A pilot study to investigate the muscle strenght of children infected with HIV

M.Sc. (Physiotherapy), Faculty of Health Sciences, University of the Witwatersrand, 2008.Paediatric Human Immunodeficiency Virus (HIV) remains a significant challenge to children and caregivers in South Africa. Although the availability of antiretroviral (ARV) therapy has improved, it is not yet universally accessible. Rates of transmission from mother to child thus remain high and the virus widely uncontrolled. One aspect affecting children infected with HIV is that of muscle strength. For children weakness has been inferred by way of developmental studies in young children infected with HIV. Impaired performance in activities such as standing, walking, stair-climbing and jumping have been noted. These gross motor activities require higher muscle outputs and strength against gravity. This study sought to ascertain the feasibility of a full study on muscle strength in children infected with HIV. It analysed the effect of HIV on muscle strength, height and weight of those children receiving and not receiving highly active antiretroviral therapy (HAART). Children were recruited from Harriet Shezi Children’s HIV Clinic at Chris Hani Baragwanath Hospital, Soweto, Gauteng Province, South Africa. The study population included a group of children receiving HAART (n=16) and a group of children not receiving HAART (n=16). A once off test of muscle strength was administered to each child using a hand-held dynamometer. A demographic questionnaire and the Household Economic and Social Status Index (HESSI) were administered to their primary caregiver. Results showed the sample population to be of low socio-economic status (average score=54%) and the children to be underweight and short for their age (p<0.001). The CD4 count of the group on HAART was significantly higher than the group not receiving HAART (p<0.05). The group not receiving HAART was significantly stronger than the HAART group (p<0.05). Length of time having received HAART and muscle strength showed no significant correlation (p=0.647). No significant correlation was shown between CD4 count and muscle strength in the group receiving HAART (p>0.1). A significant negative correlation was shown between CD4 count and muscle strength in the group not receiving HAART (p<0.05). As statistically significant normative muscle strength data for children not infected with HIV in this age group fails to exist, the study was unable to ascertain a quantitative measure of weakness in these children. Comparison of those values available, however, showed normative values to be double that of children who participated in the study. The implications of these findings are that as one observes this group of children’s CD4 count drop, so too does their muscle strength. HAART, once initiated, stems the decrease in muscle strength over a period of time but does not reverse it. Furthermore, children and caregivers who participated in this study were faced with the adversities of poor socioeconomic status, limited access to medication and ARV treatment and inadequate nutritional intake, most of which were largely beyond their immediate control. This pilot study has indicated the feasibility and importance of a full study to investigate the muscle strength of children infected with HIV. Further research is needed to establish the impact of earlier administration of HAART on muscle strength. The effect of exercise on the muscle strength of children who are infected with HIV has yet to be documented. The implication of these factors on gross motor development in children infected with HIV has yet to be investigated

On the syntactically complex status of negative indefinites

Negative Indefinites (NIs) in languages such as Dutch and German may give rise to split-scope readings. Sentences like German Du must keine Krawatte anziehen (‘you must wear no tie’) have a reading where the modal takes scope in between the negation and the indefinite. In this paper I argue that West Germanic NIs are not negative quantifiers (in the Montegovian sense), but complex syntactic structures that consist of an abstract negative operator and an indefinite that are spelled out as a single word. Split-scope effects result from application of the copy theory of movement. I argue that in split-scope constructions, though they are spelled out as a single word, after Quantifier Raising the negative operator is interpreted in a higher copy and the indefinite in a lower copy of the NI. Furthermore I demonstrate that alternative analyses that take NIs in Dutch and German to be negative quantifiers, n-words, or the result of amalgamation or incorporation processes face problems that the analysis presented in this paper does not encounter

Universal Quantifier PPIs

Why have Positive Polarity Items (PPIs) that are universal quantifiers only been attested in the domain of modal auxiliaries (cf. Homer t.a., Iatridou &amp; Zeijlstra 2010, 2013) and never in the domain of quantifiers over individuals? No PPI meaning everybody or everything has ever been reported. In this paper, I argue that universal quantifier PPIs actually do exist, both in the domain of quantifiers over individuals and in the domain of quantifiers over possible worlds, as, I argue, is predicted by the Kadmon &amp; Landman (1993) - Krifka (1995) - Chierchia (2006, 2013) approach to NPIhood. However, since the covert exhaustifier that according to Chierchia (2006, 2013) is induced by these PPIs (and responsible for their PPI-hood) can act as an intervener between the PPI and its anti-licenser, it is concluded in this paper that a universal quantifier PPIs may scope below it and thus appear in disguise; their PPI-like behaviour only becomes visible once they morpho-syntactically precede their anti-licenser. Another conclusion of this paper is that Dutch iedereen (‚everybody’), opposite to English everybody, is actually a PPI

The Lack of Full Pro Drop as a Consequence of Featural Overspecification

Despite the enormous attention that pro drop has received in the linguistic literature, there is no generally accepted answer to the question why relatively rich Germanic languages do not have argumental null subjects, neither is there a fundamental answer to the question why English would not allow them in at least 3SG contexts, where the agreement marker uniquely identifies the features of the unexpressed subject, just like in Italian. We argue that a closer inspection of the Germanic languages reveals that tense and agreement are expressed mono-morphemically, whereas Romance pro drop languages have distinct morphemes for tense and agreement. This allows us to postulate that the lack of pro drop in Germanic languages is a consequence of overspecification: the presence of the tense features makes licensing of a null subject impossible. Germanic variants that have partial pro drop, such as Frisian and Bavarian German, can be naturally accommodated in our approach by reference to complementizer agreement