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The sample consisted of black adolescents who were members of the Columbia-Presbyterian chapter of the Collaborative Perinatal Project from birth to age 7. At age 17, subjects and their parents were administered a battery of instruments that included standardized psychiatric diagnostic interviews as part of a call-back study. Results from least-squares and logistic regression analyses were compatible with the hypothesis that deficiencies in cognitive functioning are causally related to adolescent conduct disorder as defined by DSM III. The results suggested that the relation of cognitive functioning to psychiatric status appears to be specific to conduct disorders. The results were incompatible with a "third" variable hypothesis (third factors included neurological status and environmental disadvantage) and the hypothesis that conduct problems lead to deficits in cognitive functioning. The 3 most (and equally) important factors in accounting for age-17 conduct disorder were cognitive functioning, parent psychopathology, and early aggression. A closer look at the data tentatively suggested that a broad deficiency in acculturational learning, rather than narrowly focused social cognitive differences or native endowment, constitutes a key element in the link between cognitive functioning and conduct disorder. Test bias was ruled out as a possible explanation for the results. [ABSTRACT FROM AUTHOR]

An abstract of the article "Cerebral oxygen delivery, brain growth and white matter maturation are reduced in congenital heart disease fetuses," by J. Lim and colleagues is presented.

An abstract of the article "Preliminary investigation of the utility of MRI for measuring the hematocrit in fetal anemia," by A. Duan and colleagues is presented.

An abstract of the article "Fetal brain to liver volume ratio measured by MRI is a useful indicator of IUGR in vivo in late gestation," by A. Duan and colleagues is presented.

A shortage of board-certified developmental-behavioral pediatricians generates a bottleneck for children and families who seek autism diagnostic services. Wait time for autism evaluation commonly exceeds a year. To improve access, clinicians developed a coordinated Developmental-Behavioral Pediatrics and Pediatric Neurology autism diagnostic pathway. For a subset of children referred to neurology clinic, pediatric neurologists completed the medical part of an autism evaluation and Knights of Columbus Developmental Center psychologists or speech-language pathologists completed developmental assessments. Forty-four autism diagnostic evaluations completed through this coordinated pathway over the course of six months had shortened wait time [mean=50.89 days; range 3 to 184 days; median= 48.50 day]. Parents reported satisfaction with the autism evaluation and resources navigation process. Sustainability and scalability efforts are discussed., Competing Interests: Disclosure No financial disclosures reported. Artificial intelligence was not used in the study, research, preparation, or writing of this manuscript., (Copyright 2024 by the Missouri State Medical Association.)

Background: Fetuses with cyanotic congenital heart disease (CHD) exhibit profound fetal circulatory disturbances that may affect early outcomes., Objectives: This study sought to investigate the relationship between fetal hemodynamics and early survival and neurodevelopmental (ND) outcomes in patients with cyanotic CHD., Methods: In this longitudinal observational study, fetuses with cyanotic CHD underwent late gestational fetal cardiovascular magnetic resonance (CMR) to measure vessel blood flow and oxygen content. Superior vena cava (SVC) flow was used as a proxy for cerebral blood flow. Primary outcomes were 18-month mortality and Bayley Scales of Infant Development-III assessment., Results: A total of 144 fetuses with cyanotic CHD were assessed. By 18 months, 18 patients (12.5%) died. Early mortality was associated with reduced combined ventricular output (P = 0.01), descending aortic flow (P = 0.04), and umbilical vein flow (P = 0.03). Of the surviving patients, 71 had ND outcomes assessed. Cerebral oxygen delivery was the fetal hemodynamic variable most strongly associated with cognitive, language, and motor outcomes (P < 0.05). Fetal SVC flow was also associated with cognitive, language, and motor outcomes (P < 0.01), and it remained an independent predictor of cognitive (P = 0.002) and language (P = 0.04) outcomes after adjusting for diagnosis. Diminished SVC flow also performed better than other fetal CMR and echocardiographic predictors of cognitive ND delay (receiver-operating characteristic curve area: 0.85; SE 0.05)., Conclusions: Among fetuses with cyanotic CHD, diminished fetal combined ventricular output is associated with mortality, whereas cerebral blood flow and oxygen delivery are associated with early cognitive, language, and motor development at 18 months of age. These results support the inclusion of fetal CMR to help identify patients at risk of adverse ND outcomes., Competing Interests: Funding Support and Author Disclosures This work was supported by Canadian Institutes of Health Research Operating Grant MOP: 142204. The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Cognitive bias may appear in occupational therapists' interpretation of physical examinations. Since different strategies for decision making have been shown to reduce bias, its quantification is an essential first step towards awareness and bias reduction. Our aims: (1) quantify cognitive bias by testing the differences in occupational therapists' assessment of lateral pinch force modulation between young and older adults, and between women and men; and (2) to test for a correlation between the tendency to bypass an intuitive response and the degree of cognitive bias., Methods: Occupational therapists (n = 37; age 40.3 ± 11.4 years) used a visual analogue scale to rate pre-recorded simulations of the digital output of lateral pinch modulation videos of different levels of abilities coupled with videos of young/old men/woman pressing the force sensor. They filled out the Cognitive Reflection Test and the Rational-Experiential Inventory-40., Results: Subjects showed higher bias towards old individuals compared to young ones ( p < 0.001), but with no sex bias ( p = 0.119). Rational ability correlated with cognitive bias of assessment of lateral pinch modulation in old individuals (r = 0.537, p < 0.001)., Discussion: Occupational therapists might underestimate the physical abilities of older adults. Biased evaluation might cause assignment of redundant exercises and therefore loss of time, effort, and resources.

