ORCID Profile
0000-0001-6798-8875
Current Organisation
Edith Cowan University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 16-07-2012
DOI: 10.1111/J.1365-2222.2012.04031.X
Abstract: Maternal fish oil supplementation during pregnancy has been associated with altered infant immune responses and a reduced risk of infant sensitization and eczema. To examine the effect of early postnatal fish oil supplementation on infant cellular immune function at 6 months of age in the context of allergic disease. In a double-blind randomized controlled trial (ACTRN12606000281594), 420 infants of high atopic risk received fish oil [containing 280 mg docosahexaenoic acid (DHA) and 110 mg eicosapentanoic acid (EPA)] or control oil daily from birth to 6 months. One hundred and twenty infants had blood collected at 6 months of age. Fatty acid levels, induced cytokine responses, T cell subsets and monocyte HLA-DR expression were assessed at 6 months of age. Infant allergies were assessed at 6 and 12 months of age. DHA and EPA levels were significantly higher in the fish oil group and erythrocyte arachidonic acid (AA) levels were lower (all P < 0.05). Infants in the fish oil group had significantly lower IL-13 responses (P = 0.036) to house dust mite (HDM) and higher IFNγ (P = 0.035) and TNF (P = 0.017) responses to phytohaemaglutinin (PHA). Infants with relatively high DHA levels had lower Th2 responses to allergens including lower IL-13 to β-lactoglobulin (BLG) (P = 0.020), and lower IL-5 to BLG (P = 0.045). Postnatal fish oil supplementation increased infant n-3 polyunsaturated fatty acid (PUFA) levels and associated with lowered allergen-specific Th2 responses and elevated polyclonal Th1 responses. Our results add to existing evidence of n-3 PUFA having immunomodulatory properties that are potentially allergy-protective.
Publisher: MDPI AG
Date: 20-03-2015
DOI: 10.3390/NU7032061
Publisher: BMJ
Date: 23-02-2016
DOI: 10.1136/ARCHDISCHILD-2015-309441
Abstract: Very preterm children may be at risk of voice abnormalities (dysphonia). Risk factors previously identified in extremely preterm children include female gender, multiple intubations, complicated intubation and very low birth weight. This study sought to identify the prevalence of dysphonia in very preterm children, at school age. Children born between 23 and 32 weeks’ gestation were included in this prospective observational study. Participants were randomly selected from a s le stratified by gestational age and number of intubations, and were aged between 5 and 12 years at the time of assessment. Clinical voice assessments were conducted by a speech pathologist, and a diagnosis of dysphonia was made based on the presence and severity of disturbance to the voice. Retrospective chart review identified medical and demographic characteristics. 178 participants were assessed. The prevalence of dysphonia in this cohort was 61%. 31% presenting with significant dysphonia, that is, voice disturbance of greater than mild in severity. Female gender (p=0.009), gestational age (p=0.031) and duration of intubation (p=0.021) were significantly associated with dysphonia although some preterm children with dysphonia were never intubated. Significant voice abnormalities were observed in children born at up to 32 weeks’ gestation, with intubation a major contributing factor. ACTRN12613001015730.
Publisher: S. Karger AG
Date: 2016
DOI: 10.1159/000448271
Abstract: Docosahexaenoic acid (DHA), a long-chain polyunsaturated fatty acid, is essential for normal brain development. DHA is found predominantly in seafood, fish oil, breastmilk and supplemented formula. DHA intake in Western countries is often below recommendations. Observational studies have demonstrated an association between DHA intake in pregnancy and neurodevelopment of offspring but cannot fully adjust for confounding factors that influence child development. Randomised clinical trials of DHA supplementation during pregnancy and/or lactation, and of term infants, have not shown a consistent benefit nor harm on neurodevelopment of healthy children born at term. The evidence does not support DHA supplementation of healthy pregnant and lactating women, nor healthy infants.
