Children's Rehabilitation Center Research Articles

HUBUNGAN PENGETAHUAN DENGAN PERILAKU PERSONAL HYGIENE PADA ANAK DI PANTI REHABILITASI YANG BERHADAPAN DENGAN HUKUM

Personal hygiene behavior is behavior that is carried out by someone to maintain personal hygiene to avoid diseases, especially skin diseases. This behavior cannot be separated from the knowledge that an individual has to help carry it out. This study aims to determine the relationship between knowledge and personal hygienic behavior in children at the Rehabilitation Center for Children in Conflict with the Law. A cross-sectional approach was used for this study, with a total of 60 participants. The results showed that respondents had good knowledge of personal hygiene, namely 29 people (48.3%), and good personal hygiene behavior, namely 29 people (48.3%). The Chi-square bivariate analysis showed a p-value of 0.360, more than the value of 0.05, which means that Ha is denied, so it can be concluded that there is no significant relationship between knowledge and personal hygiene behavior in children in rehabilitation institutions. The orphanages need to carry out strict monitoring and also support the fostered children regarding the importance of maintaining and caring for personal hygiene to avoid skin diseases so that it can generate motivation and enthusiasm for them to continue to routinely maintain personal hygiene.

Role of Dynamic Ultrasound Scan in Detection of Hip Instability and Changing Management Plan

Objectives: To show the vital role of dynamic ultrasound in hip instability screening and review the management plans available for DDH associated with instability with a view to reduce the incidence of complication from delayed diagnosis in our region. Place and Duration of the study: Helena governmental rehabilitation center for children with special needs, Erbil-Iraq, between Nov’21 to Jan’23. Material and Method: This study included 942 infants’ hips presenting with high-risk indicators or a positive clinical examination ranging in age from 6 weeks to 6 months. We performed the ultrasonography using the static Graf technique to determine the DDH Types and then apply the dynamic scan to find stability using Moren-Terjesen’s and Harcke methods. The management approaches were conducted considering both techniques. We used SPSS version 28 along with Chi-square test for data analysis and comparison of proportions. Results: In this retrospective cross-sectional study of 942 hips, the mean age of the infants was 11.9±4.8 weeks with male to female percentage of 46% to 54%. We found a correlation between family history and breech presentation to the dynamic scan stability. In the Graf technique 55% showed the absence of dysplasia while the dynamic scan showed 66% of the hips as normal and 34% as unstable. Further, the significant statistical association (P= 0.001) between the results of dynamic scan stability to the effect on the management plan was also found to advise the change for the unstable hips. Conclusion: It is crucial to apply both static and dynamic scans in the screening of DDH, so that we can reduce the possibility of late detection and elevate the level of diagnostic accuracy. We should follow a strict guideline for the management of all DDH cases (stable and unstable) and change the plan accordingly.

The architectural spaces of a children's rehabilitation center based on adaptive technologies

The architectural spaces of a children's rehabilitation center based on adaptive technologies

Factors predicting depressive symptoms in parents of children with autism spectrum disorder in eastern China

BackgroundParents of children with autism spectrum disorder (ASD) are at a higher risk of depression than parents of typically developing children and those of children with other developmental disorders. Depression affects the well-being and quality of life of parents of children with ASD and has serious consequences for the long-term health outcomes of children with ASD. Therefore, this study explored the current status of depressive symptoms in parents of children with ASD in eastern China and further analyzed multiple aspects of the predictors of depressive symptoms.MethodsA multicenter cross-sectional survey was conducted among parents of children with ASD in the rehabilitation department of a large specialized hospital and 10 rehabilitation centers for children with special needs in Lianyungang, Jiangsu Province, Eastern China. A structured questionnaire that focused on child-related factors, parent-related factors, depressive symptoms, courtesy stigma, and social support was used to obtain data. Binary logistic regression was used to identify the independent predictors of depressive symptoms in parents of children with ASD.ResultsA total of 409 parents of children with ASD were recruited, of whom 18.8% had depressive symptoms. Parents of children with ASD who raised a child who spoke few to no words (odds ratio [OR]: 2.747, 95% confidence interval [CI]: 1.026–7.357), claimed a high economic burden (OR: 3.215, 95% CI: 1.234–8.379), reported no change or increased severity of ASD in their children (OR: 2.518, 95% CI: 1.108–5.720), and those with a higher courtesy stigma score (OR: 1.189, 95% CI: 1.093–1.294) were more likely to have depressive symptoms. Conversely, parents of children with ASD who were employed (OR: 0.427, 95% CI: 0.201–0.907), satisfied with their current marital status (OR: 0.429, 95% CI: 0.221–0.834), and those with a higher social support score (OR: 0.973, 95% CI: 0.950–0.996) were less likely to have depressive symptoms.ConclusionsDepressive symptoms are common in parents of children with ASD in eastern China. Therefore, screening and intervention for depressive symptoms in parents of children with ASD is necessary, especially for those with high-risk factors.

