A Systematic Review of Occupational Therapy-Related Interventions for Pediatric Chronic Pain.

Occupational therapists have distinct value providing pediatric chronic pain interventions (e.g., pain management, normalizing sensory responses, increasing participation); however, limited evidence exists. This review appraised empirical studies on occupational therapy pediatric chronic pain management. Three reviewers independently screened 2,401 titles, 250 abstracts, and 71 full-text sources for studies published in English, after 2008, and with sample sizes >10, participants <18 years, with chronic pain >3 months, and outcomes related to pain/function. Studies were assessed for risk of bias. The review included 23 studies on psychological, interprofessional, virtual/telehealth, or biomechanical management, demonstrating significant decreases in pain/disability. Most studies had high risk of bias for lack of randomization and control groups, and homogeneous sampling. The occupational therapists' role in chronic pain interventions is still unclear. Research including larger, heterogenous samples is warranted to examine occupational therapy's specific role providing pain interventions as part of a team.

What does the public think about sex offender registers? Findings from a national Australian study.

This article presents data from questions about sex offender registration orders in a large national survey on Australian public opinion about adult sex offenders. It outlines the legislative frameworks that govern these registers in Australia and discusses the use of public registers, the research on the effectiveness of sex offender registers, and Australian attitudes to such registers. Our surveys of three cohorts of members of the Australian public reveal strong public support for sex offender registers, especially for cases involving child victims. However, there was also support for judicial discretion in the imposition of orders and reduced support for automatic registration where a non-custodial sentence is imposed. The Australian Government has recently announced the establishment of a national public sex offender register, but our findings show limited support for this approach. The implications for policy and practice are considered.

Neighborhood Disorder and Obesity-Related Outcomes among Women in Chicago.

Neighborhood psychosocial stressors like crime and physical disorder may influence obesity-related outcomes through chronic stress or through adverse effects on health behaviors. Google Street View imagery provides a low-cost, reliable method for auditing neighborhood physical disorder, but few studies have examined associations of Street View-derived physical disorder scores with health outcomes. We used Google Street View to audit measures of physical disorder for residential census blocks from 225 women aged 18⁻44 enrolled from 4 Chicago neighborhoods. Latent neighborhood physical disorder scores were estimated using an item response theory model and aggregated to the block group level. Block-group level physical disorder scores and rates of police-recorded crime and 311 calls for service requests were linked to participants based on home addresses. Associations were estimated for 6 obesity-related outcomes: body mass index, obesity, total moderate-to-vigorous physical activity, and weekly consumption of sugar-sweetened beverages, fast food, and snacks. Hierarchical regression models estimated cross-sectional associations adjusting for individual sociodemographics and neighborhood poverty. Higher neighborhood physical disorder was associated with greater odds of obesity (OR: 1.43, 95% CI: 1.01, 2.02). Living in a neighborhood with a higher crime rate was associated with an increase in weekly snack consumption of 3.06 (95% CI: 1.59, 4.54).

Trauma training course: innovative teaching models and methods for training health workers in active conflict zones of Eastern Myanmar.

BACKGROUND: Myanmar has struggled through decades of internal conflict, which has negatively impacted the country's health outcomes. Recent government changes have brought hope and reduced conflict. The ethnic minority groups have suffered the brunt of the health consequences and reside in regions that lack health infrastructure, resources, and providers. Due to the chronic lack of healthcare providers within conflict areas, health workers (HWs) have been trained in an effort to fill the void. Research has shown that these non-physician clinicians positively impact health outcomes in developing countries. These HWs are supported by community-based organizations in collaboration with foreign non-governmental organizations. Started in 2000, the trauma training course was developed to meet the educational needs of these HWs. METHODS: Essential procedures for HWs in conflict zones were identified, and teaching methods were adapted to develop models that were simple, reproducible, cost effective, and able to facilitate effective learning within the limitations of these challenging environments. This paper presents simulation models developed to teach trauma injury evaluation and management in resource-limited settings to HWs. RESULTS: Material and construction of the models described include breathing, chest, cricothyroidotomy, circulation, wound repair, fracture/dislocation, splinting, fasciotomy/amputation, and an animal model. In 2013, a pre/post test and post-training evaluation were completed, which demonstrated an increase in understanding of the material and satisfaction with the training. CONCLUSIONS: The simulation models described engage the HWs in clinical skills practice specific to injury management, which builds upon the HWs existing knowledge and facilitates an increased understanding of life-saving procedures. Through observation of the HW performance and HW feedback, these simulation models have increased the understanding of trauma management. Limitations include lack of a graduated learning system for the HWs, logistics, and time constraints. Despite the barriers faced, we feel that this is a necessary program that has reduced morbidity and mortality due to traumatic injury in the geographic areas that the HWs serve. With the changing political environment in Myanmar and the development of peace agreements between the government and the ethnic minority groups, these HWs can be integrated into Myanmar's evolving health system.