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.EARLHUMDEV.2011.12.032
Abstract: Recent trials suggest a link between neuropsychological function, atopy and allergic disease particularly in early childhood however the nature of this association remains unclear. To investigate the relationship between early allergic disease and sensitisation at 12 months of age and neurodevelopmental outcomes at 18 months. Linear or binary logistic regression analysis was used to determine whether allergic diseases or sensitization at 12 months of age was a significant predictor of neurodevelopmental test scores at the 18 months. Infants with a maternal history of allergic disease (n=324). Allergic outcomes at 12 months of age included allergen sensitisation, eczema, IgE-mediated and food allergy, and neurodevelopmental outcomes at 18 included the Bayley Scales of Infant Toddler Development III Edition, the Achenbach Child Behaviour Checklist and the Macarthur Scales of Infant Toddler Development. Children with any diagnosed allergic disease at 12 months had evidence of reduced motor scores (p=.016), and this was most apparent for a diagnosis of eczema (p=.007). Non-IgE mediated food allergy was significantly positively associated with problem Internalising Behaviours (p=.010), along with a trend for effects on the Social-Emotional composite score for IgE-Mediated food allergies (p=.052). Allergic sensitisation was not independently associated with any effects on neurodevelopmental outcomes. This study provides evidence that an allergic phenotype in infancy is associated with effects on neurodevelopment. Further research is required to investigate the nature of this relationship.
Publisher: Cambridge University Press (CUP)
Date: 21-04-2020
DOI: 10.1017/S000711452000135X
Abstract: Fish-oil supplements are marketed as enhancing intelligence and cognitive performance. However, empirical data concerning the utility of these products in healthy term infants are mixed, particularly with respect to lasting effects into childhood. We evaluated whether fish-oil supplementation during infancy leads to better neurocognitive/behavioural development at 6 years. We conducted a double-blind randomised controlled trial of supplementation with n -3 long-chain PUFA in 420 healthy term infants. Infants received either fish oil (containing at least 250 mg DHA and at least 60 mg EPA) or placebo (olive oil) daily from birth to 6 months of age. Neurodevelopmental follow-up was conducted at a mean age of 6 years ( sd 7 months), whereby 335 children were assessed for language, executive functioning, global intelligence quotient and behaviour. No significant differences were observed between the groups for the main neurocognitive outcomes. However in parent-report questionnaire, fish-oil supplementation was associated with negative externalising ( P = 0·035, d = 0·24) and oppositional/defiant behaviour ( P = 0·006, d = 0·31), particularly in boys ( P = 0·01, d = 0·45 P = 0·004, d = 0·40). Our results provide evidence that fish-oil supplementation to predominantly breast-fed infants confers no significant cognitive or behavioural benefit to children at 6 years.
Publisher: Elsevier BV
Date: 11-2012
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.IJPORL.2014.12.037
Abstract: Intubation injury resulting in laryngeal pathology is recognised as a possible complication of preterm birth, yet few published studies have examined such pathology and its relation to voice outcomes. This study reports on the results of prospective laryngeal function examinations of a cohort of very preterm children, all of whom presented with significant dysphonia at school age. The laryngeal pathology of 20 very preterm children, born between 23 and 29 weeks gestation, was examined under halogen and stroboscopic conditions. Laryngeal structure and function were assessed using a rigid laryngoscope or a flexible nasendoscope. The approach was selected based on the age and/or likely compliance of the child. Nineteen children were found to have structural laryngeal pathology. Fourteen children presented with a chink to the posterior glottis and all demonstrated at least a mild degree of supraglottic hyperfunction. Other common findings were arytenoid prolapse and vocal fold immobility. More isolated findings included posterior scar band, vocal fold atrophy, arytenoid oedema and growth on the vocal folds. One child who presented with structural laryngeal pathology was never intubated. Supraglottic hyperfunction was common to all participants, regardless of the nature and extent of underlying structural laryngeal pathology. Posterior glottic chink was the most common pattern of incomplete vocal fold closure. These data support the hypothesis that very preterm children adopt supraglottic tightening to compensate for underlying laryngeal pathology. The mechanism underlying laryngeal damage in the child who was not intubated is unclear. Voice quality of very preterm children is affected by both laryngeal structure and function. A trial of behavioural voice treatment is recommended to evaluate any therapeutic response in this population.
