scholarly journals Gender Differences in Treatments and Interventions Received for Children and Adolescents with Cerebral Palsy

2019 ◽  
Author(s):  
Annika Lundkvist Josenby ◽  
Tomasz Czuba ◽  
Ann I Alriksson Schmidt
Keyword(s):  
Gender Differences ◽  
Cerebral Palsy ◽  
Children And Adolescents ◽  
Classification System ◽  
Nordic Countries ◽  
Place Of Birth ◽  
Swedish Population ◽  
Cross Sectional ◽  
National Quality ◽  
Significant Difference

Abstract Background: In the Swedish population-based follow-up program and national quality registry for individuals with cerebral palsy (CPUP), physiotherapy (PT) and occupational therapy (OT) treatments are regularly recorded along with functional status. By Swedish law, all citizens irrespective of personal characteristics or socioeconomic status have the right to receive healthcare and medical treatments as applicable. Previous research has shown gender differences in treatments and interventions received by children with cerebral palsy (CP). The purpose of this study was to examine differences in treatments and interventions by gender and place of birth in children and adolescents participating in CPUP. Methods: This was a cross-sectional registry study. Data from the latest PT (n = 2635) and OT assessment forms (n = 3480) in CPUP were extracted for individuals aged 0-17 years. Logistic regressions were used to assess the relationships between the outcome variables and gender and place of birth (including an interaction term gender X place of birth), adjusted for age, Gross Motor Function Classification System (GMFCS) levels and spasticity scores for PT interventions and Manual Ability Classification System (MACS) for OT interventions. Results: Results are presented as odds ratios [95% confidence intervals] and p-values. Girls were significantly more likely to have spinal braces than boys; 1.54 [1.07, 2.22] p<0.05, a significant interaction with place of birth indicated fewer spinal braces prescribed to children born outside of the Nordic countries; 0.20 [0.079, 0.53] p<0.001. Girls were less likely to have undergone selective dorsal rhizotomy (SDR); 0.49 [0.25, 0.94] p<0.05. Individuals born outside of the Nordic countries, were significantly less likely to have received intrathecal baclofen (ITB) 0.27 [0.074, 0.98] p<0.05. Conclusions Of the treatments prescribed, gender differences were observed for spinal braces and having undergone SDR. A statistically significant difference based on place of birth was noted for spinal bracing and having received ITB treatment. Other PT and OT treatments were associated with age, levels of spasticity, and functional severity as classified with the GMFCS and the MACS. Increased awareness of differences based on gender, and where a child is born, could be obtained by inter- and intraprofessional discussions.

scholarly journals Gender differences in treatments and interventions received by children and adolescents with cerebral palsy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Annika Lundkvist Josenby ◽  
Tomasz Czuba ◽  
Ann I. Alriksson-Schmidt
Keyword(s):  
Gender Differences ◽  
Cerebral Palsy ◽  
Children And Adolescents ◽  
Classification System ◽  
Nordic Countries ◽  
Place Of Birth ◽  
Swedish Population ◽  
Cross Sectional ◽  
National Quality ◽  
Significant Difference

