value for the clinical outcome after percutaneous coronary intervention

BackgroundAcute coronary syndrome (ACS) is one of the common causes of cardiovascular death. The related lncRNAs were novel approaches for early diagnosis and intervention. This paper focused on the clinical function of SNHG7 for patients after PCI.MethodsThe expression of SNHG7 was assessed in ACS patients. The predictive roles of SNHG7 were unveiled by the ROC curve. The relationship between SNHG7 and Gensini scores was judged by Pearson analysis. One-year follow-up was conducted and all patients were catalogued into different groups based on the prognosis. The qRT-PCR, K-M curve, and Cox regression analysis were performed to document the prognostic significance of SNHG7.ResultsSNHG7 was highly expressed in ACS and its three subtypes. SNHG7 showed a certain value in predicting ACS, UA, NSTEMI, and STEMI. Gensini is a closely correlated indicator of SNHG7. The declined expression of SNHG7 was observed in the non-MACE and survival groups. The risk of MACE and death was increased in the group with high expression of SNHG7. SNHG7 was an independent biomarker in patients with ACS after PCI.ConclusionsSNHG7 might be a diagnostic and prognostic tool for ACS patients.

Vision Therapy as an Early Intervention Approach in Autism Spectrum Disorder Associated with Down Syndrome: A Case Report

Vision Therapy as an Early Intervention Approach in Autism Spectrum Disorder Associated with Down Syndrome: A Case Report

Observation as a gateway: using Anna Freud’s ‘double approach’ to understand the child and parent

ABSTRACT Anna Freud’s groundbreaking use of child observation gave rise to the ‘double approach’, an innovative methodology that combined direct child observation with psychoanalytic reconstruction. This method of gathering and understanding data resulted in Anna Freud’s developmental theory that encompassed both normative and pathological child development. Anna Freud became convinced of the need to work with the parent and child and of the power of early intervention and prevention. This paper describes the use of the ‘double approach’ during a year-long observation of a therapeutic parent-toddler group, an early intervention and prevention approach that included parents and their toddlers. The observations demonstrate the valuable role of how intervening early in the toddler’s life facilitated her processing of trauma, leading to her developing the capacity to explore and play and to form strong relationships. It underscores the invaluable role of close observations in gaining insights into the child’s behaviour and internal world.

The evaluation of a stepped care approach for early intervention of borderline personality disorder

BackgroundThe current study evaluated the stepped care approach applied in AtR!Sk; a specialized outpatient clinic for adolescents with BPD features that offers a brief psychotherapeutic intervention (Cutting Down Program; CDP) to all patients, followed by a more intensive Dialectical Behavioral Therapy for Adolescents (DBT-A) for those whose symptoms persist.MethodsThe sample consisted of 127 patients recruited from two AtR!Sk clinics. The number of BPD criteria, psychosocial functioning, severity of overall psychopathology, number of days with non-suicidal self-injury (NSSI; past month), and the number of suicide attempts (last 3 months) were assessed at clinic entry (T0), after CDP (T1), and at 1- and 2-year follow-up (T2, T3). Based on the T1 assessment (decision criteria for DBT-A: ≥ 3 BPD criteria & ZAN-BPD ≥ 6), participants were allocated into three groups; CDP only (n = 74), CDP + DBT-A (eligible and accepted; n = 36), CDP no DBT-A (eligible, but declined; n = 17).ResultsCDP only showed significantly fewer BPD criteria (T2: β = 3.42, p < 0.001; T3: β = 1.97, p = 0.008), higher levels of psychosocial functioning (T2: β = -1.23, p < 0.001; T3: β = -1.66, p < 0.001), and lower severity of overall psychopathology (T2: β = 1.47, p < 0.001; T3: β = 1.43, p = 0.002) over two years compared with CDP no DBT-A, while no group differences were found with regard to NSSI and suicide attempts. There were no group differences between CDP + DBT-A and CDP no DBT-A, neither at T2 nor at T3.DiscussionThe findings support the decision criterion for the offer of a more intense therapy after CDP. However, there was no evidence for the efficacy of additional DBT-A, which might be explained by insufficient statistical power in the current analysis.

Clinical characteristics of adolescents and emerging adults presenting for integrated posttraumatic stress and substance use treatment

PurposeAdolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance-use disorders (SUDs). This study aims to compare the clinical profiles of adolescents (aged 12–17 years) and emerging adults (aged 18–25 years) presenting for treatment of posttraumatic stress disorder (PTSD) and SUD.Design/methodology/approachData was collected from the baseline assessment of individuals (n = 55) taking part in a randomized controlled trial examining the efficacy of an integrated psychological therapy for co-occurring PTSD and SUDs (PTSD+SUD) in young people.FindingsBoth age groups demonstrated complex and severe clinical profiles, including high-frequency trauma exposure, and very poor mental health reflected on measures of PTSD, SUD, suicidality and domains of social, emotional, behavioral and family functioning. There were few differences in clinical characteristics between the two groups.Research limitations/implicationsSimilarity between the two groups suggests that the complex problems seen in emerging adults with PTSD + SUD are likely to have had their onset in adolescence or earlier and to have been present for several years by the time individuals present for treatment.Originality/valueTo the best of the authors’ knowledge, this is the first study to compare the demographic and clinical profiles of adolescents and emerging adults with PTSD + SUD. These findings yield important implications for practice and policy for this vulnerable group. Evidence-based prevention and early intervention approaches and access to care are critical. Alongside trauma-focused treatment, there is a critical need for integrated, trauma-informed approaches specifically tailored to young people with PTSD + SUD.

Examining Malaysian mothers' causal attributions of maladaptive externalizing and internalizing behaviors in young children

AbstractObjectiveThis study provides insight into how cultural beliefs influence parents' causal attributions of maladaptive externalizing and internalizing behaviors in young children.BackgroundUnderstanding how parents from different cultures explain difficult behavior in young children may inform culturally sensitive approaches for early intervention and prevention. To date, work on Malaysian parents' causal attributions of maladaptive behaviors in young children has received little empirical attention.MethodWe employed a semistructured interview method to assess Malaysian mothers' (N = 16) open‐ended explanations for maladaptive externalizing and internalizing behavior in their young children, as depicted in hypothetical scenarios. Mothers' responses were coded according to a coding system of parental attributions.ResultsWe identified cultural specificity in Malaysian parents' attributions of children's behaviors, with mothers endorsing reasons for children's maladaptive externalizing and internalizing behaviors that were not previously captured by the existing coding system. Mothers' attributions were informed by religious and spiritual beliefs.ConclusionsParents' causal attributions for children's maladaptive behaviors are culturally specific and are best captured by open‐ended approaches.ImplicationsCultural frames of reference shape parental beliefs, which are crucial to the effective formulation of early intervention and prevention approaches. Caution should be taken in general against universally operationalizing parents' attributions of children's behaviors.