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6 result(s) for "Hines, Ashleigh"
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School readiness of children at high risk of cerebral palsy randomised to early neuroprotection and neurorehabilitation: protocol for a follow-up study of participants from four randomised clinical trials
IntroductionSchool readiness includes cognitive, socio-emotional, language and physical growth and development domains which share strong associations with life-course opportunities. Children with cerebral palsy (CP) are at increased risk of poor school readiness compared with their typically developing peers. Recently, earlier diagnosis of CP has allowed interventions to commence sooner, harnessing neuroplasticity. First, we hypothesise that early referral to intervention for children at-risk of CP will lead to improved school readiness at 4–6 years relative to placebo or care as usual. Second, we hypothesise that receipt of early diagnosis and early intervention will lead to cost-savings in the form of reduced healthcare utilisation.Methods and analysisInfants identified as at-risk of CP ≤6 months corrected age (n=425) recruited to four randomised trials of neuroprotectants (n=1), early neurorehabilitation (n=2) or early parenting support (n=1) will be re-recruited to one overarching follow-up study at age 4–6 years 3 months. A comprehensive battery of standardised assessments and questionnaires will be administered to assess all domains of school readiness and associated risk factors. Participants will be compared with a historical control group of children (n=245) who were diagnosed with CP in their second year of life. Mixed-effects regression models will be used to compare school readiness outcomes between those referred for early intervention versus placebo/care-as-usual. We will also compare health-resource use associated with early diagnosis and intervention versus later diagnosis and intervention.Ethics and disseminationThe Children’s Health Queensland Hospital and Health Service, The University of Queensland, University of Sydney, Monash University and Curtin University Human Research Ethics Committees have approved this study. Informed consent will be sought from the parent or legal guardian of every child invited to participate. Results will be disseminated in peer-reviewed journals, scientific conferences and professional organisations, and to people with lived experience of CP and their families.Trial registration numberACTRN12621001253897.
Harnessing neuroplasticity to improve motor performance in infants with cerebral palsy: a study protocol for the GAME randomised controlled trial
IntroductionCerebral palsy (CP) is the most common physical disability of childhood worldwide. Historically the diagnosis was made between 12 and 24 months, meaning data about effective early interventions to improve motor outcomes are scant. In high-income countries, two in three children will walk. This evaluator-blinded randomised controlled trial will investigate the efficacy of an early and sustained Goals–Activity–Motor Enrichment approach to improve motor and cognitive skills in infants with suspected or confirmed CP.Methods and analysisParticipants will be recruited from neonatal intensive care units and the community in Australia across four states. To be eligible for inclusion infants will be aged 3–6.5 months corrected for prematurity and have a diagnosis of CP or ‘high risk of CP’ according to the International Clinical Practice Guideline criteria. Eligible participants whose caregivers consent will be randomly allocated to receive usual care or weekly sessions at home from a GAME-trained study physiotherapist or occupational therapist, paired with a daily home programme, until age 2. The study requires 150 participants per group to detect a 0.5 SD difference in motor skills at 2 years of age, measured by the Peabody Developmental Motor Scales-2. Secondary outcomes include gross motor function, cognition, functional independence, social–emotional development and quality of life. A within-trial economic evaluation is also planned.Ethics and disseminationEthical approval was obtained from the Sydney Children’s Hospital Network Human Ethics Committee in April 2017 (ref number HREC/17/SCHN/37). Outcomes will be disseminated through peer-reviewed journal publications, presentations at international conferences and consumer websites.Trial registration numberACTRN12617000006347.
State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy
Purpose of ReviewCerebral palsy is the most common physical disability of childhood, but the rate is falling, and severity is lessening. We conducted a systematic overview of best available evidence (2012–2019), appraising evidence using GRADE and the Evidence Alert Traffic Light System and then aggregated the new findings with our previous 2013 findings. This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019.Recent FindingsEffective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pressure care, stepping stones triple P, strength training, task-specific training, treadmill training, partial body weight support treadmill training, and weight-bearing. Effective medical and surgical interventions include anti-convulsants, bisphosphonates, botulinum toxin, botulinum toxin plus occupational therapy, botulinum toxin plus casting, diazepam, dentistry, hip surveillance, intrathecal baclofen, scoliosis correction, selective dorsal rhizotomy, and umbilical cord blood cell therapy.SummaryWe have provided guidance about what works and what does not to inform decision-making, and highlighted areas for more research.
