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Childcare centers (CCCs) can provide opportunities to implement physical activity (PA) via health promotion interventions to prevent obesity and associated chronic disease risk factors in young children. This study evaluated the impact of the Healthy Caregivers-Healthy Children (HC2) intervention on body mass index percentile (PBMI) and the PA environment in CCCs serving children with disabilities (CWD) over one school year. Ten CCCs were cluster-randomized to either (1) an intervention arm that received the HC2 curriculum adapted for CWD or (2) an attention control arm. Mixed-effect linear regression models analyzed the relationship between change in child PBMI and CCC childcare center PA environment by experimental condition and child disability status over one school year. Findings showed a significant decrease in PBMI among children in the HC2 centers (−6.74, p = 0.007) versus those in control centers (−1.35, p = 0.74) over one school year. Increased PA staff behaviors (mean change 3.66, p < 0.001) and PA policies (mean change 6.12, p < 0.001) were shown in intervention centers during the same period. Conversely, there was a significant increase in sedentary opportunities (mean change 4.45, p < 0.001) and a decrease in the portable play environment (mean change −3.16, p = 0.03) and fixed play environment (mean change −2.59, p = 0.04) in control centers. No significant differences were found in PBMI changes between CWD and children without disabilities (beta = 1.62, 95% CI [−7.52, 10.76], p = 0.73), suggesting the intervention's efficacy does not differ by disability status. These results underscore the importance of (1) including young CWD and (2) PA and the supporting environment in CCC health promotion and obesity prevention interventions. [ABSTRACT FROM AUTHOR]

Introduction: Childcare center closures during COVID-19 impacted education for approximately 40 million children nationwide. Unfortunately, COVID-19 restrictions significantly limited the extent that outside personnel could provide in-person support to educators, resulting in the need for innovative approaches to meet childcare centers' needs. A virtual robotic telepresence approach was applied to early childhood consultation models to promote child resilience while mitigating COVID-19 risks. The goal of this study was to examine how training influenced consultants' and childcare staff uptake of the virtual robotic telepresence consultation approach and their acceptance of this technology. Methods: Ten early childhood consultants received multimedia/simulation training and weekly communities of practice related to virtual telepresence robotic consultation. Telepresence robotic consultation equipment was deployed to 16 childcare centers in a diverse multilingual metropolitan area as a part of a larger randomized controlled trial. Consultants trained childcare staff (14 center directors and 58 teachers) on how to receive virtual telepresence robotic consultation. Demographic information and measures of technology acceptability and uptake were collected from childcare staff and consultants. A mixed methods approach was used including multilevel modeling and focus groups to examine consultation uptake, acceptability, barriers, and facilitators of virtual telepresence robotic consultation implementation. Results: Consultants and childcare staff generally perceived the virtual telepresence consultation approach to be useful and easy to use. Consultant perceptions of the acceptability of technology did not change over time. Childcare staff, center, and consultant factors impacted the uptake of the virtual robotic telepresence consultation approach and childcare staff acceptance of the technology. Focus groups revealed that consultants believed that additional hands-on training with childcare staff would have benefited implementation and expressed a desire for a hybrid approach for consultation. Discussion: Perceptions of telepresence robotic consultation acceptability are discussed, including future recommendations for training. [ABSTRACT FROM AUTHOR]

Numerous youth summer programs focus upon physical fitness, nutritional health, psychological well-being, or education. Few, however, have integrated all of these elements into a single program. The Translational Health in Nutrition and Kinesiology (THINK) program provides an integrative nutrition and exercise science curriculum that is interfaced with social emotional learning (SEL) and STEM education to enhance healthy behaviors in youth. The purpose of this study was to determine whether the THINK program could improve physical fitness, nutrition habits, SEL, and STEM education in a 6-week summer program covering a 3-year period. Participants from South Miami were enrolled in THINK (n = 108, 58 males, 50 females, 12.03 + 0.56 years). Physical fitness assessments, the Positive Youth Development Inventory (PYDI), the Students' Attitude Towards STEM Survey, and the Adolescent Food Habits Checklist (ADFH) were recorded at baseline and post-testing. Means and standard error values were evaluated for all dependent variables. Paired samples t-tests (SPSS version 27) were used to determine changes. Improvements in cardiorespiratory fitness (p < 0.001), power (p < 0.006), flexibility (p < 0.001), agility (p < 0.001), muscular endurance (p < 0.001), lean body mass (p < 0.001), ADFH (p < 0.001), and PYDI (p = 0.038) were found. An integrative summer fitness program can result in improvements in physical fitness, nutrition habits, and SEL in as little as six weeks. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the effects of a novel nutrition and movement science after-school program integrating laboratory experiences for minority children. Laboratory experiences demonstrated how the body moves, functions, and performs in response to exercise and healthy nutrition. Methods: A total of 76 children from 4 after-school programs that were primarily Latino and black were randomly assigned to either an experimental translational health in nutrition and kinesiology (THINK; n = 46) or standard curriculum that served as the control group (CON; n = 30). An analysis of covariance controlling for baseline values was used to compare differences between THINK and CON after the 4-month intervention. Results: Following the program, THINK participants evidenced lower triceps and subscapular skinfold thickness (P <.01 and <.05, respectively). THINK students showed greater improvements in aerobic fitness, grip strength, and agility than CON (P <.01, <.01, and <.05, respectively). Participants in THINK also demonstrated higher scores on their nutrition habits/behaviors questionnaire (P <.01), nutrition science (P <.05), and exercise fitness tests (P <.001) than CON. Conclusion: An innovative curriculum featuring nutrition and kinesiology education interfaced with hands-on laboratory experiences and physical activities can improve physical outcomes and health-related behaviors in after-school programs serving minority children. [ABSTRACT FROM AUTHOR]

