The review suggests that the GMFM-88 and GMFM-66 are useful as outcome measures to detect changes in gross motor function in children with CP undergoing interventions. Implications for Rehabilitation Accurate measurement of change in gross motor skill acquisition is important to determine effectiveness of intervention programs in children with cerebral palsy (CP). The Gross Motor Function Measure (GMFM-88 and GMFM-66) are common tools used by rehabilitation specialists to measure gross motor function in children with CP. The GMFM appears to be an effective outcome tool for measuring change in gross motor function according to a small number of randomized control studies utilizing participant populations of convenience.
The findings suggest that hippotherapy may be a viable strategy for reducing balance deficits and improving the performance of daily life skills in children with mild to moderate balance problems.
SummaryIntensive care is one of the most costly areas of hospital care. Unfortunately, because of the diversity of case mix, costing intensive care is difficult. Many described costing methods previously are limited by being cumbersome, laborious to apply and expensive. The aim of this study was to develop a method for costing intensive care which can be applied with ease but facilitate meaningful cost comparisons between intensive care units. The method developed was based on cost blocks where the major components were identified and costed in a 'top-down' manner. Using strict definitions, the cost blocks attempted to measure the costs of equipment, estates, nonclinical support services (such as hospital management costs), clinical support services (such as physiotherapy, laboratory services), consumables (such as drugs, fluids and disposables) and staff. The study found that clinical support services, consumables and staff costs accounted for approximately 85% of the total costs.
This study suggests that motor skills and social function are related in young boys with autism. Implications for physical therapy intervention are also discussed.
Infants and toddlers with disabilities and special health care needs (SHCN) have complex habilitative and health care needs requiring multiple services throughout their lives. Providers of services to children underutilize assistive technology (AT) and AT services. This underutilization has a significant impact on how well and how easily the children are integrated in home, school, and community activities. The literature indicates that AT is appropriate when the device (a) is related to specific and clearly defined goals that are meaningful to the child and family; (b) takes into consideration practical constraints, such as the environment and funding resources; and (c) results in the child achieving desired outcomes. Using an outcome-driven model this article outlines a 10-step framework that can be used by service providers to guide them in determining the fit between the child's needs and AT and/or AT services. Components of the framework and critical information needed for decision-making at each step will be discussed. A family-centered, interdisciplinary team philosophy is promoted.
Life course theory sets the framework for strong inclusion of family centered care (FCC) in quality medical homes of children with neurodevelopmental disabilities (CNDD). The purpose of this study was to explore the perceptions of families with their experiences of FCC in medical homes for CNDD. Using a structured questionnaire, the Family-Centered Care Self-Assessment Tool developed by Family Voices, this study surveyed 122 parents of CNDD in a large urban area during 2010-2012. Data collected information on FCC in the provision of primary health care services for CNDD and focused on family-provider partnerships, care setting practices and policies, and community services. Frequency analysis classified participants' responses as strengths in the "most of the time" range, and weaknesses in the "never" range. Only 31 % of parents were satisfied with the primary health care their CNDD received. Based on an accepted definition of medical home services, 16 % of parents reported their CNDD had most aspects of a medical home, 64 % had some, and 20 % had none. Strengths in FCC were primarily evident in the family-provider partnership and care settings when focused on meeting the medical care needs of the child. Weaknesses in FCC were noted in meeting the needs of families, coordination, follow-up, and support with community resources. Improvements in key pediatric health care strategies for CNDD are recommended. CNDD and their families have multifaceted needs that require strong partnerships among parents, providers, and communities. Quality medical homes must include FCC and valued partnerships with diverse families and community-based providers.
administration and in interpreting the results, particularly in the context of previous bacille Calmette-Guérin (BCG) vaccination. 3 Of newly diagnosed patients with pulmonary tuberculosis, 10-25% will have false-negative skin tests. This is due to a combination of factors, including inadequate nutrition, the inability to react to skin tests due to immunosuppression or the release of specific cytokines liberated in active tuberculosis which inhibit the delayed hypersensitivity, severe tuberculosis or concomitant corticosteroid use.A whole-blood IGRA for the detection of LTBI is an in vitro T cell-based assay. The principal of the assay is that T cells of individuals previously sensitized with tuberculous antigen will produce IFN-c when they re-encounter mycobacterial antigens. Thus a high level of IFN-c production is presumed to be indicative of tuberculosis infection. Early assays used purified protein derivative as the stimulating antigen; however, newer assays use RD1 antigens specific to M. tuberculosis. These antigens are not shared with BCG or most nontuberculous mycobacteria. Currently, two methods exist for detecting the IFN-c released by the T cell: an enzyme-linked immunosorbent assay (e.g. QFT-TB) and an enzyme-linked immunospot assay (e.g. T-SPOT.TB; Oxford Immunotech, Abingdon, U.K.).A recent meta-analysis found that the new IGRAs were a useful diagnostic tool with excellent specificity in the diagnosis of LTBI but concluded that further research was required to define their use in high-risk populations. 4 A systematic review recommended the use of RD1 antigen-based assays in preference to those based on a TST for the diagnosis of LTBI, especially in the context of previous BCG vaccination or immunocompromise. 5 The U.S. Centers for Disease Control and Prevention published guidance for the use and interpretation of the QFT-TB test and recommend that these tests can be used safely in all circumstances in which the TST is currently used. 6 In summary, we found the QFT-TB test to be useful in the confirmation of suspected latent tuberculosis in the management of erythema induratum. These new IFN-c assays may provide a reliable and more easily administered alternative to TSTs.
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