Successful Early Intervention Research Articles

Psychometric Validation of the Compulsive Internet Use Scale in Spanish Adolescents.

Despite problematic internet use being especially high among adolescents, there are no screening instruments in Spain specifically for adolescents that would facilitate early detection of this problem. The main goal of this study was to validate the Compulsive Internet Use Scale (CIUS) in the adolescent Spanish population as well as to analyze the discriminative capacity of CIUS based on sociodemographic characteristics, grade point average, and other addictive behaviors. Data were obtained from the ESTUDES, a representative survey of addictive behaviors of Spanish adolescents. The sample consisted of a total of 34,308 adolescents aged between 14 and 18 years old (Mage = 15.70; SD = 1.19; 51.7% females). Results indicated that the CIUS fit a unidimensional structure, exhibited measurement invariance with respect to sex and age, and demonstrated excellent reliability (ω = .94). Past-month tobacco, alcohol, and cannabis use, as well as past-year gambling and gaming, were related to CIUS scores. A standardized screening instrument that provides valid, reliable information on young people's use of the Internet in Spain is a critical requirement for successful early detection and intervention in this population.

The Comparison of Lifestyles, Mental Risks, and Physical Indices among Individuals with Ultra-High Risk of Psychosis, Patients with Schizophrenia, and the General Public.

(1) Background: Early interventions may effectively reduce the risk of mental disorders in individuals with ultra-high risk. Specifying the health needs of individuals with ultra-high risk is crucial before the implementation of successful early intervention. This study aimed to explore the differences in lifestyles, mental risks, and physical indices among individuals with ultra-high risk, patients with schizophrenia, and healthy subjects. (2) Methods: A cross-section design applying seven questionnaires with physical examinations for 144 participants aged 13-45 years old was conducted in this study. The questionnaires included one about personal data, four on mental risks, and two for lifestyles. (3) Results: The individuals with ultra-high risk scored similarly in many dimensions as the patients with schizophrenia, but they displayed lower positive symptoms, lower negative symptoms, lower prodromal symptoms, higher interpersonal deficits, lower nutrition intake, and higher levels of exercise than the patients with schizophrenia. Female individuals with ultra-high risk had lower self-esteem, higher positive symptoms, lower nutrition intake, and higher exercise levels than male ones. (4) Conclusions: The study pinpointed specific health needs with interpersonal deficits, nutrition intake, and physical activity for the individuals with ultra-high risk. Future interventions targeted on improving social function, dietary pattern, and exercise will be beneficial.

Acceptance-Enhanced Behavior Therapy for Trichotillomania in Youth

Trichotillomania is a debilitating and chronic condition involving repeated hair pulling from various areas of the body. Trichotillomania often begins in childhood, suggesting that the development and understanding of treatments for trichotillomania in youth are of utmost importance, especially for successful early intervention. While habit reversal training (HRT) is considered the gold standard treatment for trichotillomania in young people, this article reviews a nascent treatment approach for trichotillomania in youth, acceptance-enhanced behavior therapy (AEBT). AEBT combines HRT and acceptance and commitment therapy skills. Each component of AEBT is described and reviewed. A detailed case exemplar of the 10-session protocol is presented. Future research directions and important clinical considerations are discussed.

Implementing Successful Early Childhood Obesity Prevention Interventions: The Need for Family-Based Effectiveness-Implementation Hybrid Studies.

Implementing Successful Early Childhood Obesity Prevention Interventions: The Need for Family-Based Effectiveness-Implementation Hybrid Studies.

Efficacy of rehabilitation initiated in the early phase after simultaneous deceased donor liver and kidney transplantation: A case report.