One of the recommendations for individuals with knee osteoarthritis (OA) is the use of specific footwear, such as sturdy or cushioned shoes. However, the long-term use effects of using cushioned shoes on the pain and spatiotemporal gait parameters in individuals with knee OA are yet to be reported. We therefore aimed to compare the efficacy of cushioned sport footwear versus sham shoes on motor functions, pain and gait characteristics of individuals with knee OA who used the shoes for 3 months. In a double-blinded study, we provided 26 individuals with knee OA with cushioned sport shoes and 12 individuals with knee OA with similar sport shoes without cushioning for 3 months. The gait analysis, the timed up and go (TUG) test and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were conducted and the pain levels were measured at the baseline, 1 month, and 3 months after the baseline. We found that the cushioned shoes reduce the amount of pain (based on WOMAC) in the affected knee and increase functionality in the research group, but not in the control group. Gait velocity and cadence were increased in both groups. Gait spatiotemporal parameters and their symmetry were unaffected during the intervention. We conclude that the use of cushioned shoes should be recommended to individuals with knee OA for alleviating pain.

When lockdown was announced in the United Kingdom, kitchen tables transformed into offices overnight, as many National Health Service (NHS) workers adapted to new ways of working from home. To respond to the developing situation, we established a programme of weekly 'Connections' meetings where staff could be together, remotely. This article describes the evolution of our Morning Connections and Oncology Connections virtual meetings, including the content of sessions, how they were evaluated and whether they met their intention to support colleagues during a particularly challenging time, both personally and professionally, for NHS staff.

Introduction and Aims: The Beads of Life (BOL) approach uses a narratively informed methodology 'to enable children and young people to make sense of their cancer journey in ways that make them stronger'. We will share feedback from BOL groups and reflect on changes made over time., Method: Between 2014 and 2019, we have run 14 groups. Participants were aged 13-25, had received a diagnosis of cancer and were either on or had completed treatment. Quantitative and qualitative feedback was gathered at each workshop and 1 month later, with qualitative data then being analysed using thematic analysis., Results: 106 young people attended the groups. Young people reported that sharing experiences of cancer was useful, that they enjoyed the group and that they were highly likely to recommend it to others. Feedback remained consistent a month post-intervention. Qualitative feedback showed the value young people placed on meeting others, sharing their stories and on things they learnt about themselves from the group., Discussion: Themes support the intention of the intervention to provide a safe space for young people to share and reflect on their cancer journey, to connect with others and to enable peer support and mutual learning.

Collective Narrative practices, such as Tree of life and Beads of life groups, have intentions of bringing people together to share their specialist knowledge and build a sense of community. We wanted to respond to the COVID-19 pandemic through making these groups accessible online to young people living with health conditions in order to counter the social isolation and disconnectedness created by the pandemic. This paper discusses our specific online adaptations for both these groups as well as online 'Peer training' events. Young people who have participated in a group are invited to join the project as peer trainers who help facilitate, engage group participants, witness their stories and consult to the project. We have included the voices of two of our peer trainer consultants on their experiences. We also briefly reflect on the recent development of trialling hybrid groups.

