Psychosomatic Musculoskeletal Pain in Childhood: Clinical and Psychological Analyses of 100 Children

PEDIATRICS ◽  
1991 ◽  
Vol 88 (6) ◽  
pp. 1093-1099 ◽  
Author(s):  
David D. Sherry ◽  
Tona McGuire ◽  
Elizabeth Mellins ◽  
Kathy Salmonson ◽  
Carol A. Wallace ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Severe Pain ◽  
Signs And Symptoms ◽  
Well Being ◽  
Family Type ◽  
Duration Of Symptoms ◽  
Academic Difficulty ◽  
Family Types ◽  
Mother And Child ◽  
Almost All

The clinical and psychological findings on 100 children with psychosomatic musculoskeletal pain seen at a major pediatric rheumatology referral center are reported. Most (76%) were female, median age was 13 years, and median duration of symptoms was 1 year. Multiple painful sites were common (66%). The pain was constant (63%) or intermittent (37%); 45% had hyperesthesia, and almost all maintained a cheerful affect when complaining of severe pain. Two predominant abnormal family milieu were seen. One was cohesive, stable, and organized, but intolerant of separation and individuation. The other was chaotic, emotionally unsupportive, with high levels of conflict. Members of the cohesive family type reported significantly less distress than members of chaotic families. Enmeshment between mother and child was common in both family types. Although frequently viewed as bright, most of these children had normal intelligence, and some had unrecognized academic difficulty. These children, compared with those with arthritis, had a significantly lower global well-being score. Clinical depression was unusual (11%). Most (97%) responded favorably to intensive physical and occupational therapy along with individual or family psychotherapy; 78% become symptom free or fully functional. Children with these signs and symptoms should have full psychological evaluations and respond well to treatment directed toward decreasing pain and restoring function.

scholarly journals The mother during pregnancy and the puerperium: Detailed data abstracted from the clinical obstetric records of ALSPAC pregnancies

2021 ◽  
Vol 6 ◽  
pp. 41
Author(s):  
Karen Birmingham ◽  
Steven Gregory ◽  
Yasmin Iles-Caven ◽  
Abigail Fraser ◽  
Deborah Lawlor ◽  
...  
Keyword(s):  
Fetal Monitoring ◽  
Signs And Symptoms ◽  
Well Being ◽  
Maternal Blood ◽  
Hospital Data ◽  
Pilot Studies ◽  
Clinical Complications ◽  
Parents And Children ◽  
Mother And Child ◽  
Clinical Records

Background: When the Avon Longitudinal Study of Parents and Children (ALSPAC) was planned, it was assumed that the clinical obstetric data would be easily accessible from the newly developed National Health Service computerised ‘STORK’ system. Pilot studies, however, showed that, although fairly accurate in regard to aspects of labour and delivery, it was, at the time (1990-2), inadequate for identifying the full antenatal and postnatal details of clinical complications and treatments of the women in the Study. Methods: A scheme was therefore developed to train research staff to find and abstract relevant details from clinical records onto proformas designed for the purpose. Extracting such data proved very time consuming (up to six hours for complicated pregnancies) and consequently expensive. Funding for the enterprise was obtained piecemeal using specific focussed grants to extract data for subsamples of the Study, including a random sample to serve as controls. Results: To date, detailed records have been completed for 8369 pregnancies, and a further 5336 (13,705 in total) have complete details on specific prenatal areas, including serial measures of maternal blood pressure, proteinuria and weight. In this Data Note we describe the information abstracted from the obstetric medical records concerning the mother during pregnancy, labour, delivery and the first two weeks of the puerperium. Information abstracted relating to the fetus (including fetal monitoring, presentation, method of delivery) and neonate (signs of asphyxia, resuscitation, treatment and well-being) will be described in a further Data Note. Conclusions: These data add depth to ALSPAC concerning ways in which the signs and symptoms, procedures and treatments of the mother prenatally, intrapartum and postnatally, may impact on the long-term health and development of both mother and child. They augment the data collected from the mothers’ questionnaires and the ‘STORK’ digital hospital data.

