Hand In Children Research Articles

Impact of hand hygiene interventions on handwashing practices and microbial risk: A study in an orphanage-based school in Pakistan

Orphaned children are often deprived of quality care, making them more susceptible to diseases due to inadequate hand hygiene. The study aimed to assess the prevalence of hand hygiene practices and detect bacterial loads on children's hands before and after hygiene interventions in an orphanage school. The study enrolled all the orphan children registered with the Save Our Souls children's orphanage school in Pakistan. Handwashing practices and swab samples from the hand was collected to evaluate the impact of handhygiene practices on bacterial load. The Quantitative Microbial Risk Assessmentmodel was used to predict the health risk. The study identified the 2 most common bacteria: Staphylococcusaureus and Escherichiacoli. The bacterial contamination was significantly reduced after the intervention (Saureus 166 Colony-forming unit (CFU) /mL and Ecoli 185 CFU/mL). The higher bacterial ingestion rate was attributed to hand contamination and increased bacteria transfer from hand to mouth. The multicomponent hand hygiene intervention showed improvement in accessibility to hand hygiene resources and practices. The findings underscore the need for hygiene interventions in orphanage schools to improve health and educational outcomes.

Penerapan Terapi Bermain Boneka Tangan terhadap Tingkat Kecemasan Hospitalisasi pada Anak Usia Prasekolah di RSUD Ir. Soekarno Kabupaten Sukoharjo

Hospitalization anxiety experienced by preschool children causes an increase in anxiety due to actions that cause trauma, children's hand puppets can explore the feelings they are experiencing. Objective: To determine the results of the implementation of hand puppet play therapy on the level of hospitalization anxiety in preschool children at the Ir. Soekarno Sukoharjo Regional Hospital. Method: This study used 2 respondents according to the inclusion and exclusion criteria, the method used pre-test and post-test, by providing hand puppet play therapy for 2 days carried out once a day for 30 minutes. Results: Results of the implementation of hand puppet play on hospitalization anxiety in preschool age children on day 1 of An. A got a score of 37 in the heavy category and An. B got a score of 28 in the heavy category. On the 2nd day on An. A got a score of 25 in the medium category and An. B got a score of 15 in the light category. Where the two patients before application were at a severe anxiety score and experienced a decrease in anxiety scores to moderate and mild. Conclusion: Hand puppet play therapy can reduce anxiety levels in children with hospitality.

The Bead Maze Hand Function Test for Children.

There is a need for a pediatric hand function test that can be used to objectively assess movement quality. We have developed a toy-based test, the Bead Maze Hand Function (BMHF) test, to quantify how well a child performs an activity. This is achieved by assessing the control of forces applied while drawing a bead over wires of different complexity. To study the psychometric properties of the BMHF test and understand the influence of age and task complexity on test measures. A cross-sectional, observational study performed in a single visit. Clinical research laboratory. Twenty-three participants (ages 4-15 yr) were recruited locally. They were typically developing children with no illness or conditions that affected their movement. Interventions/Assessments: Participants performed the BMHF test and the Box and Block test with both hands. Total force and completion time were examined according to age and task complexity using a linear mixed-effects model. We calculated intraclass correlation coefficients to measure interrater reliability of the method and estimated concurrent validity using the Box and Block test. Total force and completion time decreased with age and depended on task complexity. The total force was more sensitive to task complexity. The Box and Block score was associated with BMHF completion time but not with total force. We found excellent interrater reliability. A familiar toy equipped with hidden sensors provides a sensitive tool to assess a child's typical hand function. Plain-Language Summary: We developed the Bead Maze Hand Function (BMHF) test to determine how well a child performs an activity with their hands. The BMHF test is a toy equipped with hidden sensors. Twenty-three typically developing children with no illnesses or conditions that affected their hand movement participated in the study. We asked the children to perform the BMHF test with both hands. Our study found that occupational therapists can reliably use the BMHF test to assess a child's hand function.

Exposure of Young Children to Permethrin and Cypermethrin Insecticides in the Residential Environment.