The purpose of this case report is to describe a case of successful early rehabilitation intervention for simultaneous liver and kidney transplantation (SLKT). A 51-year-old Japanese man was diagnosed with Caroli disease 27 years ago. Hemodialysis was introduced due to end-stage renal disease 17 years ago. After successful SLKT, the patient was extubated on postoperative day (POD) 1, liberated from dialysis on POD 4, and discharged from the intensive care unit on POD 9. Supervised rehabilitation was started on POD 2, and the patient was able to walk 100 m on POD 9. Electrical muscle stimulation therapy was started to improve muscle weakness in both legs on POD 16, and aerobic exercise using a cycle-ergometer was started on POD 24. The 6-minute walking distance improved from 324 m on POD 14 to 501 m on POD 28. The patient could walk 4000 to 5000 steps per day at hospital discharge, and was discharged home on POD 32. There were no adverse events, including worsening hepatic or renal function, during the rehabilitation period. One month after discharge, the patient was able to perform 30 to 40 minutes of aerobic exercise every day, and returned to work 5 months after discharge. This case shows that early rehabilitation intervention immediately after SLKT safely and rapidly improved physical performance without adverse events. The results in the present case suggest that regular physical assessment and appropriate interventions with a variety of exercise modalities can contribute to improved physical performance in SLKT patients.

Prediction of depression onset risk among middle-aged and elderly adults using machine learning and Canadian Longitudinal Study on Aging cohort

BackgroundEarly identification of the middle-aged and elderly people with high risk of developing depression disorder in the future and the full characterization of the associated risk factors are crucial for early interventions to prevent depression among the aging population. MethodsCanadian Longitudinal Study on Aging (CLSA) has collected comprehensive information, including psychological scales and other non-psychological measures, i.e., socioeconomic, environmental, health, lifestyle, cognitive function, personality, about its participants (30,097 subjects aged from 45 to 85) at baseline phase in 2012–2015. We applied machine learning models for the prediction of these participants' risk of depression onset approximately three years later using information collected at baseline phase. ResultsIndividual-level risk for future depression onset among CLSA participants can be accurately predicted, with an area under receiver operating characteristic curve (AUC) 0.791 ± 0.016, using all baseline information. We also found the 10-item Center for Epidemiological Studies Depression Scale coupled with age and sex information could achieve similar performance (AUC 0.764 ± 0.016). Furthermore, we identified existing subthreshold depression symptoms, emotional instability, low levels of life satisfaction, perceived health, and social support, and nutrition risk as the most important predictors for depression onset independent from psychological scales. LimitationsDepression was based on self-reported doctor diagnosis and depression screening tool. ConclusionsThe identified risk factors will further improve our understanding of the depression onset among middle-aged and elderly population and the early identification of high-risk subjects is the first step for successful early interventions.

Caregiver Implemented Dialogic Reading: Impact on Children with and without Autism in Brazil

There is evidence about the effectiveness of using caregiver-implemented, shared book reading protocols for mitigating language and literacy deficits in children with autism spectrum disorders (ASD). In Brazil, studies of this nature are scarce but essential for identifying successful early intervention practices for a population that has significantly grown in the last three decades. The aim of this investigation was to evaluate the effects of Reading to Engage Children with Autism in Language and Learning (RECALL), an intervention protocol that employs dialogic reading principles on the language and literacy skills of a 3-year-old child with ASD and a 4-year-old typically developing peer. Using a single-subject A-B research design, the effects of RECALL, employed by mothers, on their children's responses were evaluated. The results revealed that: (a) average effect size for strategy use following caregiver training was large for the mother of the child with ASD (Tau-U = 0,7) and moderate for the mother of the typically developing child (Tau-U = 0,5) ; (b) both children became more responsive, significantly increasing the frequency of communication interactions following caregiver intervention (Tau-U = 1); (d) the child with typical development showed an increase in the frequency of correct and spontaneous responses, and (c) the intervention was positively evaluated by the caregivers. Adaptations of the protocol, as well as its limitations, are discussed.

