Medication, rehabilitation and health care consumption in adults with cerebral palsy: a population based study

2016 ◽  
Vol 31 (7) ◽  
pp. 957-965 ◽  
Author(s):  
Christelle Pons ◽  
Sylvain Brochard ◽  
Philippe Gallien ◽  
Benoit Nicolas ◽  
Aurélie Duruflé ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Population Based ◽  
Cross Sectional Study ◽  
Orthotic Devices ◽  
Health Care Consumption ◽  
Cross Sectional ◽  
Healthcare Consumption ◽  
Mobility Aids ◽  
High Level ◽  
Gmfcs Level

Objective: To evaluate medication, rehabilitation and healthcare consumption in adults with CP as a function of Gross Motor Function Classification System (GMFCS) level. Design: Questionnaire-based cross-sectional study. Setting: Brittany, a French county. Subjects: Adults with cerebral palsy. Interventions: Questionnaires relating to drugs, orthotic devices, mobility aids, rehabilitation and medical input were sent to 435 members of a unique regional French network dedicated to adults with cerebral palsy. The questionnaire was completed by the participant or a helper if necessary. Results: Of the 282 responders, 7.8% had a GMFCS level of I, 14.2% II, 17.7% III, 29.1% IV and 31.2% V. Participants consumed a large amount of healthcare. Almost three-quarters took orally administered drugs, of which antispastic and antiepileptic drugs were among the most frequent. Nearly all patients had at least one type of rehabilitation, 87.2% had physiotherapy, 78% used at least one mobility aid and 69.5% used at least one orthotic device. The frequency of numerous inputs increased with GMFCS level. Specificities were found for each GMFCS level, e.g. participants with GMFCS level IV and V had a high level of medical input and a greater use of trunk-supporting devices, antireflux and laxative. Profiles could be established based on GMFCS levels. Conclusions: Adults with cerebral palsy use a large amount of drugs, mobility aids, orthotic devices, rehabilitation and medical input. Healthcare is targeted at cerebral palsy-related issues. GMFCS is a determinant of healthcare consumption and thus a useful tool for clinical practice to target care appropriately.

scholarly journals Self-versus Proxy-Reported Pain in Children with Cerebral Palsy: A Population-Based Registry Study of 3783 Children

2020 ◽  
Vol 11 ◽  
pp. 215013272091152 ◽  
Author(s):  
Gunnar Hägglund ◽  
Amanda Burman-Rimstedt ◽  
Tomasz Czuba ◽  
Ann I. Alriksson-Schmidt
Keyword(s):  
Logistic Regression ◽  
Cerebral Palsy ◽  
Classification System ◽  
Population Based ◽  
Registry Study ◽  
Cross Sectional ◽  
Marginal Effects ◽  
Level I ◽  
Average Marginal Effects ◽  
Gmfcs Level

Objective: To assess how the prevalence of pain in a population-based sample of children and adolescents with cerebral palsy (CP) differ based on self- or proxy reporting. Methods: This cross-sectional registry study included 3783 children (58% boys), 1 to 18 years old, enrolled in the Swedish follow-up program for CP. Logistic regression was used to regress source of reporting (self or proxy) on the presence of general pain adjusted for age, sex, Gross Motor Function Classification System (GMFCS), and Communication Function Classification System (CFCS) levels, including marginal effects between source of reporting and adjusted covariates. Results: The pain item was self-reported in 45%, proxy-reported in 51%, and information was missing in 3%. Pain was reported in 44% of those who self-reported and in 41% of those who proxy-reported ( P = .04). The logistic regression showed that the average marginal effects of proxy versus self-reported pain were lower among children at GMFCS level IV (−0.14, 95% CI −0.17 to −0.03) and CFCS level I (−0.09, CI −0.16 to −0.01) and higher at CFCS level III (0.11, CI 0.00-0.22). There were no statistically significant differences in average marginal effects related to age, sex, or the other GMFCS and CFCS levels between proxy and self-reporting. Conclusions: Pain was more often reported by those who self-reported. However, after adjusting for age, sex, CFCS level, and GMFCS level, the proportion of reported pain was almost equal between self and proxy-reporting. Assuming that the self- and proxy-reported groups were not significantly different on relevant factors not controlled for the results indicate that presence of pain is equally reported by children and parents.