Introduction and Aims: Mindfulness has been shown to be an effective group intervention for adults and children living with a range of medical conditions. Recently, research has also explored the impact of mindfulness interventions offered to parents of children with health conditions. Few studies have examined whether the mode of delivery (face-to-face vs online) has an impact on outcomes., Methods: Four mindfulness based wellbeing courses for parents (MBWP) of children with a chronic medical condition were run (two face to face and two online). All parents ( N =37) completed the WHO Well-being Questionnaire and Neff Self-Compassion Scale Questionnaire-Short Form at the beginning and end of each course. Parents' experience of the course was also explored using a semi-structured interview 6 weeks after completing the course, with their responses analysed using Thematic analysis., Results: The groups had a statistically significant positive impact on both parent well-being and self-compassion and were equally effective face-to-face or online. All parents reported incorporating informal mindfulness practices into their day-to-day lives 6 weeks post-course The qualitative analysis highlighted improvements in present moment focus, kindness to self, and family relationships., Discussion and Conclusion: Parents valued connecting with other parents of young people with both similar and different medical conditions, within both face-to-face and online groups, increasing the accessibility of MBWP.

'Away Days' in the National Health Service are a protected time away from usual tasks where a team comes together. They can have different intentions, including connecting team members and establishing team bonds. This paper describes using a Narrative Therapy approach called "The Journey of Life" to run away days. It involves thinking about the journey a team has been on and what has helped them along the way. It invites a team to think about their future directions and how they use skills they have learned when they face obstacles in the road ahead. The importance of preparing for away days, including establishing intentions, creating a feeling of safety and thinking about the role and positioning we adopt as team members ourselves is highlighted. We also outline the benefits we have observed, including a sense of community emerging through the process.

Background: Children with developmental coordination disorder (DCD) often experience difficulties with handwriting legibility and speed. This study investigates the relationship between handwriting and upper limb kinematics to characterize movement patterns of children with DCD and typically developing (TD) children. Methods: 30 children with and without DCD matched for age, gender, and parent education were compared across handwriting abilities using a standardized handwriting assessment of both copied and dictated tasks (A-A Handwriting). The 3D motion capture system (Qualysis) was used to analyze upper limb kinematics and characterize movement patterns during handwriting and contrasted with written output. Results: Children with DCD wrote fewer legible letters in both copying and dictation. Children with DCD also showed poor automatization of key writing concepts. Atypical wrist postures were associated with reduced legibility for children with DCD (F (1,27) 4.71, p = 0.04, p-η2 = 0.15); whereas for TD children, better legibility was associated with greater variations in movement speed, particularly of the wrist (rho = −0.578, p < 0.05). Conclusion: Results reflect different movement parameters influencing handwriting in children with DCD. An improved understanding of the movement characteristics during handwriting of these children may assist intervention design.

Virtual reality enables the manipulation of a patient's perception, providing additional motivation to real-time biofeedback exercises. We aimed to test the effect of manipulated virtual kinematic intervention on measures of active and passive range of motion (ROM), pain, and disability level in individuals with traumatic stiff shoulder. In a double-blinded study, patients with stiff shoulder following proximal humerus fracture and non-operative treatment were randomly divided into a non-manipulated feedback group (NM-group; n = 6) and a manipulated feedback group (M-group; n = 7). The shoulder ROM, pain, and disabilities of the arm, shoulder and hand (DASH) scores were tested at baseline and after 6 sessions, during which the subjects performed shoulder flexion and abduction in front of a graphic visualization of the shoulder angle. The biofeedback provided to the NM-group was the actual shoulder angle while the feedback provided to the M-group was manipulated so that 10° were constantly subtracted from the actual angle detected by the motion capture system. The M-group showed greater improvement in the active flexion ROM ( p = 0.046) and DASH scores ( p = 0.022). While both groups improved following the real-time virtual feedback intervention, the manipulated intervention provided to the M-group was more beneficial in individuals with traumatic stiff shoulder and should be further tested in other populations with orthopedic injuries.