One in five preschool-aged children in the United States is obese, and children with disabilities are significantly impacted. This study aimed to determine the association between age at solid food initiation and obesity prevalence in preschool-aged children while considering disability status, ethnicity, gestational age, and birth weight. Analysis was conducted on a sample of 145 children aged 2 to 5 years who were enrolled in ten childcare centers. Parents completed a survey assessing disability status, race and ethnicity, birth weight, gestational age, and age of solid food initiation. Height and weight were collected concurrently. Multivariable logistic regression models generated the odds of developing obesity based on age at solid food initiation, disability status, ethnicity, gestational age, and birth weight. There was no significant difference in the odds of being obese based on age at solid food introduction. Children with disabilities (OR = 0.17, 95% CI 0.04–0.6, p = 0.01) and children born preterm (OR = 0.28, 95% CI 0.08–0.79, p = 0.03) had significantly lower odds of being obese. Hispanic children (OR = 4.93, 95% CI 1.91–15.32, p = 0.002) and children with higher birth weights (OR = 1.47, 95% CI 1.17–1.92, p = 0.002) were more likely to be obese. With pediatric obesity rates continuing to rise, these findings can inform future intervention efforts. [ABSTRACT FROM AUTHOR]

Objective: An optoelectronic screening device (OESD) is evaluated for the detection of cervical intra-epithelial neoplasia (CIN) 2+ lesions in comparison to Liquid Based Cytology (LBC) and high-risk HPV DNA (hrHPV) testing. Methods: In total 506 consecutive women referred because of abnormal cervical cytology or a positive high-risk HPV test, had an examination using OESD, LBC, and hrHPV testing. They were screened in 4 colposcopy clinics in New South Wales, Australia. In a retrospective audit, results were compared to the gold standard of colposcopy and biopsies if required. Sensitivity, specificity, area under the receiver operating characteristic (ROC)- curves, and differences using McNemar tests were calculated. All results were available for comparison on 474 patients. Results: The sensitivity to detect CIN II+ lesions by OESD, LBC and hrHPV-testing was 0.72, 0.81, and 0.88, and the specificity was 0.71, 0.95, and 0.76 respectively. The age- and previous-treatment adjusted area under the ROC curve for OESD was 0.83, for LBC 0.94, and for hrHPV testing 0.89. McNemar's tests showed no significant difference in sensitivity between OESD and LBC (p = 0.26), and no significant difference in specificity between OESD and hrHPV-testing (p = 1.0) amongst patients without previous treatment. Conclusions: The optoelectronic screening device demonstrated comparable sensitivity to high quality cytology conducted in a hospital clinical setting. Specificity was comparable to hrHPV-testing in an approximate primary screening setting. OESD has the advantage of producing an immediate result and being easy to use without need of laboratory equipment. This device can potentially become an important tool in the prevention of cervical cancer, particularly in developing countries and resource-limited settings. [ABSTRACT FROM AUTHOR]

