Hand Strength Changes Following a Clinical Rotation in Hand Therapy: A Pilot Study

Background: Hand therapy clinical rotations are 12 weeks, and one common anecdotal change frequently expressed is an increase in hand strength. Quantifiable measures of change are not documented in the literature. The purpose of this study is to determine if students experience significant increases in strength during a clinical rotation. Methods: This study is a quasi-experimental, double-blinded, non-randomized sample of convenience. Grip and pinch strength were assessed pre, mid, and post clinical rotation. Demographic data were collected and reported. Paired t-tests were used to compare means between groups. SPSS 27.0 was used for data analysis. Results: After removing incomplete data sets, n = 12. Grip strength in the left hand showed a significant increase from pretest to posttest. Grip strength in the right hand showed no difference. Significant increases occurred in both right and left tripod pinch and lateral pinch strength from pretest to posttest. A significant increase was not observed for 2-point pinch strength. Discussion: This study provides insight into the changes in hand strength in students after a clinical rotation in hand therapy. Significant changes in grip and pinch strength do occur during this time. Increased load in grip and pinch patterns may have clinical implications for therapists practicing long term

Scaling-up co-trimoxazole prophylaxis in HIV-exposed and HIV-infected children in high HIV-prevalence countries.

Co-trimoxazole (trimethoprim-sulfamethoxazole) is a widely available antibiotic that substantially reduces HIV-related morbidity and mortality in both adults and children. Prophylaxis with co-trimoxazole is a recommended intervention of proven benefit that could serve not only as an initial step towards improving paediatric care in young children with limited access to antiretroviral treatment, but also as an important complement to antiretroviral therapy in resource-limited settings. Despite co-trimoxazole's known clinical benefits, the potential operational benefits, and favourable recommendations by WHO, UNAIDS, and UNICEF, its routine use in developing countries--particularly sub-Saharan Africa--has remained limited. Out of an estimated 4 million children in need of co-trimoxazole prophylaxis (HIV-exposed and HIV-infected), only 4% are currently receiving this intervention. We discuss some of the major barriers preventing the scale-up of co-trimoxazole prophylaxis for children in countries with a high prevalence of HIV and propose specific actions required to tackle these challenges

Caregiver Behavior Change for Child Survival and Development in Low- and Middle-Income Countries: An Examination of the Evidence

In June of 2012, representatives from more than 80 countries promulgated a Child Survival Call to Action, which called for reducing child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. To address the problem of ending preventable child deaths, the U.S. Agency for International Development and the United Nations Children’s Fund convened, on June 3–4, 2013, an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. Six evidence review teams were established on different topics related to child survival and healthy development to identify the relevant evidence-based interventions and to prepare reports. This article was developed by the evidence review team responsible for identifying the research literature on caregiver change for child survival and development. This article is organized into childhood developmental periods and cross-cutting issues that affect child survival and healthy early development across all these periods. On the basis of this review, the authors present evidence-based recommendations for programs focused on caregivers to increase child survival and promote healthy development. Last, promising directions for future research to change caregivers’ behaviors are given

Caregiver Behavior Change for Child Survival and Development in Low- and Middle-Income Countries: An Examination of the Evidence

In June of 2012, representatives from more than 80 countries promulgated a Child Survival Call to Action, which called for reducing child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. To address the problem of ending preventable child deaths, the U.S. Agency for International Development and the United Nations Children’s Fund convened, on June 3–4, 2013, an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. Six evidence review teams were established on different topics related to child survival and healthy development to identify the relevant evidence-based interventions and to prepare reports. This article was developed by the evidence review team responsible for identifying the research literature on caregiver change for child survival and development. This article is organized into childhood developmental periods and cross-cutting issues that affect child survival and healthy early development across all these periods. On the basis of this review, the authors present evidence-based recommendations for programs focused on caregivers to increase child survival and promote healthy development. Last, promising directions for future research to change caregivers’ behaviors are given

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Concentrations of lead, cadmium and barium in urban garden-grown vegetables: The impact of soil variables