The aims of this study were to evaluate the exposure to permethrin and cypermethrin of young children aged between 2 and 5 years in Nakhon Pathom and Sing Buri provinces, Thailand. A questionnaire that included general demographic information, household characteristics, insecticide usage and exposure-related behavior in children was used to interview parents or family caregivers. Permethrin and cypermethrin concentrations on floor surfaces and children's hands, as well as their urinary metabolites, were analyzed by gas chromatography coupled with mass spectrometry. The results showed that permethrin and cypermethrin were detected in 62% and 83% of the children's hand wipe samples, with geometric mean (GM) levels of 0.02 µg and 0.04 µg, respectively. Permethrin and cypermethrin were detected in 79% and 93% of floor surface wipe samples, with GM levels of 0.90 µg/m2, and 1.49 µg/m2, respectively. For children's urine, the GM concentrations of cis- and trans-DCCA, 3-PBA, and total pyrethroid metabolites were 0.84, 0.31 and 1.23 nmol/g creatinine, respectively. This study found that household insecticide product usage and having a tile floor were associated with increased permethrin concentrations on the children's hands and floor surfaces. However, cypermethrin concentrations on floor surfaces were significantly higher in families using aerosol insecticide sprays and insecticide products in the living room and bedroom. The predictors of the total pyrethroid, DCCA and 3-PBA metabolites are permethrin on children's hands or floor surfaces and cypermethrin on floor surfaces.

Methodologies for the collection of parameters to estimate dust/soil ingestion for young children.

Heavy metals, pesticides and a host of contaminants found in dust and soil pose a health risk to young children through ingestion. Dust/soil ingestion rates for young children can be estimated using micro-level activity time series (MLATS) as model inputs. MLATS allow for the generation of frequency and duration of children's contact activities, along with sequential contact patterns. Models using MLATS consider contact types, and transfer dynamics to assign mechanisms of contact and appropriate exposure factors for cumulative estimates of ingestion rates. The objective of this study is to describe field implementation, data needs, advanced field collection, laboratory methodologies, and challenges for integrating into and updating a previously validated physical-stochastic MLATS-based model framework called the Child-Specific Aggregate Cumulative Human Exposure and Dose (CACHED) model. The manuscript focuses on describing the methods implemented in the current study. This current multidisciplinary study (Dust Ingestion childRen sTudy [DIRT]) was implemented across three US regions: Tucson, Arizona; Miami, Florida and Greensboro, North Carolina. Four hundred and fifty participants were recruited between August 2021 to June 2023 to complete a 4-part household survey, of which 100 also participated in a field study. The field study focused on videotaping children's natural play using advanced unattended 360° cameras mounted for participants' tracking and ultimately conversion to MLATS. Additionally, children's hand rinses were collected before and after recording, along with indoor dust and outdoor soil, followed by advanced mass analysis. The gathered data will be used to quantify dust/soil ingestion by region, sociodemographic variables, age groups (from 6 months to 6 years), and other variables for indoor/outdoor settings within an adapted version of the CACHED model framework. New innovative approaches for the estimation of dust/soil ingestion rates can potentially improve modeling and quantification of children's risks to contaminants from dust exposure.

Application of Health Education Program based on Intelligent Recommendation Algorithm in the Development of School-age Children's Hand Hygiene Behavior

The cultivation of hand hygiene behavior among school-age children is an important way to prevent the spread of diseases and ensure children’s health. However, traditional health education methods lack personalized programs tailored to each child, which cannot effectively improve their hand hygiene awareness and behavior. In response to this issue, the study combines multi-objective particle swarm optimization algorithm to provide personalized hand hygiene behavior development recommendations for school-age children, improving their hand hygiene awareness and behavioral level. The study adopted multi-objective particle swarm optimization algorithm and convolutional neural network, combined with the personalized needs of school-age children and the goal of cultivating hand hygiene behavior, and proposed a health education plan based on intelligent recommendation algorithm. Through deep learning, match the hand hygiene needs of school-age children with corresponding health education plans to achieve personalized recommendations. The average accuracy of the health education recommendation plan for hand hygiene behavior cultivation of school-age children based on multi-objective particle swarm optimization algorithm reaches 99.07%. Meanwhile, after introducing convolutional neural networks, the feature matching error between the recommended scheme and school-age children ranges from 10-1 to 10-2. After testing, the designed algorithm performs more stably and has less fluctuations under different sparsity conditions. Health education solutions based on intelligent recommendation algorithms can provide personalized solutions for school-age children, effectively cultivate their hand hygiene behavior, and meet various health needs.

