77 results on '"Suh-Fang Jeng"'
Search Results
2. Screen Time Exposure and Altered Sleep in Young Children With Epilepsy
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Suh-Fang Jeng, Shao Yu Tsai, Wen-Chin Weng, Chien-Chang Lee, Ying-Ying Lin, Wang-Tso Lee, and Hsiao-Ling Yang
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Male ,Sleep Wake Disorders ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Taiwan ,Screen Time ,03 medical and health sciences ,Screen time ,Epilepsy ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Humans ,Clinical significance ,030212 general & internal medicine ,Sleep study ,Child ,General Nursing ,Sleep disorder ,030504 nursing ,business.industry ,Infant ,Actigraphy ,medicine.disease ,Sleep in non-human animals ,Cross-Sectional Studies ,Child, Preschool ,Female ,Sleep onset ,0305 other medical science ,business - Abstract
To examine the association between daily screen time exposure and both sleep patterns (sleep onset, sleep offset, and nighttime, and daily sleep durations) and sleep disturbances among a clinical sample of children with epilepsy.A cross-sectional actigraphic sleep study.A convenience sample of 141 children with epilepsy (1.5-6 years of age) was recruited from an outpatient pediatric neurology clinic of a university-affiliated children's hospital in northern Taiwan. Participating families completed questionnaires and reported children's screen time use, with children wearing an actigraphy monitor for 7 days to assess sleep patterns. Multivariable linear regression analyses were conducted to examine the association of screen time exposure with the child's sleep patterns and sleep disturbance scores.Mean minutes per day of screen time exposure was 89.79 ± 83.94 min, with 62 parents (44.0%) reporting their child having1 hr of screen time daily. Mean daily sleep duration was 9.26 ± 1.01 hr, with 106 children (93.0%) sleeping10 hr in a 24-hr period. In multivariate regression models, daily screen time exposure of1 hour was associated with 23.4-min later sleep onset (b = 0.39, p = .02), 20.4-min later sleep offset (b = 0.34, p = .04), and more severe sleep disturbances (b = 2.42, p = .04).In toddlers and preschool-age children with epilepsy, daily screen time exposure is greater and sleep duration is shorter than the recommended amount, with increased screen time exposure associated with disturbed sleep.Parents need to be informed about the possible adverse impact of screen time exposure on children's sleep and health as well as the importance of limiting screen time exposure to1 hr per day for their toddlers and preschool-age children with epilepsy.
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- 2020
3. Collaborative Home-Visit Program for Young Children With Motor Delays in Rural Taiwan: A Pilot Randomized Controlled Trial
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Suh-Fang Jeng, Mei-Hui Tseng, Hua-Fang Liao, Verónica Schiariti, Sheh-Chia Sun, Yu-Hsin Hsieh, and Mei-Yan Tsai
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Parents ,Rural Population ,Program evaluation ,Gerontology ,Time Factors ,Developmental Disabilities ,Motor Disorders ,Taiwan ,Social Workers ,Poison control ,Pilot Projects ,Physical Therapy, Sports Therapy and Rehabilitation ,Occupational safety and health ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,International Classification of Functioning, Disability and Health ,law ,Early Medical Intervention ,030225 pediatrics ,Outcome Assessment, Health Care ,Health care ,Humans ,Medicine ,Single-Blind Method ,030212 general & internal medicine ,business.industry ,Infant ,House Calls ,Physical Therapists ,Caregivers ,Child, Preschool ,Early childhood intervention ,Family Relations ,Rural area ,business ,Program Evaluation - Abstract
Background Caregiver engagement and collaborative team early childhood intervention (ECI) services are international trends; however, relevant evidence of collaborative home-visiting ECI in rural areas is as yet undetermined. Objective The study aimed to investigate the effectiveness of a collaborative ECI program in a rural area of Taiwan. Design The study was a pilot randomized control led trial. Methods Children aged 6 to 33 months experiencing motor delays and their caregivers were enrolled in Taitung, Taiwan. Using stratified randomization, 24 participants were allocated to either experimental or control groups, and both received 5 home visits within 3 months. The experimental group received ECI services based on the International Classification of Functioning, Disability and Health framework and family-centered approaches. The control group received regular home visits by local social workers. Child outcomes included Pediatric Evaluation of Disability Inventory Chinese Version and Peabody Developmental Motor Scale, 2nd edition. Family outcomes included the Disability-Adapted Infant–Toddler version of Home Observation for Measurement, and Chinese versions of the Knowledge of Infant Development Inventory and Parental Stress Index-Short Form. A tester blinded to the study conducted assessments at baseline, postintervention, and 3-month follow-up. Two-way mixed analysis of variance was used with α = .05 (2-tailed). Results The experimental group improved scores on the Disability-Adapted Infant–Toddler version of Home Observation for Measurement significantly more than the control group with an effect size of 0.64 at follow-up. In other outcomes, both groups showed no significant differences. The follow-up rate was 69%, and adherence to the ECI program was acceptable. Limitations A limitation of the study was the heterogeneity of the sample. Conclusions This pilot study revealed possible effectiveness in implementing collaborative ECI programs based on family-centered approaches and the International Classification of Functioning, Disability and Health in rural areas. Larger field studies are needed to confirm our findings.
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- 2020
4. Multidimensional Developments and Free-Play Movement Tracking in 30- to 36-Month-Old Toddlers With Autism Spectrum Disorder Who Were Full Term
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Yen-Tzu Wu, Yao-Jen Li, Po-Nien Tsao, Suh-Fang Jeng, Lu Lu, Pou-Leng Cheong, Yu-Ching Yang, Hsiao-Ching Huang, and Shih-Ya Wang
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Male ,Movement tracking ,medicine.medical_specialty ,Autism Spectrum Disorder ,Cross-sectional study ,Movement ,Child Behavior ,Physical Therapy, Sports Therapy and Rehabilitation ,Audiology ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Infant, Very Low Birth Weight ,0501 psychology and cognitive sciences ,Prospective Studies ,Child Behavior Checklist ,Full Term ,Psychiatric Status Rating Scales ,05 social sciences ,Cognition ,medicine.disease ,Checklist ,Play and Playthings ,Low birth weight ,Cross-Sectional Studies ,Autism spectrum disorder ,Child, Preschool ,Female ,Tracking (education) ,medicine.symptom ,Psychology ,030217 neurology & neurosurgery ,050104 developmental & child psychology - Abstract
Background Few studies have investigated multidimensional developments and free-play movement performance in toddlers with an early diagnosis of autism spectrum disorder (ASD). Objective This study compared cognitive, motor, and behavioral developments and free-play movement performance in toddlers with ASD who were full term (FT-ASD), toddlers who were full term and are typically developing (FT-TD), and toddlers who were born preterm and had a very low birth weight (VLBW-PT). Design This was a prospective cross-sectional study. Methods Forty-five 30- to 36-month-old age-matched toddlers were recruited and divided into FT-ASD, FT-TD, and VLBW-PT groups. Their developments were examined using the Mullen Scales of Early Learning; the Peabody Developmental Motor Scales, Second Edition; the Child Behavior Checklist for Ages 1.5 to 5; and the Repetitive Behavior Scale-Revised. In addition, the toddlers’ free-play movements were tracked in laboratory settings using an automatic movement tracking system. Results Toddlers with FT-ASD exhibited lower cognitive and motor scores and a higher degree of behavioral problems compared with toddlers with FT-TD or VLBW-PT. Furthermore, the movement tracking data in a free-play setting revealed that toddlers with FT-ASD displayed a higher degree of turning velocity, a higher moving time, and a higher frequency of moving toward the peripheral region compared with toddlers with FT-TD or VLBW-PT. Moreover, several motor developmental and movement-tracking indicators were found to correlate with behavioral problems and cognitive scores in toddlers with FT-ASD. Limitations The study results may have been affected by the small sample size, the cross-sectional design, and tracking only the whole body without subtle movements or segmental motions. Conclusions The findings suggest varied aspects of co-occurring developmental conditions and movement-based problems in toddlers with FT-ASD. Using standardized and sensitive measures for the early assessment of perceptuo-motor impairments is necessary for timely early intervention for such toddlers.
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- 2019
5. Validation of the modified checklist for autism in toddlers, revised with follow-up in Taiwanese toddlers
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Yen-Hsun Huang, Jung-Mei Tsai, Yen-Tzu Wu, Lu Lu, Suh-Fang Jeng, Pou-Leng Cheong, and Susan Shur-Fen Gau
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Male ,Predictive validity ,030506 rehabilitation ,Psychometrics ,Autism Spectrum Disorder ,Taiwan ,Modified Checklist for Autism in Toddlers ,Clinical settings ,Sensitivity and Specificity ,03 medical and health sciences ,Typically developing ,Internal consistency ,mental disorders ,Developmental and Educational Psychology ,medicine ,Humans ,Mass Screening ,0501 psychology and cognitive sciences ,Autistic Disorder ,Child Behavior Checklist ,digestive, oral, and skin physiology ,05 social sciences ,Infant ,Reproducibility of Results ,medicine.disease ,Checklist ,Clinical Psychology ,Autism spectrum disorder ,Case-Control Studies ,Child, Preschool ,Female ,0305 other medical science ,Psychology ,Follow-Up Studies ,050104 developmental & child psychology ,Clinical psychology - Abstract
Background The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M−CHAT-R/F) is a two-stage screening scale for determining the risk of autism spectrum disorder (ASD) in toddlers. However, the validity of the M−CHAT-R/F for Asian populations has not yet been established. Aims This study investigated the psychometric properties of the M−CHAT-R/F, Taiwan version (M−CHAT-R/F–T), among low- and high-risk Taiwanese toddlers aged 16–30 months. The associations among M−CHAT-R/F−T scores, developmental performance at 24 and 30 months, and ASD diagnosis prediction at 36 months were examined. Methods and Procedures A two-stage screening of the M−CHAT-R/F−T was applied to a study sample comprising 25 toddlers with ASD and 71 atypically developing (ATD) and 221 typically developing (TD) toddlers. Outcomes and Results The M−CHAT-R/F–T exhibited acceptable internal consistency and test–retest reliability. The M−CHAT-R/F–T scores were significantly correlated with several syndrome scores of the Child Behavior Checklist for Ages 1.5–5 and were significantly higher among toddlers with ASD than among ATD or TD toddlers. Furthermore, M−CHAT-R/F–T scores were negatively correlated with developmental scores in the Mullen Scales of Early Learning at 24 and 30 months. Moreover, the screening exhibited acceptable predictive validity (sensitivity = 0.86; specificity = 0.96) for ASD diagnosis at 36 months. Conclusions and Implications The findings indicate that the M−CHAT-R/F–T is a valid and reliable tool for the developmental screening of low- and high-risk Taiwanese toddlers in community and clinical settings.
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- 2019
6. Interaction Between Prematurity and the MAOA Gene on Mental Development in Children: A Longitudinal View
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Nai-Jia Yao, Wu-Shiun Hsieh, Chyi-Her Lin, Ching-Ing Tseng, Wan-Yu Lin, Po-Hsiu Kuo, Yen-Ting Yu, Wei J. Chen, and Suh-Fang Jeng
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Linkage disequilibrium ,Pediatrics ,medicine.medical_specialty ,Single-nucleotide polymorphism ,030204 cardiovascular system & hematology ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,030225 pediatrics ,Medicine ,genetics ,Early childhood ,Motor skill ,Original Research ,child development ,business.industry ,prematurity ,lcsh:RJ1-570 ,longitudinal analysis ,lcsh:Pediatrics ,Tag SNP ,Child development ,Bonferroni correction ,Pediatrics, Perinatology and Child Health ,Multiple comparisons problem ,symbols ,dopamine ,business ,cognitive development - Abstract
This study aimed to examine the association of dopamine-related genes with mental and motor development and the gene-environment interaction in preterm and term children. A total of 201 preterm and 111 term children were examined for their development at 6, 12, 18, 24, and 36 months and were genotyped for 15 single-nucleotide polymorphisms (SNPs) in dopamine-related genes (DRD2, DRD3, DAT1, COMT, and MAOA). An independent sample of 256 preterm children was used for replication. Since the developmental age trends of preterm children differed from those of term children, the analyses were stratified by prematurity. Among the 8 SNPs on the MAOA gene examined in the whole learning sample, the results of linkage disequilibrium analysis indicated that they were located in one block (all D′ > 0.9), and rs2239448 was chosen as the tag (r2 > 0.85). In the analysis of individual SNPs in each dopamine-related gene, the tag SNP (rs2239448) in MAOA remained significantly associated with the mental scores of preterm children for the interaction with age trend (p < 0.0001; largest effect size of 0.65 at 24 months) after Bonferroni correction for multiple testing. Similar findings for rs2239448 were replicated in the independent sample (p = 0.026). However, none of the SNPs were associated with the motor scores of preterm children, and none were related to the mental or motor scores of term children. The genetic variants of the MAOA gene exert influence on mental development throughout early childhood for preterm, but not term, children.