Caregiver Implemented Dialogic Reading: impact on children with and without autism in Brazil

There is evidence about the effectiveness of using caregiver-implemented, shared book reading protocols for mitigating language and literacy deficits in children with autism spectrum disorders (ASD). In Brazil, studies of this nature are scarce but essential for identifying successful early intervention practices for a population that has significantly grown in the last three decades. The aim of this investigation was to evaluate the effects of Reading to Engage Children with Autism in Language and Learning (RECALL), an intervention protocol that employs dialogic reading principles on the language and literacy skills of a 3-year-old child with ASD and a 4-year-old typically developing peer. Using a single-subject A-B research design, the effects of RECALL, employed by mothers, on their children's responses were evaluated. The results revealed that: (a) average effect size for strategy use following caregiver training was large for the mother of the child with ASD (Tau-U = 0,7) and moderate for the mother of the typically developing child (Tau-U = 0,5) ; (b) both children became more responsive, significantly increasing the frequency of communication interactions following caregiver intervention (Tau-U = 1); (d) the child with typical development showed an increase in the frequency of correct and spontaneous responses, and (c) the intervention was positively evaluated by the caregivers. Adaptations of the protocol, as well as its limitations, are discussed.

Bringing personality disorder in from the cold: Why personality disorder is a fundamental concern for youth mental health.

Personality disorder (PD) has its peak incidence between puberty and young adulthood. By any measure, it is among the most severe mental health problems occurring in young people, uniquely predicting debilitating current problems and acting as a 'gateway' to diverse and serious future problems. Yet, PD still struggles for legitimacy and parity of access to services, including early intervention. Addressing PD is fundamental to youth mental health, and early intervention for PD has reached 'proof of concept'. Yet, reform is hindered by bigotry and sectarianism. Successful early intervention calls for a shift in the culture of services, countering damaging myths, addressing bigotry, and fostering hope. Such reforms are well within the reach of youth mental health.

Placental and plasma early predictive biomarkers for gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) is a common disease that can give rise to adverse obstetric outcomes. For successful early intervention, more studies on novel predictive biomarkers for GDM are required. The protein expression profiles of placental tissue from patients with GDM and normal pregnant women were investigated using data-independent acquisition proteomics with five biological replicates. Early pregnancy maternal plasma samples from the GDM (n=79) and control (n=81) groups were used for further validation of candidate biomarkers. We identified 37 differentially expressed proteins between the two groups. CD109 antigen (CD109) and endosialin (CD248) were identified as hub proteins. In the validation experiments, CD109 expression was lower in the early pregnancy maternal plasma of patients with GDM compared with that in normal pregnant women, and CD248 expression was higher in the GDM group. The area under the curve of CD109, CD248, and their combination as indicators in early pregnancy maternal plasma was 0.681, 0.609, and 0.695, respectively. The present study is the first to obtain preliminary evidence that CD109 and CD248 can predict GDM during early pregnancy, as well as providing proteome-level insights into this disease's pathological mechanisms.

Acute psychiatric symptoms in a young woman with anti-N-methyl D-aspartate receptor encephalitis: A case of successful early diagnosis and therapeutic intervention.

This clinical image presents a report on the diagnosis and treatment of anti‐NMDAR encephalitis, a rare disease. This report emphasizes the importance of a differential diagnosis for acute psychiatric symptoms. Accurate and timely diagnosis is critical for the selection and implementation of treatment and for optimal patient outcomes.

Mass cytometry analysis of blood immune cells from psoriasis patients on biological therapy.

Psoriasis is a chronic immune-mediated skin disease accompanied by systemic inflammation and comorbidities. We analyzed peripheral blood mononuclear cells (PBMCs) in the search for immune signatures and biomarkers related to psoriasis severity and treatment effect. Thirty-two patients with psoriasis and 10 matched healthy controls were included. PBMCs were collected before and after initiation of anti-TNF, anti-IL-17 or anti-IL-12/23 treatment and analyzed utilizing 26-parameter mass cytometry. The number of circulating Th17, Th22, Th9, and cytotoxic T cells were increased in severe psoriasis. Intracellular pp38 and pERK in T helper cells were associated with disease severity. Differences between responders and nonresponders regarding cell composition and intracellular signaling were identifiable already at inclusion. Biological treatment induced memory cells, restored inhibitory PD-1 function of T cells, and reduced a potential pro-atherogenic profile in monocytes. In conclusion, these results indicate amelioration of systemic inflammation in psoriasis after biological treatment. Such broad immune profiling may enable prospective stratification of patients regarding future treatment response. Successful early intervention may lead to a healthier trajectory with favorable implications on later comorbidities.