The Influence of Weaving Activities on Self-Identity Development in Kindergarten: Exploring Early Childhood Enrichment

The fine motor development of children aged 5-6 years at the ABA Kindergarten Kedai Manggeng Aceh Barat Daya experiences several obstacles in the development of their fine motor skills, and this is indicated by the child's hands still being stiff when holding a pencil and cutting not according to the pattern. So, this research aims to determine the effect of weaving activities with coconut leaves on the development of the identity of children aged 5-6 years at the ABA Kedai Manggeng Kindergarten, Aceh Barat Daya. This quantitative research uses a pre-experimental design through approach one group pre-test post-test design. The sample used was all group B1 students (29 people) taken using random sampling techniques. Data collected based on observation results obtained an average value pretest amounted to 52.06%, and the average value posttest obtained 75.10%, so the resulting normality test is 0.233 > 0.05. Based on this data, the value of tcount > ttable is 16.949 > 1.04841, So it can be stated that Ha accepted and HO. Based on these data, it can be concluded that weaving activities can influence the development of children's identity at the Kedai Manggeng ABA Kindergarten, Aceh Barat Daya. .

Children's exposure to halogenated flame retardants and organophosphate esters through dermal absorption and hand-to-mouth ingestion in Swedish preschools

Children are exposed to endocrine disrupting chemicals (EDCs) through inhalation and ingestion, as well as through dermal contact in their everyday indoor environments. The dermal loadings of EDCs may contribute significantly to children's total EDC exposure due to dermal absorption as well as hand-to-mouth behaviors. The aim of this study was to measure potential EDCs, specifically halogenated flame retardants (HFRs) and organophosphate esters (OPEs), on children's hands during preschool attendance and to assess possible determinants of exposure in preschool indoor environments in Sweden. For this, 115 handwipe samples were collected in winter and spring from 60 participating children (arithmetic mean age 4.5 years, standard deviation 1.0) and analyzed for 50 compounds. Out of these, 31 compounds were identified in the majority of samples. Levels were generally several orders of magnitude higher for OPEs than HFRs, and 2-ethylhexyl diphenyl phosphate (EHDPP) and tris(2-butoxyethyl) phosphate (TBOEP) were detected in the highest median masses, 61 and 56 ng/wipe, respectively. Of the HFRs, bis(2-ethyl-1-hexyl)-2,3,4,5-tetrabromobenzoate (BEH-TEBP) and 2,2′,3,3′,4,4′,5,5′,6,6′-decabromodiphenyl ether (BDE-209) were detected in the highest median masses, 2.8 and 1.8 ng/wipe, respectively.HFR and/or OPE levels were found to be affected by the number of plastic toys, and electrical and electronic devices, season, municipality, as well as building and/or renovation before/after 2004. Yet, the calculated health risks for single compounds were below available reference dose values for exposure through dermal uptake as well as for ingestion using mean hand-to-mouth contact rate. However, assuming a high hand-to-mouth contact rate, at the 95th percentile, the calculated hazard quotient was above 1 for the maximum handwipe mass of TBOEP found in this study, suggesting a risk of negative health effects. Furthermore, considering additive effects from similar compounds, the results of this study indicate potential concern if additional exposure from other routes is as high.