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.CCT.2011.05.019
Abstract: The Infant Fish Oil Supplementation Study is a double-blind randomised controlled trial investigating whether the incidence of allergic disease can be reduced and developmental outcomes enhanced through supplementation with omega-3 fatty acids. Infants at high risk of developing allergic disease will be randomised to receive either fish oil or olive oil supplements until 6 months of age and followed up at six postnatal clinic visits to assess allergy outcomes and infant neurodevelopment. Study groups to consist of a treatment group allocated to receive 650 mg of fish oil daily (250-280 mg docosahexaenoic acid and at least 60 mg eicosapentaenoic acid and a placebo group (olive oil) from birth to 6 months of age. Allergy outcomes will be assessed by clinical history, clinical assessments and allergen skin prick tests at the 12, 30 and 60 month visits. Neurodevelopmental assessments to be conducted at 18 months, and language questionnaires at 12, 18 and 30 months. S les will be collected from mothers antenatally, from infants at birth, and at clinic visits from 6 months onwards for immunological assessments. Fatty acid composition to be measured in erythrocytes and plasma (at birth and after the supplementation period) to assess the effect of the intervention on fatty acid status. Information on medical history, diet and other lifestyle factors at an antenatal clinic visit and postnatal clinic visits will also be collected. This study is designed to examine clinically relevant effects of a novel, non-invasive and potentially low cost approach to reduce the incidence of allergic disease and facilitate neurodevelopment during early childhood.
Publisher: Annual Reviews
Date: 21-08-2019
DOI: 10.1146/ANNUREV-NUTR-082018-124250
Abstract: Variants in the FADS gene cluster modify the activity of polyunsaturated fatty acid (PUFA) desaturation and the lipid composition in human blood and tissue. FADS variants have been associated with plasma lipid concentrations, risk of cardiovascular diseases, overweight, eczema, pregnancy outcomes, and cognitive function. Studies on variations in the FADS genecluster provided some of the first ex les for marked gene–diet interactions in modulating complex phenotypes, such as eczema, asthma, and cognition. Genotype distribution differs markedly among ethnicities, apparently reflecting an evolutionary advantage of genotypes enabling active long-chain PUFA synthesis when the introduction of agriculture provided diets rich in linoleic acid but with little arachidonic and eicosapentaenoic acids. Discovering differential effects of PUFA supply that depend on variation of FADS genotypes could open new opportunities for developing precision nutrition strategies based either on an in idual's genotype or on genotype distributions in specific populations.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2013
Abstract: Voice abnormality is a frequent finding in school age children born at & weeks’ gestation in Western Australia. The objective of this study was to determine the frequency of voice abnormality, voice-related quality of life, and demographic and intubation factors in this population. Survivors & weeks’ gestational age in Western Australia born from 1996 to 2004 were included. Voice assessments (auditory perceptual assessment scale and Pediatric Voice Handicap Index) were carried out by speech pathologists. Intubation history was obtained by retrospective chart review. Of 251 NICU admissions, 154 (61%) survived. Exclusions were based on severe disability (11) or distant residence (13). Of 70 assessed, 67 completed assessments, 4 (6%) were in the normal range and 39 (58%) showed moderate-severe hoarseness. Simultaneous modeling of demographic and intubation characteristics showed an increased odds of moderate-severe voice disorder for children who had more than 5 intubations (odds ratio 6.96, 95% confidence interval 2.07–23.40, P = .002) and for girls relative to boys (odds ratio 3.46, 95% confidence interval 1.12–10.62, P = .030). Tube size and duration of intubation were not significant in the multivariable model. Median scores of parent-reported voice quality of life on the Pediatric Voice Handicap Index were markedly different for preterm (22) and term (3) groups, P & .001. Voice disorders in this population were much more frequent than expected. Further studies are required to assess voice across a broader range of gestational ages, and to investigate voice-protective strategies in infants requiring multiple episodes of intubation.