Importance: Executive function (EF) deficits are common after traumatic brain injury (TBI). During rehabilitation, it is important to identify EF deficits and understand their impact on daily function. The internet-based Bill-Paying Task, modified from the Executive Function Performance Test, has not yet been validated for use with people with TBI., Objective: To examine the known-groups, convergent, and ecological validity of the internet-based Bill-Paying Task for assessing EF deficits after TBI., Design: Cross-sectional study with two consecutive parts based on the study's objectives., Setting: Inpatient rehabilitation and community., Participants: Part 1 included 42 adults with TBI and 47 healthy adults; Part 2 included 28 of the 42 adults with TBI., Measures: Assessments included the Internet-based Bill-Paying Task, WebNeuro neurocognitive computerized battery, Semantic Verbal Fluency test, Behavioural Assessment of the Dysexecutive Syndrome (BADS), Dysexecutive Questionnaire (DEX), and cognitive items of the FIM® and the Functional Assessment Measure (cognitive FIM+FAM)., Results: For Part 1, participants with TBI required significantly more cues and longer completion time to perform the internet-based Bill-Paying Task. For Part 2, moderate significant correlations were found between the internet-based Bill-Paying Task total score and the WebNeuro, Semantic Verbal Fluency test, BADS, DEX, and cognitive FIM+FAM., Conclusions and Relevance: This study supports the known-groups, convergent, and ecological validity of the internet-based Bill-Paying Task for assessing EF deficits among adults with preserved basic cognitive abilities after TBI. Therefore, it can be used to assist with rehabilitation treatment planning after TBI. What This Article Adds: The internet-based Bill-Paying Task, an online payment task relevant to today's technological world, is valid to assess higher cognitive abilities of people after a traumatic brain injury. This assessment may contribute to a better understanding of patients' cognitive profiles and their potential impact on daily performance., (Copyright © 2022 by the American Occupational Therapy Association, Inc.)

Patients with Coronavirus-2019 (COVID-19) manifest many neuromuscular complications. We evaluated the correlations between electromyography and nerve conduction measurements among COVID-19 patients and the severity of the initial infection, as well as the rehabilitation outcomes, and searched for the factors which best predict the rehabilitation outcomes. A total of 19 COVID-19 patients (16 men; mean ± SD age 59.1 ± 10.4), with WHO clinical progression scale of 6.8 ± 2.3, received rehabilitation for 3.9 ± 2.5 months. The Functional Independence Measure (FIM), the 10 m walk test, the 6 minute walk test, and grip force were collected before and after the rehabilitation period. Motor Nerve Conduction (MNC), Sensory Nerve Conduction (SNC) and electromyographic abnormalities were measured. All of the MNC measures of the median nerve correlated with the WHO clinical progression scale and duration of acute hospitalization. The MNC and SNC measures correlated with the rehabilitation duration and with FIM at discharge. The MNC distal latency of the median and the peroneal nerves and the MNC velocity of the median and tibial nerves predicted 91.6% of the variance of the motor FIM at discharge. We conclude that nerve conduction measurements, especially in COVID-19 patients with severe illness, are important in order to predict prognosis and rehabilitation outcomes.

Background: The guitar-playing community is the largest group at risk of developing playing related musculoskeletal disorders. A thorough investigation of the relationships between the various risk factors and players' report on musculoskeletal pain using objective and accurate means of assessment has yet to be reported., Purpose: (a) to explore the correlations between demographic characteristics, anthropometric measurements, playing habits, and personal habits of guitar player and their complaints of musculoskeletal pain, (b) explore the correlations between the upper body kinematics of guitar players during playing the guitar and their complaints of musculoskeletal pain, and (c) compare the upper body kinematics of guitar players during playing the guitar while sitting versus standing., Methods: Twenty-five guitar players (27.5±4.6 years old) filled out questionnaires regarding their guitar-playing habits, and the Standardized Nordic Questionnaires for the analysis of musculoskeletal symptoms. Kinematics of their torso and upper limbs were tracked while they played a tune twice, once while sitting and once while standing., Results: We found moderate correlations between the number of painful joints in the last year and factors, such as physical comfort while playing, years of playing, and position during playing. During standing, lower back pain severity correlated with the rotation range of the torso, while during sitting, it moderately correlated with the average radial-ulnar deviation of the right wrist. During sitting, we found higher anterior and right tilt of the torso, combined with greater abduction of the right shoulder, higher flexion in the left shoulder and higher radial deviation in the left wrist., Conclusion: Our results point to several risk factors, related both to playing habits but also to playing posture, which should be considered by the guitar players in order to prevent playing-related musculoskeletal disorders., Competing Interests: The authors have declared that no competing interests exist.