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- 2020
7. Agreement Between Actigraphy and Diary-Recorded Measures of Sleep in Children With Epilepsy
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Chien-Chang Lee, Suh-Fang Jeng, Shao Yu Tsai, Wang-Tso Lee, and Wen-Chin Weng
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medicine.medical_specialty ,business.industry ,Actigraphy ,Audiology ,medicine.disease ,Sleep in non-human animals ,Sleep patterns ,03 medical and health sciences ,Child sleep ,Epilepsy ,0302 clinical medicine ,Daytime sleep ,030225 pediatrics ,Medicine ,Sleep diary ,Sleep onset ,business ,030217 neurology & neurosurgery ,General Nursing - Abstract
Purpose To describe sleep patterns in young children with epilepsy and to examine levels of agreement between measurements derived from actigraphy and diary recordings. Design Cross-sectional study. Methods Eighty-nine toddlers and preschool-aged children with epilepsy wore an actigraph on their wrists for 7 consecutive days. Parents and caregivers maintained a concurrent sleep diary while the child was wearing the monitor. Levels of agreement between actigraphy and diary recordings were examined using the Bland and Altman method separately for all recording days, weekdays, and weekends. Findings Discrepancies between actigraphy-derived and diary-documented sleep onset, sleep offset, actual sleep at night, wake after sleep onset, and daytime sleep were ±35, ±15, ±82, ±70, and ±29 min, respectively. Differences between actigraphy and diary-derived sleep variables were consistently greater for weekends than for weekdays. Discrepancies between actigraphy and diary-derived actual sleep at night were significantly greater for children who slept alone than for those who co-slept with a parent. Conclusions Our study demonstrates an acceptable agreement between actigraphy and diary recordings for sleep onset, sleep offset, and daytime sleep, but insufficient agreement for actual sleep at night and wake after sleep onset, with parents of children sleeping alone more likely to misestimate child sleep behaviors. Deviation of weekend sleep from weekdays further decreased the accuracy of parental sleep estimates and increased the discrepancies between actigraphy and diary. Clinical relevance Sleep in children with epilepsy assessed using diary recordings alone could be misleading, and actigraphy should be preferred over diaries when resources are available.
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- 2017
8. Family-centered Care Improved Neonatal Medical and Neurobehavioral Outcomes in Preterm Infants: Randomized Controlled Trial
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Suh-Fang Jeng, Yen-Ting Yu, Yuh Jyh Lin, Ying Ju Chang, Chyong Hsin Hsu, Wu-Shiun Hsieh, Nai Jia Yao, Chyi-Her Lin, Lu Lu, Wei J. Chen, Shulan Hsieh, Rong Ju Cherng, and Pi-Chuan Fan
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Male ,Pediatrics ,medicine.medical_specialty ,Birth weight ,Taiwan ,Psychological intervention ,Physical Therapy, Sports Therapy and Rehabilitation ,Infant, Premature, Diseases ,law.invention ,Family centered care ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,030225 pediatrics ,Intensive care ,Humans ,Infant, Very Low Birth Weight ,Medicine ,Single-Blind Method ,030212 general & internal medicine ,business.industry ,Infant, Newborn ,Family nursing ,Low birth weight ,Treatment Outcome ,Family Nursing ,Intensive Care, Neonatal ,Female ,medicine.symptom ,business ,Weight gain ,Infant, Premature - Abstract
Background Family-centered care for preterm infants in Western societies has yielded short- to medium-term benefits. However, the intervention effects have rarely been validated in Eastern societies. Objective The aim of this study was to examine whether a family-centered intervention program (FCIP) could improve the short-term medical and neurobehavioral outcomes in preterm infants with very low birth weight (VLBW; a birth weight of Design This was a multicenter, single-blind, randomized controlled trial study. Setting Three medical centers in northern and southern Taiwan were the locations for the study. Participants The participants were 251 VLBW preterm infants without severe perinatal complications. Intervention The infants were randomly assigned to receive the FCIP or the UCP during hospitalization. Measurements Infant morbidities, feeding, growth, and neurobehavioral performance were evaluated during the neonatal period. Parental adherence to interventions was measured in the FCIP group. Results The FCIP promoted earlier full enteral feeding (β = –1.1 weeks; 95% CI = –1.9 to –0.2 weeks) and hospital discharge (β = –0.6 week; 95% CI = –1.1 to –0.1 weeks), greater weight gain (β = 3.3 g/d; 95% CI = 0.1 to 6.6 g/d), and better neurobehavioral performance than the UCP (β = 1.2 points; 95% CI = 0.2 to 2.3 points). Furthermore, a higher degree of parental motivation in interventions, goal attainment, and comprehensiveness of home activities was significantly associated with greater effects in infants’ neurobehavioral performance and weight gain (r = .20–.31; all Ps Limitations The findings may not be generalized to preterm infants with severe perinatal diseases and parents with a low level of interest in interventions. Conclusions Family-centered care facilitated short-term medical and neurobehavioral outcomes in VLBW preterm infants in Taiwan; the effects were likely achieved through parental adherence to interventions. The designated strategies may be considered in a future launch of family-centered care in Taiwan.
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- 2017
9. Gross Motor Trajectories During the First Year of Life for Preterm Infants With Very Low Birth Weight
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Yen-Tzu Wu, Yu-Kang Tu, Li-Chiou Chen, Yu-Han Su, Suh-Fang Jeng, and Wu-Shiun Hsieh
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Male ,Pediatrics ,medicine.medical_specialty ,Developmental Disabilities ,Birth weight ,Gross motor skill ,Physical Therapy, Sports Therapy and Rehabilitation ,Bayley Scales of Infant Development ,03 medical and health sciences ,Child Development ,0302 clinical medicine ,Risk Factors ,030225 pediatrics ,medicine ,Humans ,Infant, Very Low Birth Weight ,Prospective Studies ,Toddler ,Motor skill ,business.industry ,Infant, Newborn ,Infant ,Retinopathy of prematurity ,medicine.disease ,Low birth weight ,Logistic Models ,Bronchopulmonary dysplasia ,Motor Skills ,Female ,medicine.symptom ,business ,Infant, Premature ,030217 neurology & neurosurgery - Abstract
Background Early identification of motor dysfunction in preterm infants with very low birth weight (VLBW) is important in order to provide early intervention. Objective This study was to examine the motor trajectories of preterm infants with VLBW during their first year of life and to investigate the predictive ability and influencing factors of the trajectories. Design and Methods A total of 342 preterm infants with VLBW were prospectively assessed for motor development by the Alberta Infant Motor Scales at 4, 6, 9, and 12 months and for developmental outcomes using the Bayley Scales of Infant and Toddler Development, second edition, at 24 months. Perinatal and socio-environmental factors were collected at baseline. Growth mixture modeling was used to explore the patterns of infants’ motor trajectories during their first year of life. Logistic regression analyses were applied to examine the influencing factors associated with motor trajectories and their predictability of 24-month developmental outcomes. Results Preterm infants with VLBW showed 3 distinct motor trajectories: stably normal (55%), deteriorating (32%), and persistently delayed (13%). Furthermore, the motor trajectories were predictive of 24-month cognitive and motor outcomes. Perinatal factors including lower birth weight, male gender, moderate to severe bronchopulmonary dysplasia, stage III to IV retinopathy of prematurity, and major brain damage were associated with a risk of deteriorating and persistently delayed trajectories (all P < .05). Socio-environmental factors had no association with motor trajectories. Limitations The small sample size of the infants with a persistently delayed trajectory may have limited the assessment of some influencing factors. Conclusion The identified early motor trajectories, predictive values, and influencing factors provide insightful implications for early detection and prevention of motor -disorders in preterm infants with VLBW.
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- 2017
10. Family-Centered Care Enhanced Neonatal Neurophysiological Function in Preterm Infants: Randomized Controlled Trial
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Chia Lin Lee, Shulan Hsieh, Yen-Ting Yu, Wu-Shiun Hsieh, Wan Chi Huang, Suh-Fang Jeng, Lu Lu, Nai Jia Yao, Yu-Kang Tu, Chyi-Her Lin, Pi-Chuan Fan, and Jui Hsing Chang
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Pediatrics ,medicine.medical_specialty ,Birth weight ,Taiwan ,Physical Therapy, Sports Therapy and Rehabilitation ,Electroencephalography ,Motor Activity ,Family centered care ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,030225 pediatrics ,Intervention (counseling) ,Early Medical Intervention ,Patient-Centered Care ,Reflex ,medicine ,Humans ,Infant, Very Low Birth Weight ,Family ,Single-Blind Method ,Oddball paradigm ,Evoked Potentials ,Observer Variation ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,medicine.disease ,Neurophysiological Monitoring ,Low birth weight ,Infant Behavior ,Small for gestational age ,medicine.symptom ,business ,Sleep ,030217 neurology & neurosurgery ,Infant, Premature - Abstract
Background Family-centered intervention for preterm infants has shown short- to medium-term developmental benefits; however, the neurological effects of intervention have rarely been explored. Objective The objectives of this study were to examine the effect of a family-centered intervention program (FCIP) on neurophysiological functions in preterm infants with very low birth weight (VLBW; birth weight of Design This was a multicenter, single-blind randomized controlled trial. Setting The study took place in 3 medical centers in northern and southern Taiwan. Participants Two hundred fifty-one preterm infants with VLBW were included. Intervention The FCIP group received a family-centered intervention and the UCP group received standard care during hospitalization. Measurements Infants were assessed in terms of neurobehavioral performance using the Neonatal Neurobehavioral Examination–Chinese version, and their neurophysiological function was assessed using electroencephalography/event-related potentials during sleep and during an auditory oddball task during the neonatal period. Results The FCIP promoted more mature neurophysiological function than the UCP, including greater negative mean amplitudes of mismatch negativities in the left frontal region in the oddball task in all infants, lower intrahemispheric prefrontal-central coherence during sleep in infants who were small for gestational age, and higher interhemispheric frontal coherence during sleep in those who were appropriate for gestational age. Furthermore, interhemispheric coherence was positively associated with the total neurobehavioral score in preterm infants who were appropriate for gestational age (r = 0.20). Limitations The fact that more parental adherence strategies were used in the FCIP group than in the UCP group might have favored the intervention effect in this study. Conclusions Family-centered intervention facilitates short-term neurophysiological maturation in preterm infants with VLBW in Taiwan.
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- 2019
11. Sleep in mothers of children with epilepsy and its relation to their children's sleep
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Chien-Chang Lee, Wang-Tso Lee, Suh-Fang Jeng, Shao Yu Tsai, and Wen-Chin Weng
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Adult ,Male ,Sleep Wake Disorders ,Health Knowledge, Attitudes, Practice ,Taiwan ,Mothers ,Comorbidity ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Humans ,030212 general & internal medicine ,Child ,General Nursing ,Depression (differential diagnoses) ,Sleep disorder ,030504 nursing ,business.industry ,Infant ,Actigraphy ,medicine.disease ,Sleep in non-human animals ,Mother-Child Relations ,Poor sleep ,Cross-Sectional Studies ,Child, Preschool ,Female ,Health information ,Sleep onset ,0305 other medical science ,business ,Sleep ,Clinical psychology - Abstract
We conducted a cross-sectional study to examine sleep in mothers of children with epilepsy and its relation to their children's sleep. A total of 133 dyads of mothers and children with epilepsy aged 1.5-6 years were recruited between 2015 and 2018 from a children's hospital in northern Taiwan. Participating families provided demographic and health information, with children wearing an actigraphy monitor for 7 days and mothers completing sleep and depressive mood questionnaires. We found that 76 (57.1%) of the mothers had poor sleep quality, with 65 (48.9%) mothers having a clinically significant depressive symptom score. Mean actigraphic wake after sleep onset in children was 1.42 (standard deviation = 0.51) hours, with 126 (94.7%) of the children having a clinically significant sleep disturbance score. Multivariate regression analyses showed that higher depressive symptom scores in mothers (β = 0.14; p < .01) and higher sleep disturbance scores in children (β = 0.07; p = .04) were associated with poorer maternal sleep quality, even when maternal demographic characteristics and the child's clinical and epilepsy variables were considered. Findings from our study suggest that sleep disturbances are a shared problem for mothers and their children with epilepsy. Sleep in both mothers and their children with epilepsy should be evaluated in pediatric neurologic practices, with maternal depressive symptoms screened concurrently. Future pediatric epilepsy studies are warranted to examine whether a family-based intervention program would be effective to improve sleep in mother-child dyads and to promote better health and functioning of the entire family.
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- 2019
12. Behavioral-educational sleep interventions for pediatric epilepsy: a randomized controlled trial
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Wang-Tso Lee, Wen-Chin Weng, Suh-Fang Jeng, Shao Yu Tsai, and Chien-Chang Lee
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Male ,Parents ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Psychological intervention ,Health Promotion ,Education, Nonprofessional ,law.invention ,Pittsburgh Sleep Quality Index ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Randomized controlled trial ,Quality of life ,law ,030225 pediatrics ,Physiology (medical) ,Surveys and Questionnaires ,medicine ,Humans ,Child ,Health Education ,business.industry ,Infant ,Actigraphy ,medicine.disease ,Sleep in non-human animals ,Clinical trial ,Child, Preschool ,Physical therapy ,Quality of Life ,Female ,Neurology (clinical) ,business ,Sleep ,030217 neurology & neurosurgery - Abstract
Study ObjectivesTo evaluate the effect of a clinic-based, behavioral-educational sleep intervention on sleep of children with epilepsy, maternal knowledge about childhood sleep, and maternal sleep quality.MethodsA total of 100 toddlers and preschool-age children with epilepsy (1.5–6 years, 55% boys) and their parents were randomized to receive sleep intervention (n = 50) or usual care with attention (n = 50). Outcomes were assessed at baseline, 3, 6, and 12 months after intervention with the use of objective actigraphy, Children’s Sleep Habits Questionnaire, Parents’ Sleep Knowledge Inventory, and Pittsburgh Sleep Quality Index. Intervention effects were examined using general linear models for repeated measurements to compare the mean change in outcomes from baseline to 12 months post-intervention between the two groups.ResultsSleep intervention resulted in children having greater sleep efficiency by 2.03% compared with the usual care group (95% CI = 0.20% to 3.86%; p = .03). Children in the intervention group also had significantly longer total nighttime sleep as objectively assessed by actigraphy than did those in the usual care group, with an adjusted mean difference of 16.13 minutes (95% CI = 0.24% to 32.03%; p = .04). No intervention effects were observed for maternal knowledge about childhood sleep, and maternal sleep quality.ConclusionSleep intervention provided during routine neurologic visits results in significant, measurable, and sustained benefits in sleep quality and quantity in children with epilepsy. Future trials are warranted to evaluate whether improvements in sleep could impact health-related quality of life or other aspects of functioning in children with epilepsy.Clinical TrialThis trial has been registered at www.clinicaltrials.gov (trial name: Sleep Intervention for Pediatric Epilepsy; registration number: NCT02514291).