Grandparent Affection and Emotional Well-being of Adolescents with Different Family Types

2021 ◽  
pp. 0192513X2199318
Author(s):  
Pilar Ramos ◽  
Carmen Moreno ◽  
Sara Luna ◽  
Francisco Rivera
Keyword(s):  
Intergenerational Relationships ◽  
Well Being ◽  
Family Type ◽  
State Of Health ◽  
Joint Custody ◽  
Biological Parent ◽  
Family Types ◽  
The Impact ◽  
Reference Figure

Despite the increasing importance of grandparents in raising their grandchildren, few studies analyze the impact that these intergenerational relationships have on the grandchildren, especially during adolescence. With a sample of 3432 adolescents between 11 years and 16 years old, we analyze to what degree grandparent affection explains adolescent emotional well-being. The results reveal interesting findings according to family type: traditional two-parent families, families with joint custody, or families with only one biological parent (specifying between father or mother). Lastly, we analyze and discuss the implications of the relevant results related to the grandparents’ sex, lineage, and state of health, the adolescent’s age, as well as finding a higher impact of grandparent affection has on adolescents from families with only the father as a reference figure. This study advocates for reinforcing the role of the grandparents during adolescence, becoming especially relevant for boys and girls living in father-only families.

scholarly journals Non-Parental Investment in Children and Child Outcomes after Parental Death or Divorce in a Patrilocal Society

2021 ◽  
Vol 10 (6) ◽  
pp. 196
Author(s):  
Gretchen C. Perry
Keyword(s):  
Inclusive Fitness ◽  
Strong Predictor ◽  
Child Outcomes ◽  
Well Being ◽  
Structured Interview ◽  
Family Type ◽  
Material Resources ◽  
Inclusive Fitness Theory ◽  
Child Height ◽  
Family Types

Children rely on support from parental helpers (alloparents), perhaps especially in high-needs contexts. Considerable evidence indicates that closer relatives and maternal relatives are the most likely to provide this care, as inclusive fitness theory suggests, but whether this is equally true across different family types and in culturally patrilocal societies requires investigation. This structured interview study (N = 208 respondents with 323 dependent children) focuses on who helps raise children in rural Bangladesh after the father’s or mother’s death, or divorce, in comparison to families with both parents present or the father temporarily a migrant laborer. Family types differed in where and with whom children resided, who served as their primary and secondary caregivers, and who provided material support, but mother’s kin played a major role, and were the primary providers of material resources from outside the child’s household in all family types. Despite the patrilineal ideology, only one-quarter of children of divorce lived with the father or his family, and even after the death of the mother, only 59% remained with father or other paternal kin. Household income varied by family type and was a strong predictor of child height and weight. The children of deceased mothers moved between successive caregivers especially frequently, and were uniquely likely to have no schooling. The typology of Bangladeshi society as patrilocal obscures the extent to which matrilateral family support children’s well-being.

scholarly journals Clinicopathologic Profile of Bronchogenic Carcinoma

2010 ◽  
Vol 49 (178) ◽  
Author(s):  
SG Shrestha ◽  
R Dhakhwa ◽  
R Chokhani
Keyword(s):  
Cell Carcinoma ◽  
Bronchogenic Carcinoma ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Duration Of Symptoms ◽  
Histologic Subtype ◽  
History Of ◽  
The Mean ◽  
Clinicopathologic Profile ◽  
Almost All

INTRODUCTION: Bronchogenic carcinoma is the most common cancer in the world. It can present in many ways. Accurate diagnosis and categorization into different types is important because of its effect on prognosis and management. We conducted this study to find out the frequency of various histological types of bronchogenic carcinoma and correlate with their clinicopathologic profile. METHODS: This is a retrospective study conducted in 174 histopathologically proven cases of bronchogenic carcinoma that were referred from different parts of the country to a private hospital in Kathmandu over a period of 4 years. RESULTS: The mean age of the patients developing bronchogenic carcinoma was 64 years. Squamous cell carcinoma was the commonest histologic subtype followed by small cell carcinoma. Adenocarcinoma was more common in females. Clinical history was available in 133 cases. Among them, almost all patients had a history of smoking, the average number of pack years being 39.99. Most of the patients consulted doctor for chief complaint of cough and shortness of breath, the average duration of symptoms being 117.53 days. CONCLUSIONS: The lung cancer must be ruled out in all patients who have persistent signs and symptoms of pulmonary disease with a history of smoking. KEYWORDS:  bronchogenic, histopathology, smoking.