Exploring the Caregiving Experiences and Challenges of Mothers of Children with Autism Spectrum Disorder (ASD) in Zhuhai City, Guangdong Province, China

The aim of this research was to explore the caregiving experiences and challenges of mothers of children with ASD in Zhuhai City, Guangdong Province, China. To achieve this aim, the research employed a qualitative design and used semi-structured interviews to facilitate the collection of rich, qualitative data regarding the experiences and challenges of mothers of children with ASD. The study population comprised mothers of children with ASD in Zhuhai City, Guangdong Province, China, and purposive sampling was used to select a suitable sample of 10 mothers that was used in the study. The participants were recruited from a rehabilitation center for children with ASD in Zhuhai, Guangdong Province, while thematic analysis was used to analyze the qualitative data collected from the sample of mothers of children with ASD. Overall, the results reveal that the main social challenges experienced by mothers of autistic children in the region include stigma, inadequate social support, as well as fatigue, stress & anxiety. In addition to revealing the challenges facing mothers of children with ASD, the results also revealed the main coping strategies that can be used by mothers of autistic children in addressing the major caregiving challenges and improving their health and well-being. Thus, this research has valuable implications for both theory and practice.

EXPERIENCE OF MEDICAL REHABILITATION OF CHILDREN WITH PERINATAL LESIONS OF THE CENTRAL NERVOUS SYSTEM AT THE STAGE OF CATAMNETIC OBSERVATION IN POLTAVA REGION

Introduction. According to World Health Organization statistics, perinatal lesion of the central nervous system is one of the main causes of childhood disability. The development and scientific substantiation of new non-medicinal technologies for the medical rehabilitation of children with perinatal lesions of the central nervous system is one of the priority tasks. Timely identification of developmental delays and early intervention are particularly crucial for premature infants, ultimately enhancing their future health outcomes.
 The purpose of this work is to determine the structure of morbidity and disability of children with perinatal lesion of the central nervous system at the stage of catamnetic observation and to assess the effectiveness of the early intervention program. Results and Discussion. The study included 4.118 children, 1.711 of them were children with a birth weight of more than 2.500 g, 1.812 with a low birth weight (1.500-2.499 g), 452 children with a very low birth weight (1.000-1.499 g), and 134 children with extremely low birth weight (<1000) registered in the catamnetic observation office of the Center of Specialized Pediatric Care at M.V. Sklifosovsky Poltava Regional Clinical Hospital according to the statistical and reporting documentation over the period for 2012 – 2022. During the last year, 282 children of the first year of life and 131 children from one to three years old, who had delayed motor and psycho-speech development, were referred to the rehabilitation center "Dolon’ka Dobra" for inclusion in the early intervention program. Conclusion. Timely identification of children with developmental disorders, the creation of personalized early intervention programs, their implementation, and the ongoing assessment of effectiveness continue to serve as the fundamental principles guiding the catamnestic office and the Children's Rehabilitation Center.

Courtesy stigma among primary caregivers of children with autism spectrum disorder in eastern China.