Publisher: Frontiers Media SA
Date: 2013
Publisher: Wiley
Date: 25-09-2012
DOI: 10.1111/ALL.12027
Abstract: Previous studies have demonstrated that reduced T-cell protein kinase C zeta (PKCζ) expression is associated with allergy development in infants born to atopic mothers. This study examined whether this relationship extends to a general population and addressed the basis for the association. A flow cytometry assay was developed for the measurement of T-cell PKCζ levels in PBMC, cord blood mononuclear cell and whole blood. Cord blood T-cell PKCζ levels were measured in 135 neonates, and allergic disease was evaluated by skin prick test and clinical examination at 12 months of age. Allergic children (particularly those with eczema) had significantly lower neonatal T-cell PKCζ expression than nonallergic children (P < 0.001). PKCζ levels predicted allergic disease with optimal specificity of 86% and sensitivity of 54%. The sensitivity was increased in the children of allergic mothers, who had significantly lower PKC levels than the children of nonallergic mothers. Cord blood PKCζ levels did not affect T-cell maturation in culture as assessed by CD45RA/RO expression, but low PKCζ expression was associated with reduced capacity for IFNγ production by matured T cells. Low cord blood PKC expression was further associated with increased IL-13 responses at 6 months. The findings suggest a potential role for the use of PKCζ levels in cord blood T cells as a presymptomatic test to predict allergy risk in children, particularly offspring of allergic mothers, and that the basis of this relationship is related to cytokine patterns in mature T cells.
Publisher: Informa UK Limited
Date: 08-05-2023
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JVOICE.2016.08.004
Abstract: Dysphonia is a potential complication of prematurity. Preterm children may sustain iatrogenic laryngeal damage from medical intervention in the neonatal period, and further, adopt compensatory, maladaptive voicing behaviors. This pilot study aimed to evaluate the effects of a voice therapy protocol on voice quality in school-aged, very preterm (VP) children. Twenty-seven VP children with dysphonia were randomized to an immediate intervention group (n = 7) or a delayed-intervention, waiting list control group (n = 14). Following analysis of these data, a secondary analysis was conducted on the pooled intervention data (n = 21). Six participants did not complete the trial. Change to voice quality was measured via pre- and posttreatment assessments using the Consensus Auditory Perceptual Evaluation of Voice. The intervention group did not demonstrate statistically significant improvements in voice quality, whereas this was observed in the control group (P = 0.026). However, when intervention data were pooled including both the immediate and delayed groups following intervention, dysphonia severity was significantly lower (P = 0.026) in the treatment group. Dysphonia in most VP children in this cohort was persistent. These pilot data indicate that some participants experienced acceptable voice outcomes on spontaneous recovery, whereas others demonstrated a response to behavioral intervention. Further research is needed to identify the facilitators of and barriers to intervention success, and to predict those who may experience spontaneous recovery.
Publisher: Springer Science and Business Media LLC
Date: 19-09-2018
DOI: 10.1007/S00394-017-1529-5
Abstract: The enzymes encoded by fatty acid desaturases (FADS) genes determine the desaturation of long-chain polyunsaturated fatty acids (LCPUFA). We investigated if haplotype and single nucleotide polymorphisms (SNPs) in FADS gene cluster can influence LCPUFA status in infants who received either fish oil or placebo supplementation. Children enrolled in the Infant Fish Oil Supplementation Study (IFOS) were randomly allocated to receive either fish oil or placebo from birth to 6 months of age. Blood was collected at 6 months of age for the measurement of fatty acids and for DNA extraction. A total of 276 participant DNA s les underwent genotyping, and 126 erythrocyte and 133 plasma fatty acid measurements were available for analysis. Twenty-two FADS SNPs were selected on the basis of literature and linkage disequilibrium patterns identified from the HapMap data. Haplotype construction was completed using PHASE. For participants allocated to the fish oil group who had two copies of the FADS1 haplotype consisting of SNP minor alleles, DHA levels were significantly higher compared to other haplotypes. This finding was not observed for the placebo group. Furthermore, for members of the fish oil group only, the minor homozygous carriers of all the FADS1 SNPs investigated had significantly higher DHA than other genotypes (rs174545, rs174546, rs174548, rs174553, rs174556, rs174537, rs174448, and rs174455). Overall results of this preliminary study suggest that supplementation with fish oil may only significantly increase DHA in minor allele carriers of FADS1 SNPs. Further research is required to confirm this novel finding.