Family Type Predicts Mental Health Problems in Young Adults: A Survey of Students at a University in Botswana

2020 ◽  
Vol 32 (2) ◽  
Author(s):  
Kennedy Amone-P'Olak ◽  
Boniface Kealeboga Ramotuana
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Mental Health Problems ◽  
Single Mother ◽  
Health Problems ◽  
Family Type ◽  
Cross Sectional ◽  
Intact Family ◽  
Increased Risk ◽  
Family Types

In Africa, the structure of the family is changing rapidly. The effects of this change on mental health remain unknown. This study investigated the extent to which different family types (intact, single-mother, and multiple) predict mental health problems in young adults in Botswana (N = 264, mean age = 21.31, SD = 2.40). In a cross-sectional design, the study sampled students registered at various faculties at the University of Botswana. The revised symptoms checklist (SCL-90-R) was used to assess symptoms of mental health problems (depression, anxiety and hostility). Binary logistic regression analyses were performed to obtain odds ratios (ORs) and 95 per cent confidence intervals (CIs) of mental health problems for mother-only and multiple family types relative to the intact family type. Compared to the intact family type, single-mother (OR = 2.34; 95% CI: 1.21, 4.51) and multiple family types (OR = 1.56; CI: 0.88, 2.78) were associated with an increased risk of depression. For anxiety, the ORs were 2.27 (CI: 1.18, 4.38) and 1.10 (CI: 0.56, 1.82) for single-mother and multiple family types respectively. For hostility, the ORs were 2.60 (CI: 1.34, 5.04), and 0.79 (CI: 0.44, 1.42) for single-mother and multiple family types, respectively. Family types predict mental health problems in young adults and therefore the interventions to mitigate the effects should consider family backgrounds and the ramifications of family types for treatment and care.

Clinical evaluation of Kasisadi Ghrita local application in Parikartika (Fissure-in-ano)

2019 ◽  
Vol 4 (04) ◽  
Author(s):  
Mamta Gopalrao Mate ◽  
D. N. Farande ◽  
Vinay M. Pandey ◽  
Snehal Kukade
Keyword(s):  
Clinical Evaluation ◽  
Severe Pain ◽  
Signs And Symptoms ◽  
Study Trial ◽  
Local Application ◽  
Trial Group ◽  
Age Group ◽  
Fissure In Ano

Background: Parikartika is characterized by sharp cutting pain in anal regionIn Parikartika, Teevrashoola, bleeding is seen, similarly severe pain and slimy blood discharge are seen in Fissure-in-ano. Objective: To assess the efficiency of Kasisadi Ghruta local application in the management of fissure-in-ano. Methods: The patient having classical signs and symptoms of Parikartika (fissure in ano) having Age group 20 to 60 years were recruited for the study. Trial group was treated with Kasisadi Ghruta twice a day local application for 28 days. Results: Average relief observed was 62.5% in most of symptoms. Kasisadi Ghruta is having Shothahara, Vedanasthapana and Ropana properties due to which it helps in healing of fissure in ano. Conclusion: Kasisadi Ghruta local application is having better results in fissure-in-ano.

Knowledge, Awareness and Perception on Malaria in Tribal Regions of Vadodara District, Gujarat (India)

2019 ◽  
Vol 21 (3) ◽  
pp. 406-416
Author(s):  
Bindu Bhatt ◽  
Janak P. Joshi
Keyword(s):  
Malaria Control ◽  
Control Measure ◽  
Health Sector ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Well Being ◽  
Clear Understanding ◽  
Major Public Health Problem ◽  
Health Seeking ◽  
Tropical Regions