The experience and perception of stigma is a common problem among primary caregivers of children with autism spectrum disorder (ASD), and has a profound adverse impact on primary caregivers and children with ASD; however, few studies have explored courtesy stigma among primary caregivers of children with ASD in the Chinese context. The aim of this study was to explore the status of courtesy stigma among primary caregivers of children with ASD in Lianyungang, Jiangsu Province, Eastern China, and to conduct in-depth analysis of its predictors from multiple perspectives. An institution-based multi-center cross-sectional survey was conducted in the rehabilitation department of a large specialized hospital and 10 rehabilitation centers for children with special needs in Lianyungang, Jiangsu Province, Eastern China, from October 2022 to February 2023. A structured questionnaire to assess child-related factors, primary caregiver-related factors, courtesy stigma, general self-efficacy, and social support, was used to collect data. Predictors of courtesy stigma among primary caregivers of children with ASD were identified by linear regression. A total of 428 primary caregivers of children with ASD were recruited. The mean ± standard deviation (SD) score for courtesy stigma was 7.49 ± 4.13. Multiple linear regression analysis revealed that primary caregivers of children with ASD who were not too satisfied with their current marital status (β = 1.21, 95% CI: 0.34-2.08, p < 0.05) were more likely to have a high courtesy stigma; however, significantly lower courtesy stigma was observed in primary caregivers of children with ASD who were not picky eaters (β = -1.33, 95% CI: -2.08 - -0.58, p < 0.05), and who reported low level challenge in caring for children with ASD (β = -1.16, 95% CI: -2.20 - -0.12, p < 0.05), good general self-efficacy (β = -0.16, 95% CI: -0.25 - -0.06, p < 0.05), and good social support (β = -0.04, 95% CI: -0.08 - -0.01, p < 0.05). There is a high level of courtesy stigma among primary caregivers of children with ASD in eastern China, and it is affected by numerous factors. More resources should be directed to groups that are more likely to experience stigma.

Quality of Life Among Family Caregivers of Disabled Children in Saudi Arabia.

The physical and mental health of parents can be adversely affected by their child's disability, leading to a potential decline in their overall Quality of Life (QoL). This research aimed to determine the QoL of family caregivers and compare this based on sociodemographic factors and child characteristics. An analytical cross-sectional design was employed, and data were collected from multiple rehabilitation centers for children with special needs and learning disorders in the Kingdom of Saudi Arabia. The study sample comprised 95 family caregivers who completed a self-structured questionnaire. The questionnaire included sections on sociodemographic characteristics, child characteristics, and caregivers' QoL assessed using the RAND 36-Item Short Form Health Survey (SF-36). The collected data were analyzed using the IBM Corp. Released 2022. IBM SPSS Statistics for Windows, Version 29.0. Armonk, NY: IBM Corp, employing descriptive statistics and multivariate linear regression analysis. Our findings revealed that the overall mean QoL score among caregivers was 57, ranging from 12 to 94. There were no statistically significant differences in QoL scores based on caregivers' age, gender, occupational status, or income. However, further analysis indicated significant associations between certain factors and specific domains of QoL. Specifically, caregiver education was found to be associated with role limitations due to emotional problems, while relationships with disabled children were linked to emotional well-being. The severity of the child's disability and the presence of another child with a disability in the family were associated with the bodily pain domain. Additionally, the presence of another child with a disability had an impact on perceived change in the health domain. The QoL of family caregivers varied, highlighting the significant challenges faced by certain individuals. Factors such as education level, the relationship with the child, the severity of the disability, and the presence of multiple disabled children in the family were identified as influencing caregivers' QoL. These findings emphasize the importance of developing targeted interventions that can address emotional well-being and fatigue management while promoting a supportive society.

PERAN PEKERJA SOSIAL TERHADAP ANAK BERHADAPAN DENGAN HUKUM DI BALAI REHABILITASI SOSIAL ANAK MEMERLUKAN PERLINDUNGAN KHUSUS (BRSAMPK)

