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Results for “Early intervention”

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PubMed1994

[Early intervention and treatment of depressive and manic states among university students].

Early intervention and treatment of manic and depressive states at university mental health service are described. Frequency of depression among the population of university students is about 0.1-0.2% and has increased during the last 10 years. The diagnoses of depressive states according to DSM-III-R are as follows; adjustment disorder with depressed mood (50%), major depression (20-30%), dysthymia (20%), and bipolar disorder (5-8%). Some plans for early intervention are discussed, including screening and consultation from the teaching staff and parents. Concerning treatment, it is important to support their academic problems caused by their mental disorders in close cooperation with their parents and their teaching staff.

Adult↗

PubMedDate not supplied

[Early intervention in alcohol abuse and addiction in general acute care hospitals].

Early intervention has been shown to prevent alcohol-related diseases of the liver, the pancreas, and the gastrointestinal tract, as well as to reduce high blood pressure and the incidence of hospitalizations. At a general hospital, 27 patients were offered addiction counselling, six of whom were successfully referred to an outpatient addiction counsellor. However, prevalence rates of alcohol abuse and addiction were significantly lower than those reported in other studies. Similarly, referrals to addiction counselling were less frequent than in other programmes in which hospital staff had been specifically trained to identify problems of alcohol abuse and addiction and to initiate timely referrals. Intensive training of hospital staff as well as the provision of personal and logistical support at the hospital is crucial in the implementation of early intervention programmes for alcohol abuse and addiction in general hospitals.

Adult↗

PubMed2006

Cost-effectiveness of early intervention with once-daily budesonide in children with mild persistent asthma: results from the START study.

The inhaled Steroid Treatment As Regular Therapy in early asthma (START) study has shown that early intervention with inhaled budesonide in mild persistent asthma improves clinical outcomes in both adults and children. The aim of this study was to estimate the incremental cost-effectiveness of early treatment with budesonide Turbuhaler in children aged 5-10 yr who participated in START. Direct and indirect costs associated with asthma were determined for 1974 children participating in the double-blind, 3-year part of the study. Randomization was to placebo or to budesonide 200 microg once daily in each case in addition to usual asthma care. Cost-effectiveness ratios were calculated from the healthcare payer's and societal perspectives (using US prices). The addition of once-daily budesonide therapy to usual asthma care was associated with 16 additional symptom-free days (SFDs) per child over the 3-yr period (p < 0.001), with a substantial reduction (50%) in the mean number of days spent in hospital, and with reduced frequency of emergency room visits and missed school and caregiver work days. From the healthcare payer's perspective (direct costs), the increase in mean direct cost over 3 yr with budesonide was 169 dollars, which translated into an incremental cost of early intervention with budesonide in children of 10.50 dollars (95% CI 1.20-33.30 dollars) per SFD gained. From the societal perspective, there was a cost reduction over 3 yr of 192 dollars with budesonide relative to placebo. From a societal perspective, budesonide was therefore dominant. In conclusion, early intervention with once-daily budesonide added to usual asthma care in children with mild persistent asthma is cost-saving from a societal perspective and is acceptably cost-effective when viewed from a healthcare payer perspective.

Administration, Inhalation↗

PubMed1990

Depends on who you ask: what maximizes participation of families in early intervention programs.

This two-part study was a preliminary investigation of the types of procedures that could be useful in maximizing the participation of families in early intervention programs for their special-needs infants, toddlers, and pre-schoolers. In Study 1, 64 professionals in the early intervention field completed a survey that described 29 potential techniques for maximizing participation of families. For each technique, the respondents endorsed whether they employed the procedure, or would if they could. In addition, they rated the expected effectiveness of each procedure. Verbal praise and encouragement were highly rated and almost universally in use, as were various types of written and resource materials. Tangible reinforcement was seldom employed and professional respondents tended to indicate that they did not expect that such techniques would be useful. In Study 2, 29 mothers of high-risk infants and toddlers currently in early intervention rated the same 29 procedures, but were significantly more likely to endorse the use of tangible reinforcers and logistical support. Comparisons among respondents from professional and parent samples were discussed, along with implications of the findings and necessary directions for future research in this area.

