Effects of passive smoking on students at College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh.

BACKGROUND: Despite the recent campaigns to eliminate smoking, the rates are still increasing world-wide. Exposure to passive smoking (PS) is associated with morbidity and mortality from awful diseases. Although many college students smoke, little is known about their exposure to PS, common places and sources of exposures in Saudi Arabia. AIM: The aim of the following study is to identify prevalence and magnitude of PS among college students, exposure time, locations, sources of exposure, investigate the effects and make recommendations. MATERIALS AND METHODS: A cross-sectional study was performed to identify factors associated with PS exposure among students of College of Applied Medical Sciences, Riyadh. RESULTS: Out of 61 students included in the study, 91.8% were found exposed to PS. Exposure in Hospitality venues (Estirah) was the most common followed by other areas. Among the sources of exposure, the highest was among friends and the least were parents and guests. The frequency of highest exposure per month was >15 times and the lowest was 10-15 times. Levels of annoyance varied between 18% and 37.7%, respectively. Since the values obtained for different markers in the pulmonary function test are more than the predicted values, the observed spirometry is normal. The percent oxygen saturation in hemoglobin and blood pressure of PS were in normal range. CONCLUSION: Since the properties of mainstream smoke and environmental tobacco smoke are quite different, risk extrapolation from active to PS is uncertain, especially during a short period. Nevertheless, it can be deteriorating during a longer duration, hence; the administrators, policy makers and tobacco control advocates may endorse policies to restrict smoking in shared areas, particularly working environment.

Efficacy of constraint-induced movement therapy and bimanual training in children with hemiplegic cerebral palsy in an educational setting.

We examined the efficacy of modified constraint-induced movement therapy (CIMT) and hand-arm bimanual intensive therapy (HABIT) in a special education preschool/kindergarten in Israel. Twelve children (1.5-7 years) with congenital hemiplegic cerebral palsy were randomized to receive modified CIMT (n = 6) or HABIT (n = 6). Occupational and physical therapists administered usual and customary care for 8 weeks; children then crossed over to receive CIMT or HABIT 2 hr/day, 6 days/week for 8 weeks from their occupational therapist. The Assisting Hand Assessment and Quality of Upper Extremity Skills Test were administered 2 months prior to the intervention, immediately before, immediately after intervention, and 6 months after the first baseline assessment. Both groups demonstrated no change during baseline and comparable improvement following CIMT and HABIT (p < .001), which was maintained at 6-month follow-up. Results suggest that modified CIMT and HABIT provided in school-based settings can lead to improvements in quality of bimanual skill and movement patterns.

Non-surgical Intervention of Knee Flexion Contracture in Children with Spina Bifida: Case Report.

[Purpose] The purpose of this case report is to describe for the first time, the use of serial casting in the management of knee joint flexion contracture for a young child with spina bifida. [Case Description] The child was 6 years old, and had L3-L4 spina bifida level lesion with quadriceps muscle strength grade 3 +. The child had previously received weekly physiotherapy including stretching for knee flexion contracture on both lower limbs, but without improvement. [Results] The knee flexion contracture, which was not corrected with passive stretching, improved with casting from -40° knee extension to -5° knee extension as measured by a standard goniometer over a period of 4 weeks. Careful measures were taken to ensure skin integrity. At follow up after one-year, the child could ambulate independently with the help of walking aids. [Conclusion] The outcome indicates that using serial casting and follow-up with the use of bracing may be useful for enhancing the walking ability of a young child with spina bifida with knee flexion contractures. Further investigations of serial casting as well as investigation of serial casting with other interventions are warranted.

Factors influencing job satisfaction among Jordanian occupational therapists: a qualitative study.

PURPOSE: The main purpose of this study was to explore factors influencing job satisfaction and dissatisfaction among Jordanian occupational therapists. METHODS: Ours was an explorative qualitative study involving the use of structured open-ended written questions. Participants were asked to answer in narrative their perception about the factors behind their job satisfaction and dissatisfaction. In addition, they were asked to express their suggestions, ideas, or solutions for increasing job satisfaction. RESULTS: Ninety-three occupational therapists responded to the survey. For job satisfaction questions, four themes emerged: a humanistic profession; professional issues; work benefits; and work environment. Participant's comments at the end of the survey revealed one general theme for improving job satisfaction, 'a call for improvement'. DISCUSSION: This qualitative study revealed that the humanistic nature of occupational therapist was counterbalanced by several dissatisfying factors for occupational therapy practitioners in Jordan. The need for better supported working conditions in terms of financial rewards, recognition, awareness and resources as well as public and professional recognition of occupational therapists are needed to enhance the occupational therapy profile in Jordan. A comprehensive collaboration is highly needed between the individual practitioners, representatives of the profession, government and hospital administrators.