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- 2019
13. Sleep in children with epilepsy: the role of maternal knowledge of childhood sleep
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Wen-Chin Weng, Wang-Tso Lee, Suh-Fang Jeng, Shao Yu Tsai, and Chien-Chang Lee
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Adult ,Male ,Sleep Wake Disorders ,Health Knowledge, Attitudes, Practice ,Mothers ,Comorbidity ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Surveys and Questionnaires ,Physiology (medical) ,Intervention (counseling) ,Bayesian multivariate linear regression ,Humans ,Medicine ,030212 general & internal medicine ,Child ,Sleep disorder ,business.industry ,Infant ,Actigraphy ,medicine.disease ,Sleep in non-human animals ,Mother-Child Relations ,Clinical trial ,Child, Preschool ,Female ,Neurology (clinical) ,Sleep ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Study objectives To examine maternal knowledge of childhood sleep and its relation to sleep quantity, quality, and variability in a clinic sample of mothers of toddlers and preschool-age children with epilepsy. Methods A total of 112 epileptic children wore a wrist actigraphy to objectively assess daily sleep duration and its variability across 7 days. Mothers completed the Parents' Sleep Knowledge Inventory and Children's Sleep Habits Questionnaire (CSHQ). Multivariate linear regression models were performed to predict CSHQ sleep disturbance scores, daily sleep duration, and daily sleep duration variability in children with epilepsy. Results On average, mothers answered 30.5 per cent of the questions correctly about normal childhood sleep patterns. Only six (5.3%) of the mothers answered half or more of the questions correctly. Mothers more frequently answered "don't know" to questions about dreams, symptoms of sleep-disordered breathing, and adequate amounts of sleep required by children and adolescents. After adjusting for the child's age, gender, bed-sharing, and relevant clinical and epilepsy variables, poorer maternal sleep knowledge was the independent predictor of higher CSHQ sleep disturbance scores and greater intraindividual variability of daily sleep duration in epileptic children (p Conclusions Maternal knowledge about childhood sleep is inadequate and decreased maternal sleep knowledge is associated with poorer and more variable sleep in children with epilepsy. Findings from this study document the need to provide parental education about childhood sleep, particularly emphasizing the recommended sleep duration for children across different developmental stages and addressing the symptoms of sleep disorders commonly comorbid with epilepsy. Trial registration This trial has been registered at www.clinicaltrials.gov (trial name: Sleep Intervention for Pediatric Epilepsy; registration number: NCT02514291).
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- 2018
14. Postural Control and Interceptive Skills in Children With Autism Spectrum Disorder
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Suh-Fang Jeng, Yen-Nan Chiu, Li-Chiou Chen, Wan-Chun Su, Lu Lu, Wen-Che Tsai, and Tzu-Lin Ho
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Male ,medicine.medical_specialty ,Time Factors ,Cross-sectional study ,Autism Spectrum Disorder ,Movement ,Population ,Physical Therapy, Sports Therapy and Rehabilitation ,Sensory system ,Postural control ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Intellectual disability ,medicine ,Humans ,0501 psychology and cognitive sciences ,Generalizability theory ,education ,Child ,Postural Balance ,Motor skill ,Vision, Ocular ,education.field_of_study ,05 social sciences ,medicine.disease ,Anticipation, Psychological ,Play and Playthings ,Cross-Sectional Studies ,Autism spectrum disorder ,Motor Skills ,Arm ,Female ,Psychology ,030217 neurology & neurosurgery ,050104 developmental & child psychology - Abstract
Background Increasing evidence shows common motor deficits associated with autism spectrum disorder (ASD) that can relate to impaired planning and control processes of the sensorimotor system. Catching is a fundamental motor skill that requires coordination between vision, posture, and arm movements. Although postural control and ball catching have been shown to be impaired in children with ASD, previous studies have not investigated how these components are integrated. Objective The objective of this study was to investigate the sensorimotor control of arm movements and postural adjustments during ball catching in children with and without ASD. Design This study employed a cross-sectional design. Methods Fifteen children with ASD (mean [SD] age = 8.8 [1.2] years; 12 boys) and 15 age- and sex-matched typically developing children participated in this study. Children were asked to catch a ball rolling down a ramp in 6 test conditions in which visual inputs and ramp direction were manipulated to provide different sensory conditions and postural demands. Results Compared with their typically developing peers, children with ASD had increased difficulties catching balls, especially those from lateral directions. They less often used visual information to plan for catching motion, demonstrated fewer and delayed anticipatory postural adjustments, and exhibited increased corrective control. Limitations The sample excluded children with intellectual disability and attention deficit and hyperactivity disorders that might reduce the generalizability to the whole ASD population. Conclusions Our results suggest that motor difficulties present in children with ASD can result from compromised sensorimotor integration in planning and control of movements.
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- 2018
15. Sleep and Behavior Problems in Children With Epilepsy
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Suh-Fang Jeng, Shao Yu Tsai, Wang-Tso Lee, Wen-Chin Weng, and Chien-Chang Lee
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Male ,Sleep Wake Disorders ,Pediatrics ,medicine.medical_specialty ,Child Behavior Disorders ,Comorbidity ,Anxiety ,Bedtime ,03 medical and health sciences ,Behavior disorder ,Epilepsy ,0302 clinical medicine ,030225 pediatrics ,medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,Internal-External Control ,business.industry ,Infant ,Actigraphy ,medicine.disease ,Sleep in non-human animals ,Cross-Sectional Studies ,Nocturnal sleep ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Practice Guidelines as Topic ,Female ,medicine.symptom ,business - Abstract
We designed a cross-sectional study to examine the association between sleep and behavior problems in toddlers and preschool-age children with epilepsy. We found that 71 (78.9%) children slept less than 10 hours in a 24-hour period according to the actigraphy, with 75 (83.3%) children waking for more than an hour during nocturnal sleep. Twenty-five (27.8%) children usually or sometimes had an inconsistent bedtime, and 24 (26.7%) did not sleep the same amount each day. Twenty-nine (32.2%) and 18 (20.0%) children had an internalizing and externalizing problem in clinical range, respectively. Sleep anxiety was significantly (p < .01) associated with increased internalizing and externalizing problems, even after the relevant epilepsy variables were controlled for. Findings from our study suggest that screening of sleep and behavior problems should be part of routine epilepsy care to identify children with problematic sleep and unrecognized sleep disorders and those at risk of behavioral dysfunction.
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- 2018
16. Nationwide Twin Birth Weight Percentiles by Gestational Age in Taiwan
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Chia-Jung Hsieh, Suh-Fang Jeng, Hung-Chieh Chou, Po-Nien Tsao, Hui-Chen Wu, I-Jan Hu, Chien-Yi Chen, Pau-Chung Chen, Wu-Shiun Hsieh, and Shio Jean Lin
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Male ,Percentile ,medicine.medical_specialty ,Birth weight ,Population ,intrauterine growth ,Taiwan ,Twins ,Twin birth ,percentile ,Fetal growth ,Humans ,Medicine ,Pediatrics, Perinatology, and Child Health ,education ,gestational age ,education.field_of_study ,business.industry ,Obstetrics ,Infant, Newborn ,lcsh:RJ1-570 ,Gestational age ,birth weight ,lcsh:Pediatrics ,Twin study ,Pediatrics, Perinatology and Child Health ,Gestation ,Female ,twin ,business - Abstract
Background Nationwide birth weight norms for twins have been reported in several countries across different ethnicities, but such data have not been established in Taiwan. The purpose of this study was to develop reference growth charts that are population-based and contain the information of birth weight percentiles by gestational age for twin neonates in Taiwan. Methods In this study, we collected nationwide birth weight data for twins by sex and gestational age through the Taiwan Birth Registry. Percentiles, means, and standard deviations of birth weight for each 1-week increment of gestational age from 21 weeks of gestation were estimated and smoothed using weighted polynomial models. Results The 10 th , 50 th , and 90 th percentiles of birth weight born at the 37 th gestational week were 2174 g, 2580 g, and 3125 g for male twins, respectively, and they were 2100 g, 2500 g, and 3000 g for female twins, respectively. The 10 th , 50 th , and 90 th percentiles of birth weight born at the 40 th gestational week were 2326, 3285, and 3790 g for male twins, respectively, and they were 2200 g, 2770 g, and 3690 g for female twins, respectively. Conclusion This is the first nationwide birth weight norm for twins in Taiwan, which is particularly useful for investigation into the predictors and outcomes of altered fetal growth through twin studies in the Taiwanese population.
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- 2015
17. Nationwide Birth Weight and Gestational Age-specific Neonatal Mortality Rate in Taiwan
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Hung-Wen Chen, Shuo-Tse Hsu, Chien-Yi Chen, Hung-Chieh Chou, Chia-Jung Hsieh, Suh-Fang Jeng, Pau-Chung Chen, Po-Nien Tsao, Hui-Chen Wu, Mei-Huei Chen, and Wu-Shiun Hsieh
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Male ,Risk ,medicine.medical_specialty ,neonatal mortality ,Palliative care ,Birth weight ,Population ,Taiwan ,Gestational Age ,Birth rate ,Infant Mortality ,Birth Weight ,Humans ,Medicine ,Pediatrics, Perinatology, and Child Health ,low birth weight ,education ,education.field_of_study ,business.industry ,Obstetrics ,Infant, Newborn ,lcsh:RJ1-570 ,Infant ,preterm birth ,Gestational age ,lcsh:Pediatrics ,Infant mortality ,Low birth weight ,Pediatrics, Perinatology and Child Health ,Gestation ,Female ,medicine.symptom ,business - Abstract
BackgroundThere are limited nationwide data relating to neonatal mortality rate in Taiwan. This study aims to provide updated national birth weight/gestational age-specific neonatal mortality reference rates.MethodsWe abstracted the birth registration database from the Ministry of Interior in Taiwan from 1998 to 2002 and linked the data to the death registration database from the Ministry of Health and Welfare in Taiwan between 1998 and 2003. We included 1,331,785 infants born between 20 weeks and 44 weeks of gestation and weighing within the median ± 2 interquartile ranges in their age group in this study. We calculated the birth weight/gestational age-specific neonatal mortality rates of different genders by birth weight increments of 250 g and at gestational age intervals of 1 week. A Poisson regression model was used in modeling the mortality data.ResultsA total of 4,169 deaths occurred within 28 days of life out of a total of 1,331,785 live births between 20 weeks and 44 weeks of gestation, giving a neonatal mortality rate (0–27 days) of 3.39 per 1000 live births for males and 2.80 per 1000 for females. The infant mortality rate remained higher in the male (5.91 per 1000) than the female (5.10 per 1000) population within the 1st year of life. Birth weight/gestational age-specific neonatal mortality rates were plotted with curves representing the 10th and 90th birth weight percentiles. The risk of an early neonatal death (0–6 days) does not exceed 50% except for female neonates
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- 2015
18. A randomized controlled trial of clinic-based and home-based interventions in comparison with usual care for preterm infants: Effects and mediators
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Wu-Shiun Hsieh, Ying-Chin Wu, Yen-Tzu Wu, Li-Chiou Chen, Chyong-Hsin Hsu, Li-Jung Fang, Yen-Ting Yu, Suh-Fang Jeng, Ming-Chin Yang, Wei J. Chen, Nan-Chang Chiu, Susan Shur-Fen Gau, Hui-Chin Hsu, and Chi-Hon Leng
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Male ,Pediatrics ,medicine.medical_specialty ,Emotions ,Bayley Scales of Infant Development ,law.invention ,Child Development ,Cognition ,Ambulatory care ,Randomized controlled trial ,law ,Ambulatory Care ,Early Intervention, Educational ,Developmental and Educational Psychology ,medicine ,Humans ,Infant, Very Low Birth Weight ,Toddler ,Child Behavior Checklist ,Infant Care ,Infant, Newborn ,Infant ,Home Care Services ,Child development ,Mother-Child Relations ,Clinical Psychology ,Treatment Outcome ,Motor Skills ,Infant Behavior ,Dyadic interaction ,Female ,Psychology ,Infant, Premature - Abstract
This study examined the effects and mediators of a clinic-based intervention program (CBIP) and a home-based intervention program (HBIP) compared with usual care in very-low-birth-weight (VLBW) preterm infants on developmental and behavioral outcomes at 24 months of age (corrected for prematurity). In this randomized controlled trial, VLBW preterm infants received either CBIP (n=57), HBIP (n=63), or usual care (n=58) from hospitalization to 12 months. At 12 months, infant emotional regulation was assessed using the toy-behind-barrier procedure and dyadic interaction was observed during free play. At 24 months, infant developmental and behavioral outcomes were assessed using the Bayley Scales of Infant and Toddler Development- 3rd edition and the Child Behavior Checklist for Ages 1.5-5, respectively. Compared with infants under usual care, the CBIP-group infants showed higher cognitive composite scores (difference, 95% confidence interval (CI)=4.4, 0.8-7.9) and a lower rate of motor delay (odds ratio (OR), 95% CI=0.29, 0.08-0.99); the HBIP-group infants had lower sleep problem scores (difference, 95% CI=-1.4, -2.5 to -0.3) and a lower rate of internalizing problems at 24 months (OR, 95% CI=0.51, 0.28-0.93) (all p
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- 2014
19. Perfluorinated Compound Levels in Cord Blood and Neurodevelopment at 2 Years of Age
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Mei-Huei Chen, Hua Fang Liao, Ting Wen Wen, Yi Ning Su, Guang-Wen Lien, Eun Hee Ha, Pau-Chung Chen, Wu-Shiun Hsieh, Chia-Yang Chen, and Suh-Fang Jeng
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Male ,Epidemiology ,Developmental Disabilities ,Taiwan ,Perfluorinated compound ,Physiology ,Nervous System ,chemistry.chemical_compound ,Child Development ,Pregnancy ,medicine ,Humans ,Fluorocarbons ,business.industry ,Gestational age ,Odds ratio ,Fetal Blood ,medicine.disease ,Confidence interval ,Motor Skills Disorders ,chemistry ,Child, Preschool ,Prenatal Exposure Delayed Effects ,Cord blood ,Perfluorooctanoic acid ,Female ,Caprylates ,Cotinine ,business - Abstract
Background Epidemiologic data regarding the potential neurotoxicity of perfluorinated compounds (PFCs) are inconclusive. We investigated the associations between in utero exposure to perfluorooctanoic acid (PFOA) and perfluorooctyl sulfonate (PFOS) and early childhood neurodevelopment. Methods We recruited 239 mother-infant pairs in northern Taiwan from the Taiwan Birth Panel Study, which was established in 2004. We examined the association between PFCs in cord blood and children's neurodevelopment at 2 years of age, using the Comprehensive Developmental Inventory for Infants and Toddlers. This tool contains cognitive, language, motor, social, and self-help domains; test scores were further transformed into developmental quotients according to standardized norms. All multivariate regression models were adjusted for infant sex and gestational age, maternal education, family income, cord blood cotinine levels, postnatal environmental tobacco smoke exposure, and breastfeeding. Results Prenatal PFOS concentrations in both untransformed and natural log (Ln)-transformed values were associated with adverse performance on the whole test and the domains related to development. A dose-response relationship was observed when PFOS levels were categorized into four groups. This association was most obvious in relation to the gross-motor subdomain. Across the PFOS interquartile range, the quotients of the gross-motor subdomain decreased by 3.7 points (95% confidence interval [CI] = -6.0 to -1.5), with an increasing odds ratio of poor performance (2.4; 95% CI = 1.3 to 4.2). In contrast, measures of association between PFOA concentrations and test scores were close to null. Conclusions Prenatal exposure to PFOS, but not PFOA, may affect children's development, especially gross-motor development at 2 years of age.