Identification and characterization of proteins involved in nuclear organization using Drosophila GFP protein trap lines.

BACKGROUND: Strains from a collection of Drosophila GFP protein trap lines express GFP in the normal tissues where the endogenous protein is present. This collection can be used to screen for proteins distributed in the nucleus in a non-uniform pattern. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed four lines that show peripheral or punctate nuclear staining. One of these lines affects an uncharacterized gene named CG11138. The CG11138 protein shows a punctate distribution in the nuclear periphery similar to that of Drosophila insulator proteins but does not co-localize with known insulators. Interestingly, mutations in Lamin proteins result in alterations in CG11138 localization, suggesting that this protein may be a novel component of the nuclear lamina. A second line affects the Decondensation factor 31 (Df31) gene, which encodes a protein with a unique nuclear distribution that appears to segment the nucleus into four different compartments. The X-chromosome of males is confined to one of these compartments. We also find that Drosophila Nucleoplasmin (dNlp) is present in regions of active transcription. Heat shock leads to loss of dNlp from previously transcribed regions of polytene chromosome without redistribution to the heat shock genes. Analysis of Stonewall (Stwl), a protein previously found to be necessary for the maintenance of germline stem cells, shows that Stwl is present in a punctate pattern in the nucleus that partially overlaps with that of known insulator proteins. Finally we show that Stwl, dNlp, and Df31 form part of a highly interactive network. The properties of other components of this network may help understand the role of these proteins in nuclear biology. CONCLUSIONS/SIGNIFICANCE: These results establish screening of GFP protein trap alleles as a strategy to identify factors with novel cellular functions. Information gained from the analysis of CG11138 Stwl, dNlp, and Df31 sets the stage for future studies of these proteins.

Intervenção nutricional integrada à prática de Lian Gong em usuários hipertensos de uma unidade básica de saúde de Belo Horizonte, Minas Gerais / Nutritional intervention integrated with the practice of Lian Gong among hypertensive users of a primary healthcare unit in Belo Horizonte, Minas Gerais

A fim de integrar a prática da atividade física à educação nutricional, foi realizado um estudo de intervenção com usuários hipertensos praticantes de Lian Gong de uma Unidade Básica de Saúde de Belo Horizonte, Minas Gerais. A intervenção contemplou seis encontros, em três meses, com duração de trinta minutos cada. Dos encontros, quatro foram destinados à abordagem educativa no tocante à alimentação, à atividade física e à hipertensão arterial. Já o restante (1º e o último encontro) abrangeu avaliação antropométrica (peso, estatura e circunferências) e alimentar (questionário) dos participantes. Adicionalmente, aplicou-se, ao final da intervenção, um questionário para averiguar mudanças nos modos de vida dos usuários. Quinze usuários participaram do estudo, 73,3% do sexo feminino, com média de idade de 53,3± 10,3 anos. Os participantes adultos (n=11) e 83,2% dos participantes idosos apresentavam excesso de peso. Após intervenção, verificou-se redução de circunferência de cintura (90,38 ± 8,15cm; 89,00 ± 8,26cm; p= 0,001) e da Relação Cintura Quadril (0,89 ± 0,04; 0,87 ± 0,04; p= 0,001) entre os participantes. Observou-se, ainda, aumento significativo do consumo de verduras e legumes (p=0,04) e redução do hábito de trocar almoço/jantar por lanches (p= 0,049). A maioria dos participantes (83,3 %) informou ter realizado alguma alteração no hábito alimentar e apresentado melhoria da qualidade de vida após intervenção. Os achados demonstram que, apesar do curto período, a intervenção nutricional favoreceu a modificação da alimentação e da qualidade de vida dos integrantes do grupo estudado, denotando a importância de ações educativas na atenção primária à saúde.