The purpose of this study was to obtain an overview of the duties or functions of social workers as advocates, counselors and educators in the social rehabilitation of children dealing with the law at BRSAMPK Toddopuli Makassar. The type of research used is descriptive with a qualitative approach. Data collection techniques, the primary data is done by structured and semi-structured interviews while the secondary data is by library research. The results of the study found that the role of social workers as advocates is one of the roles that is often used by social workers at the Toddopuli Children's Social Rehabilitation Center (BRSAMPK) to provide assistance to children who are in conflict with the law in court proceedings starting from preparing all children's social reports. and referrals if possible the child has other needs. The role of social workers as educators for children dealing with the law at the Toddopuli social rehabilitation center for children requiring special protection (BRSAMPK), namely providing education both knowledge and skills for empowering children, conducting supervision, compiling educational activities. The role of social workers as counselors for children dealing with the law is in the social rehabilitation center for children requiring special protection (BRSAMPK) Toddopuli, namely providing motivation to children, helping children to be responsible in solving or facing problems, providing suggestions and solutions to children so that children can immediately solve problems , formulate or discuss problems or conduct case conferences if the social worker does not find a solution to a child's problem.

The new prospects for the development of children cardiologic rehabilitation at sanatoriums of Yevpatoria health resort

The article discusses the prospects of rehabilitation of children with congenital cardiovascular anomaly, including those after surgery. The author provides evidence that it is essential to create a system of physical, psychological, and social rehabilitation for this category of patients at all stages of medical care: in hospital, at the sanatorium, and during the follow-up, taking into account the basic principles of rehabilitation (an early start, a stage-by-stage approach, coherence, continuity, consistency, individualization of the rehabilitation plan, etc.). The sanatorium treatment at the famous climatic and balneological children’s health resorts of the Black Sea coast appears to be the most physiologically relevant stage contributing to the improvement of the regulatory processes of cardiac activity and providing optimal results of restorative treatment and rehabilitation for the young patients with congenital heart defects in the remote postoperative period. The creation of the All-Russian Rehabilitation Center for children with cardiovascular pathology, including children after heart surgery, in the Republic of the Crimea should be considered in the context of the further development and implementation of measures in accordance with the List of Instructions of the President of the Russian Federation following the meeting of the Coordinating Council under the President of the Russian Federation on the implementation of the National Strategy of Action in the Interests of Children for 2012–2017 of March 31, 2017.

The Relationship Between Physical Factors and Architecture of Rehabilitation Educational Care Centers With the Quality of Rehabilitation Services in Children With Autism From the Perspective of Their Occupational Therapists and Parents

Background and Aims Autism is a common disorder among children. Physical and architectural factors of rehabilitation centers may affect the quality of rehabilitation. This study aims to investigate the effect of physical and architectural elements of educational and therapeutic spaces on autism rehabilitation. Methods The present analytical-observational research was cross-sectional. This study used the standard Minnesota Questionnaire (MSQ) to assess employees’ job satisfaction. The standard sensory profile questionnaire 2 (short form) was employed to determine the sensory function pattern of autistic children aged 3 to 14 years. Finally, a researcher-made questionnaire of architecture quality assessment was used to evaluate the quality of physical space architecture, interior architecture, and standard facilities of educational and therapeutic spaces. In this cross-sectional study, 32 occupational therapists from university and hospital treatment centers, welfare centers, and private clinics, and 50 parents of children with autism participated as the available sample group. The Pearson correlation coefficient was used to examine the relationship between variables. Results Findings from the study population showed significant relationships between the variables studied in the groups of sensation seeking, sensation avoiding, sensation sensitive, and sensation register (from the analysis of sensory profile) and improving the quality of rehabilitation of children with autism (P&lt;0.05). Conclusion According to the study findings, job satisfaction, physical factors, sensory processing, and assessing the quality of architecture in the design of educational and therapeutic spaces of rehabilitation centers for children with autism are of particular significance. Utilizing the factors studied in this study will not only positively affect the treatment process of these patients, but it will also increase the job satisfaction of occupational therapists working in rehabilitation centers for autism.

Piloting a Strengths-Based Intervention to Enhance the Quality of Life of Families Raising Children With Autism

A strengths-based perspective puts the resources of individuals, families, communities, and their environments, rather than their deficit needs, problems and pathologies, at the center of the social work helping process.&#x0D; This research was aimed at evaluating the effectiveness of an intervention developed on the basis of an approach based on the strengths of families raising children with autism in improving the family life quality, strengthening its capacity, expanding their rights and possibilities, and enhancing resilience.&#x0D; The experimental intervention was carried out at the Educational and Rehabilitation Center for Children with Autism “Dovira” (Lviv, Ukraine) and consisted of 12 group meetings. It had one experimental group (30 people) and two control groups (60 people).&#x0D; The results of pre- and post-intervention surveys demonstrate the encouraging evidences of the effectiveness of the strength-based intervention program in social work with families raising children with autism, which indicates the possibility of its application in the family social work practice, in particular with families raising children with autism and other developmental disorders.