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- 2013
20. Differential Effects of Still-Face Interaction on Mothers of Term and Preterm Infants
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Suh-Fang Jeng and Hui-Chin Hsu
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Gynecology ,Psychiatry and Mental health ,medicine.medical_specialty ,Pediatrics, Perinatology and Child Health ,Still face ,Developmental and Educational Psychology ,medicine ,Psychology ,Differential effects - Abstract
This study investigated the effect of still-face interaction on the affect, behavior, and perception in mothers of term and low-birth-weight preterm (gestational age
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- 2013
21. The effect of in-hospital developmental care on neonatal morbidity, growth and development of preterm Taiwanese infants: A randomized controlled trial
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Suh-Fang Jeng, Ying-Chin Wu, Wei J. Chen, Li-Jung Fang, Ming-Chin Yang, Chyong-Hsin Hsu, Wang-Tso Lee, Hui-Chin Hsu, Li-Chiou Chen, Chi-Hon Leng, Nan-Chang Chiu, and Wu-Shiun Hsieh
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Pediatrics ,medicine.medical_specialty ,Developmental Disabilities ,Taiwan ,Psychological intervention ,Weight Gain ,law.invention ,Child Development ,Randomized controlled trial ,law ,Intensive care ,Intervention (counseling) ,Odds Ratio ,Humans ,Infant, Very Low Birth Weight ,Medicine ,Retinopathy of Prematurity ,Parent-Child Relations ,business.industry ,Infant, Newborn ,Infant ,Obstetrics and Gynecology ,Odds ratio ,Hospitals ,Confidence interval ,Clinical trial ,Low birth weight ,Pediatrics, Perinatology and Child Health ,Intensive Care, Neonatal ,Regression Analysis ,Morbidity ,medicine.symptom ,business ,Infant, Premature - Abstract
Introduction Intervention studies of developmental care for preterm infants in Western societies have shown early but unsustainable effects on child outcomes, however only a limited of studies have examined if developmental care interventions produce similar effects in Eastern cultural contexts. Aims To examine the effectiveness of in-hospital developmental care on neonatal morbidity, growth and development of preterm infants with very low birth weight (VLBW; birth weight Methods One hundred and seventy-eight VLBW preterm infants were randomly assigned to the clinical trial during hospitalization at three hospitals in Taiwan; the control group received five sessions of standard child-focused developmental care and the intervention group received five sessions of child- and parent-focused developmental care. Sixty-two normal term infants were also included as a comparison group. Infants were examined for morbidity, growth and developmental outcomes at term age. Results At study entry, more infants in the intervention group were twins or multiples than those in the control group (29% vs. 16%, p = 0.05). After adjusting for birth set, the intervention group had lower incidences of stage II–III retinopathy (odds ratio [OR] = 0.34 [95% confidence interval (CI): 0.15–0.79]; p = 0.01) and feeding desaturation (OR = 0.32 [95% CI: 0.10–1.00]; p = 0.05) and had greater daily weight gains (difference = 2.0 g/day [95% CI: 0–4.0 g/day]; p = 0.05) as compared with the control group. However, the intervention and control groups did not differ in any of the neurodevelopmental measures. Conclusions In-hospital developmental care has short-term benefits for Taiwanese VLBW preterm infants in reducing the risk of retinopathy and feeding desaturation as well as in enhancing weight gains at term age.
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- 2013
22. Relationship of Neonatal Cerebral Blood Flow Velocity Asymmetry with Early Motor, Cognitive and Language Development in Term Infants
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Chien-Yi Chen, Wu-Shiun Hsieh, Jui-Hsing Chang, Hung-Chieh Chou, Nan-Chang Chiu, Shinn-Forng Peng, Wei J. Chen, Han-Yang Hung, Suh-Fang Jeng, Chyong-Hsin Hsu, and Ying-Chin Wu
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Male ,Pediatrics ,medicine.medical_specialty ,Acoustics and Ultrasonics ,Statistics as Topic ,Cerebral arteries ,Biophysics ,Hemodynamics ,Language Development ,Sensitivity and Specificity ,Bayley Scales of Infant Development ,Lateralization of brain function ,Cognitive Reserve ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Toddler ,Radiological and Ultrasound Technology ,business.industry ,Infant, Newborn ,Brain ,Reproducibility of Results ,Cognition ,Echoencephalography ,Language development ,Cerebral blood flow ,Motor Skills ,Cerebrovascular Circulation ,Cardiology ,Female ,business ,Blood Flow Velocity - Abstract
The objective of this study was to examine the relationships of Doppler cerebral blood flow velocity (CBFV) asymmetry measures with developmental outcomes in term infants. Doppler CBFV parameters (peak systolic velocity [PSV] and mean velocity [MV]) of the bilateral middle cerebral arteries of 52 healthy term infants were prospectively examined on postnatal days 1-5, and then their motor, cognitive and language development was evaluated with the Bayley Scales of Infant and Toddler Development, Third Edition, at 6, 12, 18 and 24 months of age. The left CBFV asymmetry measure (PSV or MV) was calculated by subtracting the right-side value from the left-side value. Left CBFV asymmetry measures were significantly positively related to motor scores at 6 (r = 0.3-0.32, p0.05) and 12 (r = 0.35, p0.05) months of age, but were not related to cognitive or language outcome. Thus, the leftward hemodynamic status of the middle cerebral arteries, as measured by cranial Doppler ultrasound in the neonatal period, predicts early motor outcome in term infants.
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- 2013
23. In utero exposure to environmental lead and manganese and neurodevelopment at 2 years of age
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Yi Ning Su, Chien Mu Lin, Wu-Shiun Hsieh, Hua-Fang Liao, Ching Chun Lin, Feng-Chiao Su, Yaw-Huei Hwang, Yu Chuan Chen, Suh-Fang Jeng, and Pau-Chung Chen
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Adult ,Neurotoxins ,Population ,Physiology ,chemistry.chemical_element ,Nervous System ,Biochemistry ,Umbilical cord ,Tobacco smoke ,Toxicology ,Young Adult ,Child Development ,Pregnancy ,medicine ,Humans ,education ,Arsenic ,General Environmental Science ,Manganese ,education.field_of_study ,Chemistry ,Environmental Exposure ,medicine.disease ,Mercury (element) ,medicine.anatomical_structure ,Lead ,In utero ,Child, Preschool ,Prenatal Exposure Delayed Effects ,Cord blood ,Female - Abstract
Background and objective Manganese, lead, arsenic and mercury are common neurotoxic metals in the environment. Nonetheless, the relationship between prenatal exposure to low doses of neurotoxic metals and neurodevelopment in children is not clear. The objective of this study was to explore the relationship between in utero exposure to environmental neurotoxic metals and neurodevelopment at 2 years of age. Methods The population of this study came from the Taiwan Birth Panel Study. We included 230 pairs of non-smoking mothers without any occupational exposure and their singleton full-term children. The information about exposure during pregnancy was obtained using a structured questionnaire, and the manganese, lead, arsenic and mercury levels in umbilical cord blood samples were analyzed using inductively coupled plasma mass spectrometry. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) to evaluate the developmental status of each child at 2 years of age, and we examined the association of in utero exposure to environmental metals and neurodevelopment using linear regression models. Results The median concentrations of manganese, lead, arsenic and mercury in the cord blood samples in this study were 47.90 µg/L (range, 17.88–106.85 µg/L), 11.41 µg/L (range 0.16–43.22 µg/L), 4.05 µg/L (range, 1.50–12.88 µg/L) and 12.17 µg/L (range, 1.53–64.87 µg/L), respectively. After adjusting for maternal age, infant gender, environmental tobacco smoke during pregnancy and after delivery, Home Observation for Measurement of the Environment Inventory results, and arsenic and mercury levels in cord blood, we found that manganese and lead levels above the 75th percentile had a significant adverse association with the overall (β=−7.03, SE=2.65, P=0.0085), cognitive (β=−8.19, SE=3.17, P=0.0105), and language quotients (β=−6.81, SE=2.73, P=0.0133) of the CDIIT. Conclusions In utero exposure to environmental manganese and lead may have an adverse association with neurodevelopment at 2 years of age, and there is an interaction effect between the manganese and lead levels in the cord blood that could aggravate the effect.
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- 2013
24. The Impacts of Cord Blood Cotinine and Glutathione-S-Transferase Gene Polymorphisms on Birth Outcome
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Wu-Shiun Hsieh, Mei-Huei Chen, Sharon Ng, Chia-Jung Hsieh, Pau-Chung Chen, Kuan Han Huang, An-Kuo Chou, and Suh-Fang Jeng
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Adult ,medicine.medical_specialty ,Genotype ,Birth weight ,Taiwan ,Physiology ,environmental tobacco smoke ,Cohort Studies ,03 medical and health sciences ,chemistry.chemical_compound ,small for gestational age ,0302 clinical medicine ,newborn ,Pregnancy ,030225 pediatrics ,medicine ,Odds Ratio ,Humans ,Pediatrics, Perinatology, and Child Health ,030212 general & internal medicine ,Cotinine ,glutathione S-transferase ,Glutathione Transferase ,Fetus ,Polymorphism, Genetic ,business.industry ,Obstetrics ,lcsh:RJ1-570 ,Infant, Newborn ,lcsh:Pediatrics ,premature birth ,Infant, Low Birth Weight ,medicine.disease ,Fetal Blood ,Low birth weight ,chemistry ,Premature birth ,Cord blood ,Pediatrics, Perinatology and Child Health ,Infant, Small for Gestational Age ,Small for gestational age ,Female ,Tobacco Smoke Pollution ,medicine.symptom ,business - Abstract
Background This study aimed to investigate the association between cord blood cotinine levels and birth outcome, and to determine whether fetal metabolic gene polymorphisms of glutathione-S-transferase (GST) modulate the effect of environmental tobacco smoke exposure during pregnancy. Methods This study included 328 maternal and neonatal pairs. Maternal and cord blood cotinine levels were measured using high performance liquid chromatography. The GST T1 ( GSTT1 ) and GST M1 ( GSTM1 ) polymorphisms were examined using the polymerase chain reaction method. The birth outcomes included birth weight, length, and head circumference, and the risks of having low birth weight and being small for gestational age (SGA). Results Cord cotinine level had a dose-dependent impact on the reduction of birth weight, length, and head circumference in newborns. Elevation of cord blood cotinine concentration increased the rate of SGA and low birth weight. The neonates who had GSTT1 or GSTM1 polymorphism were associated with an increased risk of being SGA. A combination of the GSTT1 and GSTM1 null genotype exacerbated the effect of maternal environmental tobacco smoke exposure on SGA more than the presence of either genotype alone (odds ratio=8.90, 95% confidence interval=1.00–79.5). Conclusion Cord blood cotinine adversely affects birth outcomes. GSTT1 and GSTM1 null genotype may modify the effect of cord blood cotinine on birth outcomes.