Purpose: Our aim was to evaluate the Microsoft Kinect sensor (MKS) as a markerless system for motion capture and analysis of lower limb motion, compare it with a state-of-the-art marker-based system (MBS), and investigate its accuracy in simultaneously capturing several lower limb joint movements on several planes while participants walked freely. Method: Participants were asked to walk while gait data were simultaneously recorded by both the MKS and the MBS. Software for analysing the Kinect data stream was developed using Microsoft Visual Studio and Kinect for Windows software development kits. Visual three-dimensional (3D) C-Motion software was used to calculate 3D joint angles of the MBS. Deviation of the joint angles calculated by the two systems was calculated using root-mean-square error (RMSE) on the basis of a designated formula. Results: The calculated RMSE average was <5° between the two systems, a level of difference that has practically no clinical significance. Conclusions: Quantitative measurements of the joint angles of the knee and hip can be acquired using one MKS with some accuracy. The system can be advantageous for clinical use, at the pre- and post-treatment stages of rehabilitation, at significantly lower costs. Further evaluation of the MKS should be performed with larger study populations., (© Canadian Physiotherapy Association.)

Individuals with post-polio syndrome (PPS) suffer from falls and secondary damage., Aim: To (i) analyze the correlation between spatio-temporal gait data and fall measures (fear and frequency of falls) and to (ii) test whether the gait parameters are predictors of fall measures in PPS patients., Methods: Spatio-temporal gait data of 50 individuals with PPS (25 males; age 65.9 ± 8.0) were acquired during gait and while performing the Timed Up-and-Go test. Subjects filled the Activities-specific Balance Confidence Scale (ABC Scale) and reported number of falls during the past year., Results: ABC scores and number of falls correlated with the Timed Up-and-Go, and gait cadence and velocity. The number of falls also correlated with the swing duration symmetry index and the step length variability. Four gait variability parameters explained 33.2% of the variance of the report of falls ( p = 0.006). The gait velocity was the best predictor of the ABC score and explained 24.8% of its variance ( p = 0.001)., Conclusion: Gait variability, easily measured by wearables or pressure-sensing mats, is an important predictor of falls in PPS population. Therefore, gait variability might be an efficient tool before devising a patient-specific fall prevention program for the PPS patient.

Introduction: During daily functions, our wrist moves through an oblique plane, named the dart-throwing motion (DTM) plane. This plane is considered a more stable plane because the proximal carpal row remains relatively immobile. However, rehabilitation programs that incorporate exercising in the DTM plane have yet to be explored., Purpose of the Study: The purpose of this study was to evaluate the rehabilitation outcomes after treatment in the DTM plane compared with outcomes after treatment in the sagittal plane after distal radius fracture., Study Design: This is a pilot randomized controlled trial., Methods: Subjects after open reduction internal fixation were assigned into a research group (N = 12; ages 48.7 ± 7.3) and a control group (N = 12; ages 50.8 ± 15). The control group activated the wrist in the sagittal plane, whereas the research group activated the wrist in the DTM plane. Range of motion, pain levels, functional hand motor skills tests, and satisfaction from self-training exercise were measured before and after a 12-session intervention., Results: The outcome measures were similar between the treatment groups. The research group reported significantly higher satisfaction rates than the control group on topics such as general satisfaction (research group: 3.4 ± 0.7, control group: 2. 5 ± 1.2, P = .030), motivation to exert oneself (research group: 2.8 ± 1.0, control group: 2.3 ± 1.2, P = .009), progressed function (research group: 3.4 ± 0.7, control group: 2.4 ± 1.1, P = .012), and self-training contribution to the daily function (research group: 3.4 ± 0.7, control group: 2.5 ± 1.2, P = .030)., Discussion and Conclusion: Pilot results do not favor one treatment method over the other. However, exercising in the DTM plane may contribute to the satisfaction of the client and increase self-training motivation., (Copyright © 2020 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)