Adult↗

PubMed2005

Substance abuse in first-episode bipolar I disorder: indications for early intervention.

OBJECTIVE: This study clarified the early characteristics of substance use disorders in patients with first-episode bipolar I disorder. METHOD: The authors evaluated substance use disorders, associated factors, and clinical course, prospectively, in the first 2 years of DSM-IV bipolar I disorder with standardized methods. RESULTS: Baseline substance use disorder was found in 33% (37 of 112) of the patients at baseline and in 39% at 24 months. Anxiety disorders were more frequent in the patients with than without substance use disorder (30% and 13%, respectively). Associations of alcohol dependence with depressive symptoms and cannabis dependence with manic symptoms were suggested. Patients using two or more substances had worse outcomes. CONCLUSIONS: Since substance use disorders were frequent from the beginning of bipolar I disorder and were associated with anxiety disorders and poor outcome, early interventions for substance use disorder and anxiety might improve later outcome.

Adult↗

PubMedDate not supplied

Principles of early intervention in the treatment of psychosis.

Early intervention in psychosis is the first of a new wave of preventive strategies in psychiatry. Evidence from well-conducted studies suggests that it can prevent the development of the long-term debilitating negative symptoms of schizophrenia. This article discusses the research basis of the interventions, practical issues around its implementation and some possible limitations.

Counseling↗

PubMed1988

Minimizing adverse effects of low birthweight: four-year results of an early intervention program.

The outcome of an early intervention program for low-birthweight (LBW) infants was examined in this study. The intervention consisted of 11 sessions, beginning during the final week of hospitalization and extending into the home over a 3-month period. The program aimed to facilitate maternal adjustment to the care of a LBW infant, and, indirectly, to enhance the child's development. Neonates weighing less than 2,200 grams and under 37 weeks gestational age were randomly assigned to experimental or control conditions. A full-term, normal birthweight (NBW) group served as a second control. 6-month analyses of dyads who completed all assessments over a 4-year period (N's = 25 LBW experimental, 29 LBW control, and 28 NBW infant-mother dyads) showed that the experimental group mothers reported significantly greater self-confidence and satisfaction with mothering, as well as more favorable perception of infant temperament than LBW control group mothers. A progressive divergence between the LBW experimental and LBW control children on cognitive scores culminated in significant group differences on the McCarthy GCI at ages 36 and 48 months, when the LBW experimental group caught up to the NBW group. Possible explanations for the observed delay in the emergence of intervention effects on cognitive development and the mediating role of favorable mother-infant transactional patterns are discussed in light of recent evidence from the literature.

Child, Preschool↗

PubMed1980

Effects of early intervention and stimulation on the preterm infant.

To test the hypothesis that early intervention can enhance the development of high-risk preterm infants, a prescribed multimodal sensory enrichment program, within a regional neonatal intensive care unit, was designed and implemented. Twenty-eight appropriate-for-gestational age infants with birth weights between 1,200 and 1,800 gm were selected for study. To prevent control group contamination by the enrichment procedure the first 14 infants were designated as the control group, and the next 14 as the treatment group. Treated infants had significantly higher developmental status than control infants, as measured by the Bayley Scales of Infant Development, at six months past the maternal expected date of confinement (F = 14.98, P < .001, and F = 16.46, P < .001 for the mental and motor scales, respectively). Mean infant weight gain per day and mean total weight gain during the hospitalization were not significantly different for the two groups although the treatment group received significantly less calories per kilogram per day than the control group (F = 9.02 P < .006). Our data suggest that a prescribed intervention program for high-risk preterm infants appears to enhance the quality of development as measured at six months past the expected date of confinement. Further studies are necessary to determine the long-term value of early intervention and the apparent ability of infants receiving an enrichment program to utilize calories more efficiently than control infants.

