Sign in to use this feature.

Years

Between: -

Subjects

remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline

Journals

Article Types

Countries / Regions

Search Results (119)

Search Parameters:
Keywords = Early Intervention Centres

Order results
Result details
Results per page
Select all
Export citation of selected articles as:
18 pages, 330 KiB  
Essay
Music and Arts in Early Childhood Education: Paths for Professional Development Towards Social and Human Development
by Helena Rodrigues, Ana Isabel Pereira, Paulo Maria Rodrigues, Paulo Ferreira Rodrigues and Angelita Broock
Educ. Sci. 2025, 15(8), 991; https://doi.org/10.3390/educsci15080991 (registering DOI) - 4 Aug 2025
Viewed by 209
Abstract
This article examines training itineraries for early childhood education professionals in Portugal, focusing on promoting social and human development through music and the arts for infants. The training models discussed are categorized as short-term and long-term, encompassing both theory and practice through a [...] Read more.
This article examines training itineraries for early childhood education professionals in Portugal, focusing on promoting social and human development through music and the arts for infants. The training models discussed are categorized as short-term and long-term, encompassing both theory and practice through a transdisciplinary approach. Based on initiatives promoted by the Companhia de Música Teatral (CMT) and the Education and Human Development Group of the Centre for the Study of Sociology and Musical Aesthetics (CESEM) at NOVA University Lisbon, the article highlights projects such as: (i) Opus Tutti and GermInArte, developed between 2011 and 2018; (ii) the Postgraduate Course Music in Childhood: Intervention and Research, offered at the University since 2020/21, which integrates art, health, and education, promoting collaborative work between professionals; and (iii) Mil Pássaros (Thousand Birds), developed since 2020, which exemplifies the integration of environmental education and artistic practices. The theoretical basis of these training programs combines neuroscientific and educational evidence, emphasizing the importance of the first years of life for integral development. Studies, such as those by Heckman, reinforce the impact of early investment in children’s development. Edwin Gordon’s Music Learning Theory and Malloch and Trevarthen’s concept of ‘communicative musicality’ structure the design of these courses, recognizing music as a catalyst for cognitive, emotional, and social skills. The transformative role of music and the arts in educational and social contexts is emphasized, in line with the Sustainable Development Goals of the 2030 Agenda, by proposing approaches that articulate creation, intervention, and research to promote human development from childhood onwards. Full article
8 pages, 192 KiB  
Article
Silent Struggles: Uncovering Mental Health Burdens in Adolescents with Inflammatory Bowel Disease and Juvenile Idiopathic Arthritis—A Retrospective Chart Review
by Kayla Beaudoin, Jaden Lo, Ethan Mewhinney, Kristen Bortolin, Tania Cellucci, Jenna Dowhaniuk, Liane Heale, Robert Issenman, Nikhil Pai, Mary Sherlock, Mary Zachos, Christina Grant, Karen Beattie, Katherine Prowse and Michelle Batthish
Children 2025, 12(8), 995; https://doi.org/10.3390/children12080995 - 29 Jul 2025
Viewed by 231
Abstract
Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence [...] Read more.
Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article
(This article belongs to the Section Pediatric Mental Health)
28 pages, 1823 KiB  
Article
From Control to Connection: A Child-Centred User Experience Approach to Promoting Digital Self-Regulation in Preschool-Aged Children
by Dayoung Lee and Boram Lee
Appl. Sci. 2025, 15(14), 7929; https://doi.org/10.3390/app15147929 - 16 Jul 2025
Viewed by 330
Abstract
Although smart device use among children is increasing, most interventions overlook their cognitive and emotional development or rely too heavily on external control. Such approaches often overlook the developmental needs of children for emotional regulation and autonomy. Therefore, this study aims to propose [...] Read more.
Although smart device use among children is increasing, most interventions overlook their cognitive and emotional development or rely too heavily on external control. Such approaches often overlook the developmental needs of children for emotional regulation and autonomy. Therefore, this study aims to propose a child-centred user experience (UX) framework to support digital self-regulation in preschool-aged children. The proposed system integrates multiple psychological theories—including Piaget’s concept of animistic thinking, executive function theory, Self-Determination Theory, and Acceptance and Commitment Therapy—to support cognitive and emotional regulation during screen use. Key features include persistent visual cues to enhance time awareness and behavioural anticipation, narrative-based character interactions to foster empathy and agency, and ritualised closure routines supported by multimodal and tangible interaction elements. Developed as a mobile prototype, the system was iteratively refined through two-stage consultations with child and adolescent psychiatrists and a developmental psychologist, including formative design feedback and follow-up expert review. Their feedback provided preliminary validation of the system’s developmental validity and emotional coherence. These findings suggest that affectively attuned UX design is a viable alternative to conventional control-based screen-time interventions in early childhood. Full article
Show Figures