32 HANDFULS: A New Clinically Feasible Measure of Hand Outcome for Children with Burns and Trauma

Abstract Introduction Fine motor dexterity is important for children's normal hand function and development. In-hand manipulation (the collection and repositioning of items in the hand) and palmar workspace (functional volume in the palm) are two aspects of hand function that often become simultaneously impaired after hand trauma or burn injury. Rehabilitation emphasizes recovery of these hand functions yet few functional outcome measures address both of these constructs and even fewer are appropriate for children. Methods This study developed a new hand outcome measure to specifically assess these constructs and tested it on 192 children between the ages of 2-21. The test, called ‘HANDFULs’, uses simple instructions and inexpensive materials (i.e. marbles) shown in Figure 1. Means, standard deviations, and 95% confidence limits were estimated for children in seven age groups. Associations between age and the HANDFULs variables were examined using one-factor ANOVA. Multiple regressions were fit to test for associations between age and the HANDFULs variables after controlling for height, hand size, and hand strength. A stepwise selection procedure was then implemented, holding age into the model, to remove otherwise non-significant variables. Test-retest reliability was tested with the Shrout Fleiss Reliability Index and significance was set at p< 0.05. Results Expected normal values are reported in Figure 2 for palmar workspace volume (marbles that fit in the hand) and in-hand manipulation (collection time per marble) by age group. Age (0.16 (0.06), p=0.009), hand span (0.47 (0.09), p< 0.0001) and hand width (0.9 (0.29), p=0.003) were significantly associated with number of marbles that fit in the hand, representing palmar workspace capacity. Although hand strength and size characteristics were tested, only age (-0.02 (0.01), p=0.001) was significantly associated with the HANDFULs score of time per marble. The Intraclass Correlation Coefficient was 0.94 demonstrating excellent test-retest reliability. Conclusions This study developed a new pediatric hand outcome measure to address hand function to address a gap related to burn and trauma recovery. The measure was tested on able-bodied, noninjured children to establish validity and reliability, provide reference values for patients with injuries by age groups, and is clinically feasible to administer. Applicability of Research to Practice Outcome test for burn injured hands.

Clinical experience of using loop threads for tendon suturing of injured tendons of finger flexors in children's hands

BACKGROUND: Despite a significant progress in hand surgery, to date, the number of unsatisfactory functional outcomes in patients with injured flexor tendons of fingers still remains high, which underlines the importance and significance of the problem of flexor tendon repair in children. CLINICAL CASE DESCRIPTION: The authors present a series of clinical cases with the application of loop threads for suturing tendons in children with tendon injuries in deep finger flexors at different anatomical sites. They share their experience in using loop threads for tendon suturing in zones II, III, IV, V including tendon end reinsertion in zone I again with a loop thread. The primary task of surgical treatment of children with injured tendons of finger flexors is their restoration. In order to prevent secondary tendon ruptures, finger contractures, infectious complications and scarring of the tendon with surrounding tissues, it is recommended to use optimal suture material and surgical sutures that meets the basic requirements for tendon suturing . Specific pediatric anatomy must be taken into consideration as well. As the authors' clinical experience shows, a new approach to the restoration of injured finger flexor tendons with loop threads allows to avoid complications in 98% of cases. CONCLUSION: The implementation of loop tendon suturing into pediatric practice in combination with appropriate rehabilitation and motivation for the rehabilitation of a child and his/her parents opens up new prospects for the successful treatment of children with injured tendons of deep flexors of hand fingers.

Hand Castings of Children With Terminal Illnesses From Cancer Can Provide Comfort to Grieving Families.

Registered nurses have voluntarily created hand casts for families, providing comfort during challenging moments. Hand casting moves the patient's family and nurses. As requested by parents, staff apply a quick-drying gel to sick children's hands and feet. After preparing the gel mold, alginate molding powder is poured in and hardened for many days. Parents mourn their children with great sensitivity. Every mold and hospital bedside we go to offers closure to the lost child's dying moments. A compelling benefit of a three-dimensional hand-cast is preserving a passing moment.