Sleep and its regulation: An emerging pathogenic and treatment frontier in Alzheimer's disease.

A majority of patients with Alzheimer's disease (AD) experience some form of sleep disruption, including nocturnal sleep fragmentation, increased daytime napping, decreased slow-wave sleep (SWS, stage N3), and decreased rapid-eye-movement sleep (REM). Clinical studies are investigating whether such sleep disturbances are a consequence of the underlying disease, and whether they also contribute to the clinical and pathological manifestations of AD. Emerging research has provided a direct link between several of these sleep disruptions and AD pathophysiology, suggesting that treating sleep disorders in this population may target basic mechanisms of the disease. Here, we provide a comprehensive review of sleep disturbances associated with the spectrum of AD, ranging from the preclinical stages through dementia. We discuss how sleep interacts with AD pathophysiology and, critically, whether sleep impairments can be targeted to modify the disease course in a subgroup of affected AD patients. Ultimately, larger studies that fully utilize new diagnostic and experimental tools will be required to better define the most relevant sleep disturbance to target in AD, the interventions that best modulate this target symptom, and whether successful early intervention can modify AD risk and prevent dementia.

Results of a Government-supported Newborn Hearing Screening Pilot Project in the 17 Cities and Provinces from 2014 to 2018 in Korea.

BackgroundThe aim of this study was to present and analyze, for the first time, the results of a government-supported nationwide newborn hearing screening (NHS) pilot project in the 17 major cities and provinces of Korea.MethodsWe analyzed a nationwide NHS database of 344,955 newborns in the pilot project from 2014 to 2018. The government supported the cost of one NHS and one diagnostic auditory brainstem response (ABR) test. Hearing loss (HL) was defined as ≥ 40 dB nHL on either side of the ABR threshold test.ResultsMost NHS tests were performed in the maternity clinics (91.5%). In regions with lack of maternity clinics, the screening rate of local clinics was high (Jeju: 31.1% and Sejong: 12.9%). In most regions, automated ABR was mainly used for screening test (89.7%), but Gangwon (32.7%), Jeju (31.0%), and Jeonbuk (29.6%) performed more NHS tests using (automated) otoacoustic emissions than other regions. The mean referral rate was 1.5%, but the overall diagnostic ABR rate was low at 18.5%. The referral rates of Busan (0.6%) and Gyeongnam (0.9%) were lower than 1%, and Jeju's referral rate was 7.3%. Prevalence of HL including unilateral HL was 0.12%.ConclusionDepending on the cities and provinces, there were significant differences in the screening rates and referral rates by hospital type and NHS method. For successful early hearing detection and intervention (EHDI) and quality control, it will be necessary to support and manage EHDI according to regional NHS's characteristics and ensure that the whole country conducts EHDI as standard.

How to Obtain Reliable Visual Event-related Potentials in Newborns.

The present study discusses the characteristics of visual event-related potentials (VEPs) and outlines methodological steps for obtaining reliable measurements in newborns. Obtaining high-quality, reliable VEPs is crucial for the early detection of abnormal development of the central nervous system in at-risk newborns, and for implementing successful early interventions. Recommendations are based on a previous study which showed that when post-conceptional age, polysomnography-identified sleep stages, and light-emitting diodes (LEDs) googles as the luminous source are controlled, no more than 4 repetitions of VEP averages are required to obtain replicable recordings, variability decreases, and reliable VEPs can be obtained. By controlling for these sources of variability and using statistical analyses, we were able to clearly and reliably identify the amplitude and latency of three main components (NII, PII and NIII) present in 100% of newborns (n = 20) during active sleep. Recording VEPs during awake states, quiet sleep and transitional sleep is not recommended because VEP morphology may differ significantly from one average to the next, leading to the risk of misleading clinical prognoses. Moreover, it is easier to obtain VEPs during active sleep because this state can be clearly and reliably identified at this stage of development, sleep cycles are short enough to allow measurements to be taken in a reasonable time, and the method does not require new o expensive equipment.