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- 2016
25. A Nationwide Survey of Risk Factors for Stillbirth in Taiwan, 2001–2004
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Wu-Shiun Hsieh, Shio Jean Lin, Hua-Fang Liao, Suh-Fang Jeng, I-Jan Hu, Yi-Ning Su, Pau-Chung Chen, and Chia-Jung Hsieh
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Adult ,Male ,Polyhydramnios ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Adolescent ,Birth weight ,Taiwan ,Oligohydramnios ,Nationwide survey ,Pregnancy ,medicine ,Humans ,risk factors ,Pediatrics, Perinatology, and Child Health ,Advanced maternal age ,ethnics ,reproductive and urinary physiology ,Teenage pregnancy ,Fetus ,Obstetrics ,business.industry ,Infant, Newborn ,polyhydramnios ,lcsh:RJ1-570 ,Gestational age ,lcsh:Pediatrics ,Heart Rate, Fetal ,medicine.disease ,Pediatrics, Perinatology and Child Health ,Female ,stillbirth ,business ,oligohydramnios ,nationwide ,Maternal Age - Abstract
Objective The purpose of this study was to evaluate the nationwide stillbirth rate and explore the potential risk factors associated with stillbirths. Patients and methods Data from vital registrations during the time period from January 1, 2001 through to December 31, 2004 in Taiwan were used. Stillbirth was defined as fetal death with more than 20 completed weeks’ gestational age (GA) or with birth weight more than 500 g if the GA was not known. Results There were a total of 8481 stillbirths identified nationwide between January 1, 2001 and December 31, 2004. The stillbirth rate was nine per 1000 total births in the study period, and the proportionate decline was nearly 48.8% in the most recent decade. There was a significant increase in average maternal age during this period. Advanced maternal age and teenage pregnancy were independent significant risk factors for stillbirths even after accounting for the effects of medical conditions that were more likely to occur among these particular age groups. Those fetuses that had been exposed to cord prolapse, maternal cervical incompetence and oligohydramnios/polyhydramnios were especially vulnerable. By contrast, women who had foreign nationality, fetal ultrasound surveys, fetal heart beat monitoring and hastened parturition were less likely to have stillbirth. Conclusion The stillbirth rate in Taiwan has remained high despite advancements in medical care. Prenatal evaluation of high risk women may decrease the adverse fetal outcomes.
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- 2012
26. Maternal psychosocial factors around delivery, and the behavior of 2-year-old children
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Chao-Hua Chuang, Suh-Fang Jeng, Yi-Ning Su, Pau-Chung Chen, Wu-Shiun Hsieh, and Hua-Fang Liao
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medicine.medical_specialty ,business.industry ,Confounding ,CBCL ,Mental health ,Pediatrics, Perinatology and Child Health ,medicine ,Young adult ,Psychiatry ,Prospective cohort study ,Child Behavior Checklist ,business ,Psychosocial ,Cohort study - Abstract
Background: The objectives of the present study were to explore whether maternal psychosocial factors, mental health and work stress around delivery, are related to the behavior of 2-year-old children. Methods: In a prospective cohort study design, pregnant women attending the National Taiwan University Hospital for delivery and post-partum care from April 2004 to January 2005 were recruited and their children were observed at 24 months. A total of 186 mother–term-born child dyads completed the measurement. The five-item Mental Health Index (MHI-5) self-report data of maternal psychosocial factors were selected from the Taiwanese version of the short form 36 (SF-36). The Child Behavior Checklist for age 1½–5 (CBCL/1½-5) was completed by the parents when the child was 2 years old. Results: The mean score of mental health around delivery was 68.11. The proportion of mothers with work stress seldom and always was 61.8% and 24.7%, respectively. The mean of the total CBCL score, and internalizing, externalizing behavior and sleep problems scores was 45.95, 11.89, 15.59 and 4.23, respectively. After adjusting for the potential confounders, maternal work stress around delivery was found to have a significant effect on the total CBCL and externalizing, attention and aggressive, behavioral problems of 2-year old children. Maternal mental health around delivery, however, did not show significant effects on child behavior. Conclusions: Work stress around delivery seems to aggravate children's externalizing behavior problems at 2 years old. It is therefore important to improve the psychosocial health and reduce the stress of pregnant women.
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- 2011
27. Favorable Neonatal Outcomes Among Immigrants in Taiwan: Evidence of Healthy Immigrant Mother Effect
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Suh-Fang Jeng, Pau-Chung Chen, Wu-Shiun Hsieh, Chia-Jung Hsieh, Hua-Fang Liao, Yi-Ning Su, Pei-Jen Chang, and Shio Jean Lin
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China ,Health Status ,Population ,Taiwan ,Ethnic group ,Emigrants and Immigrants ,Mothers ,Social support ,Asian People ,Pregnancy ,Humans ,Medicine ,education ,education.field_of_study ,business.industry ,Proportional hazards model ,Incidence ,Incidence (epidemiology) ,Infant Welfare ,Infant, Newborn ,Pregnancy Outcome ,General Medicine ,Odds ratio ,Perinatal Care ,Low birth weight ,Socioeconomic Factors ,Vietnam ,Relative risk ,Female ,medicine.symptom ,business ,Demography - Abstract
Although racial/ethnic disparities in neonatal and infant health are well known, positive associations between migration and perinatal health exist among immigrant mothers in western countries. There are unique marriage migration, East Asia culture, universal national health insurance system, and adequate social support in Taiwan that may differ from the situation in western countries. We aimed to assess the neonatal outcomes among live births to married immigrant mothers in recent years in Taiwan.We conducted a population-based analysis among all the live births in Taiwan during the period 1998-2003 to assess neonatal outcomes, including incidence of low birth weight and preterm birth and of early and late neonatal mortality, according to maternal nationality. Logistic regression was used to estimate the odds ratios (ORs) associated with low birth weight and preterm birth, and Cox proportional hazards were used to estimate the relative risks (RRs) associated with mortality in the neonatal period.There were a total of 1,405,931 single live births, including 6.6% born to immigrant mothers and 93.4% born to Taiwanese mothers. Disparities existed among the intercultural couples, including paternal age, parental educational level, and residential distribution. Fewer low birth weight and fewer preterm babies were born to immigrant mothers than to Taiwanese mothers. In addition, babies born to immigrant mothers had lower early neonatal and neonatal mortalities than those born to Taiwanese mothers. There were lower risks of having a low birth weight (adjusted OR [AOR] 0.73, 95% confidence interval [CI] 0.70-0.75) or preterm (AOR 0.72, 95% CI 0.69-0.74) baby and lower hazard ratios (HRs) of having an early neonatal death (adjusted HR [AHR] 0.68, 95% CI 0.56-0.82) or neonatal death (AHR 0.74, 95% CI 0.64-0.87) in babies born to immigrant mothers. There is a gradual increase in the risks of adverse neonatal outcomes associated with increases in length of residence.Evidence of a healthy immigrant mother effect on neonatal health is clear. Despite lower parental education, advancing paternal age, and spatial distribution disparity, babies born to married immigrant mothers in Taiwan had favorable neonatal outcomes.
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- 2011
28. Noninvasive Capnometry for End-tidal Carbon Dioxide Monitoring via Nasal Cannula in Nonintubated Neonates
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Chien-Yi Chen, Chih-Che Tai, Po-Nien Tsao, Wu-Shiun Hsieh, Pau-Chung Chen, Frank Leigh Lu, Hung-Chieh Chou, and Suh-Fang Jeng
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Male ,Catheters ,medicine.medical_treatment ,Infant, Premature, Diseases ,medicine.disease_cause ,nasal cannula ,Cohort Studies ,Carbon dioxide monitoring ,Capnography ,Intubation, Intratracheal ,Tidal Volume ,Humans ,Medicine ,Intubation ,Pediatrics, Perinatology, and Child Health ,Retrospective Studies ,capnometry ,business.industry ,lcsh:RJ1-570 ,Infant, Newborn ,Reproducibility of Results ,Gestational age ,lcsh:Pediatrics ,end-tidal carbon dioxide ,respiratory system ,Respiration Disorders ,End tidal ,Arterial blood sampling ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Breathing ,Arterial blood ,Female ,neonate ,Blood Gas Analysis ,business ,Nasal cannula ,Infant, Premature - Abstract
BackgroundArterial blood gas analysis is the gold standard for assessing the adequacy of ventilation. However, arterial blood sampling may be associated with serious complications in neonates. The aim of the study was to utilize the side-stream capnometry measurement of end-tidal carbon dioxide (PetCO2) via nasal cannula circuits and to verify the reliability of PetCO2 in reflecting the arterial blood carbon dioxide (PaCO2) level in nonintubated neonates.MethodsA retrospective medical record review analysis was performed in nonintubated neonates admitted to the neonatal ward in a medical center. Simultaneous arterial PaCO2 and PetCO2 levels were evaluated. PaCO2 and PetCO2 levels were compared by paired t test and were correlated using Pearson's correlation. The PetCO2 bias was defined as the difference between PaCO2 and PetCO2, and was assessed by Bland-Altman plot analysis.ResultsA total of 34 neonates were recruited, and data of 54 pairs of PaCO2 and PetCO2 levels were available for comparison. The average (mean ± SD) gestational age was 32.5 ± 4.2 weeks, and the average birth weight was 1881 ± 1077 g. There was a good correlation between PetCO2 and PaCO2 levels among all paired samples (r = 0.809, p < 0.001). When the data were divided into those with respiratory disease (n = 34) and those without (n = 20), significant correlation between PetCO2 and PaCO2 levels were both noted in the former group (r = 0.823, p < 0.001) and the latter group (r = 0.770, p < 0.001). The overall average mean value of PetCO2 was lower than that of PaCO2 (39.4 ± 8.8 mmHg vs. 41.3 ± 9.2 mmHg, p = 0.014). The difference between PetCO2 and PaCO2 levels was significant only among those with respiratory disease (38.8 ± 9.8 mmHg vs. 41.2 ± 10.3 mmHg, p = 0.027), but not among those without (40.5 ± 7.0 mmHg vs. 41.6 ± 7.2 mmHg, p = 0.289).ConclusionsEnd-tidal CO2 measurement by side-stream capnometry through nasal cannula could provide an accurate and noninvasive estimate of PaCO2 levels in nonintubated neonates.
