Les effets de l’infection périnatale au virus HIV sur le développement du comportement d’adaptation

La présente étude porte sur le développement des fonctions d'adaptation chez neuf enfants séropositifs et neuf enfants séronégatifs, dont l'âge allait de trois mois à six ans et neuf mois. Les deux groupes montraient un développement normal du comportement d'adaptation avant l'âge de deux ans ; après cet âge, le groupe séropositif était handicapé dans tous les aspects du fonctionnement. Les résultats de l'enquête sont examinés dans l'optique des besoins des enfants atteints et de leurs familles.This study examined the development of adaptive functioning in nine HIV-positive and nine HIV-negative children ranging in age from 3 months to 6 years, 11 months. Both groups showed normal development of adaptive behaviour prior to two years of age; after this time the HIV-positive group was impaired in all areas of functioning. The results are discussed in terms of the program needs of the HIV-infected children and their families

Expanding Production of Cannabis in Iowa

Following passage of Senate Bill 2360 “Medical Cannabidiol Act” in Iowa, possession of Cannabidiol Oil become legal for patients who suffered from intractable epilepsy. The law became effective July 1, 2014, however, patients who were diagnosed by neurologist and prescribed Cannabidiol were still unable to legally access the medication in Iowa. The Controlled Substance Act still lists Cannabis and any of its components, as illegal for possession per federal law. States such as Colorado, Minnesota, and Illinois have legalized production and growing in their individual states. However, unlike the other states, Iowa’s legislation still does not permit the production and distribution of Cannabidiol Oil in the state. Thus, attention is focused on raising awareness of the medical benefits of cannabis and finding a solution to allow patients and their caregivers to legally obtain this medication in the Iowa.Capstone paper from 2015 spring MPA program. Instructed by Allen Zagoren

STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients

Background: Investigation of movement and sensory profiles across STarT Back risk subgroups. Methods: A chronic low back pain cohort (n = 290) were classified as low, medium or high risk using the STarT Back Tool, and completed a repeated spinal bending task and quantitative sensory testing. Pain summation, time taken and the number of protective behaviours with repeated bending were measured. Sensory tests included two-point discrimination, temporal summation, pressure/thermal pain thresholds and conditioned pain modulation. Subgroups were profiled against movement and sensory variables. Results: The high-risk subgroup demonstrated greater pain summation following repeated forward bending (p < 0.001). The medium-risk subgroup demonstrated greater pain summation following repeated backward bending (p = 0.032). Medium- and high-risk subgroups demonstrated greater forward/backward bend time compared to the low-risk subgroup (p = 0.001, p = 0.005, respectively). Medium- and high-risk subgroups demonstrated a higher number of protective behaviours per forward bend compared to the low-risk subgroup (p = 0.008). For sensory variables, only two-point discrimination differed between subgroups, with medium- and high-risk subgroups demonstrating higher thresholds (p = 0.016). Conclusions: This study showed altered movement characteristics and sensory discrimination across SBT risk subgroups in people with CLBP. Membership of the high SBT risk subgroup was associated with greater pain and disability levels, greater pain summation following repeated bending, slower bending times, a greater number of protective behaviours during forward bending, and a higher TPD threshold. Treatment outcomes for higher risk SBT subgroups may be enhanced by interventions specifically targeting movement and sensory alterations. Significance: In 290 people with chronic low back pain movement profile and two-point discrimination threshold differed across risk subgroups defined by the STarT Back Tool. Conversely, pain sensitivity did not differ across these subgroups. These findings may add further guidance for targeted care in these subgroups

A review of neurocognitive functioning of children with sex chromosome trisomies: identifying targets for early intervention

Sex chromosome trisomies (SCT) are among the most common chromosomal duplicationsin humans. Due to recent technological advances in non-invasive screening, SCTcan already be detected during pregnancy. This calls for more knowledge about thedevelopment of (young) children with SCT. This review focused on neurocognitivefunctioning of children with SCT between 0 and 18 years, on domains of global intellectualfunctioning, language, executive functioning, and social cognition, in order toidentify targets that could benefit from early treatment.Online databases were used to identify peer-reviewed scientific articles using specificsearch terms. In total 18 studies were included. When applicable, effect sizes werecalculated to indicate clinical significance.Results of the reviewed studies show that although traditionally, the focus has been onlanguage and intelligence (IQ) in this population, recent studies suggest that executivefunctioning and social cognition may also be significantly affected already in childhood.These findings suggest that neuropsychological screening of children diagnosed withSCT should be extended, to also include executive functioning and social cognition.Knowledge about these neurocognitive risks is important to improve clinical care andhelp identify targets for early support and intervention programs to accommodatefor the needs of individuals with SCT.NWO016.165.397Education and Child Studie

A review of trisomy X (47,XXX)

Trisomy X is a sex chromosome anomaly with a variable phenotype caused by the presence of an extra X chromosome in females (47,XXX instead of 46,XX). It is the most common female chromosomal abnormality, occurring in approximately 1 in 1,000 female births. As some individuals are only mildly affected or asymptomatic, it is estimated that only 10% of individuals with trisomy X are actually diagnosed. The most common physical features include tall stature, epicanthal folds, hypotonia and clinodactyly. Seizures, renal and genitourinary abnormalities, and premature ovarian failure (POF) can also be associated findings. Children with trisomy X have higher rates of motor and speech delays, with an increased risk of cognitive deficits and learning disabilities in the school-age years. Psychological features including attention deficits, mood disorders (anxiety and depression), and other psychological disorders are also more common than in the general population. Trisomy X most commonly occurs as a result of nondisjunction during meiosis, although postzygotic nondisjunction occurs in approximately 20% of cases. The risk of trisomy X increases with advanced maternal age. The phenotype in trisomy X is hypothesized to result from overexpression of genes that escape X-inactivation, but genotype-phenotype relationships remain to be defined. Diagnosis during the prenatal period by amniocentesis or chorionic villi sampling is common. Indications for postnatal diagnoses most commonly include developmental delays or hypotonia, learning disabilities, emotional or behavioral difficulties, or POF. Differential diagnosis prior to definitive karyotype results includes fragile X, tetrasomy X, pentasomy X, and Turner syndrome mosaicism. Genetic counseling is recommended. Patients diagnosed in the prenatal period should be followed closely for developmental delays so that early intervention therapies can be implemented as needed. School-age children and adolescents benefit from a psychological evaluation with an emphasis on identifying and developing an intervention plan for problems in cognitive/academic skills, language, and/or social-emotional development. Adolescents and adult women presenting with late menarche, menstrual irregularities, or fertility problems should be evaluated for POF. Patients should be referred to support organizations to receive individual and family support. The prognosis is variable, depending on the severity of the manifestations and on the quality and timing of treatment