Figure 1

26 pages, 2583 KiB  
Review
Neuro-Ophthalmological Disorders Associated with Obstructive Sleep Apnoea
by Snježana Kaštelan, Lea Kozina, Maja Alaber, Zora Tomić, Marina Andrešić, Ivana Bakija, Diana Bućan, Tomislav Matejić and Domagoj Vidović
Int. J. Mol. Sci. 2025, 26(14), 6649; https://doi.org/10.3390/ijms26146649 - 11 Jul 2025
Viewed by 383
Abstract
Obstructive sleep apnoea (OSA) is a prevalent condition characterised by intermittent upper airway obstruction during sleep, resulting in recurrent hypoxia and sleep fragmentation. Emerging evidence highlights the significant impact of OSA on neuro-ophthalmological health, linking it to conditions such as glaucoma, optic neuropathy, [...] Read more.
Obstructive sleep apnoea (OSA) is a prevalent condition characterised by intermittent upper airway obstruction during sleep, resulting in recurrent hypoxia and sleep fragmentation. Emerging evidence highlights the significant impact of OSA on neuro-ophthalmological health, linking it to conditions such as glaucoma, optic neuropathy, papilledema, and visual field defects. These associations emphasise the importance of understanding the mechanisms connecting OSA to neuro-ophthalmological disorders to enhance early diagnosis and management. This review explores the pathophysiological pathways, including hypoxia-induced vascular dysregulation, oxidative stress, inflammation, and intracranial pressure fluctuations, that contribute to ocular and neurological impairments in OSA patients. Advanced diagnostic tools, such as optical coherence tomography and polysomnography, offer promising avenues for detecting subclinical neuro-ophthalmological changes, enabling timely intervention. Management strategies, primarily centred on continuous positive airway pressure therapy, have shown efficacy in mitigating OSA-related neuro-ophthalmological complications. However, surgical and pharmacological interventions and lifestyle modifications remain vital components of a multidisciplinary approach to care. Despite advancements, significant research gaps persist, particularly in understanding the long-term impact of OSA treatment on neuro-ophthalmological outcomes and identifying specific biomarkers for early detection. Future research should prioritise longitudinal studies, interdisciplinary collaborations, and personalised medicine approaches to address these challenges. Recognising and treating neuro-ophthalmological disorders in OSA patients is imperative for improving quality of life and preventing irreversible visual and neurological damage. Full article
Show Figures

