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PubMed1985

A systems design developmental model for programs of deinstitutionalization: marketing base for follow-up care.

Devising plans to maintain individuals with a chronic mental disability in the community following a long-term hospitalization is a highly complex problem. One of the significant aspects of this problem is the availability of adequate living arrangements that promote individual growth and development, provide professional support and care, and elicit the concern of members in the community who will provide these living arrangements. Alternate living arrangements require social experimentation in efforts to ascertain and appraise which one(s) are most appropriate for any given community. This paper devises a method of sequential development of alternatives in which each arrangement is appraised as it emerges in the community in relation to cost, knowledge acquired and utilized, technology advanced, and other resources required. It was assumed that each living arrangement produces different results in development. It further assumes that each living arrangement learns in development to the best interest of the chronic mentally disabled. The result of this innovative systems design is that professionals can make decisions on placement based on knowledge, information, technology, and cost as it emerges in juxtaposition to the results such programs are having on those in need.

Aftercare↗
PubMedDate not supplied

Home-based developmental screening of children in foster care.

Children in foster care have a high prevalence of developmental delay. A program for developmental screening was designed to address the increased risk of developmental delay among children in foster care. Fifty-two children birth to 18 months were evaluated using the Denver Developmental Screening Test-II (DDST-II), Early Language Milestone Scale-2 (ELM-2), and the HOME Scale. Forty-nine children were screened with the Infant Neurological International Battery. Thirty five percent of the children failed DDST-II screening. Language assessment with the ELM-2 resulted in a mean global ELM-2 standard score of 89. Sixty-one percent of children had abnormal neurologic INFANIB screening exams. HOME scores reflected foster care environments that provided adequate developmental and emotional stimulation for the children. Implications for future interventions should move from developmental screening to comprehensive developmental testing and expansion of foster parent education regarding the growth and development of the foster children in their care.

Community Health Nursing↗
PubMed2002

Indications of improved cognitive development at one year of age among infants born very prematurely who received care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP).

BACKGROUND AND OBJECTIVE: Care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to exert a positive impact on the development of prematurely born infants. The aim of the present investigation was to determine the effect of such care on the 1-year development of infants born with a gestational age of less than 32 weeks. METHODS: All surviving infants (11 in the NIDCAP group and 9 in the control group) were assessed employing the Bayley Scales of Infant Development at 1 year of corrected age. RESULTS: The Mental Developmental Index (MDI) of children who had received care according to NIDCAP was higher [88 (72-114)] [median (range)] than the corresponding value for the control children [78 (50-82)] (p=0.01). The odds ratio for being alive with an MDI>80 was 14 (95% CI; 1.4-141.5) in favour of the intervention group. However, the Psychomotor Developmental Indices (PDI) were not significantly different [85 (61-108) and 69 (50-114), respectively] (p=0.23). CONCLUSION: Our findings indicate that care based on the NIDCAP might have a positive impact on the cognitive development of infants born very prematurely.

Birth Weight↗
PubMed2000

A randomized, controlled trial to evaluate the effects of the newborn individualized developmental care and assessment program in a Swedish setting.

BACKGROUND AND OBJECTIVE: Family-centered developmentally supportive care of very low birth weight infants, provided by the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to have positive medical and economic impacts. Our aim was to investigate its effect on need of ventilatory assistance, growth, and hospitalization in a Swedish setting. METHODS: Preterm infants born between September 1994 and April 1997 with a gestational age <32 weeks and with a need of ventilatory assistance at 24 hours were randomly assigned to either NIDCAP (n = 12) or conventional care (n = 13). The 2 groups were comparable (median [range]) with respect to birth weight (1083 [630-1411] vs 840[636-1939 g]), head circumference (24.0 [22.3-26.5] vs 24.0 [21. 1-30.0 cm]), gestational age (27.6 [24.0-28.7] vs 26.1 [23.9-30.3] weeks), female/male ratio (3/9 vs 9/8) and Clinical Risk Index for Babies (4.0 [0-11] vs 6.0 [2-15]). The infants in the intervention group were cared for in a separate room by a group of specially trained nurses. Formal weekly observations of these infants starting within 3 days after birth and continuing until 36 weeks postconception were used to develop individualized care plans. These plans provided recommendations as to how care might be attuned to the current developmental stage of the infant and how the family might be supported and stimulated to participate in this care. The treatment of the 2 groups was in all other respects identical. RESULTS: The duration of mechanical ventilation (median [range] was 2.8 [0-36.7] days in the intervention group vs 4.8 [.1-29.8] days; not significant [NS]) among the controls and continuous positive airway pressure was applied for 26.1 (6.9-52.0) vs 43.9 (5.0-65.1) days. Supplementary oxygen was withdrawn at 33.0 (29.3-35.7) vs 38.1 (33.1-44.9) weeks of postconceptional age (PCA). The weight gain up to 35 weeks of PCA was 13.0 (6.7-21.0) vs 9.8 (6.8-16.6) g/day (NS). The head growth up to 35 weeks of PCA was.73 (.56-1.3) vs.63 (.56-. 77) cm/week (NS). The age of the infant at discharge was 38.3 (36. 1-57.7) vs 41.0 (36.9-48.4) weeks of PCA (NS). CONCLUSIONS: NIDCAP does not seem to have detrimental effects on Swedish very low birth weight infants in comparison with conventional care. Indeed, NIDCAP might even be advantageous.