Publisher: Wiley
Date: 19-09-2012
DOI: 10.1111/J.1398-9995.2011.02714.X
Abstract: Dietary changes may epigenetically modify fetal gene expression during critical periods of development to potentially influence disease susceptibility. This study examined whether maternal and/or fetal folate status in pregnancy is associated with infant allergic outcomes. Pregnant women (n=628) were recruited in the last trimester of pregnancy. Folate status determined by both food frequency questionnaires and folate levels in maternal and cord blood serum was examined in relation to infant allergic outcomes at 1 year of age (n=484). Infants who developed allergic disease (namely eczema) did not show any differences in cord blood or maternal folate levels compared with children without disease. Although maternal folate intake from foods was also not different, folate derived from supplements was higher (P=0.017) in children with subsequent eczema. Furthermore, infants exposed to >500 μg folic acid/day as a supplement in utero were more likely to develop eczema than those taking <200 μg/day (OR [odds ratio] =1.85 95% CI 1.14-3.02 P=0.013), remaining significant after adjustment for maternal allergy and other confounders. There was a nonlinear relationship between cord blood folate and sensitization, with folate levels 75 nmol/l (OR=3.59 95% CI 1.40-9.20 P=0.008) associated with greater sensitization risk than levels between 50 and 75 nmol/l. Fetal levels between 50 and 75 nmol/l appeared optimal for minimizing sensitization. While folate taken as a supplement in higher doses during the third trimester was associated with eczema, there was no effect on other allergic outcomes including sensitization. Further studies are needed to determine the significance of this.
Publisher: Wiley
Date: 26-12-2015
DOI: 10.1111/CEA.12449
Abstract: Vitamin D (25[OH]D3) status in early life has been linked to the risk of allergic disease in multiple observational studies. While immunomodulating properties are well recognized, there are few longitudinal studies of 25(OH)D3 status, immune function and allergic disease in infants. To investigate 25(OH)D3 levels at birth [cord blood (CB)] and at 6 months of age in relation to immune function at 6 months of age, and clinical outcomes up to 30 months of age in infants with a maternal history of atopy. In a subset of infants (n = 225) enrolled in a RCT (ACTRN12606000281594), 25(OH)D3 levels were assessed in relation to peripheral blood mononuclear cell cytokine responses to house dust mite (HDM), ovalbumin (OVA) and β-lactoglobulin allergens, or Toll-like receptor (TLR) ligands (lipopolysaccharide, lipoteichoic acid, polyinosinic : polycytidylic acid and CpG oligonucleotide) at 6 months of age, in addition to clinical outcomes (eczema, wheeze and allergen sensitisation) up to 30 months of age. Infants with higher 25(OH)D3 at birth (≥ 75 nmol/L, compared with < 50 nmol/L) had lower IL-5 and IL-13 responses to HDM by 6 months (P < 0.001 and P = 0.003, respectively). This was also reflected in strong inverse correlations between CB 25(OH)D3 levels and HDM IL-13 (ρ = -0.57 P = 0.0002) and IL-5 (ρ = -0.59, P = 0.0001) responses, with a similar trend for IL-5 (ρ = -0.29 P = 0.009) responses to OVA. For innate stimulations, higher 25(OH)D3 levels at 6 months were associated with greater responses to TLR ligands. Additionally, higher CB 25(OH)D3 was associated with reduced risk eczema at 6 months (P = 0.011) and 12 months (P = 0.034). This suggests that improving 25(OH)D3 status in pregnancy or early infancy may reduce the development of allergic disease in high-risk infants by inhibiting cytokine profiles associated with allergy. Results of clinical trials are awaited to determine the efficacy of vitamin D supplementation in allergy prevention.