Figure 1

22 pages, 5786 KiB  
Review
Narrative and Pictorial Review on State-of-the-Art Endovascular Treatment for Focal Non-Infected Lesions of the Abdominal Aorta: Anatomical Challenges, Technical Solutions, and Clinical Outcomes
by Mario D’Oria, Marta Ascione, Paolo Spath, Gabriele Piffaretti, Enrico Gallitto, Wassim Mansour, Antonino Maria Logiacco, Giovanni Badalamenti, Antonio Cappiello, Giulia Moretti, Luca Di Marzo, Gianluca Faggioli, Mauro Gargiulo and Sandro Lepidi
J. Clin. Med. 2025, 14(13), 4798; https://doi.org/10.3390/jcm14134798 - 7 Jul 2025
Viewed by 495
Abstract
The natural history of focal non-infected lesions of the abdominal aorta (fl-AA) remains unclear and largely depends on their aetiology. These lesions often involve a focal “tear” or partial disruption of the arterial wall. Penetrating aortic ulcers (PAUs) and intramural hematomas (IMHs) are [...] Read more.
The natural history of focal non-infected lesions of the abdominal aorta (fl-AA) remains unclear and largely depends on their aetiology. These lesions often involve a focal “tear” or partial disruption of the arterial wall. Penetrating aortic ulcers (PAUs) and intramural hematomas (IMHs) are examples of focal tears in the aortic wall that can either progress to dilatation (saccular aneurysm) or fail to fully propagate through the medial layers, potentially leading to aortic dissection. These conditions typically exhibit a morphology consistent with eccentric saccular aneurysms. The management of focal non-infected pathologies of the abdominal aorta remains a subject of debate. Unlike fusiform abdominal aortic aneurysms, the inconsistent definitions and limited information regarding the natural history of saccular aneurysms (sa-AAAs) have prevented the establishment of universally accepted practice guidelines for their management. As emphasized in the latest 2024 ESVS guidelines, the focal nature of these diseases makes them ideal candidates for endovascular repair (class of evidence IIa—level C). Moreover, the Society for Vascular Surgery just referred to aneurysm diameter as an indication for treatment suggesting using a smaller diameter compared to fusiform aneurysms. Consequently, the management of saccular aneurysms is likely heterogeneous amongst different centres and different operators. Endovascular repair using tube stent grafts offers benefits like reduced recovery times but carries risks of migration and endoleak due to graft rigidity. These complications can influence long-term success. In this context, the use of endovascular bifurcated grafts may provide a more effective solution for treating these focal aortic pathologies. It is essential to achieve optimal sealing regions through anatomical studies of aortic morphology. Additionally, understanding the anatomical characteristics of focal lesions in challenging necks or para-visceral locations is indeed crucial in device choice. Off-the-shelf devices are favoured for their time and cost efficiency, but new endovascular technologies like fenestrated endovascular aneurysm repair (FEVAR) and custom-made devices enhance treatment success and patient safety. These innovations provide stent grafts in various lengths and diameters, accommodating different aortic anatomies and reducing the risk of type III endoleaks. Although complicated PAUs and focal saccular aneurysms rarely arise in the para-visceral aorta, the consequences of rupture in this segment might be extremely severe. Experience borrowed from complex abdominal and thoracoabdominal aneurysm repair demonstrates that fenestrated and branched devices can be deployed safely when anatomical criteria are respected. Elective patients derive the greatest benefit from a fenestrated graft, while urgent cases can be treated confidently with off-the-shelf multibranch systems, reserving other types of repairs for emergent or bail-out cases. While early outcomes of these interventions are promising, it is crucial to acknowledge that limited aortic coverage can still impede effective symptom relief and lead to complications such as aneurysm expansion or rupture. Therefore, further long-term studies are essential to consolidate the technical results and evaluate the durability of various graft options. Full article
(This article belongs to the Special Issue Clinical Advances in Aortic Disease and Revascularization)
Show Figures

Figure 1

27 pages, 1246 KiB  
Article
Nourishing Beginnings: A Community-Based Participatory Research Approach to Food Security and Healthy Diets for the “Forgotten” Pre-School Children in South Africa
by Gamuchirai Chakona
Int. J. Environ. Res. Public Health 2025, 22(6), 958; https://doi.org/10.3390/ijerph22060958 - 18 Jun 2025
Viewed by 751
Abstract
Adequate and diverse diets are essential for children’s physical and cognitive development, yet food insecurity and malnutrition continue to threaten this fundamental right, which remains a pressing concern in many resource-poor settings. This study investigated food and nutrition security in Early Childhood Development [...] Read more.
Adequate and diverse diets are essential for children’s physical and cognitive development, yet food insecurity and malnutrition continue to threaten this fundamental right, which remains a pressing concern in many resource-poor settings. This study investigated food and nutrition security in Early Childhood Development (ECD) centres in Makhanda, South Africa, through a community-based participatory research approach. Using a mixed-methods approach combining questionnaire interviews, focus group discussions, direct observations, and community asset mapping across eight ECD centres enrolling 307 children aged 0–5 years, the study engaged ECD facilitators and analysed dietary practices across these centres. Results indicated that financial constraints severely affect the quality and diversity of food provided at the centres, thus undermining the ability to provide nutritionally adequate meals. The average amount spent on food per child per month at the centres was R90 ± R25 (South African Rand). Although three meals were generally offered daily, cost-driven dietary substitutions with cheaper, less diverse alternatives, often at the expense of nutritional value, were common. Despite guidance from Department of Health dieticians, financial limitations contributed to suboptimal feeding practices, with diets dominated by grains and starchy foods, with limited access to and rare consumption of protein-rich foods, dairy, and vitamin A-rich fruits and vegetables. ECD facilitators noted insufficient parental contributions and low engagement in supporting centre operations and child nutrition provision, indicating a gap in awareness and limited nutrition knowledge regarding optimal infant and young child feeding (IYCF) practices. The findings emphasise the need for sustainable, multi-level and community-led interventions, including food gardening, creating ECD centre food banks, parental nutrition education programmes, and enhanced financial literacy among ECD facilitators. Strengthening local food systems and establishing collaborative partnerships with communities and policymakers are essential to improve the nutritional environment in ECD settings. Similarly, enhanced government support mechanisms and policy-level reforms are critical to ensure that children in resource-poor areas receive adequate nutrition. Future research should focus on scalable, locally anchored models for sustainable child nutrition interventions that are contextually grounded, community-driven, and should strengthen the resilience of ECD centres in South Africa. Full article
Show Figures