Paired vegetable/soil samples from New York City and Buffalo, NY, gardens were analyzed for lead (Pb), cadmium (Cd) and barium (Ba). Vegetable aluminum (Al) was measured to assess soil adherence. Soil and vegetable metal concentrations did not correlate; vegetable concentrations varied by crop type. Pb was below health-based guidance values (EU standards) in virtually all fruits. 47% of root crops and 9% of leafy greens exceeded guidance values; over half the vegetables exceeded the 95th percentile of market-basket concentrations for Pb. Vegetable Pb correlated with Al; soil particle adherence/incorporation was more important than Pb uptake via roots. Cd was similar to market-basket concentrations and below guidance values in nearly all samples. Vegetable Ba was much higher than Pb or Cd, although soil Ba was lower than soil Pb. The poor relationship between vegetable and soil metal concentrations is attributable to particulate contamination of vegetables and soil characteristics that influence phytoavailability.Funding for this research was provided by the National Institute of Environmental Health Science

Developmental influences on symptom expression in antipsychotic-naïve first-episode psychosis.

BACKGROUND: The neurodevelopmental model of psychosis was established over 30 years ago; however, the developmental influence on psychotic symptom expression - how age affects clinical presentation in first-episode psychosis - has not been thoroughly investigated. METHODS: Using generalized additive modeling, which allows for linear and non-linear functional forms of age-related change, we leveraged symptom data from a large sample of antipsychotic-naïve individuals with first-episode psychosis (N = 340, 12-40 years, 1-12 visits), collected at the University of Pittsburgh from 1990 to 2017. We examined relationships between age and severity of perceptual and non-perceptual positive symptoms and negative symptoms. We tested for age-associated effects on change in positive or negative symptom severity following baseline assessment and explored the time-varying relationship between perceptual and non-perceptual positive symptoms across adolescent development. RESULTS: Perceptual positive symptom severity significantly decreased with increasing age (F = 7.0, p = 0.0007; q = 0.003) while non-perceptual positive symptom severity increased with age (F = 4.1, p = 0.01, q = 0.02). Anhedonia severity increased with increasing age (F = 6.7, p = 0.00035; q = 0.0003), while flat affect decreased in severity with increased age (F = 9.8, p = 0.002; q = 0.006). Findings remained significant when parental SES, IQ, and illness duration were included as covariates. There were no developmental effects on change in positive or negative symptom severity (all p > 0.25). Beginning at age 18, there was a statistically significant association between severity of non-perceptual and perceptual symptoms. This relationship increased in strength throughout adulthood. CONCLUSIONS: These findings suggest that as maturation proceeds, perceptual symptoms attenuate while non-perceptual symptoms are enhanced. Findings underscore how pathological brain-behavior relationships vary as a function of development

Supporting parents of adolescents: a powerful and under-utilised opportunity to influence adolescent development

Throughout the rapid and intense changes that adolescents experience, their parents retain important influence over how they interact with the complex factors that shape their development. How parents care for their adolescent children has a deep and lasting impact on their well-being and development. Yet, parents often require support to meet their own and their adolescent children’s needs, which can be achieved through parenting support programmes. Parenting support programmes are delivered to parents of younger children across different contexts and populations, but the benefit of these programmes for parents of adolescents is not well-recognised or prioritised. Given the clear need for these interventions during adolescence and the substantial evidence for effectiveness in this age group, it is time to move the field forward. Increased resources to support parents of adolescents would maximise adolescents’ developmental potential and promote their well-being. We highlight four pressing areas for action: including parents of adolescents in parenting initiatives; involving parents in adolescent programming; strengthening efforts to address poverty and inequality, violence, and gender inequality; and engaging in strategic research to intensify the impact of programming

Assembling an effective paediatric HIV treatment and prevention toolkit

The world has woken up to the importance of antiretroviral treatment and HIV prevention for children and adolescents. There is a clear need to expand access to paediatric treatment and prevention by building clinical delivery mechanisms. But stand-alone clinical services are insufficient: uptake of antiretroviral therapy (ART) and adherence remain suboptimal, and adolescent HIV incidence remains high. To improve paediatric survival, several psychosocial and economic barriers to treatment and prevention must be overcome. Such barriers include depression and stigma, which inhibit treatment adherence; psychological and community barriers to the prevention of vertical transmission; and severe poverty and child abuse, which are risk factors for transactional sex in adolescent girls