Building Professional Capacity to Strengthen Parent/Professional Relationships in Early Intervention: The FAN Approach

A strong relationship between parents and professionals is essential to successful early intervention. Yet, programs struggle to engage families in services. This article describes a successful pilot project to strengthen parent/professional relationships for families with children with disabilities living in a high-poverty urban area. Early intervention (EI) providers were trained to use the FAN (Facilitating Attuned Interactions) approach to increase their attunement to parent concerns and capacity to collaborate with parents during early intervention therapy sessions. Over the pilot project, the providers felt more empathic with parents, more collaborative, and more effective and satisfied in their roles. FAN is a promising approach and practical tool to strengthen relationships between parents and professionals in EI.

SAT-292 Superimposed Peripheral Precocious Puberty Caused by Autonomous Ovarian Follicular Cyst in Being Treated Central Precocious Puberty Patient: Underlying Condition of Herlyn-Werner-Wunderlich Syndrome

Autonomous ovarian follicular cysts are known as the most common cause of peripheral precocious puberty(PPP) in prepubertal girls, and relapses of autonomous ovarian cysts resulting in prolonged estrogen exposure can precipitate early maturation of the hypothalamic-pituitary-gonadal axis, resulting in progression from PPP to central precocious puberty(CPP), which is called “combined precocious puberty”, an evolution which may require GnRH therapy. In present case, PPP caused by autonomous ovarian follicular cyst was developed concomitantly during the treatment course of CPP, with suppressed status of hypothalamic-hypophyseal-axis. In addition, a rare congenital Müllerian anomaly known as Herlyn-Werner-Wunderlich syndrome(HWWS), consisting of uterus didelphys, obstructed hemivagina and unilateral renal agenesis was incidentally diagnosed as an underlying condition. A 7-year-old girl was presented to our clinic with the development of breast buds which was examined as Tanner stage 2-3. Right renal agenesis was diagnosed in infancy. Her bone age was advanced as 10 years of age, and Luteinizing hormone(LH) showed pubertal response in LHRH stimulation test. The pelvic US revealed absence of right kidney and uterine enlargement. Brain MRI showed no specific abnormalities. Based on these results, We diagnosed idiopathic central precocious puberty. Thereafter, we commenced the treatment with Leuprolide acetate 3.75mg every 4 weeks. After the 11th injection of Leuprolide acetate, however, the patient complained of sudden breast engorgement and vagnal bleeding. Being considered as unsuccessful suppression of HPG axis, Leuprolide acetate was boosted. Hormonal analysis results revealed an extremely elevated level of estradiol and suppressed baseline gonadotropin levels. The pelvic US revealed double uterus, which had not been detected to that point. Abdominopelvic MRI demonstrated right renal agenesis and uterus didelphys with clearly separated uterine body, cervix and vagina. About 3cm sized cystic lesion with several internal daughter cysts is also discovered in left adnexa area. Based on all examinations, we concluded that PPP caused by autonomous ovarian cyst was superimposed on treatment course of CPP and HWWS was incidentally found as underlying disease. Maintaining GnRH agonist treatment, the progression of secondary sexual characteristics was halted and left ovarian cyst disappeared. In couclusion, clinician should be aware of possibility of autonomous ovarian follicular cyst when sudden progression of secondary sexual characteristics is shown in being treated CPP patients, and discriminate PPP from unsuccessfully treated CPP. Additionally, careful suspicion for HWWS that is tied to indications of renal agenesis in children may be the key for successful early diagnosis and immediate treatment intervention, which could prevent long-term complications.