Figure 1

24 pages, 389 KiB  
Review
Early Intervention for Children with Hearing Impairment in the South African Context: A Narrative Review of Legislative and Policy Frameworks
by Luisa Petrocchi-Bartal, Katijah Khoza-Shangase and Amisha Kanji
Disabilities 2025, 5(2), 52; https://doi.org/10.3390/disabilities5020052 - 31 May 2025
Viewed by 570
Abstract
Globally, many countries have promulgated extensive, contextually relevant disability legislative policies for children with hearing impairment/d/Deafness (HI/d/D). The alignment of policies with their implementation, with robust monitoring, is essential for effective early intervention (EI) and early education (EE) outcomes. The study’s purpose was [...] Read more.
Globally, many countries have promulgated extensive, contextually relevant disability legislative policies for children with hearing impairment/d/Deafness (HI/d/D). The alignment of policies with their implementation, with robust monitoring, is essential for effective early intervention (EI) and early education (EE) outcomes. The study’s purpose was to review current South African EI and EE regulations, acts, and policies in relation to children with HI/d/D from birth to age six. An adapted Arksey and O’Malley framework with inductive thematic analysis was applied to synthesise and evaluate relevant information. Documentation was sourced between 1993 and 2023 from the official South African government portal and Google online searches using keywords. While 7976 documents were initially identified with the broad search and 1249 with a refined category search, only 17 met the specific inclusion criteria for policies referencing hearing impairment in early intervention and education. Seventeen documents were selected for study inclusion, with sixteen mentioning HI/d/D and multi-disciplinary, multi-sectoral, family-centred, culturally sensitive considerations superficially. One document from the Department of Health (DoH) specifically addressed early hearing detection and intervention (EHDI). Three main themes emerged, including Partnerships, Participation and Integration, Screening, Identification and/or Intervention, and Education/Special Education. Greater engagement with South African EI and education policies is essential to strengthen implementation, especially across sectors and at the community level. Mandating EHDI guidelines is critical to improving service delivery and ensuring smoother transitions between health, education, and social services for children with hearing impairment. Full article
Show Figures

Figure 1

11 pages, 381 KiB  
Article
Impact of Delirium-Related Stress, Self-Efficacy, Person-Centred Care on Delirium Nursing Performance Among Nurses in Trauma Intensive Care Units: A Cross-Sectional Descriptive Survey Study
by Ga-Hee Seong and Hyung-Ran Park
Healthcare 2025, 13(11), 1243; https://doi.org/10.3390/healthcare13111243 - 25 May 2025
Viewed by 527
Abstract
Background/Objectives: Enhancing delirium nursing performance in trauma intensive care units (TICUs), where the prevalence of delirium is high, causes early detection of delirium and improves the quality of nursing care. TICU nurses experience various stress levels while caring for patients with delirium, [...] Read more.
Background/Objectives: Enhancing delirium nursing performance in trauma intensive care units (TICUs), where the prevalence of delirium is high, causes early detection of delirium and improves the quality of nursing care. TICU nurses experience various stress levels while caring for patients with delirium, which negatively affects their performance. Self-efficacy improves delirium nursing performance based on their capacity. Person-centred care identifies the holistic needs of patients in TICUs, which stimulates their recovery. This study aimed to examine the relationship of delirium-related stress, self-efficacy, and person-centred care with delirium nursing performance and identify factors influencing delirium nursing performance among nurses in TICUs. Methods: This cross-sectional descriptive survey study was conducted on 170 TICU nurses from eight hospitals in Korea from 22 July to 30 September 2024. Data was collected using self-reported questionnaires after informed consent was provided. Data were analysed using multiple regression analysis. Results: Delirium nursing performance showed significant positive correlations with person-centred care (r = 0.51, p < 0.001) and self-efficacy (r = 0.41, p < 0.001). Regression analysis revealed person-centred care (β = 0.46, p < 0.001) and self-efficacy (β = 0.24, p = 0.004) as significant predictors of delirium nursing performance in TICUs, accounting for 28.6% of the variance. Conclusions: Interventions focused on person-centred care may help improve delirium nursing performance and practice holistic care. Full article
Show Figures