To integrate physical activity practices with nutritional education, an intervention study was conducted among hypertensive users of a primary healthcare unit in Belo Horizonte, Minas Gerais, who were Lian Gong practitioners. The intervention envisaged six meetings over three months, lasting 30 minutes each. Among these, four provided an educational approach towards diet, physical activity, and arterial hypertension. The other two (first and last meetings) covered anthropometric evaluation (weight, height, and circumferences) and dietary assessment (questionnaire) among the participants. In addition, at the end of the intervention, a questionnaire was applied to check on changes to users? lifestyles. Fifteen users participated in the study: 73.3% were female and the mean age was 53.3 ± 10.3 years. The adult participants (n = 11) and 83.2% of the elderly participants were overweight. After the intervention, reductions in waist circumference (90.38 ± 8.15 cm; 89.00 ± 8.26 cm; p = 0.001) and waist/hip ratio (0.89 ± 0.04; 0.87 ± 0.04; p = 0.001) were seen among the participants. Significantly increased consumption of greens and vegetables (p = 0.04) and reduction in the habit of replacing lunch/dinner with snacks (p = 0.049) were also observed. Most participants (83.3%) said that they had made changes in dietary habits and showed improved quality of life after the intervention. The findings demonstrate that despite its short duration, the nutritional intervention promoted the modification of diet and quality of life among the study group?s members, thus indicating the importance of educational actions within primary healthcare.

Subjective social status predicts smoking abstinence among light smokers.

OBJECTIVES: To determine if community subjective social status (SSS) predicted smoking abstinence through 26 weeks postrandomization among 755 African American light smokers of low SES (socioeconomic status). METHODS: Participants were enrolled in a double-blind, placebo-controlled, randomized clinical trial, which examined the efficacy of nicotine gum and counseling for smoking cessation. RESULTS: Results indicated that SSS predicted smoking abstinence over time [P=.046; odds ratio (OR) =1.075 (1.001-1.155)] after adjusting for covariates. CONCLUSIONS: Further research is needed to understand the effects of community SSS on smoking cessation among heavy smokers and other ethnic groups.

Analysis of femoral artery intima-media thickness during the cardiac cycle.

BACKGROUND: Variations in the intima-media thickness (IMT) of the carotid artery during the cardiac cycle are well established. The change in femoral IMT during the cardiac cycle is largely unknown. This study focuses on the variation of femoral IMT, vessel diameter, and cross-sectional area (CSA) of the IMT during the cardiac cycle. METHODS: Video clips of the femoral artery were obtained using B-mode ultrasonography in 60 patients between the ages of 18 and 50. IMT and diameter measurements were made using automated software, and CSA was subsequently calculated. Triplicate measurements of each femoral artery were made at three points in the cardiac cycle: the R wave, the T wave, and at the point of maximal vessel diameter falling after the T wave and before the following P wave. RESULTS: Femoral IMT, diameter, and CSA did not show a statistically significant difference with measurement on the R versus the T wave (P>0.36, P>0.28, and P>0.76, respectively). Interestingly, when comparing measurements on the R or T wave with measurements taken at the maximum vessel diameter, there was a statistically significant difference in vessel diameter (P<0.001) and CSA (P<0.005) but not in femoral IMT (P>0.2). CONCLUSIONS: Unlike studies of the carotid artery, there were no statistically significant differences between measurements made at the R versus the T wave. There were, however, statistically significant differences noted in diameter and CSA when measurements were taken at a point later in the cardiac cycle. This has ramifications for future studies on vascular remodeling.

Identification of SPRED1 deletions using RT-PCR, multiplex ligation-dependent probe amplification and quantitative PCR.

Legius syndrome, is a recently identified autosomal dominant disorder caused by loss of function mutations in the SPRED1 gene, with individuals mainly presenting with multiple café-au-lait macules (CALM), freckling and macrocephaly. So far, only SPRED1 point mutations have been identified as the cause of this syndrome. To determine if copy number changes (CNCs) are a cause of Legius syndrome, we have used a Multiplex Ligation-dependent Probe Amplification (MLPA) assay covering all SPRED1 exons in a cohort of 510 NF1-negative patients presenting with multiple CALMs with or without freckling, but no other NF1 diagnostic signs. Four different deletions were identified by MLPA and confirmed by quantitative PCR, reverse transcriptase PCR and/or array CGH: a deletion of exon 1 and the SPRED1 promoter region in a proband and two first-degree relatives; a deletion of the entire SPRED1 gene in a sporadic patient; a deletion of exon 2-6 in a proband and her father; and an ∼6.6 Mb deletion on chromosome 15 that spans SPRED1 in a sporadic patient. Deletions account for ∼10% of the 40 detected SPRED1 mutations in this cohort of 510 individuals. These results indicate the need for dosage analysis to complement sequencing-based SPRED1 mutation analyses.

Leveraging the power of the media to combat HIV/AIDS.

Improving HIV/AIDS prevention efforts, especially those focused on young people, is a key challenge in the fight against the pandemic. Since the mid-1990s the Henry J. Kaiser Family Foundation has partnered with U.S.-based media companies on comprehensive HIV/AIDS campaigns. This paper outlines the unique public education model that it is using, and how Kaiser is expanding this work globally by working with some of the largest media companies in the world to undertake new initiatives in Russia and India.