Use of Powered Prosthesis for Children with Upper Limb Deficiency at Hyogo Rehabilitation Center

Background

There has been no research investigating the use of powered prosthetic for children in Japan.

Objective

To gain better insight into the state of powered prosthesis usage and identify a ratio of rejection among children.

Methods

Subjects were 37 unilateral below elbow amputees between the ages of 0 and 16 at the time of their first experienced fitting with a powered prosthesis at our Center. The information was collected from medical records and through face-to-face interviews, and we examined rejection rate and the factors affecting the use of powered prosthesis.

Results

The rate of discontinuation was 21.6% as 8 of the 37 children stopped using powered prosthesis. All of them were fitted their prosthesis after 2 years of age, and they rejected prosthesis between 5 to 19 years. We found that the level of amputation had no influence on the use of a powered prosthesis.

Conclusions

Children fitted before 2 years of age tend to accept their powered prosthesis than those fitted after 2 years. Multidisciprinary team approach, adequate rehabilitation, detailed follow-up and involvement of parents are quite important for introducing powered prosthesis for children.     

Estimates of the Prevalence of Obesity in Canadian Children

Childhood obesity is becoming a topic of great concern due to the rising prevalence of this condition in North America. Studies conducted in the United States have indicated that the prevalence of obesity has increased dramatically over the past few decades. The purpose of this study was to estimate the prevalence of obesity in Canadian children between the ages of 5 and 12 years by examining data from two national and two regional surveys. The 85th percentiles of each of four anthropometric indices derived from large normative populations were used as diagnostic criteria for obesity. As expected, the resulting prevalences varied according to the criteria used. A significant increase in childhood obesity between the 1981 to 1988 national surveys was observed when the three indices which used skinfolds were applied. Weight-for-height percentiles did not indicate an increase in obesity in these samples. Regional samples showed a less than expected prevalence of obesity among the middle-class children and a higher than expected rate among the inner city boys. It can be concluded that there is a need for a defined criteria for identifying obesity in children in order to avoid confusion resulting from the wide variation in estimates of prevalence resulting from different standards and measurements. Using adiposity-based criteria for obesity it was clearly evident that the prevalence of obesity has increased in Canadian children.     

Geographic and Demographic Variation in the Prevalence of Overweight Canadian Children

Objective : To examine the geographic and demographic variation in the prevalence of overweight Canadian children. Research Methods and Procedures : Using BMI data from the 1981 Canada Fitness Survey and the 1996 National Longitudinal Survey of Children and Youth, this study assessed: 1) the prevalence of overweight and obesity among Canadian boys and girls ages 7 to 13 years; 2) secular trends in the prevalence of overweight from 1981 to 1996, by province and adjusted for age and sex; and 3) provincial variation in the prevalence of overweight, before and after adjusting for socioeconomic and demographic characteristics. Results : The prevalence of boys and girls classified as overweight in 1996 was 33% and 26%, respectively. The corresponding figures for obesity were 10% for boys and 9% for girls. Provincial variation was observed with a trend of increasing risk of being overweight from west to east. Socioeconomic status was inversely related to the prevalence of overweight regardless of geographic region. The risk of being overweight was more related to geography (province) than demographic variables (income and family background); however, the effect of secular trends (1981 to 1996) exceeded the effect of geographic or demographic variables. Discussion : The prevalence of childhood overweight and obesity is increasing in all areas of Canada and can be explained only partially by geographic or demographic characteristics.     

A Prospectus for Canadian Studies in Medical Education

The need for factual information on all phases of medical education is widely recognized. In the United States the Association of American Medical Colleges has initiated an extensive program of research in medical education. No comparable program exists in Canada.On the basis of studies of medical students at the University of British Columbia and the University of Saskatchewan, a prospectus for Canadian studies in medical education is suggested. Such studies might include an annual census of Canadian medical students as well as detailed studies of specific problems. Until such studies have been undertaken in Canada, only an incomplete picture of the various problems in medical education will be available.