Figure 1

20 pages, 267 KiB  
Article
Crohn’s Disease Patients Referred for Home Parenteral Nutrition—A Comprehensive Analysis of 18 Years’ Experience at a National Reference Centre
by Sandra Banasiak, Mariusz Panczyk, Jacek Sobocki and Zuzanna Zaczek
Nutrients 2025, 17(10), 1697; https://doi.org/10.3390/nu17101697 - 16 May 2025
Viewed by 559
Abstract
Background: Within 10 years of diagnosis, about 50% of patients with Crohn’s disease (CD) require surgery. Repeated small bowel resections can lead to the development of short bowel syndrome (SBS). It is estimated that 65–75% of CD patients are malnourished. This retrospective [...] Read more.
Background: Within 10 years of diagnosis, about 50% of patients with Crohn’s disease (CD) require surgery. Repeated small bowel resections can lead to the development of short bowel syndrome (SBS). It is estimated that 65–75% of CD patients are malnourished. This retrospective observational study was conducted in a Polish reference centre for home parenteral nutrition (HPN). The aim of the study was to investigate the nutritional status and characteristics of patients with CD referred to HPN and to analyse the course of their HPN treatment. Methods: The study group consisted of all adult patients (N = 46) with CD who qualified for HPN between November 2004 and April 2022. Results: The most common indication for HPN was SBS (n = 27; 58.70%), followed by ineffective gastrointestinal nutrition causing progressive malnutrition (N = 9; 19.57%), fistulas (N = 6; 13.04%), and short bowel syndrome and fistulas (N = 4; 8.70%). According to the results of Subjective Global Assessment (SGA), 47.83% (N = 22) of patients were diagnosed with severe malnutrition, followed by 15 patients (32.61%) with moderate malnutrition. Global Leadership Initiative on Malnutrition (GLIM) criteria showed that 71.73% (n = 33) of patients were malnourished on admission to the HPN centre. All patients received parenteral formulas based on individually tailored prescriptions. The results showed that patients with a stoma received statistically significantly higher PN volumes (p = 0.027) and higher amounts of amino acids (p = 0.046) and fat emulsion (p = 0.046). Septic complications were twice as common as mechanical or metabolic complications, although 43.47% of patients had no complications. At the time of data analysis, 19 patients (41.30%) had been successfully weaned from HPN, of whom 12 (26%) achieved nutritional autonomy after 136–1419 days (mean: 560 ± 380.9). Conclusions: Malnutrition is a major problem in CD patients, especially those with SBS. Early nutritional intervention and consideration of artificial nutrition in this study group (HPN) are necessary to prevent the long-term consequences of severe malnutrition. To our knowledge, this was the first study to report on Crohn’s patients referred to long-term HPN. Further studies are needed to assess the impact of HPN on functional, laboratory, and anthropometric outcomes with a view to optimising treatment outcomes. Full article
(This article belongs to the Special Issue Nutritional Strategies in Inflammatory Bowel Disease)
12 pages, 3915 KiB  
Perspective
Artificial Intelligence and Assistive Robotics in Healthcare Services: Applications in Silver Care
by Giovanni Luca Masala and Ioanna Giorgi
Int. J. Environ. Res. Public Health 2025, 22(5), 781; https://doi.org/10.3390/ijerph22050781 - 14 May 2025
Viewed by 1257
Abstract
Artificial intelligence (AI) and assistive robotics can transform older-person care by offering new, personalised solutions for an ageing population. This paper outlines recent advances in AI-driven applications and robotic assistance in silver care, emphasising their role in improved healthcare services, quality of life [...] Read more.
Artificial intelligence (AI) and assistive robotics can transform older-person care by offering new, personalised solutions for an ageing population. This paper outlines recent advances in AI-driven applications and robotic assistance in silver care, emphasising their role in improved healthcare services, quality of life and ageing-in-place and alleviating pressure on healthcare systems. Advances in machine learning, natural language processing and computer vision have enabled more accurate early diagnosis, targeted treatment plans and robust remote monitoring for elderly patients. These innovations support continuous health tracking and timely interventions to improve patient outcomes and extend home-based care. In addition, AI-powered assistive robots with advanced motion control and adaptive response mechanisms are studied to support physical and cognitive health. Among these, companion robots, often enhanced with emotional AI, have shown potential in reducing loneliness and increasing connectedness. The combined goal of these technologies is to offer holistic patient-centred care, which preserves the autonomy and dignity of our seniors. This paper also touches on the technical and ethical challenges of integrating AI/robotics into eldercare, like privacy and accessibility, and alludes to future directions on optimising AI-human interaction, expanding preventive healthcare applications and creating an effective, ethical framework for eldercare in the digital age. Full article
(This article belongs to the Special Issue Perspectives in Health Care Sciences)
Show Figures