44 Prevalence estimates of Cerebral Palsy among 4-year-old children living Manitoba, Births: 2013-2015

Abstract Background Cerebral palsy (CP) is the most common physical disability in children with an estimated prevalence of 2.1 per 1000 live births. Understanding the provincial prevalence of CP and describing clinical sub-types within Manitoba assists with planning future funding and ensuring adequate resources. Objectives This study aimed to determine the prevalence estimate of CP among 4-year-old children in Manitoba, and further describe children’s clinical presentation. Design/Methods As the Rehabilitation Centre for Children (RCC) is a referral site for all Manitoba children requiring multidisciplinary evaluation/treatment for CP, this retrospective study used RCC’s electronic medical records to identify all 4-year-old children who had a confirmed CP diagnosis, were living in Manitoba and were born between Jan 2013 to Dec 2015. To ensure provincial data was complete, information was cross-referenced with the Pediatric Neurology Clinic’s medical records and the Neonatal Follow-up database. Prevalence rate was determined using Government of Manitoba denominators of same age children. The Gross Motor Function Classification system (GMFCS) determined the child’s level of functioning Results The prevalence of CP in Manitoba (birth years 2013-2015) for 108 4-year-old-children is 2.05 (95% CI1.7, 2.5) per 1000 4-year-old children. Of the 108 4-year-old children with CP, 6 (5.6%) had a post neonatal cause, while 102 (94.4%) had a perinatal cause; and 51/108 (47%) were born preterm. Motor subtypes for 108 children are: Spastic 99 (91.7%) including hemiplegia 41.4%, diplegia 21.2%, triplegia 8.1%, and quadriplegia 29.3%; Dyskinetic 4 (3.7%); Ataxic 3(2.8%) and Hypotonic 2 (1.8%). 58/108 (54%) were independent ambulators (GMFCS level II/II). Conclusion Our provincial rate of CP is consistent with the prevalence reported in developed countries. Understanding the clinical presentation assists in informing treatment and resources for children with CP in our province.

Effect of Acupuncture at Lumbar Huatuo Jiaji Point Combined with Exercise Rehabilitation on Sitting Ability of Children with Cerebral Palsy

Objective: To provide a new method for improving the sitting ability of children with cerebral palsy by using traditional acupuncture at the lumbar Huatuo Jiaji point combined with exercise rehabilitation. Methods: A total of 30 children with cerebral palsy aged 1-3 years old who were admitted to the Children's Rehabilitation Center of rehabilitation Medicine Department of Jingzhou First People's Hospital from June 2020 to February 2022 were selected as the research objects, and they were divided into observation group (n = 15) and control group (N = 15). GMF 88 gross motor Rating Scale and sitting ability (LSS) grading were performed in both groups. Observation group only routine exercise rehabilitation training. The control group was treated with acupuncture at lumbar Huatuo Jiaji point on the basis of exercise rehabilitation. 2 groups, once a day,10 times a course of treatment. The next course of treatment was continued at an interval of 1 week, and the treatment lasted for 3 courses. Before and after treatment, the sitting function area (B) and sitting ability (LSS) of GMFM88 gross motor function assessment were evaluated, and the differences were compared. Results: In the first course of treatment, there was no statistical significance in the total effective rate between the observation group and the control group (P&gt;0.05). After the second and third courses of treatment, the total effective rate in control group was higher than that in observation group, and the difference was statistically significant (P&lt;0.05). Conclusion: Acupuncture at lumbar Huatuo Jiaji point combined with exercise therapy can significantly improve the sitting ability of children with cerebral palsy.

