Age at first prosthetic fitting and later functional outcome in children and young adults with unilateral congenital below-elbow deficiency:A cross-sectional study

The objective of this study was to evaluate whether prosthetic fitting before the age of one year is associated with better outcomes in children with unilateral congenital below-elbow deficiency compared to children fitted after the age of one. Twenty subjects aged 6-21 years were recruited (five prosthetic users and 15 non-users). The Child Amputee Prosthetics Project-Prosthesis Satisfactory Inventory (CAPP-PSI) and the Prosthetic Upper Extremity Functional Index (PUFI) were used to assess patient satisfaction and functional use of the prosthesis. Videotapes were used to assess motor performance. Initial prosthetic fitting before one year of age was related to use of a prosthesis for at least four years. Age at first fitting was not associated with satisfaction with the prosthesis, functional use of the prosthesis or motor skills. Discrepancies between ease of performance with prosthesis and usefulness of the prosthesis as well as between capacity and performance of activities were found. The video assessments showed impaired movement adaptation to some tasks in six subjects. In conclusion, early prosthetic fitting seems to have a limited impact on prosthesis use during later stages of life

Indigenous Languages of Scotland: culture and the classroom

Scotland’s indigenous languages were, for very many years, under attack. The Gaelic of the Highlands and Western Isles, arguably one of the earliest written European languages, after Greek and Latin, had a brief apotheosis around 1000CE when it was the language of the Scottish Royal Court. Scots, spoken by the mass of the people, was the language of the renowned Mediaeval poets known as the Makars. Gaelic was effectively ignored but for attempts, by the Scottish Society for the Propagation of Christian Knowledge, to engender transient bilingualism in order to have the Gaelic diminished and then forgotten. Following the accession of the James VI of Scotland to the throne of the United Kingdom of England and Scotland, the Authorised Edition of the Bible was commissioned and published but only in English, no Scots version being deemed necessary. After the Union of the Parliaments in 1707, what prestige remained to the Scots language diminished rapidly and henceforth almost the entire written output from Scotland has been in English. Exceptions have included Hugh MacDiarmid’s poetry, Liz Lochhead’s translation into Scots of Molière’s Tartuffe (1664/1986), which toured urban working-class areas in the 1980s and to great acclaim, and Trainspotting

Children’s Participation in the Justice System

The rights of children in youth justice and civil court proceedings, and in particular the right of children to be heard or to “participate” in such systems, is an area in which there has been much interest in recent years, particularly sparked by Article 12 of the UN Convention on the Rights of the Child. There are a wide variety of proceedings in which children’s interests are decided, for example, where they are accused of a crime, where their parents are in dispute on family breakdown and where there are child protection concerns. This chapter examines recent developments in standards at international level concerning children’s participation in proceedings, such as the drafting of General Comment No. 12 of the UN Committee on the Rights of the Child on the right to be heard and the Guidelines on Child-friendly Justice of the Council of Europe. It draws on recent international research in order to provide analysis of the extent to which such standards have affected practice and made a difference for children. It concludes that although the development of such standards is to be welcomed, and although these standards have achieved some improvements at domestic level, the more extensive modifications required for genuine participation of children in the justice system has not occurred.Effective Protection of Fundamental Rights in a pluralist worl

A long-term review of children with congenital and acquired upper limb deficiency

A long-term review of 131 children fitted with upper limb prostheses at the Ontario Crippled Children's Centre between 1965 and 1975 is reported. There were 116 children with congenital deficiencies and 15 who had had amputations. Follow-up ranged from 7 to 17 years. A total of 42 children had abandoned their prostheses, 37 of whom had congenital deformities and five were amputees. The level of deficiency was of fundamental importance in determining whether the prosthesis would be accepted; in the forearm, the longer the stump, the more likely it was that the child would discard the prosthesis. Overall, 50 per cent of children fitted over the age of two years abandoned their prostheses compared with only 22 per cent of patients who had been fitted before the age of two years. The highest drop-out rate was at the age of 13 years when the children became more conscious of their cosmetic appearance. Suggestions for reducing the high drop-out rate in the early teens are put forward. </jats:p

Dutch women in midwife-led care at the onset of labour: Which pain relief do they prefer and what do they use?

Contains fulltext : 125360.pdf (publisher's version ) (Open Access)BACKGROUND: Pain experienced during labour is more extreme than many other types of physical pain. Many pregnant women are concerned about labour pain and about how they can deal with this pain effectively.The aim of this study was to examine the associations among low risk pregnant women's characteristics and their preferred use and actual use of pain medication during labour. METHODS: Our study is part of the DELIVER study: a dynamic prospective multi-centre cohort study. The data for this study were collected between September 2009 and March 2011, from women at 20 midwifery practices throughout the Netherlands. Inclusion criteria for women were: singleton pregnancies, in midwife-led care at the onset of labour and speaking Dutch, English, Turkish or Arabic. Our study sample consisted of 1511 women in primary care who completed both questionnaire two (from 34 weeks of pregnancy up to birth) and questionnaire three (around six week post partum). These questionnaires were presented either online or on paper. RESULTS: Fifteen hundred and eleven women participated. Prenatally, 15.9% of women preferred some method of medicinal pain relief. During labour 15.2% of the total sample used medicinal pain relief and 25.3% of the women who indicated a preference to use medicinal pain relief during pregnancy, used pain medication. Non-Dutch ethnic background and planned hospital birth were associated with indicating a preference for medicinal pain relief during pregnancy. Primiparous and planned hospital birth were associated with actual use of the preferred method of medicinal pain relief during labour. Furthermore, we found that 85.5% of women who indicated a preference not to use pain medication prenatally, did not use any medication. CONCLUSIONS: Only a small minority of women had a preference for intrapartum pain medication prenatally. Most women did not receive medicinal pain relief during labour, even if they had indicated a preference for it.Care providers should discuss the unpredictability of the labour process and the fact that actual use of pain medication often does not match with women's preference prenatally.8 p

Long-term outcome of MacIntosh reconstruction of chronic anterior cruciate ligament insufficiency using fascia lata.

The purpose of this study was to assess the long-term outcome of the MacIntosh lateral-substitution over-the-top anterior cruciate ligament (ACL) reconstruction in 82 patients (84 knees) at an average follow-up of 9.8 years. In this retrospective cohort study patients were evaluated with subjective questionnaires and by clinical and radiographic examination. Using the Lysholm score, 17 knees were rated excellent, 35 good, 19 fair, and 13 poor. The pivot shift test was negative in 74 patients. Altogether, 30 knee radiographs were evaluated. The mean Hospital for Special Surgery ACL radiographic score was 20.9. There was a non-significant association between the radiographic score and the Lysholm score and between a worsening radiographic score and increasing time from injury. The MacIntosh lateral-substitution over-the-top ACL reconstruction shows results comparable to those of previously reported long-term studies. Although endoscopically assisted intraarticular reconstructions with faster rehabilitation protocols have now become popular, this procedure may be considered in patients needing an intra- and extraarticular reconstruction in whom cosmesis is not an issue