Relationships between grip strength, dexterity, and fine hand use are attenuated by age in children 3 to 13†years-of-age.

[Purpose] The purpose of this secondary analysis of data from the validation phase of National Institutes of Health Toolbox study was to describe the relationship between grip strength, dexterity, fine hand use, and age. [Participants and Methods] Children 3 to 13 years (n=132) contributed data. Grip strength was measured bilaterally with a Jamar dynamometer. Dexterity was measured bilaterally with the Nine-hole Peg Test. Fine hand use was characterized using 5 items of the Bruininks Oseretsky Test of Motor Proficiency. [Results] All grip strength and dexterity and fine hand use measures were correlated moderately to highly with one another and with age. The Cronbach's alpha for all measures was 0.88. Factor analysis suggested that all measures loaded strongly on a single component with the first factor explaining 75.6% of the total variance. Nevertheless, correlations between grip strength and dexterity and fine hand use measures were mostly negligible after controlling for age. [Conclusion] As moderate to strong relationships between grip strength and dexterity and fine hand use are attenuated by age in children of 3 to 13 years, we cannot recommend the use of any one measure over others to characterize motor function of the hand.

Shifting perspectives on pain management after an interprofessional international service learning experience: A qualitative assessment of pilot data.

Interprofessional education and international service learning (ISL) experiences are increasing in healthcare education and have the potential to broaden healthcare providers' strategies to manage patients' pain. After the addition of a physical therapy (PT) cohort to an existing interprofessional ISL, survey data was collected for program evaluation. Responses indicated altered ideation regarding the role of PT in pain management, and this theme was investigated further. Following two one-week interprofessional ISL experiences in Honduras in 2015 (Y1) and 2016 (Y2), participating students and preceptors in pharmacy, physician assistant and osteopathic medicine and Y1 PT preceptors were surveyed regarding their impressions of the PT cohort and the PT profession in general. Researchers performed thematic analysis to identify trends in responses, yielding three themes regarding PT's role in pain management: Patient Empowerment (46.2%), Management of Musculoskeletal Pain (42.3%), and Alternatives to Pharmacological Pain Management (11.5%). Results suggest that participating in an interprofessional ISL experience with a PT cohort encourages consideration of non-pharmacological methods to treat pain, including referral to PT to address musculoskeletal pain, and empowering patients to prevent or self-manage pain. These findings may be especially significant for under-resourced communities.

Medical device-related hospital-acquired pressure ulcers in children: an integrative review.

The management, cost, physical and emotional suffering associated with pressure ulcers have a significant impact on the health status of patients-especially infants and children. The purpose of this integrative review was to identify factors associated with medical device-related (MDR) hospital acquired pressure ulcers (HAPUs) in the pediatric population. Pediatric MDR HAPUs are becoming more prevalent and require further exploration in terms of describing devices which cause injury and preventive interventions to improve patient outcomes. Opportunities to uncover new methods for addressing this important problem and to inform and advance the state of the science in this evolving area exist.

Using the Braden Q Scale to Predict Pressure Ulcer Risk in pediatric patients.

The Braden Q Scale for Predicting Pediatric Pressure Ulcer Risk (Braden Q Scale) is a widely used, valid, and reliable pediatric-specific pressure ulcer risk assessment tool. Since its original publication, requests for clarification on how best to use the tool across the wide spectrum of pediatric patients commonly cared for in health care systems have been received. Common clarifications focus on using the Braden Q Scale as originally designed; specifically, not using untested derivations of the tool, and not using the Braden Q Scale to predict medical device-related pressure damage. The purpose of this article is to provide practical information on how best to use the Braden Q Scale and how to score a pediatric patient's risk for pressure ulcers. Accurate assessment of patient risk for pressure ulcers is the first step in guiding appropriate nursing interventions that prevent pressure ulcers. Patient assessment, scoring, and common clinical scenarios are presented.

Accuracy Assessment of a GPS Device for Maximum Sprint Speed.

Global positioning system (GPS) technology can capture maximum sprint speed (MSS) using fewer resources than electronic timing gates (ETG). Yet, errors with GPS technology are typically 1.01 km·hr-1 for instantaneous velocity, potentially limiting GPS accuracy. The purpose of this study was to compare MSS values obtained from GPS technology to those obtained from ETG. The MSS of 24 female athletes was determined using two tests that both began with a 20-m fly-in followed by: 1) 80-m maximal sprint with ETG placed at the start line, 30 m, 60 m, and 80 m, and 2) 30-m maximal sprint with ETG placed every 10 m. Sprint speed was calculated from each timing segment, and the fastest segment for each test was used for the calculated MSS. MSS was also obtained using a GPS unit measuring at 10 Hz. Mean bias and mean absolute percent error (MAPE) of the GPS was lower for the 80-m test (0.09 ± 1.24 km·hr-1, 3.5 ± 3.1%) than the 30-m test (1.58 ± 0.80 km·hr-1, 5.5 ± 2.6%). Lin's concordance agreement was found to be poor for both tests. The equivalence test indicated that the GPS was equivalent for both short and long distances, p < .05, meaning the two results were within a 5% equivalence interval. The GPS devices were within the acceptable range of accuracy at short (10-m) and long (30-m) distances. These results can guide coaching staff regarding how to test their athlete's metrics and the reliability of those results.

Skin integrity in hospitalized infants and children: a prevalence survey.

The purpose of this paper was to describe the spectrum of alterations in skin integrity and skin care needs of hospitalized infants and children. A 1-day skin prevalence audit was conducted in the spring of 2005 in a tertiary care university-affiliated children's hospital. Patient skin was assessed for any alterations. The Braden Q Scale was used to assess patient risk for pressure ulcer development. Alterations in skin integrity included diaper dermatitis, pressure ulcers, intravenous infiltrations, device-related injuries, and epidermal injuries. Many patients required additional skin care, including wound/incision care, ostomy care, and care related to invasive devices. Alterations in skin integrity represent a serious problem in the pediatric inpatient setting. The data presented identify skin integrity challenges in the hospitalized patient and can help guide staff education and resource allocation, encourage evidenced-based management protocols, and serve as a benchmark for similar pediatric facilities.