A systematic review of the evidence on the effect of parental communication about health and health behaviours on children's health and wellbeing.

Parents report feeling unsure how best to talk with their children about sensitive health topics and may avoid such conversations; yet if children have questions or concerns about their health, talking to a parent could enhance their health and wellbeing. We investigated the effects of parental communications about health and health behaviours on children's health and wellbeing, and explored what strategies can encourage parents to communicate about health. We conducted a systematic review and narrative synthesis of research published between January 2008 and April 2020 from five databases. Of 14,007 articles identified, 16 met inclusion criteria focusing on five topics: diet and weight (n = 5), body image (n = 2), sexual health (n = 7), physical activity (n = 1) and bullying (n = 1). Positive child outcomes were associated with positive general parent-child communication characterised by warmth, openness and allowing children choice. Conversely, hostility, negative and inconsistent messaging were associated with poorer outcomes. Interventions to increase parent-child communication could be classified as providing single directive messages, media campaigns or intensive support. Single messages increased communication frequency; media campaigns and intensive interventions showed mixed outcomes. No differences in outcomes were found according to child's gender or socio-economic status. Generally, parents were less confident in initiating, rather than continuing, conversations and were more likely to initiate conversations when they felt they had good topic knowledge. While the relatively small, diverse sample limits the strength of these findings, this review provides provisional support for approaches to promote positive parent-child communication about health that are associated with better child health and wellbeing.

In vivo measurement of distal radioulnar translation following distal radius fracture.

The incidence of distal radioulnar joint instability following a distal radius fracture is estimated around one in three based upon clinical examination. Using a validated rig, we objectively measured distal radioulnar joint translation in vivo following distal radius fracture. Dorsopalmar translation of the distal radioulnar joint was measured in 50 adults with previous distal radius fractures. Measurements were compared with the uninjured wrist and against a database of previous measurements within healthy and clinically lax populations. Translation at the distal radioulnar joint was greater in injured wrists at 12.2 mm (range 10-15, SD 1.2) than the uninjured wrists at 6.4 (range 4-9, SD 0.8) (p < 0.001) and was always outside the established normal range. There was no statistically significant link between translation and the severity of the injury. Instability appears almost inevitable following a distal radius (wrist) fracture, albeit subclinical in the vast majority.

Volar Tenodesis for the Treatment of Swan-neck Deformity; A Systematic Review.

BACKGROUND: Swan-neck deformity is a common problem particularly in patients with Rheumatoid arthritis. Mobile swan-neck deformities (Nalebuff types I,II) can be treated non-operatively and operatively. In this paper we report on a systematic review of the treatment of swan-neck deformities with volar tenodesis. METHODS: We performed a literature search and analysed the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only eight papers were eligible. None was of high quality. The data reporting was very variable. Therefore, no meta-analysis could be performed, but only a descriptive analysis. RESULTS: The techniques work in preventing proximal inter-phalangeal joint hyperextension between 60 and 100% in these studies. There appears to be some recurrence of hyper-extension with time so that papers with longer follow-up tend to have poorer results. CONCLUSIONS: There is no good evidence that one technique is superior to another. The choice of technique is likely to remain based on surgeon preference for the foreseeable future. Future studies should be at least comparative and preferably part of a trial.

A qualitative study of patients' motivations and expectations for dental implants.

OBJECTIVE: To explore patients' motivations and expectations for dental implants. DESIGN: Single-setting, qualitative interview study. SUBJECTS, SETTING AND METHOD: Semi-structured, telephone interviews were conducted with nine patients who had consulted a restorative dental practitioner with an interest in implantology about the possibility of replacing their missing teeth with dental implants. OUTCOME MEASURE: Interview transcripts were subjected to thematic analysis to identify relevant themes. RESULTS: The main theme to emerge was 'normality'. Participants expected implants to restore their oral-related quality of life to 'normal'. However, individual definitions of normality differed; some were appearance focused, while others were more concerned with functioning. Several participants who had completed implant treatment regarded their new prostheses as 'just like natural teeth'. CONCLUSIONS: Patients' belief that dental implants are just like natural teeth could be cause for concern if it leads them to treat them as such, and thereby not follow the recommended specialist care they require. The findings emphasise the importance of good dental practitioner-patient communication in assessing expectations of treatment and outcomes. Further studies should explore the expectations of patients of different ages and socioeconomic backgrounds and consider ways of eliciting patients' beliefs about implants before treatment takes place.