Body Weight↗

PubMed1980

Early intervention with Down syndrome children: follow-up report.

This report compares developmental milestones and current intellectual and adaptive functioning of 20 children with Down syndrome who participated in an early intervention program with those of 53 noninstitutionalized children with Down syndrome who did not experience such a program. The children in the former group generally showed earlier acquisition of motor and self-help skills and significantly higher intelligence quotients and social quotients at three to six years of age. Because of certain variables that could not be rigorously controlled in this type of program, the higher functioning cannot be clearly attributed to early intervention. These findings nevertheless are consistent with the hypothesis that early intervention has a beneficial effect and should provide encouragement for further studies.

Child↗

PubMed1995

Surgery for low-grade glioma: rationale for early intervention.

We feel that early surgical intervention is appropriate in the patient who presents with a clinical picture suggesting a low-grade glioma. Neuroimaging is not adequate to make an accurate diagnosis of the underlying pathology. Tumor tissue sampling allows a more specific diagnosis and testing for biologic factors such as the proliferative potential of the lesion. Surgical diagnosis allows a disease-specific therapy to be more appropriately prescribed to the patient, including the option for no further treatment, radiotherapy, and/or chemotherapy. There is compelling early data that suggest that the extent of surgery and the postoperative tumor volume will be predictive of outcome in at least some tumor types. We encourage participation of physician and patients in well-designed clinical trails that will ultimately answer the many questions that remain about these unique diseases.

Brain Neoplasms↗

PubMedDate not supplied

Pediatrician practices regarding referral to early intervention services: is an established diagnosis important?

OBJECTIVE: Early intervention (EI) programs provide services to children with developmental conditions, regardless of whether such children have an underlying medical diagnosis. We aim to (1) Determine the proportion of general pediatricians who believe an established diagnosis is important when considering EI referral; and (2) Determine whether this perception is associated with lower reported likelihood of referral. METHODS: Mailed survey to random sample of pediatricians. We used multivariable logistic regression to study the association between the perception that a medical diagnosis is important when referring to EI, and the reported likelihood of EI referral for children with common developmental conditions. RESULTS: Response rate was 55% (894 of 1617). A total of 64% of respondents considered an established diagnosis important for EI referral. Likelihood of referral for delayed speech was lower among those who considered a diagnosis important than among those who did not (77% vs 87%; P = .02). Similar patterns held for global delay (91% vs 97%; P = .02), loss of developmental milestones (80% vs 88%; P = .03), and parental concern for inappropriate development (45% vs 60%; P = .002). In multivariable models, perception of the importance of an established diagnosis was associated with lower likelihood of referral for children with delayed speech (adjusted odds ratio [aOR] 0.48; 95% confidence interval [CI] 0.26-0.87) and for parental concern for inappropriate development (aOR 0.46; 95% CI 0.30-0.72). CONCLUSIONS: A majority of general pediatricians believe that an established diagnosis is important when considering EI referral. This perception is associated with decreased reported referral for children with speech delay and those whose parents express concern for inappropriate development.

Attitude of Health Personnel↗

PubMed1996

Effect of an early intervention program on the relationship between subjective pain and disability measures in nurses with low back injury.

