Neurodevelopmental Outcome of Childhood Cancer Survivors Treated at the Eric Williams Medical Sciences Complex.

OBJECTIVE: To investigate the neurodevelopmental outcome of childhood cancer survivors treated at the Eric Williams Medical Sciences Complex (EWMSC). METHODS: Study participants were children treated at EWMSC from January 2003 to March 31, 2012 for various childhood cancers. All had completed treatment and were in remission. The McCarthy Scales of Children's Abilities (MSCA) was administered. The study was conducted from December 2011 to March 31, 2012. RESULTS: Twenty-six children were evaluated, a response rate of 74%. There were 12 males and 14 females. Ages ranged from 3.25 to 9.00 years. Four (15.4%) children scored a general cognitive index (GCI) < 68. One child (3.8%) scored a GCI > 132. The children's mean estimated mental age was found to be significantly lower than their mean actual age (p = 0.0086). Children treated for solid tumours had the least difference between their actual ages and estimated mental ages (p = 0.0301). The mean GCI for the genders was 97.4 for females and 81.0 for males; this difference was statistically significant (p = 0.0302). Age at diagnosis, type and length of treatment were not found to significantly affect development. CONCLUSION: The paediatric cancer survivors in this survey were found to have delays in their development. This group of children should have their development closely monitored. This would ensure that any delays in development can be discovered early and appropriate interventions instituted, so that childhood cancer survivors are adequately prepared for adult life beyond cancer.

Screening thoroughbreds for antibodies to the Equine infectious anemia virus.

One hundred and seventy two Thoroughbreds were screened for the presence of anitbodies to the capsid protein, p26 of the equine infectious anemia (EIA)virus using agarose gel immunodiffusion (AGOD) Coggins test. Horses ranged in age from 1 month to 21 years old and were either imported or locally bred. The majority were involved in racing and breeding and were housed either at the Santa Rosa Racing Complex at Arima or at privately owned farms. Complete blood counts (CBCs) were performed on all horses. Low haemoglobin concentrations were found in 18(10.5%), high white blood cell counts in 17 (9.9%) with neutrophilia in 13 (7.6%). Low red blood cell counts were seen in 11 of 154 horses (7.1%). At least 12 horses had evidence of clinical babesiosis, but only 7 were confirmed infected by examination of Giemsa stained blood smears. Racehorses from trinidad and Tobago occasionally move inter-island for racing and increasingly come in contact with foreign horses with the increasing importation of horses from countries known to harbour the virus. All 172 horses tested negative for antibodies to EIA virus. This implies that the strict adherence to import and quarantine regulations may have contributed to keeping the country free from EIA virus. This ongoing study is the first to provide sero-prevalence data and document the prevalence of EIA in the equine population in Trinidad and Tobago.

Screening thoroughbreds for antibodies to the Equine infectious anemia virus.

One hundred and seventy two Thoroughbreds were screened for the presence of anitbodies to the capsid protein, p26 of the equine infectious anemia (EIA)virus using agarose gel immunodiffusion (AGOD) Coggins test. Horses ranged in age from 1 month to 21 years old and were either imported or locally bred. The majority were involved in racing and breeding and were housed either at the Santa Rosa Racing Complex at Arima or at privately owned farms. Complete blood counts (CBCs) were performed on all horses. Low haemoglobin concentrations were found in 18(10.5%), high white blood cell counts in 17 (9.9%) with neutrophilia in 13 (7.6%). Low red blood cell counts were seen in 11 of 154 horses (7.1%). At least 12 horses had evidence of clinical babesiosis, but only 7 were confirmed infected by examination of Giemsa stained blood smears. Racehorses from trinidad and Tobago occasionally move inter-island for racing and increasingly come in contact with foreign horses with the increasing importation of horses from countries known to harbour the virus. All 172 horses tested negative for antibodies to EIA virus. This implies that the strict adherence to import and quarantine regulations may have contributed to keeping the country free from EIA virus. This ongoing study is the first to provide sero-prevalence data and document the prevalence of EIA in the equine population in Trinidad and Tobago.

Effectiveness of an Indonesian model for rapid training of Guatemalan health workers in diarrhea case management.

The aim of this study was to assess the effectiveness of a newly developed method for rapid tiered training of health workers in improving community health worker knowledge and case management skills. The interactive "Kader" method, developed in West Java, Indonesia, was compared with traditional didactic training in a prospective trial with rural health workers ("Tecnicos") and village health promoters ("Promotores") for the Public Health Department in the state of Alta Verapaz, Guatemala. Twenty-five tecnicos received one day of training concerning diarrhea and dehydration. One group was trained using the interactive Kader method of Indonesia; the other with didactic methods. A sample of these tecnicos then trained 49 randomized promotores utilizing the same training method with which they were trained. The tecnicos and promotores in each group completed a case-based pre-test and post-test before and after their training sessions. Both tecnicos and promotores trained using the Kader tiered training approach demonstrated significantly greater improvement in their ability to correctly diagnose and recommend treatment for diarrhea of varying type and severity. Non-significant differences favoring the experimental groups were found in the tecnicos' and promotores' general knowledge regarding diarrhea prevention practices, signs of dehydration and preparation of oral rehydration solution. This pilot study suggests that the Kader method for rapid tiered training of health workers has applicability to the populations of other developing nations and can be recommended for large scale implementation and evaluation in the training of public health workers, village health promoters and families in Guatemala.

PIP: A study was conducted to assess the effectiveness of a newly developed method of rapid tiered training of health workers to improve their knowledge and case management skills. The interactive Kader method, developed in Indonesia, was compared with traditional didactic training in a prospective trial involving rural health workers and village health promoters in Alta Verapaz state. 25 rural health workers received one day of training on diarrhea and dehydration, one group with the Kader method and the other with didactic methods. A sample of the workers then trained 49 randomized village health promoters using the same training method with which they were trained. Both the rural health workers and village health promoters trained with the Kader approach demonstrated significantly greater improvement in their ability to correctly diagnose and recommend treatment for diarrhea of varying type and severity. These findings suggest that the Kader approach could be applicable to the populations of other developing countries and recommended for large-scale implementation and evaluation in the training of public health workers, village health promoters, and families in Guatemala.