Systematic Evaluation of Variables Associated with Emesis: A Case Study

AbstractRecurrent emesis (i.e., vomiting) during mealtime is often a great concern of caregivers of children with pediatric feeding disorders. Identifying the cause and treating the emesis may be difficult due to the multiple factors that may contribute to the occurrence overtime. Emesis may result from various factors, some of which include volume sensitivity, inadequate oral motor skills, and environmental factors related to food novelty and texture. This case study describes a 6-year-old boy with spina bifida who was dependent upon gastrointestinal-tube feedings due to frequent emesis when fed orally. Upon admission to an intensive feeding program, several potential factors maintaining the emesis were identified based upon clinical assessment, observation, and caregiver report. These factors were each evaluated systematically and results indicated that emesis was more likely to occur when foods of novel taste and texture were presented. With exposure, rates of emesis decreased across both type and texture of food. However, emesis decreased more quickly for novel foods at a pureed texture compared to the same food at a higher texture. There were no significant differences in rates of emesis during environmental manipulations related to observer response or associated with volume sensitivity. The methods utilized in this study may be useful to practitioners to systematically evaluate the variables contributing to the occurrence and maintenance of emesis.
Source: Journal of Developmental and Physical Disabilities - Category: Disability Source Type: research

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Abstract Spina bifida is the most common nonchromosomal birth defect, resulting in permanent disability of multiple organ systems, yet compatible with long-term survival. Important advances across various disciplines have now improved survival among the spina bifida population. Although the majority of individuals living with spina bifida are now adults, there are few publications in the neurosurgical literature regarding the care of adults with spina bifida, associated medical conditions, surgical interventions, and long-term complications. The major goals for transitioning adult patients with spina bifida are pr...
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
Conclusions Vocational interventions may be effective in improving vocational outcomes, QoL, and CI for individuals with ABI. There is limited experimental evidence on interventions that specifically target employment. Observational data suggest that receiving job placement assistance, on-the-job training and supports, counselling/guidance, maintenance, and supported employment successfully predicted employment outcomes.
Source: Journal of Occupational Rehabilitation - Category: Rehabilitation Source Type: research
Abstract Aim: To determine prevalence, incidence and risk factors for foot pressure ulcers in ambulatory children with spina bifida. Method: Retrospective cohort study of 72 ambulatory children (age range 0-23.9 years) with spina bifida treated at a pediatric tertiary care facility. Data on foot pressure ulcers were recorded and analyzed to determine prevalence, incidence and predictive factors. Results: Foot pressure ulcers occurred in 50/143 limbs (35%) over 10.5 ± 3.5 years. Average incidence was 0.10 foot pressure ulcer incidents per person-year, and prevalence in year...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Conclusion: Acknowledging the contributors and hindrances to the well-being of adolescents with spina bifida myelomeningocele is crucial for guiding informed positive interventions and preventing blind spots. Given the limited number of positive contexts, concentrated effort is required to facilitate opportunities for growth in a range of environments. Primary caregivers lack insight into the positive and negative aspects of the adolescents' lives. We suggest families prioritize bonding time and open communication. Implications for rehabilitation Exploring the perspectives of adolescents living with spina bifida and their ...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
CONCLUSION: Large myelomeningocele defects may be successfully repaired with utilization of a skin allograft. PMID: 31289012 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Operating before birth can minimize nerve damage caused by severe defects in tissue around the spinal column.
Source: NYT - Category: American Health Authors: Tags: Pregnancy and Childbirth Paralysis Birth Defects Spina Bifida Disabilities Spine (Body Part) Fetal surgery Texas Children ' s Hospital your-feed-healthcare Source Type: news
Abstract Purpose: To study physical function perspectives in persons with spina bifida (SB) aged ≥50 years. In relation to this, we also wanted to survey participation perspectives, health issues and health services usage. Methods: We used predefined fixed questions to interview community-dwelling adults with SB in Norway. Physical function assessments included Timed Up and Go, the Six Minute Walk Test, and BMI was calculated. Descriptive statistics were used, and logistic regression was performed to study variables associated with community walking. Results: Eighteen women and twelve men, twenty-four of...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
CONCLUSION: The young adults expressed that the Cognitive Orientation to daily Occupational Performance intervention, although sometimes challenging, was worth the effort because it provided them with an opportunity to master everyday-life problems by using meta-cognitive thinking, which enhanced their self-efficacy. Implications for rehabilitation The Cognitive Orientation to daily Occupational Performance Approach™ - was perceived to provide opportunities to master everyday-life problems by using meta-cognitive thinking. The Cognitive Orientation to daily Occupational Performance Approach boosted the persons feelin...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
CONCLUSIONS: Our findings highlight the role of intellectual functioning, bowel continence, and the environmental factors in explaining participation of children with SB across different settings and, therefore, demonstrate the need for more supports and environmental modifications (especially for those who have lower level of cognitive abilities), as well as interventions targeting improved bowel continence. Implications for rehabilitation Children with spina bifida had low levels of participation in the community and preschool/school settings. The most important predictors for participation were intellectual abilities, b...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
CONCLUSIONS: Findings revealed that there are few sex-based differences. Additionally, the need for thorough assessment of disordered eating behaviors in this population is warranted, including those with a lower body mass index who might be overlooked for assessment of unhealthy attempts to lose or maintain their weight. Implications for rehabilitation Adolescents and young adults with spina bifida are often advised to lose weight without clear guidelines on how to do so, putting them at risk for disordered eating. Professionals should expect variable body mass indices in this population, with some health behaviors fallin...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
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