Publisher: MDPI AG
Date: 14-11-2012
DOI: 10.3390/NU4111747
Publisher: American Speech Language Hearing Association
Date: 11-2014
DOI: 10.1044/VVD24.3.124
Abstract: Many more children than ever before survive and thrive following preterm birth (Saigal & Doyle, 2008). To date, research has focussed on medical, developmental, neurological, and behavioral outcomes. As the number of surviving children increases and survivors reach school age and beyond, it has become apparent that many children experience difficulties with voice production (French et al., 2013). Following preterm birth, endotracheal intubation may be necessary to deliver surfactant or relieve respiratory distress during the neonatal period (Ho, Subramaniam, Henderson-Smart, & Davis, 2002). Intubation injury to the larynx and resultant dysphonia are well described in the literature (Bray, Cavalli, Eze, Mills, & Hartley, 2010). This article presents a brief review of the literature relevant to intubation-related injury following preterm birth and 2 case studies of voice outcomes following a trial of behavioral voice therapy in extremely preterm children who were intubated.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.CCT.2013.12.004
Abstract: Mild dysphonia in childhood is surprisingly common, yet moderate to severe dysphonia is rare. The latter has been associated with complex medical conditions and congenital abnormalities. Intubation injury has also been documented as a cause of childhood dysphonia. Children born very preterm may be intubated as part of the intensive care administered in the perinatal and neonatal periods, yet there are few studies investigating dysphonia in this population. This study will be the first to: use an objective acoustic voice assessment in a paediatric study, document the incidence of dysphonia in very preterm children at school age, and conduct a controlled trial of behavioural voice therapy in this population. This study will consist of three phases: assessment of voice quality and its impact on quality of life in up to 200 children born at less than 32 weeks' gestation: assessment of the nature and extent of laryngeal pathology in children with moderate to severe dysphonia and a non-blinded, randomised controlled trial of behavioural voice therapy in children with moderate to severe dysphonia. This study will be the first to use clinical assessment to examine the voice quality of very preterm children, and to use fibre optic endoscopic evaluation of laryngeal function to determine the nature and extent of any laryngeal pathology in such children. Those participants with significant voice difficulties will be randomised to receive treatment immediately or after the eight week assessment. This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12613001015730/ACTRN12613001012763).
Publisher: Oxford University Press (OUP)
Date: 09-0004
DOI: 10.1111/J.1753-4887.2011.00381.X
Abstract: Numerous randomized controlled trials (RCTs) have been undertaken to determine whether supplementation with long-chain polyunsaturated fatty acids (LCPUFAs) in infancy would improve the developmental outcomes of term infants. The results of such trials have been thoroughly reviewed with no definitive conclusion as to the efficacy of LCPUFA supplementation. A number of reasons for the lack of conclusive findings in this area have been proposed. This review examines such factors with the aim of determining whether an optimal method of investigation for RCTs of LCPUFA supplementation in term infants can be ascertained from previous research. While more research is required to completely inform a method that is likely to achieve definitive results, the findings of this literature review indicate future trials should investigate the effects of sex, genetic polymorphisms, the specific effects of LCPUFAs, and the optimal tests for neurodevelopmental assessment. The current literature indicates a docosahexaenoic acid dose of 0.32%, supplementation from birth to 12 months, and a total s le size of at least 286 (143 per group) should be included in the methodology of future trials.
