Comparison of Constrained Induced Movement Therapy and Bimanual Training on Functional Outcome of Hemiplegic Cerebral Palsy

OBJECTIVES The aim of this study was to compare the effects of constrained induced movement therapy (CIMT) and BimanualIntensive Training (BIT) on functional outcomes of hemiplegic cerebral palsy children. METHODOLOGY Cerebral palsy children with age groups of 5 to 12 years were included with a total sample size of 38. Simplerandom sampling was done, and data was collected from Islamabad. Two groups were formed and named groupA: constrained induced movement therapy with 19% and group B: bimanual training with 19% respectively. Thefunctional outcome for the CIMPT and for the BIT group was assessed on the pretest and post-test scoreevaluation of QUEST and JTHF tests. RESULTS Statistically significant (p <0.05) improvement was found in The Quality of Upper Extremity Skills Test (QUEST)and Jebsen-Taylor Test of Hand Function (JTHF) in the between -group analysis. For within the group analysisthe p-value <0.05 suggests that there was a significant diffe rence in within-group analysis too. The values forgrasp and dissociated movements suggest that QUEST post-test values are impactful in the CMIT group whereasin the BIT group simultaneous and spontaneous movement was increased but JTHF post -test values were moresignificant in CMIT. CONCLUSION BIT is more beneficial for both hand’s simultaneous and spontaneous movement, whereas CMIT is morebeneficial for grip and overcoming the “learned-nonuse” phenomena in cerebral palsy children

Access to justice during the COVID-19 pandemic in the UK

The COVID-19 pandemic has presented many challenges for our legal system. The courts have had to adapt to the unprecedented change in circumstances. One of the most dramatic changes to occur was the introduction of remote court hearings. This report, jointly authored by the Open University and Northumbria University, seeks to explore this transition and the impact it has had on access to justice. The Open University Policy Clinic is part of the Open Justice Centre. Open Justice provides free legal advice and education to members of the public in a variety of legal areas. In 2019, Open Justice established the Policy Clinic to undertake research on behalf of organisations and charities, aiming to influence policy and law reform. The Northumbria Student Law Office was set up in 1981 and offers free legal advice to members of the public on a range of different areas. The Policy Clinic within the Student Law Office was set up in the 2018/2019 academic year with the aim to undertake research influencing policy and law reform. We began our research by gathering data from a sample of 80 Crown Courts and 77 County Courts. In addition to this, we conducted fieldwork in the Court of Protection. This involved all members of the team requesting access as public observers to remote hearings. In total, 25 hearings were attended. There was also a review of existing literature surrounding remote hearings. This report will identify the themes arising from our research that have a direct influence on access to justice. We will discuss the findings from our research alongside the existing data, and comparisons will be made between these two data sets. We believe this report is particularly important as we enter a post-COVID-19 world and questions are being raised as to whether the changes that have occurred during the pandemic should be implemented permanently. The aim of this report is to gain an insight into the effect of the pandemic and to assess the practicality of online courts

Treatment Outcomes of Childhood TB Patients in Four TB High Burden States of Malaysia: Results from a Multicenter Retrospective Cohort Study

Data regarding treatment outcomes among childhood TB patients are lacking in Malaysia. The present study aimed to evaluate the treatment outcomes and predictors of unsuccessful treatment outcomes among childhood TB patients in four TB high-burden states of Malaysia. This was a retrospective cohort study conducted at 13 healthcare centers in four states of Malaysia, namely, Sabah, Sarawak, Selangor, and Penang. During the study period, a total of 8932 TB patients were enrolled for treatment at the study sites, of whom 206 (2.31%) were children. The majority of the childhood TB patients were female (52.9%) and belonged to the age group of 6–10 years (42.7%). Pulmonary TB accounted for 70.9% of childhood TB. Among childhood PTB patients, 50% were sputum smear negative. One hundred and seventy-eight patients (86.4%) were successfully treated (87 were cured and 91 completed treatment). Among 28 (13.6%) patients with unsuccessful treatment outcomes, 13 (6.3%) died, 3 (1.5%) failed treatment, 9 (4.4%) defaulted, and 3 (1.5%) were transferred out. Multivariate analysis revealed that patients’ age (5–14 years) (OR = 0.279, p-value = 0.006) and male gender (OR = 0.390, p-value = 0.046) had a statistically significant negative association with unsuccessful treatment outcomes. The prevalence of childhood TB in the current study was comparable to the recently published national estimates. The study sites reached the WHO target of treatment success. Special attention to patients with identified risk factors can improve treatment outcomes