Implementation of constraint-induced movement therapy for young children with unilateral cerebral palsy in Jordan: a home-based model.

PURPOSE: The aim of this study was to investigate the feasibility of implementing constraint-induced movement therapy (CIMT) in Jordan, a country with a different culture to that of the western world where CIMT has previously been investigated. METHOD: Twenty children with unilateral cerebral palsy (CP) were randomised to either CIMT or neurodevelopmental treatment (NDT). NDT is the usual treatment method in Jordan for children with CP and was used in the control group. Fourteen children fulfilled the treatment; mean age was 47 months (SD 19 months) in the CIMT group and 65 months (SD26 months) in the NDT group. Jordanian therapists learned the CIMT method in a 2-day workshop. CIMT was based on 2-h per day for eight weeks, with the families being responsible for the training aside from a weekly session with the therapist, i.e. a home-based model. Children in the NDT group had 2 h of training per week by therapists. RESULTS: Hand function, measured with Assisting Hand Assessment on a scale of 0-100 AHA-units, improved from 41.6 (12.6) to 48 (11.6) in the CIMT group and from 56 (18.7) to 56.6 (18.8) among controls. ANOVA show a group effect of treatment (F(1,12) = 7.77; p = 0.016). CONCLUSIONS: A treatment effect of CIMT can be seen after a 2-day workshop in a novel environment.

Effectiveness of motor learning coaching in children with cerebral palsy: a randomized controlled trial.

OBJECTIVE: To evaluate effectiveness of motor learning coaching on retention and transfer of gross motor function in children with cerebral palsy. DESIGN: Block randomized trial, matched for age and gross motor function. SETTING: Coordinated, multinational study (Israel, Jordan and Palestinian Authority) in schools and rehabilitation centers. SUBJECTS: 78 children with spastic cerebral palsy, gross motor functional levels II and III, aged 66 to 146 months. INTERVENTIONS: 1 hr/day, 3 days/week for 3 months treatment with motor learning coaching or neurodevelopmental treatment: two groups. MAIN MEASURES: Gross motor function Measure (GMFM-66), stair-climbing mechanical efficiency (ME) and parent questionnaire rating their child's mobility. Immediate treatment effects were assessed after 3 months and retention determined from follow-up measurements 6 months after treatment. RESULTS: GMFM-66, ME and parent questionnaires were obtained from 65, 31 and 64 subjects, respectively. Although both groups increased GMFM-66 score over 3 months, measurements 6 months later indicated retention was significantly superior by 2.7 in the motor learning coaching children of level-II. Similar retention trend was evident for ME, increasing 6 months after motor learning coaching by 1.1% and declining 0.3% after neurodevelopmental treatment. Mobility performance in the outdoors and community environment increased 13% from 3 to 9 months after motor learning coaching and decreased 12% after neurodevelopmental treatment. Minor group differences occurred in children of level-III. CONCLUSIONS: In higher functioning children with cerebral palsy, the motor learning coaching treatment resulted in significantly greater retention of gross motor function and transfer of mobility performance to unstructured environments than neurodevelopmental treatment.

Repeatability of net mechanical efficiency during stair climbing in children with cerebral palsy.

PURPOSE: To determine the smallest significant change in mechanical efficiency (MEnet) measured by a stair-climbing test. METHODS: Duplicate stair-climbing tests (T1 and T2), with more than a 30-minute rest between, were performed by 51 children with diplegic cerebral palsy (CP) at levels II and III of Gross Motor Function Classification System (GMFCS) and 9 children with typical development, aged 5.5 to 13.0 years. RESULTS: The T2 versus T1 slope values of MEnet for CP and typical development did not significantly differ from 1.00. MEnet was significantly higher for GMFCS level II (7.0%) than level III (1.2%). The mean percentage of difference was 7.8% (T2 > T1) for the children with CP, with a 95% confidence interval of -39% to +54%. The 95% confidence interval for MEnet scores computed from the standard error of the mean (SEM) of the percentage of differences was 4.0 to 4.5 for CP. CONCLUSIONS: An increase of >13.4% in MEnet score (eg, mean increase from 4.0% to 4.5%) can indicate improved motor status resulting from interventions.