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- 2010
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29. Preschool Psychopathology Reported by Parents in 23 Societies
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Pranvera Jetishi, Alessandra Frigerio, Manfred Doepfner, Felipe Lecannelier, Roma Jusiene, Bernardine S.C. Woo, Sarah De Pauw, Christiane Capron, Rolando Pomalima, Nese Erol, Solvejg Kristensen, Patrick W. L. Leung, Andre Sourander, Zynep Simsek, Jaime R. Silva, Yen-Tzu Wu, Jianghong Liu, Elaheh Mohammad Esmaeili, Halldor S. Gudmundsson, José Valverde, Kyung Ja Oh, Valerie S. Harder, Anca Dobrean, Niels Bilenberg, Valsamma Eapen, Thomas M. Achenbach, Frank C. Verhulst, Miguel M. Gonçalves, Rosario Montirosso, Karla Van Leeuwen, Leslie Rescorla, Young Ah Kim, Julia Plueck, Michele Duyme, Masha Y. Ivanova, Rebecca P. Ang, Lourdes Ezpeleta, Stephen R. Zubrick, Pedro Dias, Mimoza Shahini, Gudrun Bjarnadottir, Suh-Fang Jeng, Veritati - Repositório Institucional da Universidade Católica Portuguesa, [et al.], Child and Adolescent Psychiatry / Psychology, and Universidade do Minho
- Subjects
Male ,Social Sciences ,CBCL ,Personality Assessment ,0302 clinical medicine ,Developmental and Educational Psychology ,Mass Screening ,Psicologia [Ciências Sociais] ,Salary ,Child Behavior Checklist ,Incidence ,Mental Disorders ,05 social sciences ,Syndrome ,respiratory system ,Multicultural ,Checklist ,3. Good health ,Psychiatry and Mental health ,Child, Preschool ,Ciências Sociais::Psicologia ,Female ,Psychology ,Key Words ,Research center ,050104 developmental & child psychology ,Cross-Cultural Comparison ,medicine.medical_specialty ,Psychometrics ,Child Behavior Disorders ,Models, Psychological ,Assessment ,Confirmatory factor analysis ,Article ,03 medical and health sciences ,medicine ,Remuneration ,Humans ,0501 psychology and cognitive sciences ,Affective Symptoms ,Psychiatry ,Mass screening ,Taxonomy ,Science & Technology ,Preschoolers ,Infant ,Reproducibility of Results ,Social Behavior Disorders ,Cross-cultural studies ,Cross-Sectional Studies ,human activities ,030217 neurology & neurosurgery - Abstract
Objective: To test the fit of a seven-syndrome model to ratings of preschoolers' problems by parents in very diverse societies. Method: Parents of 19,106 children 18 to 71 months of age from 23 societies in Asia, Australasia, Europe, the Middle East, and South America completed the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). Confirmatory factor analyses were used to test the seven-syndrome model separately for each society. Results: The primary model fit index, the root mean square error of approximation (RMSEA), indicated acceptable to good fit for each society. Although a six-syndrome model combining the Emotionally Reactive and Anxious/Depressed syndromes also fit the data for nine societies, it fit less well than the seven-syndrome model for seven of the nine societies. Other fit indices yielded less consistent results than the RMSEA. Conclusions: The seven-syndrome model provides one way to capture patterns of children's problems that are manifested in ratings by parents from many societies. Clinicians working with preschoolers from these societies can thus assess and describe parents' ratings of behavioral, emotional, and social problems in terms of the seven syndromes. The results illustrate possibilities for culture general taxonomic constructs of preschool psychopathology. Problems not captured by the CBCL/1.5-5 may form additional syndromes, and other syndrome models may also fit the data., Dr. Ivanovo receives research and salary support from the Research Center for Children, Youth, and Families, which publishes the Child Behavior Checklist [CBCL]. Dr. Achenbach is President of the Research Center for Children, Youth, and Families, and receives remuneration. Dr. Rescorla receives remuneration from the Research Center for Children, Youth, and Families. Dr. Harder previously held a University of Vermont Postdoctoral Fellowship funding by the Research Center for Children, Youth, and Families. Drs. Bjarnadottir, Gudmundsson, Leung, Verhulst, and Mr. Gudmundsson, receive research support from the sole of the CBCL. Dr. Bilenberg has received honoraria from Eli Lilly and Co., Novartis, Neuroscience, and Janseen Cilag. He has received research support from the Danish Research Foundation, the Lundbeck Foundation, Hermansens Mindelegat, and Mods Clausen Fond. Dr. Rapes has received research support from the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences. Dr. Jusiene has received research support from the Lithuanian Science and Studies Foundation. Drs. Ang, Capron, Dias, Dobrean, Doepfner, Duyme, Erol, Esmaeili, Ezpeleta, Frigerio, Goncalves, Jung, Kim, Liu, Oh, Plueck, Pomo limo, Shahini, Silva, Simsek, Souronder, Valverde, Van Leeuwen, and Zubrick, Ms. De Paw, Ms. Kristensen, Mr. Lecannelier, Ms. Montirosso, Ms. Jetishi, Ms. Woo, and Ms. Wu report no biomedical financial interests or potential conflicts of interest., info:eu-repo/semantics/publishedVersion
- Published
- 2010
30. Serial measurements of serum alkaline phosphatase for early prediction of osteopaenia in preterm infants
- Author
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Wu-Shiun Hsieh, Suh-Fang Jeng, Po-Nien Tsao, Yi-Li Hung, Chia-Jung Hsieh, Steven Shinn-Forng Peng, Rouh-Fang Yen, Pau-Chung Chen, Chien-Yi Chen, and Hung-Chieh Chou
- Subjects
medicine.medical_specialty ,business.industry ,Early detection ,Gastroenterology ,Predictive value ,Bone remodeling ,Endocrinology ,Inorganic phosphate ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Early prediction ,medicine ,Alkaline phosphatase ,Gestation ,business ,Serum alkaline phosphatase - Abstract
Aim: Osteopaenia commonly occurs in preterm infants; however, its diagnosis is often delayed when based on radiological findings. The aim of this study was to examine whether serial measurements of bone turnover markers are useful for early prediction of osteopaenia in preterm infants. Methods: Premature infants of ≤34 weeks gestation were enrolled. Serum alkaline phosphatase (ALP), bone form ALP (BALP), calcium and inorganic phosphate were concurrently measured biweekly from 3 weeks post-natal age until 40 weeks post-conceptional age. Radiographic examination of the forearm was performed at term age. Osteopaenia was defined as positive radiographic findings according to Koo's criteria. Results: Of the 46 premature infants completing the follow-up study at term age, 18 showed osteopaenia in radiographic examination. Serum ALP was highly correlated with BALP (R2 = 0.93, P
- Published
- 2010
31. Maternal psychosocial factors around delivery on development of 2-year-old children: A prospective cohort study
- Author
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Pau-Chung Chen, Chao-Hua Chuang, Hua-Fang Liao, Wu-Shiun Hsieh, Yi-Ning Su, and Suh-Fang Jeng
- Subjects
Gerontology ,medicine.medical_specialty ,Pregnancy ,business.industry ,Confounding ,medicine.disease ,Vitality ,Pediatrics, Perinatology and Child Health ,Positive relationship ,Medicine ,business ,Psychiatry ,Adverse effect ,Prospective cohort study ,Psychosocial ,Motor skill - Abstract
Aim: To explore whether maternal psychosocial factors around delivery are related to development of 2-year-old children. Methods: Pregnant women going to the hospital for delivery were recruited, and their children were observed at 24 months. A total of 186 mother–child dyads completed the measurement. Self-report data of maternal psychosocial factors around delivery were selected from the Taiwanese version of the short-form 36. The Comprehensive Developmental Inventory for Infants and Toddlers was completed by interviewers and the main care givers for the child at 2 years old. Results: Using the multiple linear regression analysis and adjusting for potential confounders, maternal vitality around delivery was found to have a significantly positive relationship with the whole Comprehensive Developmental Inventory for Infants and Toddlers (P = 0.005) and self-help development (P = 0.001), but work stress had a significantly negative relationship with motor development (seldom, P = 0.050; always, P = 0.048). Conclusions: Maternal vitality around delivery was beneficial to a child's self-help development, while work stress seemed to be an adverse effect on child's motor development in later life. It is important to improve the psychosocial health of pregnant women.
- Published
- 2010
32. Reliability of the Assessment of Mother–Infant Sensitivity—Chinese Version for Preterm and Term Taiwanese Mother–Infant Dyads
- Author
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Wu-Shiun Hsieh, Suh-Fang Jeng, Li-Ying Wang, Chyong-Hsin Hsu, Yen-Ting Yu, Hui-Chin Hsu, Yen-Tzu Wu, and Ui-Chih Lin
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,Mother infant ,Physical Therapy, Sports Therapy and Rehabilitation ,Articles ,Term (time) ,Correlation ,Chinese version ,Inter-rater reliability ,Corrected Age ,Internal consistency ,medicine ,business ,Reliability (statistics) - Abstract
Purpose: The objectives of this study were to translate and modify the Assessment of Mother–Infant Sensitivity scale into a Chinese version (modified AMIS-C) and to examine its reliability with preterm and term Taiwanese mother–infant dyads. Method: A total of 241 mother–infant pairs (179 preterm dyads and 62 term dyads) were prospectively recorded and their behaviour in feeding assessed using the modified AMIS-C when infants were at 4 and 6 months corrected age. A subset of the sample was used for interrater reliability testing, and the whole sample was used for assessment of internal consistency. Results: Interrater reliability was high for the modified AMIS-C section and total scores (intra-class correlation coefficients=0.91–0.99). Internal consistency was good to excellent for the maternal section and total score (α=0.71–0.86) and was fair to good for the infant and dyadic section score (α=0.44–0.75). Conclusions: The modified AMIS-C scale is a clinically feasible and reliable instrument for assessing mother–infant interaction of preterm and term dyads during early infancy.
- Published
- 2010
33. Severity of bronchopulmonary dysplasia and increased risk of feeding desaturation and growth delay in very low birth weight preterm infants
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Chyong Hsin Hsu, Hui-Chin Hsu, Nan Chang Chiu, Wu-Shiun Hsieh, Pei Shan Chen, Wang-Tso Lee, Li-Ying Wang, Hong Ji Luo, and Suh-Fang Jeng
- Subjects
Pulmonary and Respiratory Medicine ,Pediatrics ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Confounding ,Gestational age ,medicine.disease ,behavioral disciplines and activities ,Low birth weight ,Pulse oximetry ,Bronchopulmonary dysplasia ,mental disorders ,Pediatrics, Perinatology and Child Health ,medicine ,Risk factor ,medicine.symptom ,Growth delay ,business ,Oxygen saturation (medicine) - Abstract
Oral feeding has been reported to compromise breathing among preterm infants with bronchopulmonary dysplasia (BPD) during hospitalization or shortly after discharge. However, limited information was available concerning whether preterm infants with BPD remain vulnerable to feeding and growth insufficiency after a longer term of follow-up. The purpose of this study was therefore to examine the effect of severity of BPD on pulse oxygen saturation (SpO(2)) during feeding and growth in very low birth weight (VLBW) preterm infants during infancy. Seventy-two preterm infants with VLBW and 15 term infants were prospectively examined their growth and SpO(2) during feeding at 2, 4, and 6 months of corrected age. The severity of BPD was graded in VLBW infants according to the American National Institutes of Health consensus definition. In comparison to VLBW infants with mild BPD and term infants, VLBW infants with severe BPD showed significantly lower mean levels of SpO(2) during feeding at 2-6 months corrected age (P < 0.05). Those with severe BPD further exhibited higher rates of growth delay (weight < 10th percentile) throughout the study period. Among VLBW infants, severe BPD had an adverse relation with subsequent weight measures after adjustment for medical and demographic confounding variables (beta = -904 g, P = 0.03). The consensus BPD definition is useful to identify those preterm infants who are at greater risk of feeding desaturation and growth delay during infancy and close monitoring of SpO(2) during feeding should be advised.
- Published
- 2010
34. Neonatal and Pregnancy Outcome in Primary Antiphospholipid Syndrome: A 10-year Experience in One Medical Center
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An-Kuo Chou, Po-Nien Tsao, Suh-Fang Jeng, Song-Chou Hsieh, Hung-Chieh Chou, Wu-Shiun Hsieh, Yi-Ning Su, and Chien-Yi Chen
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Offspring ,Placental insufficiency ,Infant, Newborn, Diseases ,Neonatal Thrombocytopenia ,small for gestational age ,Pregnancy ,Antiphospholipid syndrome ,medicine ,Humans ,Pediatrics, Perinatology, and Child Health ,Prospective cohort study ,Fetal Death ,Obstetrics ,business.industry ,Medical record ,lcsh:RJ1-570 ,Infant, Newborn ,Pregnancy Outcome ,preterm birth ,lcsh:Pediatrics ,Antiphospholipid Syndrome ,medicine.disease ,Thrombocytopenia ,Abortion, Spontaneous ,Pregnancy Complications ,Pediatrics, Perinatology and Child Health ,maternal and neonatal outcome ,Small for gestational age ,Female ,business - Abstract
Background Antiphospholipid syndrome (APS) in pregnancy is characterized by the presence of maternal autoantibodies in association with recurrent fetal loss and severe obstetric complications such as prematurity, intrauterine growth retardation, or placental insufficiency. This study aimed to assess the perinatal outcomes in neonates born to mothers with APS. Methods The medical records of pregnant women with APS and their offspring were retrospectively collected between January 1997 and July 2007. Maternal and perinatal histories including demographic data, medications, obstetric histories, and neonatal clinical manifestations and laboratory data were analyzed. Results Eleven women with a diagnosis of primary APS were included. Eight of these patients had experienced frequent spontaneous abortions (72.7%), and four had unexplained fetal deaths (36.3%). None of them had vascular thrombosis. Specific autoimmune antibodies were detected, including anticardiolipin antibody (n = 6), anti-β2 glycoprotein I (n = 3), and antiphospholipid antibody (n = 7). Among the pregnancies, five had preterm births (45.4%), two had intrauterine growth retardation (18.1%), and one had intrauterine fetal demise (9.1%). Thrombocytopenia was noted in three babies, all of whose mothers had lower platelet counts. One patient with neonatal thrombocytopenia developed intracranial hemorrhage, seen on brain images. Conclusions This limited study suggests that neonates born to mothers with primary APS are at risk of prematurity, being small for gestational age, and having thrombocytopenia. Further large, prospective studies are required to better define the perinatal outcomes.
- Published
- 2009
35. Cognitive Development at Age 8 Years in Very Low Birth Weight Children in Taiwan
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Li-Jung Fang, Chyong-Hsin Hsu, Suh-Fang Jeng, Chia-Han Chang, Kuo-Su Tsou, Kuo-Inn Tsou, and Shu-Chi Mu
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Birth weight ,Intelligence ,Taiwan ,full-scale intelligence quotient ,very low birth weight ,performance intelligence quotient ,verbal intelligence quotient ,Child Development ,Cognition ,Humans ,Infant, Very Low Birth Weight ,Medicine ,Child ,freedom from distractibility index score ,Retrospective Studies ,perceptional organization index score ,Wechsler Intelligence Scale for Children ,Full Term ,Medicine(all) ,lcsh:R5-920 ,verbal comprehension index score ,Intelligence quotient ,business.industry ,Infant, Newborn ,Gestational age ,Retrospective cohort study ,General Medicine ,Child development ,Low birth weight ,Female ,intelligence quotient ,medicine.symptom ,lcsh:Medicine (General) ,business ,Infant, Premature ,Follow-Up Studies - Abstract
Background/PurposeAll children should have some developmental screening periodically throughout childhood, especially those who were born prematurely. There is limited information about the development of children with very low birth weight (VLBW; birth weight < 1500 g) beyond the preschool age in Taiwan. We evaluated intelligence quotient (IQ) and cognitive ability of prematurely born school-aged children in Taiwan.MethodsThis was a multicenter study of VLBW and full-term children born between 1995 and 1997 at four hospitals in northern Taiwan. We used the Wechsler Intelligence Scale for Children, 3rd Edition (WISC-III), to assess these children. Demographic data were recorded including maternal and paternal age, education, birth weight, gestational age, and gender.ResultsA total of 189 children (130 with VLBW born prematurely and 59 born at full term) were recruited. There were significant differences in performance IQ (PIQ; 90.16 ± 17.05 vs. 108.51 ± 15.65, p < 0.001), verbal IQ (VIQ; 97.43 ± 15.62 vs. 111.78 ± 13.65, p < 0.001), full-scale IQ (FSIQ; 93.14 ± 16.33 vs. 111.05 ± 14.81, p < 0.001), verbal comprehension index score (VCIS; 98.06 ± 15.53 vs. 112.47 ± 13.74, p < 0.001), perceptional organization index score (POIS; 92.39 ± 17.13 vs. 109.42 ± 14.87, p < 0.001) and freedom from distractibility index score (FDIS; 98.34 ± 17.71 vs. 110.53 ± 10.94, p = 0.008). There was no correlation between perinatal outcomes and FSIQ.ConclusionOur results suggest that VLBW children have significantly lower PIQ, VIQ, FSIQ, VCIS, POIS and FDIS at primary school compared with full-term children.