The idiopathic inflammatory demyelinating disease (IIDD) spectrum has been investigated among different populations, and the results have indicated a low relative frequency of neuromyelitis optica (NMO) among multiple sclerosis (MS) cases in whites (1.2%-1.5%), increasing in Mestizos (8%) and Africans (15.4%-27.5%) living in areas of low MS prevalence. South America (SA) was colonized by Europeans from the Iberian Peninsula, and their miscegenation with natives and Africans slaves resulted in significant racial mixing. The current study analyzed the IIDD spectrum in SA after accounting for the ethnic heterogeneity of its population. A cross-sectional multicenter study was performed. Only individuals followed in 2011 with a confirmed diagnosis of IIDD using new diagnostic criteria were considered eligible. Patients’ demographic, clinical and laboratory data were collected. In all, 1,917 individuals from 22 MS centers were included (73.7% female, 63.0% white, 28.0% African, 7.0% Mestizo, and 0.2% Asian). The main disease categories and their associated frequencies were MS (76.9%), NMO (11.8%), other NMO syndromes (6.5%), CIS (3.5%), ADEM (1.0%), and acute encephalopathy (0.4%). Females predominated in all main categories. The white ethnicity also predominated, except in NMO. Except in ADEM, the disease onset occurred between 20 and 39 years old, early onset in 8.2% of all cases, and late onset occurred in 8.9%. The long-term morbidity after a mean disease time of 9.28±7.7 years was characterized by mild disability in all categories except in NMO, which was scored as moderate. Disease time among those with MS was positively correlated with the expanded disability status scale (EDSS) score (r=0.374; p=<0.001). This correlation was not observed in people with NMO or those with other NMO spectrum disorders (NMOSDs). Among patients with NMO, 83.2% showed a relapsing-remitting course, and 16.8% showed a monophasic course. The NMO-IgG antibody tested using indirect immunofluorescence (IIF) with a composite substrate of mouse tissues in 200 NMOSD cases was positive in people with NMO (95/162; 58.6%), longitudinally extensive transverse myelitis (10/30; 33.3%) and bilateral or recurrent optic neuritis (8/8; 100%). No association of NMO-IgG antibody positivity was found with gender, age at onset, ethnicity, early or late onset forms, disease course, or long-term severe disability. The relative frequency of NMO among relapsing-remitting MS (RRMS) + NMO cases in SA was 14.0%. Despite the high degree of miscegenation found in SA, MS affects three quarters of all patients with IIDD, mainly white young women who share similar clinical characteristics to those in Western populations in the northern hemisphere, with the exception of ethnicity; approximately one-third of all cases occur among non-white individuals. At the last assessment, the majority of RRMS patients showed mild disability, and the risk for secondary progression was significantly superior among those of African ethnicity. NMO comprises 11.8% of all IIDD cases in SA, affecting mostly young African-Brazilian women, evolving with a recurrent course and causing moderate or severe disability in both ethnic groups. The South-North gradient with increasing NMO and non-white individuals from Argentina, Paraguay, Brazil and Venezuela confirmed previous studies showing a higher frequency of NMO among non-white populations. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONThis mixed methods study examined the impact of a multi-faceted professional development (PD) program for preschool teachers and classroom assistants on teacher-supported assistive technology (AT) use and early literacy development of children with disabilities. Four special education preschools were randomized into intervention (2 schools, 9 teachers, 50 children) and waitlist control (2 schools, 17 teachers, 42 children) groups. The 24-week PD included online modules, coaching, and AT device kits. Pre-post gains in children’s AT use and early literacy skills were analyzed using χ2 and repeated measures ANOVA. Teacher interviews and reflective commentaries were analyzed using Framework Analysis methodology. From pre- to post-test, the percent of children in the intervention group using some form of AT rose from 36 to 80%. The percent of children using AT in the control group went from 45 to 62%. The difference in change between the two groups was statistically significant, χ2 = 13.93, p=.001. Gains in early literacy skills were not significantly different across groups, F(1,90)=0.010, p=.922. Analysis of the qualitative data revealed three themes: the positive impact of AT on child engagement and participation, the importance of individualizing AT for each student, and barriers teachers faced in AT implementation. The PD program had a positive effect on children’s AT use but not on gains in early literacy. Teachers’ comments highlighted the nuanced relationship between AT use and literacy outcomes, suggesting the need for more targeted implementation of AT during literacy activities.This research emphasized the importance of a comprehensive approach to PD that involves hands-on AT experience and coaching to bolster the AT practices of early childhood educators.The multi-faceted PD provided to preschool staff increased children’s teacher-supported AT use but was not shown to result in increased gains in early literacy skills. These results highlight the need for additional focused research to elucidate how to best leverage AT to advance foundational early literacy competencies.Professional development that trains teachers and classroom assistants collaboratively as a unit promotes inclusive, empowered implementation and allows for integrated AT planning that utilizes assistants’ expanding roles vis-á-vis students with disabilities.Future research should investigate flexible coaching approaches, just-in-time learning, and train-the-trainer models that cultivate site-based AT expertise and on demand resources to provide ongoing, tailored support and build local capacity, promoting sustainability and mitigating barriers like time constraints and high teacher turnover.This research emphasized the importance of a comprehensive approach to PD that involves hands-on AT experience and coaching to bolster the AT practices of early childhood educators.The multi-faceted PD provided to preschool staff increased children’s teacher-supported AT use but was not shown to result in increased gains in early literacy skills. These results highlight the need for additional focused research to elucidate how to best leverage AT to advance foundational early literacy competencies.Professional development that trains teachers and classroom assistants collaboratively as a unit promotes inclusive, empowered implementation and allows for integrated AT planning that utilizes assistants’ expanding roles vis-á-vis students with disabilities.Future research should investigate flexible coaching approaches, just-in-time learning, and train-the-trainer models that cultivate site-based AT expertise and on demand resources to provide ongoing, tailored support and build local capacity, promoting sustainability and mitigating barriers like time constraints and high teacher turnover. [ABSTRACT FROM AUTHOR]