scholarly journals Very high relative seroprevalence of anti-SARS-CoV-2 antibodies among communities in Bangui, Central African Republic

2021 ◽  
Author(s):  
Alexandre Manirakiza ◽  
Christian Malaka ◽  
Brice Martial Yambiyo ◽  
Saint Calver Henri Diemer ◽  
Jean de Dieu Longo ◽  
...  
Keyword(s):  
Large Scale ◽  
Central African Republic ◽  
Venous Blood ◽  
Population Level ◽  
Significant Degree ◽  
Population Based ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Cross Sectional ◽  
High Level

Background: Large-scale population-based seroprevalence studies of SARS-CoV-2 are essential to characterize the cumulative incidence of SARS-CoV-2 infection and to extrapolate the prevalence of presumptive immunity at the population level. Objective: The objective of our survey was to estimate the cumulative population immunity for COVID-19 and to identify individual characteristics associated with a positive serostatus. Method: This was a clustered cross-sectional study conducted from July 12 to August 20, 2021, in households in the city of Bangui, the capital of the Central African Republic. Information regarding demographic characteristics (age, gender, and place of residence), comorbidities (chronic diseases) was collected. A venous blood sample was obtained for each participant to determine the level of total anti-SARS-CoV-2 antibodies using a WANTAI SARS-CoV-2 Ab ELISA kit. Results: All up, 799 participants were surveyed. The average age was 27 years, and 45.8% of the respondents were male (sex ratio: 0.8). The overall proportion of respondents with a positive serostatus was 74.1%. Participants over 20 years of age were twice as likely to have a positive serostatus, with an OR of 2.2 (95% CI: [1.6, 3.1]). Interpretation: The results of this survey revealed a high cumulative level of immunity in Bangui, thus indicating a significant degree of spread of SARS-CoV-2 in the population. The public health implications of this high level of immunity to SARS-CoV-2, particularly on its variants burden, remain to be determined.

scholarly journals Plasma n-3 fatty acids and psychological distress in aboriginal Cree Indians (Canada)

2009 ◽  
Vol 12 (12) ◽  
pp. 2343-2351 ◽  
Author(s):  
Michel Lucas ◽  
Éric Dewailly ◽  
Carole Blanchet ◽  
Suzanne Gingras ◽  
Bruce J Holub
Keyword(s):  
Fatty Acids ◽  
Psychological Distress ◽  
Reference Group ◽  
Docosapentaenoic Acid ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
James Bay Cree ◽  
High Level ◽  
The Relationship

AbstractObjectiveTo examine the relationship between psychological distress (PD) and plasma n-3 long-chain (LC) PUFA, i.e. EPA, docosapentaenoic acid (DPAn-3) and DHA.DesignPopulation-based, cross-sectional Santé-Québec Health Survey (1991). Participants were categorized as high-level PD if they scored over the 80th percentile of the PD Index in the Santé-Québec Survey; non-distressed subjects were those who scored less than this cut-off. Associations between tertiles of n-3 fatty acids (FA) and the risk of high-level PD were expressed as odds ratios, with the lowest tertile as the reference group.SettingQuébec, Canada.SubjectsData were analysed from a representative sample of 852 James Bay Cree Indian adults aged 18 years and over.ResultsProportions of n-3 FA were statistically significantly lower in the PD than in the non-distressed group. After adjustment for confounders, EPA was the only individual n-3 FA significantly associated with the risk of high-level PD. Combinations of EPA + DHA or EPA + DPAn-3 + DHA or the sum of n-3 were also associated with the risk of high-level PD. Compared with the lowest tertile of EPA + DHA, the OR for high-level PD was 0·89 (95 % CI 0·59, 1·36) for the second and 0·56 (95 % CI 0·32, 0·98) for the third tertile, after controlling for confounders.ConclusionsIn the present retrospective, cross-sectional study, we found that proportions of n-3 LC PUFA in plasma phospholipids, markers of n-3 LC PUFA consumption from fish, were inversely associated with PD.