Is detection of enteropathogens and human or animal faecal markers in the environment associated with subsequent child enteric infections and growth: an individual participant data meta-analysis

Quantifying contributions of environmental faecal contamination to child diarrhoea and growth faltering can illuminate causal mechanisms behind modest health benefits in recent water, sanitation, and hygiene (WASH) trials. We aimed to assess associations between environmental detection of enteropathogens and human or animal microbial source tracking markers (MSTM) and subsequent child health outcomes. In this individual participant data meta-analysis we searched we searched PubMed, Embase, CAB Direct Global Health, Agricultural and Environmental Science Database, Web of Science, and Scopus for WASH intervention studies with a prospective design and concurrent control that measured enteropathogens or MSTM in environmental samples, or both, and subsequently measured enteric infections, diarrhoea, or height-for-age Z-scores (HAZ) in children younger than 5 years. We excluded studies that only measured faecal indicator bacteria. The initial search was done on Jan 19, 2021, and updated on March 22, 2023. One reviewer (AM) screened abstracts, and two independent reviewers (AM and RT) examined the full texts of short-listed articles. All included studies include at least one author that also contributed as an author to the present Article. Our primary outcomes were the 7-day prevalence of caregiver-reported diarrhoea and HAZ in children. For specific enteropathogens in the environment, primary outcomes also included subsequent child infection with the same pathogen ascertained by stool testing. We estimated associations using covariate-adjusted regressions and pooled estimates across studies. Data from nine published reports from five interventions studies, which included 8603 children (4302 girls and 4301 boys), were included in the meta-analysis. Environmental pathogen detection was associated with increased infection prevalence with the same pathogen and lower HAZ (ΔHAZ -0·09 [95% CI -0·17 to -0·01]) but not diarrhoea (prevalence ratio 1·22 [95% CI 0·95 to 1·58]), except during wet seasons. Detection of MSTM was not associated with diarrhoea (no pooled estimate) or HAZ (ΔHAZ -0·01 [-0·13 to 0·11] for human markers and ΔHAZ -0·02 [-0·24 to 0·21] for animal markers). Soil, children's hands, and stored drinking water were major transmission pathways. Our findings support a causal chain from pathogens in the environment to infection to growth faltering, indicating that the lack of WASH intervention effects on child growth might stem from insufficient reductions in environmental pathogen prevalence. Studies measuring enteropathogens in the environment should subsequently measure the same pathogens in stool to further examine theories of change between WASH, faecal contamination, and health. Given that environmental pathogen detection was predictive of infection, programmes targeting specific pathogens (eg, vaccinations and elimination efforts) can environmentally monitor the pathogens of interest for population-level surveillance instead of collecting individual biospecimens. The Bill & Melinda Gates Foundation and the UK Foreign and Commonwealth Development Office.

Prevalence oftrachomatous inflammation-follicular and associated factors among children aged 1-9 yearsin northeastern Ethiopia.

Trachoma is the most prevalent eye disease in Ethiopia, especially among children aged 1-9 years and continues to be a public health concern. Nevertheless, in Ethiopia's rural Jamma district in South Wollo Zone of Amhara Regional State, factors associated with trachomatous inflammation-follicular (TF) among children aged 1-9 yearshave not yet been studied. A community-based cross-sectional study was conducted among 616 children aged 1-9 years in rural Jamma district in Ethiopia from January-March, 2019. Data were collected using a pre-tested structured questionnaire, an observation checklist and clinical examination of study participants for active trachoma. The presence of TF and trachomatous inflammation-intense (TI) was clinically assessed by integrated eye care workers using the World Health Organization simplified grading system. Data were analysed using SPSS (Statistical Package for Social Sciences) Version 25.0. A logistic regression model with 95% CI was used. From the multivariable analysis, variables with p-value < 0.05 were declared as associated factors of TF. The prevalence of TF was 10.9% (95% CI [8.6 - 13.6%]) among the rural children aged 1-9 years.The mean family size was 5.5 ± 1.9 persons. About one-fifth (20.6%) of households kept domestic animals overnight in the same room as family. Almost one-sixth (17.5%) of the children involved in this study had an ocular discharge. Two-thirds of the children (68.8%) washed their hands once per day and just over half (55.8%) washed their faces once per day. From multivariable analysis, we found that the presence of domestic animals kept overnight in the same room as the family (adjusted odds ratio [AOR] = 4.32; 95%CI [2.49-9.52]), mother's/caregiver's illiteracy (AOR = 2.01; 95%CI [1.11-4.67]), household size (> 7 persons) (AOR = 3.50; 95%CI [1.66-8.50]), washing of children's hands and face without soap (AOR = 2.41; 95%CI [1.29-5.18]), feces observed in the compound (AOR = 5.10; 95%CI [2.01-10.14]), presence of ocular discharge (AOR = 7.23, 95%CI [4.10-12.51]) and nasal discharge (AOR = 4.54, 95%CI [1.95-9.26]) were significantly associated with TF. The prevalence of TF among rural children aged 1-9 years in this study was almost two times higher than the WHO-recommended threshold (TF < 5%) for trachoma elimination and beyond the trachoma control target (TF < 10%). Presence of domestic animals kept overnight in the same room as the family, mother's/caregiver's illiteracy, household size (> 7 persons), washing of children's hands and face without soap, feces observed in the compound, presence of ocular and nasal discharge were significantly associated with TF. We recommended interventions that will help household income to be improved to enable families to be able to construct separate rooms in which to keep animals overnight. Furthermore, we also recommend to policy makers to design mechanisms for enhancement of behavioural change among householdersto keep household compounds clean and creating awareness among mothers/caregivers about prevention of trachoma.

