Provision of rehabilitation for congenital conditions.

Considerable progress has been made in saving the lives of children younger than 5 years. Nevertheless, these advances have failed to help all children thrive, particularly children with disabilities. We describe the increasing prevalence of disability among children and adolescents. We evaluate the current situation regarding children with disabilities and rehabilitation in the context of health systems, particularly those in low- and middle-income countries. Within the newborn health agenda, congenital anomalies often require early intervention and rehabilitation. We provide Argentina as an example of a country where rehabilitation for congenital anomalies is integrated into the health system. We argue that congenital anomalies that require rehabilitation have the potential to strengthen rehabilitation systems and policies by: strengthening coordination between primary care and rehabilitation; identifying and understanding pathways that allow families to engage with services; providing human resources for rehabilitation; and building systems and resources that support assistive technology and rehabilitation. We propose ways for countries to prioritize and integrate early identification, referral and care for children with congenital anomalies to strengthen health systems for all. We identify opportunities to expand policy and planning and to design service delivery and workforce strategies through World Health Organization guidelines and frameworks for rehabilitation. We argue that the global health community must act to ensure that rehabilitation services to support functioning from birth are well established, accepted and integrated within health systems, and that disability is prioritized within child health. These steps would strengthen health systems, ensure functioning from birth and make rehabilitation accessible to all.

Des progrès considérables ont été réalisés pour sauver la vie des enfants de moins de cinq ans. Pourtant, ces avancées n'ont pas permis à tous les enfants de s'épanouir, en particulier lorsqu'ils présentent un handicap. Dans ce document, nous faisons état de la prévalence croissante du handicap chez les enfants et adolescents. Nous évaluons la situation actuelle des enfants porteurs de handicap ainsi que leur réadaptation au sein des systèmes de santé, surtout dans les pays à revenu faible et intermédiaire. Dans le cadre du programme de santé néonatale, les anomalies congénitales nécessitent souvent des interventions et une réadaptation rapides. Nous utilisons l'exemple de l'Argentine, un pays où la réadaptation fait partie intégrante du système de santé en cas d'anomalie congénitale. Nous estimons que les anomalies congénitales impliquant une réadaptation sont susceptibles de renforcer les systèmes et mesures en la matière grâce à: l'amélioration de la coordination entre les soins primaires et la réadaptation; l'identification et la compréhension des parcours qui permettent aux familles d'entrer en contact avec de tels services; la mise à disposition de ressources humaines compétentes dans ce domaine; et enfin, grâce au développement des mécanismes et ressources qui soutiennent les technologies d'assistance et la réadaptation. Nous proposons aux pays des pistes favorisant un diagnostic précoce, un transfert et une prise en charge des enfants souffrant d'anomalies congénitales, afin de consolider le système de santé et d'en faire bénéficier l'ensemble de la population. En outre, nous recensons les moyens d'étoffer les politiques et programmes, mais aussi d'élaborer des stratégies de prestation de services et de gestion des effectifs conformes aux lignes directrices et cadres relatifs à la réadaptation formulés par l'Organisation mondiale de la Santé. Selon nous, la communauté sanitaire internationale doit agir pour faire en sorte que les services de réadaptation soient pris en compte, acceptés et intégrés dans les systèmes de santé afin de contribuer au bon fonctionnement dès la naissance, et que le handicap figure parmi les priorités en ce qui concerne la santé infantile. De telles actions renforceraient les systèmes de soins de santé, assureraient un développement optimal dès la venue au monde et rendraient la réadaptation accessible à toutes et tous.

Se han hecho progresos considerables para salvar la vida de los niños menores de 5 años. Sin embargo, estos avances no han permitido que todos los niños prosperen, en particular los niños con discapacidades. En este artículo, se describe la creciente prevalencia de la discapacidad entre los niños y adolescentes. Se evalúa la situación actual de los niños con discapacidad y la rehabilitación en el contexto de los sistemas sanitarios, en particular los de los países de ingresos bajos y medios. Dentro de los programas de salud neonatal, las anomalías congénitas suelen requerir una intervención y rehabilitación tempranas. Se menciona a Argentina como ejemplo de un país en donde la rehabilitación de las anomalías congénitas está integrada en el sistema sanitario. Se argumenta que las anomalías congénitas que requieren rehabilitación tienen el potencial de fortalecer los sistemas y las políticas de rehabilitación mediante: el fortalecimiento de la coordinación entre la atención primaria y la rehabilitación; la identificación y la comprensión de las vías que permiten a las familias participar en los servicios; la provisión de recursos humanos para la rehabilitación; y la creación de sistemas y recursos que apoyen la tecnología de asistencia y la rehabilitación. Asimismo, se proponen mecanismos para que los países den prioridad e integren la identificación, derivación y atención tempranas de los niños con anomalías congénitas, con el fin de fortalecer los sistemas sanitarios para todos. Se identifican las oportunidades para ampliar la política y la planificación y para diseñar estrategias de prestación de servicios y de personal a través de las directrices y los marcos de la Organización Mundial de la Salud para la rehabilitación. Se sostiene que la comunidad sanitaria mundial debe actuar para asegurar que los servicios de rehabilitación para apoyar el funcionamiento desde el nacimiento estén bien establecidos, aceptados e integrados dentro de los sistemas sanitarios, y que se dé prioridad a la discapacidad dentro de la salud infantil. Estas medidas reforzarían los sistemas sanitarios, asegurarían el funcionamiento desde el nacimiento y harían que la rehabilitación fuera accesible para todos.