Graphical abstract

13 pages, 1734 KiB  
Review
Implementing Interventions Under “National Action Plan for Snakebite Envenoming (NAPSE) in India”: Challenges, Lessons Learnt and Way Forward for Stakeholders Participatory Approach
by Ajit Dadaji Shewale, Dipti Mishra, Simmi Tiwari, Tushar Nanasaheb Nale, Jitesh Kuwatada and Nidhi Khandelwal
Trop. Med. Infect. Dis. 2025, 10(5), 132; https://doi.org/10.3390/tropicalmed10050132 - 14 May 2025
Viewed by 797
Abstract
Snakebite envenoming remains a critical yet underrecognized public health issue, particularly in tropical and subtropical regions, with India bearing nearly half of the global burden of snakebite-related deaths. Despite its significant impact, underreporting, delayed medical intervention, and insufficiently trained healthcare professionals continue to [...] Read more.
Snakebite envenoming remains a critical yet underrecognized public health issue, particularly in tropical and subtropical regions, with India bearing nearly half of the global burden of snakebite-related deaths. Despite its significant impact, underreporting, delayed medical intervention, and insufficiently trained healthcare professionals continue to exacerbate the problem. In response, the Government of India launched the National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) in March 2024, aiming to halve snakebite-related deaths by 2030. Key challenges during the development and implementation of NAPSE included the limited multisectoral engagement initially, variations in state-level capacities, and logistical barriers in reaching remote populations. Lessons learned include the value of early stakeholder consultations, the importance of inter-ministerial collaboration, and the need for continuous community engagement. This comprehensive strategy emphasizes strengthening surveillance systems, enhancing anti-snake venom (ASV) distribution and quality, improving healthcare infrastructure, and promoting community awareness through a One Health approach. The plan also addresses critical challenges such as inadequate training at primary healthcare levels, inconsistent ASV supply, and inefficient emergency referral systems. By fostering multisectoral collaboration and targeted interventions, such as strengthening Regional Venom Centres and establishing Poison Information Centre, targeted training, and awareness campaigns, NAPSE aims to reduce mortality and disability associated with snakebite envenoming, aligning with global health objectives and setting an example for regional efforts in Southeast Asia. Full article
(This article belongs to the Special Issue Snake Bite: Prevention, Diagnosis and Treatment)
Show Figures