- Published
- 2008
36. Spontaneous Multiseptated Cystic Pneumomediastinum in a Term Newborn
- Author
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Wu-Shiun Hsieh, Steven Shinn-Forng Peng, Hung-Chieh Chou, Chien-Yi Chen, Cheng-Ting Lee, Suh-Fang Jeng, and Po-Nien Tsao
- Subjects
medicine.medical_specialty ,SpiNNaker ,Radiography ,congenital cystic lung disease ,Computed tomography ,pulmonary air leak ,Humans ,Medicine ,Pediatrics, Perinatology, and Child Health ,Pneumomediastinum ,Mediastinal Emphysema ,pneumomediastinum ,Respiratory distress ,medicine.diagnostic_test ,Cysts ,business.industry ,lcsh:RJ1-570 ,Infant, Newborn ,lcsh:Pediatrics ,medicine.disease ,Surgery ,Pediatrics, Perinatology and Child Health ,Spontaneous pneumomediastinum ,Female ,Radiology ,Cystic mass ,Presentation (obstetrics) ,business - Abstract
Pneumomediastinum usually occurs after assisted ventilation. Spontaneous pneumomediastinum without preceding assisted ventilation, and presenting as a huge cystic mass in a term newborn infant has rarely been reported. We report a term baby who developed respiratory distress at 2 days of age. A huge cystic tumor of the thymus or a congenital mediastinal cystic tumor was initially suggested by chest radiography and computed tomography. Follow-up chest film revealed a “spinnaker sail sign” which is a typical radiographic presentation of pneumomediastinum.
- Published
- 2008
37. Two-month-olds’ attention and affective response to maternal still face: A comparison between term and preterm infants in Taiwan
- Author
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Hui-Chin Hsu and Suh-Fang Jeng
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Taiwan ,Mothers ,Developmental psychology ,Child Development ,Social cognition ,Still face ,Reaction Time ,Developmental and Educational Psychology ,medicine ,Humans ,Attention ,Maternal Behavior ,Reactivity (psychology) ,Affective response ,Age Factors ,Infant ,Cognition ,Gaze ,Social relation ,Term (time) ,Facial Expression ,Premature Birth ,Female ,Psychology - Abstract
Maternal still face is a robust experimental procedure designed to examine infants' sensitivity to social contingency and reactivity to its violation. To extend earlier research on the still-face effect on term infants in Western cultures, the present study compared Taiwanese term and preterm infants' attention and affective response to and recovery from a modified maternal still-face procedure that used an additional still-face reengagement sequence at 2 months of age (corrected age for preterm infants). Infants' gaze and facial affect were coded from videos. Results showed that preterm infants were as sensitive as term infants to the interruption to social contingency. Both groups of infants reacted with decreased gaze and positive affect across episodes, together with a decreased latency to gaze aversion and an increased latency to positive affect. Both term and preterm infants also demonstrated a W-shaped pattern of decline-followed-by-recovery in their latency to negative affect. However, compared to term infants, preterm infants became distressed faster and stayed in a negative affective state longer after the first exposure to maternal still face. Effects of prematurity on infant attention and affect regulation were discussed. Implications of preterm infants' heightened affective negativity to mild stress for intervention studies were also addressed.
- Published
- 2008
38. Factors associated with treatment mode and termination among preschoolers with ADHD in Taiwan
- Author
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Nicole Huang, Yi Ting Lien, Wei Tsuen Soong, Hsueh Han Yeh, Chuan Yu Chen, and Suh-Fang Jeng
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Rehabilitation ,business.industry ,medicine.medical_treatment ,Taiwan ,Newly diagnosed ,Logistic regression ,Psychiatry and Mental health ,National health insurance ,Socioeconomic Factors ,Attention Deficit Disorder with Hyperactivity ,Child, Preschool ,Health care ,Cohort ,Initial treatment ,Medicine ,Humans ,Patient Compliance ,Family ,Female ,Longitudinal Studies ,business ,Database research - Abstract
This study examined the extent to which characteristics of family and health care providers predict treatment initiation, treatment mode, and treatment termination among preschool children with newly diagnosed ADHD.A cohort of 3,583 preschoolers with ADHD was identified from the National Health Insurance Research Database of Taiwan. Individual characteristics and health care records, including medication and nonmedication treatment, were documented. Logistic regression and time-dependent survival analyses were used to evaluate association estimates.Over 80% of the children with newly diagnosed ADHD received initial treatment within a month of diagnosis, with 41% starting with combined treatment. Only one-quarter remained in treatment by the end of 12 months. In the first year, the termination rate was lowest for those who received rehabilitation treatment only (log-rank test, p.001). Predictors of termination varied by treatment mode. For combined treatment, factors that marginally increased the likelihood of treatment termination were coming from a family in poverty (adjusted hazard ratio [AHR]=1.72) or from a rural region (AHR=1.40). Receiving initial treatment from a psychiatrist was associated with an increased likelihood of treatment termination for children receiving psychosocial treatment (AHR=1.80, 95% confidence interval [CI]=1.46-2.22) and combined treatment (AHR=1.38, CI=1.20-1.60).Family and service provider characteristics appeared to have differential effects on initial receipt and mode of treatment and on one-year treatment termination among preschoolers with ADHD in Taiwan's universal health insurance program. Future efforts should aim at reducing access barriers to comprehensive and continuous health care for very young children with mental or developmental disorders.
- Published
- 2015
39. Intervention effects on emotion regulation in preterm infants with very low birth weight: A randomize controlled trial
- Author
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Chyong-Hsin Hsu, Yu-Wen Ho, Ying-Chin Wu, Suh-Fang Jeng, Wei-J. Chen, Nan-Chang Chiu, Wang-Tso Lee, Hui-Chin Hsu, Hung-Chieh Chou, Wu-Shiun Hsieh, and Jui-Hsing Chang
- Subjects
Behavior Control ,Male ,Pediatrics ,medicine.medical_specialty ,Birth weight ,Emotions ,Psychological intervention ,Taiwan ,Emotional Adjustment ,Language Development ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Cognition ,Randomized controlled trial ,law ,030225 pediatrics ,Developmental and Educational Psychology ,medicine ,Humans ,Infant, Very Low Birth Weight ,Affective Symptoms ,Toddler ,Parent-Child Relations ,Infant Care ,Infant, Newborn ,Infant ,Clinical Psychology ,Low birth weight ,Language development ,Child, Preschool ,Female ,medicine.symptom ,Psychology ,Behavior Observation Techniques ,030217 neurology & neurosurgery ,Infant, Premature ,Program Evaluation - Abstract
Preterm infants are at risk for emotional difficulties and behavioral problems. This study was aimed to investigate the effects of a clinic-based intervention program (CBIP) and a home-based intervention program (HBIP) compared with a usual care program (UCP) on emotion regulation to stress in preterm infants with very low birth weight (VLBW, birth weight
- Published
- 2014
40. Relationship Between Spontaneous Kicking and Age of Walking Attainment in Preterm Infants With Very Low Birth Weight and Full-Term Infants
- Author
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Li-Chiou Chen, Wei J. Chen, Kuo Inn Tsou, Suh-Fang Jeng, and Hong Ji Luo
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Movement ,Video Recording ,Physical Therapy, Sports Therapy and Rehabilitation ,Walking ,Corrected Age ,Functional importance ,mental disorders ,medicine ,Humans ,Infant, Very Low Birth Weight ,Prospective Studies ,Prospective cohort study ,Survival analysis ,Proportional Hazards Models ,Analysis of Variance ,Leg ,Chi-Square Distribution ,Age Factors ,Infant, Newborn ,Infant ,Delayed walking ,Low birth weight ,Increased risk ,Female ,medicine.symptom ,Psychology ,Full term infants ,Infant, Premature - Abstract
Background and Purposes. Although early kicking differences have been reported for preterm infants without overt cranial sonographic abnormalities, their functional importance remains unclear because no outcomes have been measured. Therefore, the first purpose of this prospective study was to examine the age of walking attainment in preterm infants who had very low birth weight (VLBW) but no overt neurosonographic abnormalities and full-term infants without known impairments or pathology. The second purpose was to examine the relationship between spontaneous kicking and age of walking attainment in these infants. Subjects and Methods. Twenty-two preterm infants and 22 full-term infants were examined for kicking movements at 2 and 4 months corrected age and were followed up for age of walking attainment until 18 months corrected age. Results. Survival analysis showed that infants with VLBW attained walking ability at older ages than full-term infants after correction for prematurity. Cox proportional-hazards regression analyses for all infants revealed that a high hip-knee correlation at 2 months corrected age, a high kick frequency at 4 months corrected age, and a short intra-kick pause together with a low variability in interlimb coordination at 2 and 4 months corrected age were all associated with a decreased rate of walking attainment. Discussion and Conclusion. The results indicated that preterm infants who had VLBW but no overt neurosonographic abnormalities had an increased risk of delayed walking attainment compared with full-term infants. Alterations of spontaneous kicking may predict a decreased rate of walking attainment in both preterm and full-term infants.
- Published
- 2004
41. Operating Room Within the Neonatal Intensive Care Unit--Experience of a Medical Center in Taiwan
- Author
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Po-Nien Tsao, Ya-Lei Wang, Chien-Yi Chen, Hung-Chieh Chou, Suh-Fang Jeng, and Wu-Shiun Hsieh
- Subjects
Waiting time ,Male ,medicine.medical_specialty ,Pediatrics ,Operating Rooms ,Neonatal intensive care unit ,health care facilities, manpower, and services ,Critical Illness ,education ,Taiwan ,Mean airway pressure ,Tertiary Care Centers ,Fraction of inspired oxygen ,Chart review ,Intensive Care Units, Neonatal ,medicine ,Humans ,Pediatrics, Perinatology, and Child Health ,Retrospective Studies ,Critically ill ,business.industry ,Tertiary Healthcare ,lcsh:RJ1-570 ,Infant, Newborn ,Retrospective cohort study ,lcsh:Pediatrics ,neonatal intensive care unit ,operation ,operating room ,Baseline characteristics ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Female ,business - Abstract
Background Most neonates who reside in the neonatal intensive care unit (NICU) and require surgery are transferred to the operating room (OR) or undergo bedside surgery. However, critically ill neonates who are transferred often encounter the risk of complications. An OR in our NICU was therefore launched in 2009. This study was to appraise the surgeries performed in the NICU OR and compare results with the traditional main OR outside the NICU. Methods This was a retrospective study in the NICU of a tertiary center. Retrospective chart review was conducted for all neonates who underwent surgical procedures in the NICU OR and the main OR. The information regarding baseline characteristics, surgical procedures and duration, ventilator use, hypothermia, hyperglycemia, instrument dislocations, surgically related infection or complications, and outcomes was obtained. Results There were a total of 65 patients in this study, 37 in the NCIU OR group and 28 in the main OR group. The presurgical mean airway pressure and the fraction of inspired oxygen (FiO 2 ) were comparable between the two groups, but the postsurgical FiO 2 was significantly lower in the NICU OR group (31.0%) than in the main OR group (40.9%; p = 0.027). Furthermore, the NICU OR group required a significantly shorter preoperation waiting time (34.4 minutes vs. 63.6 minutes, p = 0.001) and had a lower incidence of hypothermia than the main OR group (8.1% vs. 39.3%, p = 0.008). However, surgically related complications were similar between groups. Conclusion The OR within the NICU may reduce the risk of complications during transportation and provide continuity of care to critically ill neonates. It also decreases the disturbance to other NICU patients during operation.
- Published
- 2014
42. Mercury, APOE, and child behavior
- Author
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Pau-Chung Chen, Yaw-Huei Hwang, Sharon Ng, Wu-Shiun Hsieh, Ching-Chun Lin, and Suh-Fang Jeng
- Subjects
Apolipoprotein E ,Adult ,Male ,Environmental Engineering ,Food Chain ,Genotype ,Health, Toxicology and Mutagenesis ,Taiwan ,Physiology ,Poison control ,Child Behavior ,CBCL ,Apolipoproteins E ,Pregnancy ,Genetic predisposition ,Environmental Chemistry ,Medicine ,Animals ,Humans ,Prospective Studies ,Child Behavior Checklist ,Child ,business.industry ,Confounding ,Public Health, Environmental and Occupational Health ,Fishes ,Infant, Newborn ,General Medicine ,General Chemistry ,Mercury ,Middle Aged ,Fetal Blood ,Pollution ,Cord blood ,Child, Preschool ,Prenatal Exposure Delayed Effects ,Toxicity ,Environmental Pollutants ,Female ,business - Abstract
Methylmercury (MeHg) is a neurotoxicant and may have an adverse impact on child behavior. However, this impact was found to be inconsistent in fish-eating populations. Although the positive effects of the nutrients provided by a fish diet may overcome the effect of MeHg, the possibility of genetic variants influencing an individual’s response to MeHg has also been discussed. The role of the Apolipoprotein E (APOE) epsilon 4 allele (e4) on MeHg related neurotoxicity is still unclear. In the present study, we investigated the role of APOE variants in the relationship between cord blood mercury (Hg) and child behavior. A total of 166 subjects were recruited at delivery, and their cord blood was collected for laboratory analyses of Hg and the APOE genotype. The Child Behavior Checklist (CBCL) was administered to the subjects when they reached the age of two years. An increase in cord blood Hg concentrations in APOE e4 carriers was consistently associated with an increased score for all CBCL syndromes. After controlling for potential confounding factors, the group of e4 carriers with an elevated cord blood Hg concentration had significantly higher scores in the syndrome categories of general internalizing, emotionally reactive, and anxiety/depression as well as CBCL total scores. Furthermore, general externalizing and aggressive syndromes were borderline significantly higher in this group. In conclusion, we suggest that APOE may modify the toxicity of MeHg. APOE e4 carriers may be more vulnerable to the effects of MeHg on child behavior at the age of two years.