Abstract Background In the Swedish population-based follow-up program and national quality registry for individuals with cerebral palsy (CPUP), physiotherapy (PT) and occupational therapy (OT) treatments are regularly recorded along with functional status. By Swedish law, all citizens irrespective of personal characteristics or socioeconomic status, have the right to receive healthcare and medical treatments as applicable. Previous research has shown gender differences in treatments and interventions received by children with cerebral palsy (CP). The purpose of this study was to examine differences in treatments and interventions by gender and place of birth in children and adolescents participating in CPUP. Methods This was a cross-sectional registry study. Data from the latest PT (n = 2635) and OT assessment forms (n = 3480) in CPUP were extracted for individuals aged 0–17 years. Logistic regressions were used to assess the relationships between the outcome variables and gender and place of birth (including an interaction term gender X place of birth), adjusted for age, Gross Motor Function Classification System (GMFCS) levels and spasticity scores for PT interventions and Manual Ability Classification System (MACS) for OT interventions. Results Results are presented as odds ratios [95% confidence intervals] and p-values. Girls were significantly more likely to have spinal braces than boys; 1.54 [1.07, 2.22] p < 0.05, a significant interaction with place of birth indicated fewer spinal braces prescribed to children born outside of the Nordic countries; 0.20 [0.079, 0.53] p < 0.001. Girls were less likely to have undergone selective dorsal rhizotomy (SDR); 0.49 [0.25, 0.94] p < 0.05. Individuals born outside of the Nordic countries, were significantly less likely to have received intrathecal baclofen (ITB) 0.27 [0.074, 0.98] p < 0.05. Conclusions Of the treatments prescribed, gender differences were observed for spinal braces and having undergone SDR. A statistically significant difference based on place of birth was noted for spinal bracing and having received ITB treatment. Other PT and OT treatments were associated with age, level of spasticity, and functional severity as classified using the GMFCS and the MACS. Increased awareness of differences based on gender, and where a child is born, could be obtained by inter- and intraprofessional discussions.

scholarly journals Gender Differences in Treatments and Interventions Received for Children and Adolescents with Cerebral Palsy

2020 ◽  
Author(s):  
Annika Lundkvist Josenby ◽  
Tomasz Czuba ◽  
Ann I Alriksson Schmidt
Keyword(s):  
Gender Differences ◽  
Cerebral Palsy ◽  
Children And Adolescents ◽  
Classification System ◽  
Nordic Countries ◽  
Place Of Birth ◽  
Swedish Population ◽  
Cross Sectional ◽  
National Quality ◽  
Significant Difference

Abstract Background: In the Swedish population-based follow-up program and national quality registry for individuals with cerebral palsy (CPUP), physiotherapy (PT) and occupational therapy (OT) treatments are regularly recorded along with functional status. By Swedish law, all citizens irrespective of personal characteristics or socioeconomic status have the right to receive healthcare and medical treatments as applicable. Previous research has shown gender differences in treatments and interventions received by children with cerebral palsy (CP). The purpose of this study was to examine differences in treatments and interventions by gender and place of birth in children and adolescents participating in CPUP. Methods: This was a cross-sectional registry study. Data from the latest PT (n = 2635) and OT assessment forms (n = 3480) in CPUP were extracted for individuals aged 0-17 years. Logistic regressions were used to assess the relationships between the outcome variables and gender and place of birth (including an interaction term gender X place of birth), adjusted for age, Gross Motor Function Classification System (GMFCS) levels and spasticity scores for PT interventions and Manual Ability Classification System (MACS) for OT interventions. Results: Results are presented as odds ratios [95% confidence intervals] and p-values. Girls were significantly more likely to have spinal braces than boys; 1.54 [1.07, 2.22] p<0.05, a significant interaction with place of birth indicated fewer spinal braces prescribed to children born outside of the Nordic countries; 0.20 [0.079, 0.53] p<0.001. Girls were less likely to have undergone selective dorsal rhizotomy (SDR); 0.49 [0.25, 0.94] p<0.05. Individuals born outside of the Nordic countries, were significantly less likely to have received intrathecal baclofen (ITB) 0.27 [0.074, 0.98] p<0.05. Conclusions: Of the treatments prescribed, gender differences were observed for spinal braces and having undergone SDR. A statistically significant difference based on place of birth was noted for spinal bracing and having received ITB treatment. Other PT and OT treatments were associated with age, levels of spasticity, and functional severity as classified with the GMFCS and the MACS. Increased awareness of differences based on gender, and where a child is born, could be obtained by inter- and intraprofessional discussions.

scholarly journals Gender Differences in Treatments and Interventions Received for Children and Adolescents with Cerebral Palsy

2019 ◽  
Author(s):  
Annika Lundkvist Josenby ◽  
Tomasz Czuba ◽  
Ann I Alriksson Schmidt
Keyword(s):  
Gender Differences ◽  
Cerebral Palsy ◽  
Children And Adolescents ◽  
Motor Function ◽  
Classification System ◽  
Place Of Birth ◽  
Gross Motor ◽  
Gross Motor Function ◽  
National Quality ◽  
Manual Ability Classification System