Figure 1

16 pages, 280 KiB  
Article
Caregiver Challenges and Opportunities for Accessing Early Hearing Detection and Intervention: A Narrative Inquiry from South Africa
by Katijah Khoza-Shangase and Ntsako Precious Maluleke
Int. J. Environ. Res. Public Health 2025, 22(4), 605; https://doi.org/10.3390/ijerph22040605 - 11 Apr 2025
Viewed by 444
Abstract
Background: Early Hearing Detection and Intervention (EHDI) is essential for minimising the negative impact of childhood hearing loss on speech, language, and cognitive development. However, in low- and middle-income countries such as South Africa, various challenges hinder the implementation of EHDI services, leading [...] Read more.
Background: Early Hearing Detection and Intervention (EHDI) is essential for minimising the negative impact of childhood hearing loss on speech, language, and cognitive development. However, in low- and middle-income countries such as South Africa, various challenges hinder the implementation of EHDI services, leading to delayed diagnosis and intervention. Aim: This study explores caregivers’ experiences with EHDI services, identifying key challenges and facilitators affecting access and timely intervention. Methods: A narrative inquiry approach was used as part of a broader research initiative on family-centred EHDI. Nine caregivers of children who are deaf or hard of hearing (DHH) were purposively sampled, and data were collected through semi-structured interviews. Results: Thematic analysis revealed systemic and structural challenges, logistical and financial constraints, and caregiver-related factors that hindered access to EHDI services. Key facilitators included caregiver knowledge and advocacy, family support services such as counselling and South African Sign Language training, and high-quality audiological and educational services. Conclusions: Findings emphasise the need for policy-driven reforms, including expanding newborn hearing screening programmes, improving financial assistance mechanisms, and increasing public awareness. Addressing these challenges and leveraging facilitators can help South Africa align with global EHDI benchmarks and improve outcomes for DHH children. Full article
(This article belongs to the Special Issue Hearing Health in Vulnerable Groups)
32 pages, 4746 KiB  
Article
Loosening the Lid on Shoulder Osteoarthritis: How the Transcriptome and Metabolic Syndrome Correlate with End-Stage Disease
by Samuel J. Lynskey, Zihui Ling, Mark Ziemann, Stephen D. Gill, Sean L. McGee and Richard S. Page
Int. J. Mol. Sci. 2025, 26(7), 3145; https://doi.org/10.3390/ijms26073145 - 28 Mar 2025
Viewed by 1151
Abstract
Metabolic syndrome (MetS) associated with Osteoarthritis (OA) is an increasingly recognised entity. Whilst the degenerative pattern in cuff-tear arthropathy (CTA) has been well documented, the biological processes behind primary shoulder OA and CTA remain less understood. This study investigates transcriptomic differences in these [...] Read more.
Metabolic syndrome (MetS) associated with Osteoarthritis (OA) is an increasingly recognised entity. Whilst the degenerative pattern in cuff-tear arthropathy (CTA) has been well documented, the biological processes behind primary shoulder OA and CTA remain less understood. This study investigates transcriptomic differences in these conditions, alongside the impact of MetS in patients undergoing total shoulder replacement. In a multi-centre study, 20 OA patients undergoing total shoulder replacement were included based on specific treatment indications for OA and cuff-tear arthropathy as well as 25 patients undergoing rotator cuff repair (RCR) as a comparator group. Tissues from subchondral bone, capsule (OA and RCR), and synovium were biopsied, and RNA sequencing was performed using Illumina platforms. Differential gene expression was conducted using DESeq2, adjusting for demographic factors, followed by pathway enrichment using the mitch package. Gene expressions in CTA and primary OA was differentially affected. CTA showed mitochondrial dysfunction, GATD3A downregulation, and increased cartilage degradation, while primary OA was marked by upregulated inflammatory and catabolic pathways. The effect of MetS on these pathologies was further shown. MetS further disrupted WNT/β-catenin signalling in CTA, and in OA. Genes such as ACAN, PANX3, CLU, and VAT1L were upregulated, highlighting potential biomarkers for early OA detection. This transcriptomic analysis reveals key differences between end-stage CTA and primary glenohumeral OA. CTA shows heightened metabolic/protein synthesis activity with less immune-driven inflammation. Under MetS, mitochondrial dysfunction (including GATD3A downregulation) and altered Wnt/β-catenin signalling intensify cartilage and bone damage. In contrast, primary OA features strong complement activation, inflammatory gene expression, and collagen remodelling. MetS worsens both conditions via oxidative stress, advanced glycation end products, and ECM disruption—particularly, increased CS/DS degradation. These distinctions support targeted treatments, from antioxidants and Wnt modulators to aggrecanase inhibitors or clusterin augmentation. Addressing specific molecular disruptions, especially those amplified by MetS, may preserve shoulder function, delay surgical intervention, and improve long-term patient outcomes. Full article
Show Figures