- Published
- 2013
43. Prognostic factors for walking attainment in very low-birthweight preterm infants
- Author
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Suh-Fang Jeng, Li-Chiou Chen, Kuo-Inn Tsou Yau, Hua-Fang Liao, and Pei-Shan Chen
- Subjects
Male ,Aging ,congenital, hereditary, and neonatal diseases and abnormalities ,Pediatrics ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Gross motor skill ,Gestational Age ,Walking ,Oxygen therapy ,medicine ,Humans ,Infant, Very Low Birth Weight ,Prospective Studies ,Risk factor ,Prospective cohort study ,reproductive and urinary physiology ,Motor skill ,Cerebral Hemorrhage ,business.industry ,Medical record ,Infant, Newborn ,Obstetrics and Gynecology ,Gestational age ,Retinopathy of prematurity ,Prognosis ,medicine.disease ,Respiration, Artificial ,Pediatrics, Perinatology and Child Health ,Regression Analysis ,Female ,business ,human activities - Abstract
The purpose of this study was to compare the age of walking attainment between very low-birthweight (VLBW) preterm infants and normal term infants, and to determine the variables that affect the walking attainment in VLBW infants. Ninety-six VLBW preterm infants and 82 normal term infants were prospectively followed to determine their age of walking attainment and to monitor gross motor development with sequential clinic visits at 6, 9, 12 and 18 months corrected age. Perinatal and sociodemographic data were collected through review of medical records. The VLBW infants were significantly older at attainment of walking (median 14 months) than the term infants (median 12 months) after correction for prematurity. By the age of 18 months, all term infants had attained walking ability; while 11% of VLBW infants were still unable to walk. Multivariate proportional hazards regression analysis revealed that low gestational age was significantly associated with late attainment of walking in VLBW infants. With the adjustment for gestational age, prolonged ventilation (or oxygen therapy) and severe retinopathy of prematurity were significant predictors of late walking attainment. Our findings indicate that VLBW preterm infants have an increased risk of delayed attainment of walking. Furthermore, the contribution of low gestational age to the delayed walking attainment in VLBW infants may occur via the plausible pathways of neonatal respiratory distress and severe retinopathy of prematurity.
- Published
- 2000
44. Head Stability in Walking in Children With Cerebral Palsy and in Children and Adults Without Neurological Impairment
- Author
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Robert Ratcliffe, Kenneth G. Holt, and Suh-Fang Jeng
- Subjects
medicine.medical_specialty ,business.industry ,Head (linguistics) ,Poison control ,Physical Therapy, Sports Therapy and Rehabilitation ,medicine.disease ,Sagittal plane ,Cerebral palsy ,medicine.anatomical_structure ,Physical medicine and rehabilitation ,Injury prevention ,Medicine ,Analysis of variance ,Spastic hemiplegia ,medicine.symptom ,Treadmill ,business - Abstract
Background and Purpose. The location of several sensory systems in the head implies that maintenance of head stability may be a potentially important part of locomotor activity. A limited amount of research, however, has been conducted to measure stability or to compare head stability among different groups. The purpose of this study was to determine whether a method for measuring head stability during walking could differentiate among 3 groups: (1) children with cerebral palsy, (2) children without neurological impairment, and (3) adults without neurological impairment. Subjects. Eight adults without known neurological impairment, 6 children without known neurological impairment, and 6 children with cerebral palsy and mild spastic hemiplegia were compared. Methods. Subjects walked on a treadmill at their preferred speed at a number of frequencies. Head stability was characterized by fluctuations in period and amplitude of head motion in the sagittal plane across walking cycles. Results. Mean period fluctuation was lower for the adults than for the children, and it was lower for the children without neurological impairments than for the children with cerebral palsy. Conclusion and Discussion. The method can be used to differentiate head stability among different groups during functional activities.
- Published
- 1999
45. Effectiveness of a family-centered intervention program in very low birth weight preterm infants at term age: a randomized controlled trial
- Author
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Suh-Fang Jeng, Li-Chyong Chen, Wen-Jone Chen, Chyong-Hsin Hsu, F.C. Liu, Y.J. Chang, L. Lu, Wu-Shiun Hsieh, Shulan Hsieh, Y.J. Lin, C.H. Lin, and Rong Ju Cherng
- Subjects
Low birth weight ,Pediatrics ,medicine.medical_specialty ,Intervention program ,Randomized controlled trial ,law ,business.industry ,medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,medicine.symptom ,business ,law.invention ,Term (time) - Published
- 2015
46. Short-term effect of a family-centered intervention program on the cortical auditory processing function in very low birth weight preterm infants
- Author
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Yen-Ting Yu, Yuh Jyh Lin, Suh-Fang Jeng, Lu Lu, Chyong-Hsin Hsu, Wen-Jone Chen, Pi-Chuan Fan, Shulan Hsieh, and Wu-Shiun Hsieh
- Subjects
Low birth weight ,Pediatrics ,medicine.medical_specialty ,Intervention program ,business.industry ,medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,Term effect ,Function (mathematics) ,medicine.symptom ,business - Published
- 2015
47. Stranger sociability in preterm infants with very low birth weight and term infants
- Author
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Yen-Ting Yu, Wei Chien Huang, Suh-Fang Jeng, Chih-Hung Hsu, Hui-Chin Hsu, Ying-Chin Wu, and Wu-Shiun Hsieh
- Subjects
Orthodontics ,Future studies ,business.industry ,Cartilage ,Healthy population ,Significant difference ,Physical Therapy, Sports Therapy and Rehabilitation ,Asymptomatic ,Knee cartilage ,Low birth weight ,medicine.anatomical_structure ,Mixed-design analysis of variance ,Medicine ,medicine.symptom ,business - Abstract
55.2± 6.51; BMI: 22.5± 1.4) were recruited in this study. BMI of the knee OA group was significant higher when compared to the control group (p< 0.001). Baseline lateral tibial cartilage thickness was significant higher in asymptomatic controls compare to knee OA group (p= 0.045). There were no significant difference in age, cartilage property and cartilage morphology in other regions between groups. Two-way mixed ANOVA revealed no significant differences on cartilage property and morphology changes before and after dynamic loading between groups. Both groups showed significant decreased T2 relaxation time in medial femoral cartilage region (35.83± 12.41ms vs. 29.17± 10.9ms) after stepping, increased medial tibial cartilage volume (1.4± 0.27mm vs. 1.45± 0.26mm) between M2 (post loading 7min) and M4 (post loading 21min). Lateral tibial cartilage volume and thickness were significant difference between knee OA group and control group. Conclusion(s): There were no significant differences in cartilage property andmorphology between kneeOApatients and asymptomatic controls before and after ten minutes stepping. Decrease T2 relaxation time inmedial femoral cartilage regionwas identified in both group after tenminutes dynamic loading. Implications: This was the first in vivo study to observe knee cartilage changes after dynamic loading in both individuals with kneeOA and asymptomatic controls. Future studies could investigate effects of different loading magnitudes, correlation between cartilage deformation and recovery in healthy population with a larger sample size.
- Published
- 2015
48. Neurobehavioral development at term in very low-birthweight infants and normal term infants in Taiwan
- Author
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Suh-Fang Jeng, Kuo-Inn Tsou Yau, and Ru-Jeng Teng
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Respiratory Tract Diseases ,Taiwan ,Neuropsychological Tests ,Risk Factors ,Humans ,Infant, Very Low Birth Weight ,Medicine ,Risk factor ,Respiratory illness ,medicine.diagnostic_test ,business.industry ,Potential risk ,Medical record ,Infant, Newborn ,Postmenstrual Age ,Reproducibility of Results ,Obstetrics and Gynecology ,Gestational age ,Neuropsychological test ,Term (time) ,Logistic Models ,Pediatrics, Perinatology and Child Health ,Apgar Score ,Female ,business ,Infant, Premature - Abstract
We compared the neurobehavioral performance at term between very low-birthweight (VLBW) infants and term infants in Taiwan, and investigated the relationships between neonatal factors and neurobehavioral performance in VLBW infants. Sixty VLBW infants and 58 healthy term infants were examined using the Neonatal Neurobehavioral Examination-Chinese version (NNE-C) at 40 weeks postmenstrual age. Medical records of the VLBW infants were reviewed to assess neonatal factors. The mean total score of the preterm infants (67.4+/-5.0) was significantly lower than that of the term infants (73.8+/-3.0) (t = 8.51, P0.0001). Furthermore, respiratory illness had a marginal effect on the rate of low neurobehavioral score (defined as 2SD below the mean score of term infants) in the preterm infants after adjustment for gestational age (odds ratio = 7.67, chi2 = 3.36, P = 0.067). Our findings indicate that preterm infants have lower neurobehavioral scores at term than their healthy term counterparts. Furthermore, respiratory illness may be a potential risk factor for low neurobehavioral score at term in preterm infants when gestational age is adjusted for.
- Published
- 1998
49. MicroRNA expression aberration associated with bronchopulmonary dysplasia in preterm infants: a preliminary study
- Author
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Wei J. Chen, Wu-Shiun Hsieh, Wen-Chung Lee, Sung-Liang Yu, Suh-Fang Jeng, Yen-Tzu Wu, Po-Nien Tsao, and Chi-Yu Lai
- Subjects
Pulmonary and Respiratory Medicine ,Male ,Pediatrics ,medicine.medical_specialty ,Birth weight ,Down-Regulation ,Critical Care and Intensive Care Medicine ,Bioinformatics ,Real-Time Polymerase Chain Reaction ,Pathogenesis ,mental disorders ,microRNA ,Medicine ,Humans ,Infant, Very Low Birth Weight ,Prospective Studies ,Prospective cohort study ,Bronchopulmonary Dysplasia ,business.industry ,Case-control study ,Infant, Newborn ,General Medicine ,medicine.disease ,Up-Regulation ,Gene expression profiling ,Low birth weight ,MicroRNAs ,Logistic Models ,Bronchopulmonary dysplasia ,ROC Curve ,Case-Control Studies ,Female ,medicine.symptom ,business ,Biomarkers ,Infant, Premature - Abstract
BACKGROUND: Because environmental insults and genetic factors account for the variance in the risk of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW, birth weight < 1,500 g) preterm infants, the search for BPD biomarkers has begun to focus on the regulators of non-coding RNA such as microRNAs (miRNAs). Therefore, this study aimed to identify potential miRNAs involved in the pathogenesis of BPD in VLBW preterm infants. METHODS: A case-control study (15 subjects with BPD and 15 sex-matched control subjects without BPD) was conducted to investigate the expression profiles of 365 miRNAs in the peripheral blood of VLBW preterm infants at 36 weeks post-menstrual age (called the older-age set). The expression levels of identified miRNAs were further evaluated in a subsample of blood collected during the first 2 weeks post-natal age (called the younger-age set). Possible biological functions and pathways implicated in the target genes regulated by the miRNAs were explored using database predictions. RESULTS: A 4-miRNA signature ( miR-152 , miR-30a-3p , miR-133b , and miR-7 ) with aberrant expression levels at 36 weeks, derived from a supervised classification with internal cross-validation, discriminated the subjects with BPD from those without BPD with an accuracy of 0.91. The discriminative accuracy of the 4 miRNAs was supported by random permutations of either the disease status or the number of miRNAs selected (both P < .001). A down-regulation change of miR-152 and miR-30a-3p expression levels and an up-regulation change of miR-133b and miR-7 expression levels were found in the older-age set, compared to the younger-age set. CONCLUSIONS: This is the first study to identify blood-based miRNAs associated with BPD. The findings provide information regarding the roles of these biomarkers in the development of BPD in VLBW preterm infants.
- Published
- 2013
50. PERFLUORINATED COMPOUND LEVELS IN UMBILICAL CORD BLOOD AND CHILD BEHAVIOR AT 2 YEARS OF AGE
- Author
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Guang-Wen Lien, Yi-Ning Su, Wu-Shiun Hsieh, Hua-Fang Liao, Chia-Yang Chen, Pau-Chung Chen, Suh-Fang Jeng, Ting-Wen Wen, and Mei-Huei Chen
- Subjects
chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Global distribution ,business.industry ,medicine ,General Earth and Planetary Sciences ,Physiology ,Perfluorinated compound ,business ,Umbilical cord ,General Environmental Science - Abstract
Background and Aims: The perfluorinated compound (PFCs) is persistent organic pollutants with global distribution. Their adverse impact on neurobehavior had been reported in animal studies with hig...
- Published
- 2011
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