STUDY DESIGN: The effect of a workplace-based early intervention program on perceptions of pain and disability in nurses with low back injury was studied using a preintervention versus postintervention design with concurrent control group. OBJECTIVES: To examine the relationship and changes over time between pain and disability measures in two groups of back-injured nurses--those who received the early intervention program (study) and those who were not offered the program (control). SUMMARY OF BACKGROUND DATA: The relationship between back pain and disability is not straightforward. The effects of an intervention program on changes in perceptions of pain and disability over time have not been widely reported. METHODS: The Oswestry Low Back Disability Questionnaire and a visual analog pain scale were administered to 46 study nurses and 137 control nurses at time of injury and at 6 months after injury. Correlation and regression analyses were used to explore the relationships between the two measures. Changes over time were compared with analyses of variance. RESULTS: Pain and disability were positively correlated in both groups at time of injury and at follow-up evaluation. Mean scores for pain and disability were lower at follow-up evaluation than at initial injury in both groups; study nurses had significantly (P < 0.01) lower scores at 6 months than nurses in the control group. Disability at time of injury predicted disability at 6 months only for nurses in the control group. CONCLUSIONS: This workplace-based early intervention program decreased levels of pain and disability in back-injured nurses and altered the relationship between these two variables over a 6-month time interval.

Demography↗

PubMed2002

The practice of early recognition and early intervention to prevent psychotic relapse in patients with schizophrenia: an exploratory study. Part 1.

In this article we describe the findings of an exploratory study into the application of early recognition and early intervention methods aimed at prevention of psychotic relapses in patients with schizophrenia. We addressed several models of symptom recognition plans and indicated how patients, healthcare professionals and other persons involved may be able to list and evaluate early warning signs systematically. We also paid attention to the role of the patient's family and to the potential effects of using early recognition and early intervention methods. In a follow-up article (part 2), we will focus more specifically on factors which favourably or adversely affect the use of early recognition and early intervention methods. The results of this exploratory study will be used to design an intervention protocol for nursing staff to serve as a tool for preparing symptoms recognition plans with the individual patient and his/her social network.

Adult↗

PubMedDate not supplied

Patterns of service use in preschool children: correlates, consequences, and the role of early intervention.

This article explores service use broadly by examining the mix of educational, health, and psychosocial services that preschool children received in the fifth year of life. The sample included 869 children who participated in the Infant Health and Development Program, an early intervention program designed to evaluate the efficacy of a comprehensive early intervention for low-birth-weight, premature infants during the first 3 years of life and who were followed until age 5. Cluster analyses of services at age 5 yielded 4 service groups--basic health only (doctor visits; n = 114); basic health and educational services (doctor visits and school/preschool; n = 444); basic health, educational, and psychosocial services (or multiple services; doctor visits, school/preschool, and psychosocial services; n = 129); and specialized health and educational services (doctor visits, school/preschool, emergency room visits and special medical visits [ear and/or eye examinations]; n = 182). Results suggest that neonatal health conditions, maternal education at the time of the child's birth, child developmental status at age 3, and maternal health, family income, and insurance status at age 5 were associated with patterns of services at age 5. Patterns of use are consistent over time (the first 3 years of life to the 5th year of life). After covarying the correlates of the service patterns, participation in the early intervention was not associated with patterns of services at age 5, and service patterns were associated with child well-being (health, school readiness, mental health), but results differed by intervention status. Findings are discussed in terms of preventive, responsive, and deficit models of service use.

Child Health Services↗

PubMed2006

A randomized, controlled trial of the effectiveness of an early-intervention program in reducing parenting stress after preterm birth.