scholarly journals Comparison of the CHU-9D and the EQ-5D-Y instruments in children and young people with cerebral palsy: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037089
Author(s):  
Jennifer M Ryan ◽  
Ellen McKay ◽  
Nana Anokye ◽  
Marika Noorkoiv ◽  
Nicola Theis ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Missing Data ◽  
Young People ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Poor Agreement ◽  
Cross Sectional ◽  
Children And Young People ◽  
Utility Values ◽  
Gmfcs Level

ObjectiveTo compare the performance of the EuroQol 5D youth (EQ-5D-Y) and child health utility 9D (CHU-9D) for assessing health-related quality of life (HRQoL) in children and young people (CYP) with cerebral palsy (CP).DesignCross-sectional study.SettingEngland.ParticipantsSixty-four CYP with CP aged 10–19 years in Gross Motor Function Classification System (GMFCS) levels I–III.Main outcome measuresMissing data were examined to assess feasibility. Associations between utility values and individual dimensions on each instrument were examined to assess convergent validity. Associations between utility values and GMFCS level were examined to assess known-group differences.ResultsMissing data were <5% for both instruments. Twenty participants (32.3%) and 11 participants (18.0%) reported full health for the EQ-5D-Y and CHU-9D, respectively. There was poor agreement between utilities from the two instruments (intraclass correlation coefficient=0.62; 95% limits of agreement −0.58 to 0.29). Correlations between EQ-5D-Y and CHU-9D dimensions were weak to moderate (r=0.25 to 0.59). GMFCS level was associated with EQ-5D-Y utility values but not CHU-9D utility values.ConclusionThe EQ-5D-Y and CHU-9D are feasible measures of HRQoL in CYP with CP. However, the two instruments demonstrate poor agreement and should not be used to measure and value HRQoL in CYP with CP interchangeably. We propose that the CHU-9D may be preferable to use in this population as it assesses concepts that influence HRQoL among CYP with CP and provides less extreme utility values than the EQ-5D-Y.

scholarly journals What triggers healthcare-seeking behaviour when experiencing a symptom? Results from a population-based survey

BJGP Open ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. bjgpopen17X100761 ◽  
Author(s):  
Sandra Elnegaard ◽  
Anette Fischer Pedersen ◽  
Rikke Sand Andersen ◽  
René de-Pont Christensen ◽  
Dorte Ejg Jarbøl
Keyword(s):  
General Population ◽  
Symptom Burden ◽  
Population Based ◽  
Cross Sectional Study ◽  
Daily Activities ◽  
Cross Sectional ◽  
Web Based ◽  
Symptom Experiences ◽  
Level Of Concern ◽  
High Level

BackgroundThe decision process of whether or not to contact the GP is influenced by different factors which have not all been well examined.AimThe aim of this study was to analyse whether contact to the GP is associated with concern about the symptom, influence on daily activities and symptom burden, such as the total number of symptoms experienced by each person in a general population.Design & settingThis Danish nationwide cross-sectional study comprises a random sample of 100 000 people, representative of the adult Danish population ≥20 years.MethodBaseline data were collected in a web-based survey conducted from June to December 2012.ResultsIn total 49 706 (52.5%) individuals answered the questionnaire; 45 483 (91.5%) individuals experienced at least one of 44 predefined symptoms during the 4 weeks preceding the completion of the questionnaire. They reported 268 772 symptom experiences of which 58 370 symptoms (21.7%) resulted in contact with a GP. A high level of concern and influence on daily activities was associated with significantly higher odds for GP contact. A high burden of symptoms was associated with lower odds of contact with the GP.ConclusionApproximately every fifth symptom reported by individuals from the general population leads to GP contact. Influence on daily activities, burden of symptoms, and concern about the symptom were significant factors associated with the decision of whether to contact the GP. No overall association between sex and GP contact was observed.