Emotional and behavioral problems in children with autism spectrum disorder and psychological distress in their parents in Saudi Arabia: The moderating effect of marital relationship satisfaction

BackgroundThere is a well-established association between emotional and behavioral problems in children with Autism Spectrum Disorder (ASD), unmet family support needs, and psychological distress in their parents. However, no studies hypothesized a buffering effect of marital relationship satisfaction. AimThe aim of this research was to investigate the moderating effect of marital relationship satisfaction in the associations among emotional and behavioral problems in children with ASD, unmet family support needs, and anxiety and depression of their parents in the context of Saudi Arabia. Design and methodsThis cross-sectional study recruited parents from five rehabilitation centers for children with ASD in Saudi Arabia. Data were collected with surveys completed online. A sample of 93 parents (84% female, 4.3% were 24 or younger, 36.2% between 25 and 34 years old, 40.5% between 35 and 44, and 14.7% between 45 and 54) of children with ASD was obtained. Two models of multiple regression analysis were performed to determine the relationships. ResultsAbout 56% of the parents had anxiety symptoms and 60% had depressive symptoms. Emotional and behavioral problems of children and higher levels of unmet family support needs were associated with higher levels of anxiety in parents, and adaptive behavior of children was associated with reduced levels of depression in parents. Relationship satisfaction moderated the impact of children's emotional and behavioral problems on parental anxiety. Conclusion and implicationsThe study highlighted the importance of marital relationship satisfaction in buffering the negative effects of ASD-related factors of children on the psychological well-being of their parents.

“Does Change Last?”: Evaluating the Strengths-Based Intervention for Families Raising Children with Autism

The study evaluated the effectiveness of the intervention for families raising children with autism aimed to improve the family’s quality of life, strengthen its capacity, and expand rights and opportunities. The experimental intervention was implemented at the Educational and Rehabilitation Center for Children with Autism “Trust” (Lviv, Ukraine). It had one experimental group (30 people) and two control groups (60 people). The effectiveness and duration of the intervention effects were assessed using a before/after study design with the same questionnaire. Findings from the survey evidence the effectiveness of the intervention, in particular, for expanding the family’s capabilities, its capacity, improving relationships in family subsystems, increasing parental competence, and improving well-being. Limitations of the intervention are discussed.

Stress, anxiety and depression in parents of children with autism spectrum disorders in Kazakhstan: prevalence and associated factors.

Studies worldwide reported increased levels of stress among parents of children with autism due to the unique caregiving challenges. While research has shown that parents' and autistic child's demographics and behavioral characteristics are associated with psychological distress among caregivers of children with autism, very few studies have investigated the impact of the caregiver's unmet needs on various aspects of the perceived family burden. This cross-sectional study examined the prevalence of stress, anxiety and depressive symptoms among a wide range of 146 parents with different sociodemographic characteristics, social support and unmet needs who care for children with autism spectrum disorder. These parents were recruited from autism non-governmental organizations and the National Children's Rehabilitation Center in Astana, Kazakhstan, a post-Soviet country in Central Asia. Multiple linear regression analyses were utilized to examine the relationship of parental psychological distress variables with social support, unmet needs and parental and child sociodemographic characteristics. Significantly higher levels of stress and depression were reported among parents who perceived their needs as being unmet or extremely unmet as addressed by societal acceptance as compared to parents who reported adequate levels of needs met by social acceptance. Employed parents and parents with a higher level of perceived friends' support had less symptoms of stress, anxiety, and depression. Increasing public awareness about autism and providing early detection and interventions for distressed caregivers of children with autism may be helpful in improving healthy functioning of parents and the entire family.

