Training Community Health Workers to be Advocates for Health Promotion: Efforts Taken by a Community-Based Organization to Reduce Health Disparities in Cardiovascular Disease

Compared to white adults, blacks are less likely to be aware of their cardiovascular risk factors and are less likely to respond appropriately to signs and symptoms of a myocardial infarction or stroke. This fact highlights the need for better dissemination of health information about cardiovascular disease among communities of color. Community health workers (CHWs) are important resources for disseminating health information. Recognizing this important role of CHWs, the Greater Southern Brooklyn Health Coalition and its community and academic partners developed a workshop designed to educate CHWs about the risk factors, signs and symptoms of cardiovascular disease. The purpose of this workshop was to educate CHWs so that they themselves could be better informed and thus, be in a better position to educate their respective clients. The resulting workshop, Taking Action Against Cardiovascular Disease in Our Communities: A Training for Service Providers, was a half-day workshop attended by 70 CHWs from various community service organizations. Approximately 97% of attendees said that the workshop met their expectations. More than half said they learned the signs and symptoms of cardiovascular disease and about 90% said that they received clear and concrete information that they could use with their clients. These evaluations also provided critiques regarding aspects of the workshop that could be improved upon and other information which will be used as a formative tool in developing future educational initiatives. In conclusion, this workshop demonstrated that it was feasible to develop effective community programs targeted at educating CHWs about cardiovascular disease.     

Transcranial direct current stimulation and constraint-induced therapy in cerebral palsy: A randomized,blinded, sham-controlled clinical trial

We investigated the safety, feasibility, and efficacy of transcranial direct current stimulation (tDCS) combined with constraint-induced movement therapy (CIMT) in children and young adults with unilateral cerebral palsy. Twenty participants were randomized to receive active or sham tDCS. The intervention consisted of 10 consecutive weekday sessions of tDCS applied to the non-lesioned hemisphere (20 min) concurrently with CIMT (120 min). Participants, caregivers, and interventionists were blinded to group assignment. The primary safety outcome investigated adverse events. The primary behavioral outcome was the Assisting Hand Assessment. All 20 participants (mean age = 12.7 yrs, range = 7.4–21.6 years) were evaluated for the primary outcomes. No serious adverse events occurred, and the most commonly reported minor adverse events were headache and itchiness. Both groups demonstrated a significant improvement in hand function after the intervention, although no significant effect of tDCS was observed (between-group difference = ?2.18, 95% CI = [?6.48, 2.12], p = 0.30). Although hand function improved overall, no significant differences between intervention groups were found. Children with preserved corticospinal tract circuitry from the lesioned hemisphere, compared to those without, showed greater improvement in hand function (mean difference = 3.04, 95% CI = [?0.64, 6.72], p = 0.099). Our study demonstrates the safety and feasibility of serial sessions of tDCS, and presents preliminary evidence for the effect of CST circuitry on outcomes following tDCS/CIMT. Future work in children with unilateral cerebral palsy should focus on the optimal dosing and consider individual brain circuitry when describing response to combined interventions.

Barriers to the community support of orphans and vulnerable youth in Rwanda

A consistent theme in the literature on interventions for orphans and vulnerable children is the need for community-based care. However, a number of socio-cultural factors may impede community response. In this study, mixed methods are used to elucidate community-level barriers to care for orphans and vulnerable youth in Rwanda. Data from a large survey of youth heads of household on perceptions of marginalization from the community and the factors predicting that marginalization are considered in light of additional data from a survey of adults who volunteered to mentor these youth and focus groups with both community adults and youth heads of household. Results highlight how orphans' impoverished condition, cause of parents' death, and community perceptions of orphan behavior play a role in the marginalization of orphaned youth in Rwanda. Evidence is also offered to show that targeting humanitarian assistance to vulnerable youth may inadvertently lessen the level of community support they receive and contribute to their marginalization. The implications of these data for community-based program approaches are discussed.     

Emotion regulation in preschoolers: the roles of behavioral inhibition, maternal affective behavior, and maternal depression

Background:  This study examined preschoolers' emotion regulation (ER) strategies and the association with temperament, maternal interactive style, and maternal history of childhood-onset depression (COD).
Methods:  Participants were 62 children and their mothers, 37 of whom had mothers with COD. Children's ER was assessed using a disappointment paradigm; temperament assessment also was laboratory-based.
Results:  Maternal COD was inversely related to offspring's active ER and positive mood. Among children of COD mothers, behavioral inhibition was associated with passive regulation and sadness, and maternal positivity toward these children was associated with child active ER and positive mood.
Conclusion:  Behavioral inhibition may place children of COD mothers at risk for developing maladaptive ways of regulating negative emotion, whereas mothers' positivity may serve as a protective factor for them.     

How long to prosecute child sexual abuse for a community using a Children's Advocacy Center and two comparison communities?

This article explores the length of time between key events in the criminal prosecution of child sexual abuse cases (charging decision, case resolution process, and total case-processing time), which previous research suggests is related to victims' recovery. The sample included 160 cases in three communities served by the Dallas County District Attorney. Most cases (69%) took at least 60 days for the charging decision, with cases investigated at the Children's Advocacy Center having a quicker time than either comparison community. Only 20% of cases had a case resolution time within the 180-day target suggested by the American Bar Association standard for felonies. Controlling for case characteristics, one of the three communities and cases with an initial arrest had a significantly quicker case resolution time. Total case processing generally took more than 2 years. Implications include the need to better monitor and shorten case resolution time.     

A systematic review of East African-Indian family of Mycobacterium tuberculosis in Brazil

Introduction

The Mycobacterium tuberculosis East African-Indian (EAI) spoligotyping family (belonging to lineage 1, Indo-Oceanic, defined by the region of deletion RD239) is distributed worldwide, but is more prevalent in Southeast Asia, India, and East Africa. Studies in Latin America have rarely identified EAI. In this study, we describe the occurrence of the EAI family in Brazil.

School based post disaster mental health services: decreased trauma symptoms in youth with multiple traumas

Children exposed to disasters are at an increased likelihood for multiple trauma exposure. The objective of our study is to understand the efficacy of post disaster school based services for reducing trauma symptoms of youth exposed to multiple traumatic events. Students (N = 112) age 8–17 that were survivors of Hurricane Katrina received individual treatment for multiple traumas on site at school. We used repeated measures ANOVA to investigate the effectiveness in self-reported trauma symptoms over time. Results indicated significant reduction in overall posttraumatic stress symptoms as well as subscales assessing anxiety, anger, depression, dissociation, overt dissociation, and fantasy dissociation. The school based services for students with multiple traumas were effective at reducing trauma symptoms following disaster.