scholarly journals Population-based study on the prevalence and clinical profile of adults with cerebral palsy in Northern Ireland

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e044614
Author(s):  
Karen McConnell ◽  
Emma Livingstone ◽  
Oliver Perra ◽  
C Kerr
Keyword(s):  
Cerebral Palsy ◽  
Northern Ireland ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Population Based Study ◽  
Care Services ◽  
Neurological Conditions ◽  
The Uk

ObjectivesThis study aimed to report the prevalence and clinical characteristics of adults with cerebral palsy (CP) in a geographically defined region of the UK.Design and settingCross-sectional study using the Northern Ireland Cerebral Palsy Register (NICPR).ParticipantsAll validated cases known to the NICPR, born 1981–2001 and alive and resident in Northern Ireland at age 19 years were included.ResultsThe study included 1218 persons with CP aged 19–39 years, 46 of whom died in adulthood. The prevalence of CP was 2.38 per 1000. The majority of cases had spastic CP (n=1132/1218, 93%) and could walk (n=949/1218, 78%). Those that died in adulthood typically had bilateral spastic CP (n=39/46) and used a wheelchair (n=40/46).ConclusionThe prevalence of CP in adults is similar to other common neurological conditions such as multiple sclerosis and Parkinson’s disease. The needs of adults with CP vary widely with almost half having two or more associated impairments that may require multiprofessional and multiagency coordination. Results from this study can be used to inform transformation of health and care services for adults with CP.

scholarly journals Health Conditions in Adults With Cerebral Palsy: The Association With CP Subtype and Severity of Impairments

2021 ◽  
Vol 12 ◽  
Author(s):  
Ulrica Jonsson ◽  
Meta N. Eek ◽  
Katharina Stibrant Sunnerhagen ◽  
Kate Himmelmann
Keyword(s):  
Cerebral Palsy ◽  
Intellectual Disability ◽  
Pressure Ulcers ◽  
Population Based ◽  
Cross Sectional Study ◽  
Health Conditions ◽  
Gastrointestinal Disorders ◽  
Cross Sectional ◽  
Respiratory Disorders ◽  
Prevalence Of Pain

Aim: To determine the prevalence of common health conditions in adults with cerebral palsy (CP) and to identify associations with the CP subtype or the severity of impairments.Methods: A population-based, cross-sectional study of 153 adults with CP born from 1959 to 1978 (87 males, 66 females; median age 48 years 3 months, range 37–58 years; 41% with unilateral spastic, 36% bilateral spastic, 19% dyskinetic, and 4% with ataxic CP). Data was gathered through interviews, physical assessments, and medical record reviews.Results: The most common health conditions in adults with CP were pain 65%, upper gastrointestinal disorders 33%, dysphagia 29%, epilepsy 29%, and depression 27%. Cerebral palsy subtype was significantly associated with the presence of pain (p = 0.029), gastrointestinal (p &lt; 0.001), and respiratory disorders (p = 0.006). A more severe physical impairment was associated with a higher prevalence of gastrointestinal disorders (p &lt; 0.001), respiratory disorders (p &lt; 0.001), and pressure ulcers (p &lt; 0.001). Intellectual disability was associated with a higher prevalence of gastrointestinal disorders (p &lt; 0.001), pneumonia (p = 0.001) epilepsy (p = 0.001), and pressure ulcers (p &lt; 0.001), but with a lower prevalence of pain (p &lt; 0.004) and hypertension (p = 0.043).Conclusion: The prevalence of several common health conditions is related to the CP subtype and severity of impairments, indicating that CP plays a role in the development of these health conditions. Follow-up of adults with CP needs to include not only impairments, but general health as well. Increased attention directed toward signs of gastrointestinal and respiratory disorders in individuals with either dyskinetic CP, gross motor function classification system (GMFCS) levels IV–V, or intellectual disability, is recommended.

scholarly journals Video instructions improve accuracy of self-measures of waist circumference compared with written instructions