Malaria affects health and general well-being of many people in the developing world. In India also, malaria is a major public health problem. It continues to be a leading cause of morbidity and mortality in many tropical regions of the world, despite global efforts to eradicate the disease. To achieve the targets of reducing malaria prevalence and preventing malaria epidemic, it is essential to have active community participation. Therefore, clear understanding of the Knowledge, Awareness and Perception (KAPs) of a particular community can help in framing the policy of prevention and promotion of any malaria control measure. In this context, the decision makers in the health sector are recognizing the importance of community’s KAPs on malaria and, thus, is gaining stimulus as one of the methods for malaria control. KAPs, however, play an important role in the improvement of health and health-seeking behaviour of a disease-burdened group. This study, therefore, investigates a local community’s KAPs on malaria in tribal areas of Vadodara District. The KAP investigates the community’s understanding of malaria transmission, their recognition of signs and symptoms, their treatment-seeking behaviours and community preventive measures and practices.

scholarly journals Chronic vulval problems: A gynaecologist’s perspective

2016 ◽  
Author(s):  
Akanksha Sharma ◽  
Saritha Shamsunder ◽  
Geetika Khanna ◽  
Neeti Khunger ◽  
Vijay Zutshi
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Examination ◽  
Squamous Cell ◽  
Well Being ◽  
Careful Examination ◽  
Blue Dye ◽  
Lichen Sclerosus Et Atrophicus ◽  
Cell Hyperplasia ◽  
Duration Of Symptoms ◽  
The Mean

Introduction: Chronic vulval symptoms are common complaints in women seeking health care and can significantly interfere with a woman’s sexual function and sense of well being. Many practitioners feel diagnostically challenged, particularly by chronic or recurrent forms of vulval disease. The aim of this study was to assess the role of various diagnostic modalities in evaluation of chronic vulval symptoms. Methods: Between August 2012 and February 2014, 100 women presenting with chronic vulval symptoms (i.e. ≥ 3 months duration) were evaluated. All of them had a thorough clinical history taken including use of vulval washes and creams, a general and gynaecological examination. Patients having chronic vaginal discharge in addition had urethral, vaginal and cervical smear and culture. All women had a careful examination of the vulva with and without magnification. Vulval scrape cytology was taken after moistening the vulva with normal saline and stained by Pap stain. Colposcopy of the vulva was then carried out after applying 5% acetic acid and 1% toluidine blue dye. Vulval biopsy was taken from suspicious areas on colposcopy and further management was based on histopathology report. Results: The mean age of women in our study was 43.57 years (range 22-80 years.), 70% women were pre-menopausal and 30% were post-menopausal. The mean duration of symptoms was 1.625 years (range 6 months - 15 years) and atypical vulval hygiene practices (excessive washing with soaps) was used in 77% of women. The commonest presenting complaint was pruritus in 92% of women; visible lesions on vulva were seen in 20%, pain in 6% and burning sensation in vulva in 5% of women. The histopathology was abnormal in 77 patients; the most common histopathological finding was non-neoplastic epithelial disorders in 64 women {Squamous cell hyperplasia (n=52), Lichen Sclerosus et atrophicus (n=6), other dermatoses including lichen Planus (n=6)}. Vulvar Intra-epithelial Neoplasia (VIN) was seen in 6 patients, 5 were squamous type VIN and 1 was non-squamous type (Paget’s disease). Squamous cell carcinoma was seen in 3 patients; malignant melanoma, benign appendiceal tumor, angiofibroma and neurofibroma in 1 patient. Examination without magnification had sensitivity of 25.97% and with magnification was 29.87% and specificity was 100% for both of them. Cytology had sensitivity and specificity of 75.32% and 86.95% respectively and sensitivity and specificity of colposcopy was 77.92% and 17.39% respectively. Conclusion: Clinical examination with and without magnification had low sensitivity but were highly specific in diagnosing vulvar lesions. A normal vulval smear and colposcopy have a high negative predictive value and are very reassuring. Colposcopy and biopsy is the gold standard for diagnosis, however clinical examination with naked eyes and magnifying glass are invaluable and can diagnose most of the neoplastic lesions.

scholarly journals For which population groups will strong identification and thus eHealth services use not be possible?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vehko ◽  
E Lilja ◽  
S Parikka ◽  
A-M Aalto ◽  
H M Kuusio
Keyword(s):  
Health Care Services ◽  
Service Use ◽  
Response Rate ◽  
Well Being ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Population Groups ◽  
Digital Services ◽  
Operating Environments ◽  
Almost All