Figure 1

15 pages, 485 KiB  
Review
Family-Centred Early Hearing Detection and Intervention in the African Context: Relevance and Responsiveness to African Culture
by Katijah Khoza-Shangase
Audiol. Res. 2025, 15(2), 30; https://doi.org/10.3390/audiolres15020030 - 15 Mar 2025
Cited by 1 | Viewed by 786
Abstract
Family-centred early hearing detection and intervention (FC-EHDI) is an established framework globally recognized for its emphasis on family involvement in supporting children who are deaf and hard of hearing (DHH). In the African context, unique sociocultural and systemic challenges necessitate tailored approaches to [...] Read more.
Family-centred early hearing detection and intervention (FC-EHDI) is an established framework globally recognized for its emphasis on family involvement in supporting children who are deaf and hard of hearing (DHH). In the African context, unique sociocultural and systemic challenges necessitate tailored approaches to ensure effective implementation. This narrative review explores the relevance of FC-EHDI in Africa, highlights barriers to its implementation, and offers recommendations for creating sustainable and culturally aligned interventions. A narrative review methodology synthesizing evidence from African countries to examine the intersection of FC-EHDI with cultural practices, systemic barriers, and opportunities for innovation was adopted. Databases including PubMed, Scopus, Web of Science, and Google Scholar were searched for peer-reviewed journal articles, books, and reports published between 2000 and 2024. Keywords included “family-centred care”, “EHDI”, “Africa”, “cultural responsiveness”, and “early hearing detection and intervention”. Studies were included if they addressed EHDI in African contexts, explored family-centred approaches, or provided barriers and recommendations specific to the region. Thematic analysis was employed to synthesize findings into barriers, evidence, and strategies for FC-EHDI implementation. Data were extracted and analysed thematically to identify patterns and gaps in knowledge. Key challenges identified include resource limitations, economic constraints, linguistic and cultural diversity, and fragmented healthcare systems. Evidence highlights the effectiveness of community-based care, linguistic inclusivity, and culturally tailored interventions in enhancing family engagement and programme outcomes. Recommendations focus on leveraging technology, interdisciplinary collaboration, and policy advocacy. FC-EHDI offers a transformative approach to addressing DHH African children by integrating family involvement, cultural responsiveness, and systemic innovations. Future efforts should emphasize technology, scalable models, and family empowerment to create sustainable and equitable services. Full article
Show Figures

Figure 1

13 pages, 311 KiB  
Article
Interleukin-6 and Leukocyte Cell Population Data in Newly Diagnosed Sepsis—A Prospective Study
by Sara Šundalić, Iva Košuta, Ivana Baršić Lapić, Ivana Rako, Dunja Rogić, Radovan Radonić and Ana Vujaklija Brajković
Medicina 2025, 61(3), 468; https://doi.org/10.3390/medicina61030468 - 7 Mar 2025
Cited by 2 | Viewed by 1273
Abstract
Background and Objectives: Sepsis still represents a syndrome with a high mortality. A timely sepsis diagnosis and an early intervention are crucial for the disease outcomes. Sepsis-associated acute kidney injury (SA-AKI) is highly prevalent but often diagnosed late. We aimed to investigate whether [...] Read more.
Background and Objectives: Sepsis still represents a syndrome with a high mortality. A timely sepsis diagnosis and an early intervention are crucial for the disease outcomes. Sepsis-associated acute kidney injury (SA-AKI) is highly prevalent but often diagnosed late. We aimed to investigate whether serum interleukin-6 (IL-6) and leukocyte cell population data (CPD) could be adequate biomarkers for the prediction of survival and SA-AKI development. Materials and Methods: We conducted a prospective observational study in a medical intensive care unit of a tertiary hospital centre in Zagreb, Croatia from June 2020 to October 2023. Adult patients with newly diagnosed sepsis were included and classified as immunocompetent or immunocompromised. Blood samples were collected upon admission. Results: A total of 150 patients were included in the study. Ninety-six (64%) patients were immunocompetent and fifty-four (36%) were immunocompromised. The median SOFA score was 8 (6–11). SA-AKI was diagnosed in 108 (72%) patients. ICU and hospital mortality was 27.3% and 37.3%, with no significant difference between groups. Significantly higher serum IL-6 levels were noted in the immunocompromised group, while neutrophil granularity intensity was higher in the immunocompetent group. According to logistic regression analyses, elevated IL-6 levels predicted a lethal ICU outcome, while elevated IL-6 levels and neutrophil reactivity intensity were predictors of SA-AKI development. A cluster analysis revealed two patient groups with different IL-6 concentrations, and further studies indicated that the group with higher IL-6 values had significantly higher SA-AKI occurrence and increased lethal outcomes. Conclusions: An early serum IL-6 measurement regardless of the patients’ immune status indicates disease severity. Its measurement in the early phase of disease presentation, potentially in the emergency department, might facilitate ICU admission. Further research is warranted in the field of leukocyte CDP application. Full article
(This article belongs to the Section Intensive Care/ Anesthesiology)
Back to TopTop