Study protocol for Attachment & Child Health (ATTACHTM) program: promoting vulnerable Children's health at scale.

BACKGROUND: Children's exposure to toxic stress (e.g., parental depression, violence, poverty) predicts developmental and physical health problems resulting in health care system burden. Supporting parents to develop parenting skills can buffer the effects of toxic stress, leading to healthier outcomes for those children. Parenting interventions that focus on promoting parental reflective function (RF), i.e., parents' capacity for insight into their child's and their own thoughts, feelings, and mental states, may understand help reduce societal health inequities stemming from childhood stress exposures. The Attachment and Child Health (ATTACHTM) program has been implemented and tested in seven rapid-cycling pilot studies (n = 64) and found to significantly improve parents' RF in the domains of attachment, parenting quality, immune function, and children's cognitive and motor development. The purpose of the study is to conduct an effectiveness-implementation hybrid (EIH) Type II study of ATTACHTM to assess its impacts in naturalistic, real-world settings delivered by community agencies rather than researchers under more controlled conditions. METHODS: The study is comprised of a quantitative pre/post-test quasi-experimental evaluation of the ATTACHTM program, and a qualitative examination of implementation feasibility using thematic analysis via Normalization Process Theory (NPT). We will work with 100 families and their children (birth to 36-months-old). Study outcomes include: the Parent Child Interaction Teaching Scale to assess parent-child interaction; the Parental Reflective Function and Reflective Function Questionnaires to assess RF; and the Ages and Stages Questionnaire - 3rd edition to examine child development, all administered pre-, post-, and 3-month-delayed post-assessment. Blood samples will be collected pre- and post- assessment to assess immune biomarkers. Further, we will conduct one-on-one interviews with study participants, health and social service providers, and administrators (total n = 60) from each collaborating agency, using NPT to explore perceptions and experiences of intervention uptake, the fidelity assessment tool and e-learning training as well as the benefits, barriers, and challenges to ATTACHTM implementation. DISCUSSION: The proposed study will assess effectiveness and implementation to help understand the delivery of ATTACHTM in community agencies. TRIAL REGISTRATION: Name of registry: https://clinicaltrials.gov/. REGISTRATION NUMBER: NCT04853888 . Date of registration: April 22, 2021.

Evaluating the Patient Family Advisor Experience in Patient-Oriented Research.

As part of the Saskatchewan Centre for Patient-Oriented Research (SCPOR)'s commitment to improving the experience of patient and family advisors (PFAs) who engage with local patient-oriented research teams, one of the supports offered is an evaluation that assesses the experiences and effectiveness of PFAs as research team members. In a recent evaluation project, SCPOR used an academically validated questionnaire and a survey co-designed by local PFAs. The results showed that PFAs wanted more frequent updates throughout the research project and greater role clarity. They also reported that the best part of their engagement was feeling like a valued team member.

A MATLAB-based tool for accurate detection of perfect overlapping and nested inverted repeats in DNA sequences.

SUMMARY: Palindromic sequences, or inverted repeats (IRs), in DNA sequences involve important biological processes such as DNA-protein binding, DNA replication and DNA transposition. Development of bioinformatics tools that are capable of accurately detecting perfect IRs can enable genome-wide studies of IR patterns in both prokaryotes and eukaryotes. Different from conventional string-comparison approaches, we propose a novel algorithm that uses a cumulative score system based on a prime number representation of nucleotide bases. We then implemented this algorithm as a MATLAB-based program for perfect IR detection. In comparison with other existing tools, our program demonstrates a high accuracy in detecting nested and overlapping IRs. AVAILABILITY AND IMPLEMENTATION: The source code is freely available on (http://bioinfolab.miamioh.edu/bioinfolab/palindrome.php) CONTACT: liangc@miamioh.edu or karroje@miamioh.edu SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.