Adult↗
PubMed1995

A social skills training program for preschoolers with developmental delays. Generalization and social validity.

This investigation was designed to assess a social skills training program with 32 developmentally delayed preschoolers. Subjects were evaluated in an unstructured play session, matched for levels of appropriate and inappropriate social behaviors, and assigned to either a treatment or control condition. The treatment group (N = 16) was presented with a 6-week protocol involving positive reinforcement, modeling, rehearsal, feedback, and time out. Controls (N = 16) received no instruction beyond regular classroom activities during the 6 weeks. The two groups were reevaluated in a posttest session and again in a generalization setting where two peers with developmental delays (not included in either experimental condition) were included. Prosocial behaviors were successfully taught and maintained in generalization settings. Efforts to reduce inappropriate behaviors were less successful. A test of social validity via teachers' ratings of videotapes of pretest and posttest assessments was also conducted. Implications for generalization and social validity research are discussed.

Behavior Therapy↗
PubMed1976

Negotiating educational programs for children with developmental disorders: assessment, interpretation, demonstration, support (AIDS).

An approach to negotiating educational programs for children with multiple developmental problems is presented using two case examples from an interdisciplianry setting, the University Affiliated Cincinnati Center for Developmental Disorders. The use of the AIDS (Assessment, Intervention, Demonstration, Support) approach offers the schools evidence that the professional educator and psychologist are working in good faith and will not abandon them prematurely. Proper school placement through mediation also allows the school personnel to receive credit from the family for making the necessary changes, therefore not losing face with the parents. This approach seems particularly applicable to children with multiple and chronic problems who do not fit single special educational/diagnostic categories or labels.

Child Psychiatry↗
PubMed1982

A transdisciplinary mobile intervention program for rural areas (developmental disabilities, pediatrics, rural health).

A critical priority in allied health today is the efficient delivery of comprehensive services with the family and professionals as equal partners. In rural areas this is particularly important because of sparsely located populations and limited distribution of services. Few facilities in the rural community are able to deliver comprehensive services to a wide geographical area. Location of the services also presents additional burdens on the rural family with a developmentally disabled child. In this paper the stages of program development to meet a specific regional health need are described. The use and characteristics of a mobile program of early intervention serving developmentally disabled infants and preschoolers in rural areas of southwestern New York State are discussed. The practical application of this approach is considered.

Child↗
PubMed1998

Developmental phenotypic plasticity: where internal programming meets the external environment.

Developmental plasticity has long been the focus of research in both evolutionary ecology and molecular genetics. Recently, the concept of ontogenetic contingency has been proposed to indicate the dependence of plastic responses on the timing and sequence of developmental events. Also, the idea of the developmental reaction norm has been put forward to indicate the complex interactions among development, phenotypic plasticity, and allometry of different structures. Finally, for the first time, studies ranging from the ecological to the molecular aspects of the same plastic response are available on insect and flowering plant model systems.

Biological Evolution↗
PubMed2005

Developmentally induced changes in transcriptional program alter spatial organization across chromosomes.