Publisher: Frontiers Media SA
Date: 2013
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.PLEFA.2012.03.006
Abstract: Although omega (n)-3 long-chain polyunsaturated fatty acids (LCPUFA), particularly docosahexaenoic acid (DHA), intakes are important during infancy, the optimal method of increasing infant status remains unclear. We hypothesized that high-dose infant fish oil supplementation would have greater relative effects upon n-3 LCPUFA status at six months of age than breast milk fatty acids. Infants (n=420) were supplemented daily from birth to six months with fish oil or placebo. In a subset of infants, LCPUFA levels were measured in cord blood, breast milk and in infant blood at 6 months. DHA levels increased in the fish oil group relative to placebo (p<05). Breast milk DHA was the strongest predictor of infant erythrocyte DHA levels (p=<001). This remained significant after adjustment for cord blood DHA, supplementation group and adherence. In this cohort, breast milk DHA was a greater determinant of infant erythrocyte n-3 LCPUFA status, than direct supplementation with fish oil.
Publisher: Cambridge University Press (CUP)
Date: 21-02-2012
DOI: 10.1017/S0007114511006878
Abstract: n -3 Long-chain PUFA (LC-PUFA) intake during infancy is important for neurodevelopment however, previous studies of n -3 LC-PUFA supplementation have been inconclusive possibly due to an insufficient dose and limited methods of assessment. The present study aimed to evaluate the effects of direct supplementation with high-dose fish oil (FO) on infant neurodevelopmental outcomes and language. In the present randomised, double-blind, placebo-controlled trial, 420 healthy term infants were assigned to receive a DHA-enriched FO supplement (containing at least 250 mg DHA/d and 60 mg EPA/d) or a placebo (olive oil) from birth to 6 months. Assessment occurred at 18 months via the Bayley Scales of Infant and Toddler Development (3rd edition BSID-III) and the Child Behavior Checklist. Language assessment occurred at 12 and 18 months via the Macarthur–Bates Communicative Development Inventory. The FO group had significantly higher erythrocyte DHA ( P = 0·03) and plasma phospholipid DHA ( P = 0·01) levels at 6 months of age relative to placebo. In a small subset analysis (about 40 % of the total population), children in the FO group had significantly higher percentile ranks of both later developing gestures at 12 and 18 months ( P = 0·007 P = 0·002, respectively) and the total number of gestures ( P = 0·023 P = 0·006, respectively). There was no significant difference between the groups in the standard or composite scores of the BSID-III. The results suggest that improved postnatal n -3 LC-PUFA intake in the first 6 months of life using high-dose infant FO supplementation was not beneficial to global infant neurodevelopment. However, some indication of benefits to early communicative development was observed.
Publisher: American Speech Language Hearing Association
Date: 11-04-2022
DOI: 10.1044/2021_LSHSS-21-00094
Abstract: Multilingual children are disproportionately represented on speech pathology caseloads, in part due to the limited ability of traditional language assessments to accurately capture multilingual children's language abilities. This systematic review evaluates the evidence for identification of language disorder in multilingual children using dynamic assessment and considers clinical applications of the evidence. A systematic search of the Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Centre, Education Source, Google Scholar, Linguistics, Medline, and PsycINFO databases produced 10 articles that met the inclusion criteria: between-groups comparison studies that used dynamic assessment to identify language disorder in children under 12 years old that spoke a different language at home to the majority society language. Articles were critically appraised using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) protocol. Nine of the 10 studies reported that their dynamic assessment identified language disorder in multilingual children. However, small s le sizes, limited language pairs, variability in the reference standard, and design deficiencies resulted in poor ratings for all studies on QUADAS-2. The studies in this review reflected an emergent area of research. Preliminary guidelines for clinical application indicate that dynamic assessment may be a suitable and time-efficient complementary method of diagnosis of language disorder in multilingual children. Further recommendations about age of use, language of instruction, and relevant scores are included.
