scholarly journals Longitudinal Fibular Deficiency: A Cross-Sectional Study Comparing Lower Limb Function of Children and Young People with That of Unaffected Peers

Children ◽  
2019 ◽  
Vol 6 (3) ◽  
pp. 45
Author(s):  
Joshua Pate ◽  
Mark Hancock ◽  
Louise Tofts ◽  
Adrienne Epps ◽  
Jennifer Baldwin ◽  
...  

Longitudinal fibular deficiency (LFD), or fibular hemimelia, is congenital partial or complete absence of the fibula. We aimed to compare the lower limb function of children and young people with LFD to that of unaffected peers. A cross-sectional study of Australian children and young people with LFD, and of unaffected peers, was undertaken. Twenty-three (12 males) children and young people with LFD (74% of those eligible) and 213 unaffected peers, all aged 7–21 years were subject to the Knee Osteoarthritis Outcome Score (KOOS/KOOS-Child) and the Cumberland Ankle Instability Tool (CAIT/CAIT-Youth). Linear regression models compared affected children and young people to unaffected peers. Participants with LFD scored lower in both outcomes (adjusted p < 0.05). The difference between participants with LFD and unaffected peers was significantly greater among younger participants than older participants for KOOS activities and sports domain scores (adjusted p ≤ 0.01). Differences in the other KOOS domains (pain/symptoms/quality of life) and ankle function (CAIT scores) were not affected by age (adjusted p ≥ 0.08). Children and young people with LFD on average report reduced lower limb function compared to unaffected peers. Knee-related activities and sports domains appear to be worse in younger children with LFD, and scores in these domains become closer to those of unaffected peers as they become older.

Author(s):  
Ajediran I Bello ◽  
Love Kanebi ◽  
Fidelis T Iyor ◽  
Babatunde O A Adegoke

Background: The rehabilitation phase of patients with lower extremity fractures (LEF) is often hindered post-operatively by fear of moving (kinesiophobia) with consequent deconditioning and declining of functions. Profiling the prevalence of kinesiophobia and its association with demographic variables could become useful during the rehabilitation process. Objective: The study aimed to determine the prevalence of kinesiophobia and its correlation with lower limb functions among patients with LEF post-operatively. Methods: One-hundred and nine (n = 109) patients [male = 79 (72.50%)] with mean age of 41.83 ± 17.37 yr. participated in the cross-sectional study. Participants with LEF who had either undergone closed reduction and immobilization or open reduction with internal or external fixation were recruited into this study using convenience sampling during the rehabilitation phase at the orthopaedic wards of two tertiary healthcare facilities in Accra. Data collection was performed using the Tampa Scale of Kinesiophobia (TSK) and Lower Extremity Functional Scale. Data were analyzed using Spearman’s Rho correlation coefficient and Chi-square tests at p < 0.05.Results: Seventy-nine (72.50%) of the participants exhibited kinesiophobia based on their TSK scores (≥37). The TSK scores were significantly inversely correlated with participants’ lower limb function (r = -0.345; p < 0.001). Participants’ sex as well as the causes, types and sites of the fractures sustained had no significant association (p > 0.050) with the level of kinesiophobia. Conclusion: There was a high prevalence of kinesiophobia which negatively correlated with LEF but was not associated with the type, site, and cause of fracture as well as the participants’ sex. Mitigating kinesiophobia should always be considered an integral rehabilitation goal for in-patients with LEF.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037089
Author(s):  
Jennifer M Ryan ◽  
Ellen McKay ◽  
Nana Anokye ◽  
Marika Noorkoiv ◽  
Nicola Theis ◽  
...  

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.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.


2021 ◽  
Author(s):  
Daba Abdissa ◽  
Workitu Sileshi

Abstract BackgroundSexual and reproductive health (SRH) is at the base of young people's living and wellbeing. A significant number of young peoples are affected by avoidable SRH problems due to a lack of appropriate knowledge regarding SRH. Parent-young communication on SRH is critical in informing them about risk and protective behaviors which in turn decrease the likelihood of involvement in risky sexual behaviors. Therefore, the purpose of this study was to evaluate the parent-young communication on SRH issues among secondary and preparatory school students at Agaro town, Southwestern Ethiopia. MethodsSchool based cross-sectional study was conducted from April 13 to April 20, 2019 using stratified random sampling technique. Data were collected using pretested interviewer-administered structured questionnaire entered into Epi data version 3.1; and analyzed using SPSS version 20. A variable having a p-value of <0.25 in the bivariable logistic regression model was subjected to multivariable logistic regression analysis to avoid the confounding variable’s effect. Adjusted odds ratios were calculated at the 95% confidence interval and considered significant with a p-value of <0.05.ResultsA total of 315 students were included to the study. The mean age of the respondents was 20.2±2.6 years. The study finding showed that 61.3% of the participants were discussed on SRH issues with their parents. Educational status of mother [primary education (AOR=3.67; 95%CI=1.93,6.97),secondary education(AOR:2.86;95%CI=1.20,6.80)],educational status of father[primary education (AOR=5.8;95%CI=2.8,12.3,secondary education (AOR=3.21; 95%CI=1.55,6.59)],having family size of <5 (AOR= 6.4; 95%CI= 3.36,12.37) and having boy/girlfriend(AOR=1.99; 95%CI=1.0,3.8) were significantly associated with parent-young people communication. ConclusionAbout two third of the participants communicate with their parents about SRH issues. Parents’ educational status, family size of <5 and having boy/girlfriend were significantly associated with the parent-young people communication. The main reasons for not communicated was cultural taboos, shame and parents lack of knowledge. Therefore, it is necessary to educate and equip students and parents to address the identified problems.


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