Although the spatial location of genes within the nucleus has been implicated in their transcriptional status, little is known about the dynamics of gene location that accompany large-scale changes in gene expression. The mating of haploid yeast Saccharomyces cerevisiae is accompanied by a large-scale change in transcription and developmental program. We examined changes in nuclear organization that accompany stimulus by the mating pheromone alpha factor and found that most alpha-factor-induced genes become associated with components of the nuclear envelope. The myosin-like protein Mlp1, which has been implicated in mRNA export, was further shown to exhibit RNA dependence in its association with alpha-factor-induced genes. High-resolution mapping of association of chromosome III with Mlp1 revealed alpha-factor-dependent determinants of nuclear pore association, including origins of replication, specific intergenic regions, and the 3' ends of transcriptionally activated genes. Taken together, these results reveal RNA- and DNA-dependent determinants of nuclear organization as well as a detailed picture of how an entire chromosome alters its spatial conformation in response to a developmental cue.

Chromosomes, Fungal↗
PubMed2006

Mothers' perception of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) as compared to conventional care.

BACKGROUND: Family-centred care according to the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to positively influence family function. The aim was to examine if NIDCAP affects the views of prematurely born infants' mothers regarding maternal role, perception of the infant and the neonatal care. METHOD: Preterm infants with gestational age <32 weeks were randomly assigned to receive either care based on NIDCAP (n=12) or conventional neonatal care (n=13), forming two comparable groups with respect to gestational age, birth weight, female/male ratio, and initial illness severity. A questionnaire was designed to evaluate various aspects of the mothers' attitudes and apprehension of their maternal role, perception of their infant and the neonatal care. The questionnaire was validated and given to the mothers when the infants reached 36 weeks postmenstrual age (PMA). RESULTS: Ten mothers in each group replied to the questionnaire. The mothers in the NIDCAP-group perceived more closeness to their infants than did the control mothers (p=0.022) and this feeling demonstrated no significant correlation to the infant's gestational age, weight at birth or severity of illness. Furthermore, the mothers in the NIDCAP-group tended to rate the staff's ability to support them in their role as a mother somewhat higher (p=0.066), but at the same time they expressed more anxiety than did the control mothers (p=0.033). CONCLUSION: Early intervention according to NIDCAP seems to facilitate a feeling of closeness between the mother and her premature infant regardless of the infant's birth weight or health status. The higher level of anxiety in the mothers in the NIDCAP-group, may mirror that the mothers in the NIDCAP-group had already bonded to their infants during the hospital stay.

Adult↗
PubMed2004

Differential regulation of Tec1 by Fus3 and Kss1 confers signaling specificity in yeast development.

Transcriptional regulation by mitogen-activated protein (MAP) kinase signaling cascades is a major control mechanism for eukaryotic development. In budding yeast, Fus3 and Kss1 are two MAP kinases that control two distinct developmental programs-mating and invasive growth. We investigated whether signal-specific activation of mating and invasive growth involves regulation of the transcription factor Tec1 by Fus3 and Kss1. We present evidence that, during mating, Fus3 phosphorylates Tec1 to downregulate this invasive growth-specific transcription factor and its target genes. This function of Fus3 is essential for correct execution of the mating program and is not shared by Kss1. We find that Kss1 controls the activity of Tec1 mainly during invasive growth by control of TEC1 gene expression. Our study suggests that signaling specificity can arise from differential regulation of a single transcription factor by two MAP kinases with shared functions in distinct developmental programs.

DNA-Binding Proteins↗
PubMed1989

A critique of therapeutic intervention programming with reference to an alternative approach based on motor learning theory.

As an alternative to current therapeutic intervention programming for developmentally delayed children, a rationale for intervention programming based on theories of motor control and learning is presented. The authors believe that the keys to successful motor training programs are repetition, correctly performed practice of functional skills, and sufficient learning time to facilitate skill retention and transfer. In order for therapists to construct and implement the most appropriate motor training programs for developmentally delayed children, they must be knowledgeable of the sensory-motor basis of motor skill acquisition. Some of the more important concepts of motor control and learning are presented.

Journal Article↗
PubMed1999

Expression of cysteine proteinase during developmental events associated with programmed cell death in brinjal.