2011 ◽  
Vol 14 (7) ◽  
pp. 1192-1199 ◽  
Author(s):  
Dara F McEneaney ◽  
Susan C Lennie
Keyword(s):  
Waist Circumference ◽  
English Language ◽  
Epidemiological Studies ◽  
Population Based ◽  
Cross Sectional Study ◽  
Hip Circumference ◽  
Cross Sectional ◽  
Heterogeneous Samples ◽  
High Level ◽  
To Receive

AbstractObjectiveTo determine whether video-based instructions improve the accuracy of self-measures of waist and hip circumference compared with written instructions.DesignPopulation-based, cross-sectional study. Self-measurements of waist circumference (WC) and hip circumference (HC) of fifty-seven participants randomly allocated to receive either written instruction or video instruction were compared with those of a trained technician.SettingAberdeen, Scotland, and Brussels, Belgium, between February and April 2010.SubjectsAdults aged 18–62 years with a high level of English language and no prior training in anthropometry.ResultsWC was significantly overestimated by the written method (1·75 cm bias; P = 0·007) but not the video method (0·95 cm bias; P = 0·239). HC was significantly underestimated in both written (−0·35 cm bias; P = 0·009) and video methods (−0·75 cm bias; P = 0·046). Reliability was not significantly affected by age, sex, BMI or WC. Bland–Altman plots demonstrated wide limits of agreement for WC (−6·83, 6·08 cm for written method; −10·14, 6·72 cm for video method) and HC (−12·85, 1·60 cm for written method; −10·82, 2·50 cm for video method).ConclusionsVideo technology can support more accurate self-measurements of anthropometric data in epidemiological studies. Further research is warranted using larger and more heterogeneous samples in order that results can be generalised.

Minerals Intake Distributions in a Large Sample of Iranian at-Risk Population Using the National Cancer Institute Method: Do They Meet Their Requirements?

2015 ◽  
Vol 85 (3-4) ◽  
pp. 129-144 ◽  
Author(s):  
Zahra Heidari ◽  
Awat Feizi ◽  
Leila Azadbakht ◽  
Nizal Sarrafzadegan
Keyword(s):  
At Risk ◽  
National Cancer Institute ◽  
Population Based ◽  
Cross Sectional Study ◽  
Normal Function ◽  
Dietary Intakes ◽  
Middle Aged ◽  
Cross Sectional ◽  
Nutritional Interventions ◽  
High Prevalence

Abstract. Background: Minerals are required for the body’s normal function. Aim: The current study assessed the intake distribution of minerals and estimated the prevalence of inadequacy and excess among a representative sample of healthy middle aged and elderly Iranian people. Methods: In this cross-sectional study, the second follow up to the Isfahan Cohort Study (ICS), 1922 generally healthy people aged 40 and older were investigated. Dietary intakes were collected using 24 hour recalls and two or more consecutive food records. Distribution of minerals intake was estimated using traditional (averaging dietary intake days) and National Cancer Institute (NCI) methods, and the results obtained from the two methods, were compared. The prevalence of minerals intake inadequacy or excess was estimated using the estimated average requirement (EAR) cut-point method, the probability approach and the tolerable upper intake levels (UL). Results: There were remarkable differences between values obtained using traditional and NCI methods, particularly in the lower and upper percentiles of the estimated intake distributions. A high prevalence of inadequacy of magnesium (50 - 100 %), calcium (21 - 93 %) and zinc (30 - 55 % for males > 50 years) was observed. Significant gender differences were found regarding inadequate intakes of calcium (21 - 76 % for males vs. 45 - 93 % for females), magnesium (92 % vs. 100 %), iron (0 vs. 15 % for age group 40 - 50 years) and zinc (29 - 55 % vs. 0 %) (all; p < 0.05). Conclusion: Severely imbalanced intakes of magnesium, calcium and zinc were observed among the middle-aged and elderly Iranian population. Nutritional interventions and population-based education to improve healthy diets among the studied population at risk are needed.

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