A BÁBOZÓ GYEREK TITKA, AVAGY A BÁBU MINT A LÉLEK KIHANGOSÍTÓJA

According to Teréz Virág (1998) a psychologist with regard to the 'mysteries' of the power of the puppet, three different spheres are worth investigating, namely the mysteries of the puppets, that of the child who plays with the object, and that of the puppeteer's. She views puppetry as creation, the puppeteer as the life-giver, and the puppet as an object of transition. When the aim is to develop the artistic methods as well as explore the 'general utility' of puppetry, it is worth further focusing on segments such as the making of the puppet, acting with the puppet, and perceiving the puppet play. These are three different viewpoints and three approaches. The study presents that the puppet in the child's hand is capable of embodying incomprehensible and insufferable feelings as well as making the unknowable accessible. In pedagogy today puppet play is believed to undoubtedly have a developmental impact, argued for widely with conventions, but it seems that there is still a lack of sincerely understanding of the being of the puppet and its mechanism of action, its principal essence. In my study, I elaborate on the questions of why and how puppet play can be of assistance, and what the puppet can actually mean in the child's hands. The puppet is an object, that makes a motion as it is assuming a role and takes action while portraying this role, it substitutes for someone or something. Being the puppet presupposes a space for the play, in which it takes the place of this someone/something by replacing what it represents. The primary goal of the study is to show that by playing with an object, a puppet lays a bridge in an abstract way between the visible and the invisible world, enabling thus art pedagogy to develop the child with its complex mode of action. The psychological mechanism of identification is best characterized by the eagerness to act, and the artistic genre of puppet play, providing the stage for action, is eminently capable of satisfying this urge. In the creative process, the approach of animation, the metaphorical thinking of the puppeteer, the abstraction as well as the development of the related assertive skills rely on all the operations of thinking; also, the simultaneity of the multi-lateral perception, the complex interpretation of communication play important roles.

Empowering Coloring Program at Preschool Pelita, Tumbang Randang Village, Timpah Sub-District

In Desa Tumbang Randang, a significant number of children struggled to distinguish and correctly color pictures or sketches. Recognizing coloring as a crucial skill for kindergarten children, a Community Engagement (PkM) initiative was launched. This program aimed to enhance children's coloring abilities, focusing on image texture sensitivity, finger adaptation, sensory awareness, and vocabulary expansion through the introduction of colors and image types. The research assessed children's development before and after participating in guided coloring activities. Initial observations noted that some children were rarely involved in such activities. The project's dream was to enable children to competently apply color combinations. During the design phase, mentors physically guided the children's hands, teaching them to color within boundaries. The define phase involved observing each child's color combination skills and their ability to express these on paper. This initiative, running from August 7 to 11, 2023, also aimed to benefit parents, locals, and village officials. It was conducted by IAKN Palangka Raya students through a cross-program educational approach. The results indicated improvements in the children's abilities to color pictures, compare and combine colors, and articulate color names using colored pencils. Additionally, the children exhibited increased independence and self-confidence, as evidenced by their artwork displayed on walls, celebrating their creative achievements.