Here we show that the expression of a cysteine proteinase coincides with several developmental events associated with programmed cell death (PCD) in Solanum melongena (brinjal), i.e. during leaf senescence, fruit senescence, xylogenesis, nucellar cell degeneration and anther senescence. We have isolated a cDNA encoding brinjal cysteine proteinase (SmCP) that shares high (90-92%) amino acid identity to cysteine proteinases of tobacco (CYP-8) and tomato (LCYP-2) that have not been previously reported to be senescence-associated. In contrast, SmCP shows lower (39-41%) amino acid identity to other senescence-related cysteine proteinases and, unlike most of them, it is not preferentially expressed in certain organs or cell types. Northern analysis of leaves, fruits and flowers at different stages of development showed that SmCP expression increased significantly at senescence in leaf and fruit, but was highly expressed throughout flower development. In situ hybridization studies on flower sections using an antisense RNA probe localized the SmCP mRNA to the xylem, the epidermis and the endothecium of the anther and the nucellar cells, suggesting its involvement in PCD during xylogenesis, anther senescence and ovule development, respectively. Its expression during nucellar cell degeneration suggests that protein reserves of the nucellus are released to the developing embryo. Polarity in its pattern of expression in the nucellus of the developing seed (40DAP) further implies a directional flow of these nutrients.

Amino Acid Sequence↗
PubMed2004

Specific Newborn Individualized Developmental Care and Assessment Program movements are associated with acute pain in preterm infants in the neonatal intensive care unit.

OBJECTIVE: The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is widely used in neonatal intensive care units and comprises 85 discrete infant behaviors, some of which may communicate infant distress. The objective of this study was to identify developmentally relevant movements indicative of pain in preterm infants. METHODS: Forty-four preterm infants were assessed at 32 weeks' gestational age (GA) during 3 phases (baseline, lance/squeeze, and recovery) of routine blood collection in the neonatal intensive care unit. The NIDCAP and Neonatal Facial Coding System (NFCS) were coded from separate continuous bedside video recordings; mean heart rate (mHR) was derived from digitally sampled continuous electrographic recordings. Analysis of variance (phase x gender) with Bonferroni corrections was used to compare differences in NIDCAP, NFCS, and mHR. Pearson correlations were used to examine relationships between the NIDCAP and infant background characteristics. RESULTS: NFCS and mHR increased significantly to lance/squeeze. Eight NIDCAP behaviors also increased significantly to lance/squeeze. Another 5 NIDCAP behaviors decreased significantly to lance/squeeze. Infants who had lower GA at birth, had been sicker, had experienced more painful procedures, or had greater morphine exposure showed increased hand movements indicative of increased distress. CONCLUSIONS: Of the 85 NIDCAP behaviors, a subset of 8 NIDCAP movements were associated with pain. Particularly for infants who are born at early GAs, addition of these movements to commonly used measures may improve the accuracy of pain assessment.

Acute Disease↗
PubMed2002

The Newborn Individualized Developmental Care and Assessment Program is not supported by meta-analyses of the data.

OBJECTIVES: To systematically review the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) as compared with conventional care to improve long-term neurodevelopmental outcomes or short-term medical and neurodevelopmental outcomes in preterm and/or low birth weight infants. STUDY DESIGN: With the use of standard systematic review methodology, all randomized, controlled trials (RCTs) and prospective cohort studies evaluating in-hospital developmental care based on the framework of NIDCAP in preterm and/or low birth weight infants were identified. The quality of the RCTs was assessed. Meta-analyses were performed by using relative risk and risk difference for dichotomous data and weighted mean difference for continuous data with 95% confidence intervals. RESULTS: Five RCTs (n = 136) and 3 phase-lag cohort studies (n = 185) met inclusion criteria. School-age neurodevelopmental outcomes after NIDCAP have not been reported. Meta-analyses of medical outcomes showed a statistically significant benefit of NIDCAP on requirement for supplemental oxygen. Neurodevelopmental outcome was improved at 9 or 12 months but not at 2 years. CONCLUSIONS: There is insufficient evidence to support the NIDCAP to improve medical and neurodevelopmental outcomes of preterm infants.

Body Weight↗
PubMed2006

How floral meristems are built.

The formation of flowers involves the activity of a genetic network that acts in meristems to specify floral identity. The main output of this network is the initiation of a developmental patterning program for the generation of floral organs. The first characteristic of meristem identity genes is their capacity to integrate the environmental and endogenous cues that regulate the onset of flowering. This mechanism synchronizes temporal and spatial information, ensuring that flowers arise in the correct location at the appropriate time. The second characteristic of this network is the mutual regulatory interactions established between meristem identity genes. These interactions provide flexibility and robustness against environmental noise and prevent reversion once the decision to flower has been made. Finally, the third feature is the overlap between the meristem identity and other developmental programs that operate simultaneously to regulate different aspects of the construction of flowers.

Body Patterning↗