School readiness of children at high risk of cerebral palsy r andomised to early neuroprotection and neurorehabilitation: protocol for a follow-up study of participants from four randomised clinical trials
School readiness includes cognitive, socio-emotional, language and physical growth and development domains which share strong associations with life-course opportunities. Children with cerebral palsy (CP) are at increased risk of poor school readiness compared with their typically developing peers. Recently, earlier diagnosis of CP has allowed interventions to commence sooner, harnessing neuroplasticity. First, we hypothesise that early referral to intervention for children at-risk of CP will lead to improved school readiness at 4-6 years relative to placebo or care as usual. Second, we hypothesise that receipt of early diagnosis and early intervention will lead to cost-savings in the form of reduced healthcare utilisation. Infants identified as at-risk of CP ≤6 months corrected age (n=425) recruited to four randomised trials of neuroprotectants (n=1), early neurorehabilitation (n=2) or early parenting support (n=1) will be re-recruited to one overarching follow-up study at age 4-6 years 3 months. A comprehensive battery of standardised assessments and questionnaires will be administered to assess all domains of school readiness and associated risk factors. Participants will be compared with a historical control group of children (n=245) who were diagnosed with CP in their second year of life. Mixed-effects regression models will be used to compare school readiness outcomes between those referred for early intervention versus placebo/care-as-usual. We will also compare health-resource use associated with early diagnosis and intervention versus later diagnosis and intervention. The Children's Health Queensland Hospital and Health Service, The University of Queensland, University of Sydney, Monash University and Curtin University Human Research Ethics Committees have approved this study. Informed consent will be sought from the parent or legal guardian of every child invited to participate. Results will be disseminated in peer-reviewed journals, scientific conferences and professional organisations, and to people with lived experience of CP and their families. ACTRN12621001253897.
Tobacco cessation interventions in high-income countries with Chinese, Vietnamese and Arab people who smoke: a scoping review of outcomes and cultural considerations
ObjectivesThere are large and growing communities of Chinese, Vietnamese and Arab populations within many high-income countries, including Australia. These populations experience disproportionately higher rates of tobacco smoking. Cessation strategies are required that acknowledge the cultural factors shaping smoking behaviours. This review aimed to synthesise the evidence for smoking cessation interventions among Chinese, Vietnamese and Arab people, including outcomes and cultural considerations.DesignScoping review.Data sourcesWe searched five electronic databases for peer-reviewed literature (CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, PsycINFO, PubMed and Scopus). Relevant grey literature was sourced from research and health organisations, and community cultural organisations.Eligibility criteriaEnglish-language studies of tobacco cessation interventions with Chinese-speaking, Vietnamese-speaking or Arabic-speaking participants conducted in Australia, the USA, Canada, the UK or New Zealand between 2013 and 2025.Data extraction and synthesisTwo reviewers independently screened for eligible studies and, if included, assessed risk of bias using Joanna Briggs Institute critical appraisal tools.ResultsWe identified 23 studies describing 15 intervention types, with written resources most highly featured. Promising category evidence was found for nine intervention types with Chinese people (written information, education sessions, visual information, counselling, involving others, providing nicotine replacement therapy, intervention branded merchandise, mobile messaging and telephone follow-up), as well as counselling with Arab people, and telephone follow-up with Vietnamese people. A variety of cultural considerations were addressed in the interventions, most commonly language barriers as well as the use of co-design and community participation.ConclusionsSmoking cessation interventions with Chinese people were strongly supported, with less evidence for interventions with Vietnamese and Arabic people. Education-focused interventions were particularly effective, addressing low baseline knowledge underpinning smoking. Language barriers to smoking cessation were addressed through primary language supports. Further research is needed on effective smoking cessation intervention types with Arab and Vietnamese people.
Election Day Just 10 Weeks From Tomorrow; Both Campaigns Focused on First of Three Presidential Debates. Aired 12:30-1p ET
Election Day is just 10 weeks from tomorrow. But right now both campaigns are focused on a ritual that comes much, much sooner, just four weeks from today. That the first of three presidential debates. The first time the voters are going to see Donald Trump versus Hillary Clinton, mano a mano on the stage.