Publisher: Informa UK Limited
Date: 29-06-2016
DOI: 10.3109/14015439.2015.1054307
Abstract: Dysphonia is a potential long-term complication of preterm birth. Childhood voice disorders caused by vocal hyperfunction resolve with pubertal changes to the vocal mechanism in many cases. In extremely preterm children, whose voice quality is affected by supraglottic hyperfunction adapted secondary to underlying structural laryngeal pathology sustained during neonatal intubation, the prognosis is unknown. A pilot study was conducted to assess the incidence and severity of dysphonia in children born at < 25 weeks' gestation. Ten in iduals, aged between 9.67 and 17.08 years, presented for repeat assessment in a replication and extension of the original study. The mean period between assessments was 2.85 (SD 0.38) years. The primary outcome measure was the severity score on the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), with the Acoustic Voice Quality Index score as the secondary outcome measure. Scores on the Pediatric Voice Handicap Index were also compared. Perceptual dysphonia severity scores were significantly lower on repeat assessment, but no differences were observed in objective or quality of life scores. In idual variation was observed: the difference in CAPE-V scores ranged from -36 to + 1. No participant presented with normal voice quality on repeat assessment. Analysis of group data masked in idual variability in this series. Mechanisms underlying such in idual variation are currently unknown. These data suggest that dysphonia is persistent in extremely preterm children. Further investigation is warranted to elucidate the progression of voice disorders in extremely preterm children, to inform prognostic predictors and treatment decisions.
Publisher: S. Karger AG
Date: 2014
DOI: 10.1159/000360841
Abstract: b i Introduction: /i /b Intubation is a known risk factor for dysphonia yet is essential in the perinatal care of many very preterm infants. Children born preterm, who are frequently resuscitated with endotracheal intubation, may be at risk of dysphonia at school age and beyond. b i Objectives: /i /b To identify and describe the evidence pertaining to long-term voice outcomes and risk factors for developing dysphonia in preterm children. b i Results: /i /b In addition to case studies and series, three larger-scale studies have reported on dysphonia and voice outcomes in preterm children. Studies reporting treatment outcomes were not available. Factors associated with poor voice outcomes included female gender, birth weight ,000 g, birth at weeks' gestation, surgical closure of patent ductus arteriosus, emergency versus elective intubations and multiple intubations. Adverse voice outcomes were associated with laryngeal pathology and compensatory supraglottic compression. b i Conclusions: /i /b Dysphonia is a newly reported, long-term complication of preterm birth, yet the number of relevant studies remains limited. Further research is required to confirm the risk factors for developing dysphonia, which will inform future voice treatment studies.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2012
Abstract: Relative deficiency of dietary omega 3 polyunsaturated fatty acids (n-3 PUFA) has been implicated in the rising allergy prevalence in Westernized countries. Fish oil supplementation may provide an intervention strategy for primary allergy prevention. The objective of this study was to assess the effect of fish oil n-3 PUFA supplementation from birth to 6 months of age on infant allergic disease. In a double-blind randomized controlled trial, 420 infants at high atopic risk received a daily supplement of fish oil containing 280 mg docosahexaenoic acid and 110 mg eicosapentaenoic acid or a control (olive oil), from birth to age 6 months. PUFA levels were measured in 6-month-old infants’ erythrocytes and plasma and their mothers’ breast milk. Eczema, food allergy, asthma and sensitization were assessed in 323 infants for whom clinical follow-up was completed at 12 months of age. At 6 months of age, infant docosahexaenoic acid and eicosapentaenoic acid levels were significantly higher (both P & .05) and erythrocyte arachidonic acid levels were lower (P = .003) in the fish oil group. Although n-3 PUFA levels at 6 months were associated with lower risk of eczema (P = .033) and recurrent wheeze (P = .027), the association with eczema was not significant after multiple comparisons and there was no effect of the intervention per se on the primary study outcomes. Specifically, between-group comparisons revealed no differences in the occurrence of allergic outcomes including sensitization, eczema, asthma, or food allergy. Postnatal fish oil supplementation improved infant n-3 status but did not prevent childhood allergic disease.
Publisher: S. KARGER AG
Date: 2014
DOI: 10.1159/000356107
Publisher: Elsevier BV
Date: 2013
Location: Australia
No related grants have been discovered for Suzanne Meldrum.