Pairing transcutaneous vagus nerve stimulation with an intensive bimanual training in children and adolescents with cerebral palsy: study protocol of a randomized sham-controlled trial.

Gross motor function impairments and manual dexterity deficits are frequently observed in children and adolescents with Cerebral Palsy (CP), having a major impact on their activity level and autonomy. Improving manual dexterity and activity level of patients with CP is often the focus of rehabilitation. Novel and adjuvant treatment methods that could support the standard training also in chronic conditions are a research priority. The transcutaneous Vagus Nerve Stimulation (tVNS) is a non-invasive brain stimulation technique, which provides a bottom-up stimulation of subcortical and cortical brain structures, enhancing brain GABA and Noradrenaline levels. This technique may play a pivotal role in brain plasticity, which has not been tested in CP patients before. 44 children and adolescents with CP will be involved, treated in pairs in a randomized, double-blind, pre-post test study. The two groups will undergo the Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) for 2 consecutive weeks, with 3 h daily sessions for 5 days per week, for an overall time interval of 30 h; the training will be combined with the application for 75 min/day of active or sham tVNS, in separate, randomly allocated groups. The primary outcome measure will include the scores at the Assisting Hand Assessment and Box and Block Test, and at an ad-hoc visuomotor task evaluating manual visuomotor control. Secondary outcomes will include the scores at the Children's Hand Experience Questionnaire, Canadian Occupational Performance Measure, Melbourne Assessment of Unilateral Upper Limb Function, Gross Motor Function Measure, Vineland, Pediatric quality of life inventory. The evaluation points will include pre (T0), post (T1) and 3-month follow up (T2) assessments. Safety and tolerability will also be assessed. The results of this trial will assess whether tVNS can effectively boost the effects of an intensive two-week bimanual training, in improving manual dexterity in children and adolescents with cerebral palsy, ensuring safety and tolerability throughout the intervention period.Clinical trial registration: ClinicalTrials.gov, NCT06372028.

Paediatric hand function assessment practices of occupational therapists in South Africa

Introduction: South African occupational therapists' assessment practices of children's hand function are unknown, although the treatment thereof is an integral part of the paediatric scope of practice and clientele. Hand function assessment frameworks and instruments are available, but a lack of contextually relevant, comprehensive standardised instruments was identified. The study aimed to investigate occupational therapists' current paediatric hand function assessment practices and their preferences towards future practice. Methods: A quantitative, cross-sectional study design using convenient and snowball sampling was employed. An EvaSysco survey system, custom-developed online questionnaire, was used to collect information. Results: In total, 194 HPCSA-registered occupational therapists participated. All the participants currently rely on informal observations. Although not exclusively designed for hand function, standardised developmental tests were often used. Limited familiarity with and use of t he available published hand function assessment instrument was reported. Future assessment preferences supported a standardised, comprehensive hand function assessment instrument for different age groups and paedi atric conditions. Conclusion: This study provides baseline evidence of current and preferred paediatric hand fu net ion assessment practices used by occupational therapists. The need for training to use the available published instruments was highlighted. Recommendations towards the refinement of existing or the development of a standardised, contextually relevant instrument for paediatric practice in South Africa are offered. Implications for practice This article offers a deeper understanding of available paediatric hand function assessment frameworks, assessment instruments, and practices of occupational therapists. It provides an outline of existing methods therapist use and offersclear directives for how the South African OT would prefer to assess hand function in eh ildren. Emphasis is placed on the need for a contextually relevant instrument and future research in refining existing instruments or developing a new instrument is proposed. Additionally, practitioners provided practical suggestions to guide the development of a contextually relevant instrument for potential use in future instrument development research.