Increased risk of intraventricular hemorrhage in low birth weight infants with aortic coarctation

Objective: To determine if there is an association between aortic coarctation (CoA) and intraventricular hemorrhage (IVH) in low birth weight (LBW) infants that may justify earlier intervention. While there is an increasing number of reports of successful early CoA intervention in LBW infants, there are no data to justify this approach.Material and methods: Retrospective review of the University Health System Consortium Clinical Data Base/Resource Manager, a national hospital discharge database. LBW (≤2 kg) infants, with and without IVH and isolated CoA were identified; IVH was stratified into low (grade 1 or 2) and high (grade 3 or 4) severity. Odds ratios were calculated for any, low and high-grade IVH with CoA.Results: Forty-six thousand and twenty LBW infants were identified; 3716 (8.1%) had IVH, 3001 (81%) with low, and 724 (19%) with high severity. Sixty-four infants had CoA, 13 had associated IVH (10 with low and three with high severity). The odds ratio for any IVH with CoA was 2.91 (95% CI 1.58–5.35), low severity 2.77 (95% CI 1.41–5.46) and high severity 3.45 (95% CI 1.07–11.07).Conclusions: In conclusion, this large retrospective database review found that LBW infants with CoA may be at increased risk of IVH. Further study is needed to determine if earlier catheter- or surgical-based intervention for CoA could reduce the risk of IVH in this population.

Current status of newborn hearing screening in low-income families in the southeastern region of Korea.

OBJECTIVESThe aim of this study was to analyze the current status and problems of hearing screening tests for newborns in low-income families in the southeastern Korea.METHODSThis study analyzed data from the Ministry of Health and Welfare’s project on the early detection of hearing loss in newborns in low-income families in the southeastern Korea (2011-2015).RESULTSThe referral rate was 1.33, 1.69, and 1.27% in Daegu, Gyeongbuk, and Ulsan, respectively. The confirmatory test rate was 36.09, 23.38, and 52.94% in Daegu, Gyeongbuk, and Ulsan, respectively. The incidence of hearing loss (adjusted) was 0.41, 0.62, and 0.41% in Daegu, Gyeongbuk, and Ulsan, respectively. After confirming hearing loss, newborns with hearing handicaps were mostly lost to follow-up, and rehabilitation methods, such as hearing aids or cochlear implants, were not used. The screening tests were performed within 1 month of birth, and the confirmatory tests were generally performed within 3 months of birth. However, more than 3 months passed before the confirmatory tests were performed in infants with risk factors for hearing loss in Gyeongbuk and Ulsan.CONCLUSIONSHearing screening tests were conducted in newborns from low-income families in southeastern Korea who received a coupon for free testing, but the newborns that were referred after the screening tests were not promptly linked to the hospitals where confirmatory tests were performed. Furthermore, hearing rehabilitation was not consistently performed after hearing loss was confirmed. To successful early hearing loss detection and intervention, a systematic tracking system of hearing loss children is needed.

Fatalno intracerebralno krvarenje na dvojnoj antitrombocitnoj terapiji kod pacijenta sa infarktom miokarda bez ST elevacije koji je lečen urgentnom perkutanom koronarnom intervencijom

According to valid guidelines for the use of dual antiplatelet therapy in patients with myocardial infarction without ST elevation (NSTEMI), the use of dual antiplatelet therapy -ASA and ticagrelor is recommended (class I level of evidence B). We report a case of a successful early percutaneous coronary intervention (early PCI) in a patient with a myocardial infarction without ST elevation which received a loding dose ticagrelor after coronary angiography. We found the subtotal stenosis of the right coronary artery and stent implantation is performed.Our case showed implementation of 2015. ESC guidelines on dual antiplatelet therapy in patient with NSTEMI. The procedure was successful without periprocedural complication.but at 22 hours next day patient was intracranial hemorrhage and 48 after patient died.