METHODOLOGICAL BASES OF A.S. MAKARENKO’S PEDAGOGY AND HUMANISTIC GUIDELINES OF MODERN EDUCATION

The article deals with the methodological sources and humanistic guidelines of modern education. The philosophical bases of A.S. Makarenko’s pedagogy and pedagogical ideas of G.V. Mohnenko are presented. New approaches to eliminating bad habits such as smoking, alcoholism and drug addiction are shown in modern conditions. The purpose of the study is to identify and systematize humanistic guidelines and dimensions, their meaning and prospects in modern education. In his colonies A.S. Makarenko organized a humanistic and democratic micro-society. One of his main pedagogical ideas was the education of the individual in the team and through the team. The young teacher tokk interest in philosophical works, literature, psychology, history and other sciences, in particular, the works by Bergson, Schopenhauer, Nietzsche and others. The idea of pedagogical expediency was successfully implemented in the practice of A.S. Makarenko, and is closely intertwined with the concept of "common sense" by Henri Bergson. The article considers the following principles of Makarenko's pedagogy: parallel action, i.e. influence on the personality through the team, reliance on positive in the pupil’s personality, perspective lines in the development of the team, "tomorrow's joy" and others. Nowadays, new societal challenges have emerged that require new approaches to education in the context of the spread of alcoholism, smoking and drug addiction. An important and interesting experience is the approaches of Gennady Viktorovich Mokhnenko, an innovative teacher, the founder and head of the largest children's rehabilitation center "Republic Pilgrim" and a network of rehabilitation centers for adults.

Determining the Interrater Reliability of the SOFMER Activity Score (version 2) for Individuals in Rehabilitation Centers

ObjectiveTo assess the interrater reliability of the SOFMER Activity Score (SAS) (version 2 [v2], an 8-item [4 motor and 4 cognitive] and 5-level scale) and improve its scoring system before conducting further validation steps. DesignCross-sectional, prospective, observational, noninterventional, and multicentric study. SettingThe study was conducted between November 2018 and September 2019 in 4 French rehabilitation centers (2 public university hospitals for adults and 2 private not-for-profit rehabilitation centers for children). ParticipantsThe study included 101 participants (N=101; mean age, 44.5±25.4 years; 28.7% younger than 18 and 18.8% older than 65 years). The female/male sex ratio was 0.6. The causes for admission to the center were mainly neurologic (65%) or orthopedic (24%). InterventionsNone. Main Outcome MeasuresActivity limitation was rated with the SAS the same day by 2 independent multidisciplinary teams. The interrater reliabilities of the score items were assessed using weighted kappa coefficients. ResultsAll weighted kappa coefficients ranged between 0.83 and 0.92, indicating “good” to “excellent” interrater reliability. Interteam score disagreements occurred in 227 of 808 scores (28%). The reason for most disagreements was unnoticed human or material aid during the observation period. ConclusionsThe results demonstrate the high interrater reliability of the SASv2 and allow carrying out further validation steps after minor changes to item scoring instructions and clearer definitions of some items that help improving scoring standardization. The SASv2 may then become a consistent measure of activity level for clinical research or burden of care investigations.

Toxoplasma gondii Infection Among Institutionalized Children with Down syndrome in Sana'a city, Yemen: Implications of Low IgG Seroprevalence.

PurposeTo assess the IgG seroprevalence of Toxoplasma gondii as an indicator of past exposure and immunity against infection among children with Down syndrome (DS) in Sana’a city, Yemen. This preliminary study is justified by the primary immunodeficiency of children with DS and the opportunistic nature of the parasite, considering the vague situation of anti-Toxoplasma IgG seroprevalence among children with DS because of neglecting its study on local and global scales.MethodsThis descriptive, facility-based, cross-sectional study was conducted among 107 children with DS hosted in six randomly selected rehabilitation centers for children with special needs in Sana’a city. Demographics of children and their mothers’ knowledge of toxoplasmosis were collected using a pre-designed, structured questionnaire. Anti-Toxoplasma IgG antibodies were measured in the sera of children using electrochemiluminescence assay.ResultsOf 107 children with DS, 3 (2.8%) were seropositive for anti-Toxoplasma IgG. Approximately two-thirds (71/106) of the mothers of children with DS were aware of toxoplasmosis. Of whom, 83.1% (59/71) were aware of its congenital complications.ConclusionThe majority of children with DS in Sana’a city are seronegative for anti-Toxoplasma IgG, where the seropositivity rate is lower than 3.0%. Therefore, children with DS are non-immune and susceptible to the acquisition of primary infections during their life. Further analytical studies are recommended to determine whether the defective immune response of children with DS is associated with false seronegativity, to assess the role of their mothers’ knowledge in reducing their exposure to infection if they were confirmed truly seronegative and to identify the predictors of infection among them.