Abstract Background In the Swedish population-based follow-up program and national quality registry for individuals with cerebral palsy (CPUP), physiotherapy (PT) and occupational therapy (OT) treatments are regularly recorded along with functional status. By Swedish law, all citizens irrespective of personal characteristics or socioeconomic status have the right to receive medical treatments as applicable. Previous studies have shown gender differences in terms of certain treatments and interventions received among children with CP. The purpose of this study was to examine differences in PT and OT treatments and interventions by gender and place of birth in children and adolescents participating in CPUP. Methods This was a cross-sectional study. Data from the latest PT form (n = 2695) and OT form (n = 3480) measures were extracted for individuals aged 0-17 years in CPUP. Logistic regressions were used to assess the relationships between the outcome variables and gender and place of birth (including an interaction term gender x place of birth), adjusted for age, Gross Motor Function Classification System (GMFCS) levels and spasticity scores for PT interventions, and Manual Ability Classification System (MACS) for OT interventions. Results are presented as odds ratios [95% confidence intervals] and p-values. Girls were more likely to have spinal braces than boys; 1.544 [1.073, 2.223] p<0.05, a significant interaction with place of birth indicated less spinal braces prescribed to children born outside Scandinavia; 0.204 [0.0792, 0.525] p<0.001. Boys were more likely to have undergone selective dorsal rhizotomy (SDR); 0.485 [0.251, 0.939] p<0.05. Individuals born outside Scandinavia, were less likely to have received intrathecal baclofen (ITB) 0.269 [0.0737, 0.980] p<0.05. Conclusions Of the treatments prescribed, gender differences were observed for spinal braces and having undergone SDR. A statistically significant difference based on place of birth was seen for spinal brace and having received ITB treatment. Other PT and OT treatments were associated with age, levels of spasticity, and functional severity classified with the Gross Motor Function Classification System and the Manual Ability Classification System. Increased awareness of differences based on gender and where a child is born, could be obtained by inter- and intraprofessional discussions.

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Classification System ◽  
West African ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Common Cause ◽  
Low Income Country ◽  
Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

Self perceived oro-facial behaviour and malocclusion among young adults in Hyderabad city

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Dasari Tejaswini ◽  
Suhas Kulkarni ◽  
Dolar Doshi ◽  
Adepu Srilatha
Keyword(s):  
Gender Differences ◽  
Young Adults ◽  
Health Knowledge ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Sampling Procedure ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Face ◽  
The Impact

AbstractBackgroundAesthetic alterations in the face can be self-perceived and can affect quality of life in young adults.ObjectiveTo assess the impact of malocclusion on self- perceived oro-facial behaviour among young adults.MethodsA Cross sectional study was conducted among 638 young adults (aged 18–21 years) of Hyderabad city. One college from each of the five zones of the Hyderabad city (five colleges) were selected by simple random sampling procedure. A 21-item Oro-facial investment scale (OFIS) questionnaire assessing self-perceived oral health knowledge, attitude, practice and Dental Aesthetic Index (DAI) assessing the severity of malocclusion was used. Data were analysed with standard statistical software (SPSS, Statistical package for the social sciences, version 20.0). p < 0.05 was considered statistically significant.ResultsMales had higher mean scores for knowledge (2.90 ± 0.49) than females (2.73 ± 0.82) and was statistically significant (p = 0.002*). No statistically significant gender differences were found in relation to attitude and practice. Analysis of variance (ANOVA) showed that there was a significant difference in all the three scores (knowledge, attitude, practice) with respect to age, with significantly high score for knowledge and practice among 18 year old subjects (p = 0.0001*; p = 0.0003* respectively) and attitude among 21 year old subjects (p = 0.0049*). No statistically significant age, gender differences were found in relation to DAI scores. Upon correlation, DAI significantly and positively correlated with knowledge (p = 0.03*) and attitude (p = 0.0001*).ConclusionThis study has shown significant impact of malocclusion on the self-perceived oro-facial behaviour.