WASH practices increased the prevalence of malnutrition among under-five children (6–59 months) in an urban slum area in Ibadan, Nigeria

Abstract Access to safe water, proper sanitation, and hygienic practices are fundamental to the growth and survival of children. This study assessed the relationship between water, sanitation, and hygiene (WASH) practices and the nutritional status of children aged 6–59 months in the Beere/Oja-Oba community, Ibadan, Oyo State. This cross-sectional study involved 200 mothers/caregivers with under-five children. WASH practices were assessed using an interviewer-administered questionnaire. Anthropometric measurements were taken and analyzed using WHO Anthro. Data were analyzed using SPSS at p &amp;lt; 0.05. The mean age of the children was 24.91±10.52, and the majority were females (77.5%). Prevalence of stunting (44.0%), wasting (37.5%), and underweight (34.0%) were high among the children. Well (71.5%) and tap/borehole (74.0%) were the major sources of domestic and drinking water respectively, and required 5–15 min (36.9%) to source. The occurrence of diarrhea was high (48.5%) among the children. Time to drinking water source and washing a child's hands before feeding were WASH practices significantly associated with stunting (p = 0.000) and underweight (p = 0.003) among the children from lower socio-economic households (p = 0.045). Access to unsafe water was significantly associated with child malnutrition. There is a need to educate and encourage mothers/caregivers to improve their hygiene practices in the community.

Effect of handwashing on the reduction of Escherichia coli on children's hands in an urban slum Indonesia.

Poor hand hygiene practice has been linked to an increase in the number of infections among children in urban slums. Hands are considered an intersection for bacterial transmission, but it is unclear whether the handwashing technique affects bacteria elimination. This study investigated the effect of handwashing on the concentration of Escherichia coli (E. coli) and factors related to its reduction among children in an urban slum in Bandung, Indonesia. We observed handwashing and conducted repeated hand swabs before and after handwashing among 137 participants. The mean E. coli concentration on the hands decreased after handwashing, with a higher reduction in E. coli count among students who used soap and had soap contact for more than 10 s during handwashing. Cleaning in-between fingers, using soap, soap contact for more than 10 s, and drying hands with a single-use towel were effective factors for reducing E. coli concentration after handwashing (p < 0.05). More than half of the swab samples (59%) tested positive for E. coli after handwashing, indicating that the children's handwashing technique was not effective in completely removing E. coli from the hands. Moreover, sustained and consistent handwashing practice as a daily behavior in children would maximize the effect.

Evaluating Outcome of Surgical Centralization for Radial Club Hand in Children

Background: Various types of osteotomy have been proposed to treat Radial club hand. We reviewed the results of Ulnar osteotomy, Centralization, and tendon transfer. Methods: Between 2000 and 2011, we treated 32 cases of Radial club hand with two Variants Variation 1 (n= 23): ulnar osteotomy; Variation 2 (n=9): without osteotomy; There were 23 patients. Male 10 and Female: 13. Unilateral: 14. Bilateral: 9. Mean age at Operation: 33 months and Follow Up: 56 months. We compared Wrist-Forearm, Hand-Forearm angles before and after surgery, range of motion for all patients. Results: Surgical Centralization on all patients, and Ulnar Osteotomy on 23 forearms. The Patients was Operated according to separated two Variants; there were 23 Variant 1, mean Ulnar bow: 38.68° ±3.583 (33.6° – 45.2°); and there were 9 Variant 2. mean Ulnar bow: 28.15° ± 3.176 (25.7°—28.4°)without ulnar osteotomy. There were 14 patients with unilateral: 8 (57.1%) in V1, and 6 (42.9%) in V2. There were 9 patients with bilateral (18 radial club hand): 15 (83.3%) in V1, and 3 (16.7%) in V2. Compared results on V1 and V 2 with P-values are not significant. Conclusion: Centralization and Ulnar osteotomy technique for operative treatment of the radial club hand is presented. The improved mechanical forces are further stabilized by transposition of the radial wrist extensor and flexor; this favors a better muscle balance.