Abstract Background Digital services are expected to improve the availability of public social and health care services in many European countries as well as in Finland. eHealth and eWelfare services often require strong electronic identification which may form barriers in the availability of care. This study focuses on recognising population groups who are vulnerable to exclusion either by not having access to web or by lacking a strong electronic identification. Methods The data were gathered from the cross-sectional survey on well-being among people aged 20-64 with foreign background (PFB) (FinMonik), conducted in Finland 2018-19 (N = 12 877; response rate 53%). The data from the National survey of health, well-being and service use (FinSote 2017-18) were used as reference data for the overall population, (N = 26 422, response rate 45%). Surveys asked respondents “Do you have at your disposal internet access at home, your workplace, library or some other place?” and 'Do you have at your disposal online banking codes or a mobile certificate for electronic identification online?”. PFB were defined by background country into seven country-groups. The age-standardized proportions with confidence intervals were examined by socio-demographic background variables. Results Almost all (98%) of the overall population reported access to internet, but the proportion was lower (92%) among PFB (p < 0.001). Proportion of having a strong electronic identification was higher among general population (98%) than among PFB (88%) (p < 0.001). In both populations, younger age increased the likelihood of having a strong electronic identification. PFB students reported lower level of strong electronic identification compared to the employed. Conclusions Although most had access to internet and a strong identification, there were statistically significant differences between country-groups and by employment status. Key messages Designing and developing of eHealth and eWelfare services must ensure that everyone has the opportunity to have a strong electronic identification. Development of digital services requires user guidance, which takes into account the varying needs and operating environments.

scholarly journals Espondilodiscite Brucélica: Casuística dos Últimos 25 Anos

2014 ◽  
Vol 27 (2) ◽  
pp. 204 ◽  
Author(s):  
Ana Lebre ◽  
Jorge Velez ◽  
Diana Seixas ◽  
Eduardo Rabadão ◽  
Joaquim Oliveira ◽  
...  
Keyword(s):  
Average Duration ◽  
Signs And Symptoms ◽  
Neurological Deficits ◽  
Imaging Method ◽  
Low Back ◽  
Positive Serology ◽  
Abscess Drainage ◽  
Duration Of Symptoms ◽  
Spinal Magnetic Resonance Imaging ◽  
Appropriate Therapy

<strong>Introduction:</strong> Brucellosis is an endemic zoonosis in Portugal. Brucellar spondylodiscitis is one of the most frequent focal manifestations which may cause severe sequelae despite appropriate therapy.<br /><strong>Material and Methods:</strong> Retrospective study of patients with diagnosis of brucellar spondylodiscitis admitted to the Infectious Diseases Department of Centro Hospitalar e Universitário de Coimbra, over a 25-year period (1988-2012).<br /><strong>Results:</strong> We identified 54 patients, 55.6% male, mean age of 54.8 years. In 81.5% an epidemiological context was identified, mostly contact with sheep and goats. The duration of symptoms prior to diagnosis was 5.5 months. The most common signs and symptoms were pain (98.1%), fever (46.3%) and neurological deficits (25.9%). Spinal magnetic resonance imaging was the most used imaging method (77.8%) showing abscesses in 29.6% of patients. Lumbar location predominated (77.7%). Diagnosis was attained in 47 patients (87.0%): positive blood cultures (3 patients), positive serology (32 patients) or by both methods (12 patients). Combined regimens of doxycycline and rifampicin (64.8%), or streptomycin (24.1%) were most used, for an average duration of 4.4 months. A patient was referred for surgery for abscess drainage. Evolution was mostly favorable (92.6%), no deaths occurring.<br /><strong>Discussion:</strong> Research of the epidemiologic context turned out to be a major key leading to the diagnosis. Treatment of osteoarticular brucellosis is still controversial.<br /><strong>Conclusions:</strong> Brucellar spondylodiscitis should be considered in the differential diagnosis of patients with low back pain, even in the absence of fever, particularly in regions where the disease is endemic. Antibiotic regimen, its’ duration and the need for surgery should be individualized to achieve a better prognosis. Cases have declined over the years, a fact related to better control of animal endemic.

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