Gender differences in upper airway compliance during NREM sleep: role of neck circumference

2002 ◽  
Vol 92 (6) ◽  
pp. 2535-2541 ◽  
Author(s):  
James A. Rowley ◽  
Carrie S. Sanders ◽  
Brian R. Zahn ◽  
M. Safwan Badr
Keyword(s):  
Gender Differences ◽  
Gender Difference ◽  
Upper Airway ◽  
Nrem Sleep ◽  
Neck Circumference ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Significant Difference ◽  
Upper Airway Structure

It has been proposed that the gender difference in sleep apnea prevalence is related to gender differences in upper airway structure and function. We hypothesized that men would have smaller retropalatal cross-sectional area and higher compliance during sleep compared with women. Using upper airway imaging, we measured upper airway cross-sectional area and retropalatal compliance in wakefulness and non-rapid eye movement (NREM) sleep in 15 men and 15 women without sleep-disordered breathing. Cross-sectional area at the beginning of inspiration tended to be larger in men compared with women in both wakefulness [194.5 ± 21.3 vs. 138.8 ± 12.0 (SE) mm2] and NREM sleep (111.1 ± 17.6 vs. 83.3 ± 11.9 mm2; P = 0.058). There was no significant difference, however, after correction for body surface area. Retropalatal compliance also tended to be higher in men during both wakefulness (5.9 ± 1.4 vs. 3.1 ± 1.4 mm2/cmH2O; P = 0.006) and NREM sleep (12.6 ± 2.7 vs. 4.7 ± 2.6 mm2/cmH2O; P = 0.055). However, compliance was similar in men relative to women after correction for neck circumference. We conclude that the gender difference in retropalatal compliance is more accurately attributed to differences in neck circumference between the genders.

scholarly journals Access to Intrathecal Baclofen Treatment for Children with Cerebral Palsy in European Countries: An SCPE Survey Reveals Important Differences

2020 ◽  
Vol 51 (02) ◽  
pp. 129-134
Author(s):  
Kate Himmelmann ◽  
Magnus Påhlman ◽  
Guro L. Andersen ◽  
Torstein Vik ◽  
Daniel Virella ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Gross Domestic Product ◽  
Sex Difference ◽  
Motor Function ◽  
Classification System ◽  
Intrathecal Baclofen ◽  
Population Based ◽  
Treatment Access ◽  
Significant Difference ◽  
Children With Cerebral Palsy

Abstract Aim The aim is to study access to intrathecal baclofen (ITB) for children with cerebral palsy (CP) in Europe, as an indicator of access to advanced care. Methods Surveys were sent to CP registers, clinical networks, and pump manufacturers. Enquiries were made about ITB treatment in children born in 1990 to 2005 by sex, CP type, level of gross motor function classification system (GMFCS) and age at the start of treatment. Access to ITB was related to the country's gross domestic product (GDP) and % GDP spent on health. Results In 2011 population-based data from Sweden, Norway, England, Portugal, Slovenia, and Denmark showed that 114 (3.4%) of 3,398 children with CP were treated with ITB, varying from 0.4 to 4.7% between centers. The majority of the children were at GMFCS levels IV-V and had bilateral spastic CP. In Sweden, dyskinetic CP was the most commonly treated subtype. Boys were more often treated with ITB than girls (p = 0.014). ITB was reported to be available for children with CP in 25 of 43 countries. Access to ITB was associated with a higher GDP and %GDP spent on health (p < 0.01). Updated information from 2019 showed remaining differences between countries in ITB treatment and sex difference in treated children was maintained. Conclusion There is a significant difference in access to ITB for children with CP across Europe. More boys than girls are treated. Access to ITB for children with CP is associated with GDP and percent of GDP spent on health in the country.

scholarly journals Assessment of the influence of overweight and obesity on the development of prehypertension and hypertension in children aged 6-15