BACKGROUND: Preterm birth has been associated with increased parenting stress in early infancy, and some reports have found this to be a risk factor for later behavioral problems. There are, however, few studies and conflicting results. Information about the fathers is scarce. OBJECTIVES: Our goal was to study the effects of an early-intervention program on parenting stress after a preterm birth until 1 year corrected age. METHODS: A randomized, controlled trial was conducted including infants with a birth weight <2000 g treated at the University Hospital of North Norway Trust, which serves the 2 northern-most counties in Norway, to examine the effects of a modified version of the Mother-Infant Transaction Program on parenting stress measured by the Parenting Stress Index. A term control group was also recruited. The Parenting Stress Index was administered to the mothers at 6 and 12 months' corrected age and to the fathers at 12 months' corrected age. The intervention consisted of 8 sessions shortly before discharge and 4 home visits by specially trained nurses focusing on the infant's unique characteristics, temperament, and developmental potential and the interaction between the infant and the parents. RESULTS: Seventy-one infants were included in the preterm intervention group, and 69 were included in the preterm control group. The preterm groups were well balanced. Seventy-four infants were included in the term control group. Compared with the preterm controls, both the mothers and fathers in the preterm intervention group reported significant lower scores in child domain, parent domain, and total stress on all occasions except the mother-reported child domain at 12 months. These differences were not related to birth weight or gestational age. The level of stress among the preterm intervention group was comparable to their term peers. Both parents in the intervention group reported consistently lower scores within the distractibility/hyperactivity, reinforces parents, competence, and attachment subscales compared with the preterm control group. There were no differences in mean summary stress scores between the mothers and fathers in the 2 preterm groups at 12 months, but the intraclass correlation coefficient was higher in the intervention group. CONCLUSIONS: This early-intervention program reduces parenting stress among both mothers and fathers of preterm infants to a level comparable to their term peers. We are now studying whether this will result in long-term beneficial effects.

Adult↗

PubMed1992

Child psychiatry and early intervention: II. The internalizing disorders.

This paper uses the concepts introduced in the paper Child Psychiatry and Early Intervention: I. The Aggregate Burden of Suffering to review the internalizing disorders of childhood. This review surveys the internalizing disorders from the point of view of early intervention, for their prevalence, course, risk, early indicators, associated impairment, and responses to intervention. In general, the internalizing disorders have little effect on the community. When coupled with other disorders such as conduct disorder, or when dealing with suicide, the community's concern for these disorders increases and allocation of resources to target populations who are at risk becomes an important public health goal.

Anxiety Disorders↗

PubMed2001

Thoughts on early intervention.

The concept of early psychological intervention in response to traumatic events has been a compelling notion since World War I. Recently, its wisdom applied to mass disasters such as September 11th, has been called into question. A review of relevant research reveals support for its continued utilization, but not without caution. Crisis intervention, in response to mass disasters, should consist of an integrated multi-component intervention system.

Crisis Intervention↗

PubMed1990

[Preventive approach to newborn infants, at risk, early intervention: what is its purpose? 2].

In this study, the bases of the principle of early intervention have been examined. At-risk neonates should be assessed as early as possible via a preventive and therapeutic approach. Before the situation aggravates to such an extent that treatment administered has no effect, early intervention can in fact prevent a number of difficulties from taking place, which arise when the environment cannot be adapted to the at-risk neonates. During early childhood, the association of the child's developmental processes and the parent's available energy, resulting in development of the child's optimum potential, has in fact exceeded our expectations. The assessment of the infant's capacity to organize positive interaction experiences with a nurturing adult has led us to better understand the plasticity process which permits the neonate's recuperation form damage to the central nervous system (CNS). Informing the parents in question of our observations and approach in order to improve the child's behaviour has resulted in gained confidence and cooperation, and therefore optimum recuperation. Our assessments of normal and premature neonates have both for ourselves and the parents led to a better understanding of organization and ongoing development, which in early childhood may also include the direct interview procedure. In other words, assessment by observation of a neonate's state of health consists not only of evaluating organizational capacities connected with his or her present state, but also how the infant will affect parental attitudes, and in turn what the parents will have to do to organize the child. By sharing our assessment with the parents, and with close cooperation, we aid them in identifying the positive elements as well as the defects in the child's potential. Thus the parents can utilize their nurturing capacities in their relationship with the child to bring about the best recuperation possible. Repeated observations enable an evaluation to be made of the neonate's organizational capabilities during the recuperative period following birth, and adaptation to the new environment. Adopting the same procedure throughout the child's first year of life has permitted us to share with the parents observation of the child's progress, and to point out to them the effect that they have in this area. The above system has aided the parents by showing them that the child can be organized and that its health is recuperable, even after damage to the CNS or premature birth.(ABSTRACT TRUNCATED AT 400 WORDS)

Child Behavior↗