2021 ◽  
Vol 50 (4) ◽  
pp. 85-96
Author(s):  
Marijana Jandrić-Kočić
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Primary School ◽  
Children And Adolescents ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Primary School Children ◽  
Cross Sectional ◽  
Significant Difference ◽  
Hypertension In Children

Introduction/Aim: 41 million children under the age of 5 and 340 million children and adolescents aged 5 to 19 are overweight or obese. Obesity in children and adolescents is the most important predictor of high blood pressure. The aim of the study was to examine the incidence of overweight and obesity in primary school children aged 6 to 15 years, as well as to examine the incidence of prehypertension and hypertension in children who were overweight and obese. Method: The study included 85 of 86 children from the Primary School "Krupa na Uni". Data were collected with the help of a questionnaire, while body weight and blood pressure were measured. The chi-square test and t-test were used for the statistical analysis of data Results: The cross-sectional study included 85 children, 45 (52.9%) boys and 40 (47.1%) girls with an average age of 10.87 ± 2.70 years. Normal weight was found in 54 (63.5%) subjects, underweight in 12 (14.1%), overweight in 5 (5.9%), and obesity in 14 (16.5%). 76 (89.4%) subjects had normal blood pressure values, 5 (5.9%) prehypertensive state, and 4 (4.7%) arterial hypertension. There was no significant difference between younger and older children regarding their nutritional status (p=0.477) and blood pressure levels (p=0.453). Children who were overweight and obese had prehypertension and hypertension significantly more often (p˂0.001). Conclusion: Every fifth child was overweight or obese, while prehypertension or hypertension were found in every tenth child. The timely change of diet and physical activity could contribute to the regulation of body weight and the regulation of blood pressure, as well.

scholarly journals Chronic pain among children with cerebral palsy attending a Ugandan tertiary hospital: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emma Nsalazi Bambi ◽  
Angelina Kakooza Mwesige ◽  
Hervé Monka Lekuya ◽  
Philip Kasirye ◽  
Richard Idro
Keyword(s):  
Chronic Pain ◽  
Cerebral Palsy ◽  
Pain Management ◽  
Classification System ◽  
Behavioral Problem ◽  
Cross Sectional Study ◽  
Mulago Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Children With Cerebral Palsy

Abstract Background Children with cerebral palsy (CP) frequently experience chronic pain. The burden and severity of such pain is often underestimated in relation to their other impairments. Recognition and awareness of this chronic pain among children with CP constitute the cornerstone for caretakers and clinicians to improve the quality of life of those children. This study aimed to determine the prevalence of chronic pain among children with CP, and the factors associated. Methods A cross-sectional study of children with CP, aged 2–12 years, attending the CP rehabilitation clinic and Pediatric Neurology Clinic at Mulago Hospital, Uganda from November 2017 to May 2018. A detailed history and clinical examination were performed and the co-morbidities were determined. CP was classified using the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, Communication Function Classification System (CFCS), and the Eating and Drinking Ability Classification System (EDACS) and documented with the level of impairment in the different domains. Pain was assessed by using the revised Face, Legs, Activity, Consolability, Cry pain scale. Results A total of 224 children with CP were enrolled. The prevalence of chronic pain was 64.3%. The majority had spastic bilateral CP (77.8%), moderate pain lasting over 6 months, and none of them was on long-term pain management. Epilepsy (60.9%), behavioral problem (63.2%), hearing impairment (66,7%), learning problem (67,6%), dental caries (75%), gastro-esophageal reflux (75%), sleep disorders (79.5%), vision impairment (80%), and malnutrition (90%) were co- morbid conditions of chronic pain in children with CP in this study. The factors independently associated with chronic pain among children with CP were the GMFCS level IV & V, CFCS level IV & V, EDACS level IV & V, female children, and caretaker aged more than 30 years. Conclusions Two-thirds of children with CP attending rehabilitation in this hospital had chronic pain. None was receiving pain management. Chronic pain was associated with the presence of multiple co-morbidities and more severe disability. Rehabilitation and care programs for children with CP should include assessment of pain in routine care and provide interventions for pain relief in children with CP even at an early age.

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