RESUMEN
In the management of early onset scoliosis (EOS) and adolescent idiopathic scoliosis (AIS), orthopedic surgeons are tasked with considering the effects that curves and their treatment can have on the respiratory system, possibly the most relevant being pulmonary dysfunction due to thoracic cage changes. The pulmonary impairment that occurs as a result of scoliosis varies widely and requires a multimodal response, including physiologic testing, such as pulmonary function tests (PFTs) and consistent psychosocial monitoring of the patient. This forces healthcare providers to consider all factors affecting the patient's quality of life (QOL) and not just the primary pathology they are treating. One method that could be utilized to ensure a more holistic approach to treatment is the use of patient-reported outcome measures (PROMs) to assess the QOL domains. Thus, this review serves to highlight the importance of addressing and correcting pulmonary dysfunction in the care of children with EOS and AIS in a holistic manner.
RESUMEN
Background India's health disparities are clearly visible in the southern state of Karnataka. A community needs assessment, one of the first done in this area in over a decade, was conducted to identify unsatisfied needs. The Northwell Center for Global Health worked alongside a local boarding school, Shanti Bhavan, to conduct a needs assessment using the Center for Disease Control and Prevention's Community Assessment for Public Health Emergency Response tool. Methods A community-based cross-sectional survey design was implemented in low-income sections of 10 rural villages in Karnataka throughout February 2019. The target population for this study included people who earned less than US$2 per day. The survey instrument consisted of a questionnaire and tracking form. Results One-hundred ninety-seven (197) of 359 households participated in the survey, which encompassed a total of 1,023 individuals. Proper housing structure was the most common need (27.7 %), followed by access to transportation (16.1 %) and access to healthcare (15.2 %). Agitated behavior, sad mood, and frequent worries were the most-experienced behavioral health concerns, with a 47.7%, 41.6%, and 41.1 % prevalence, respectively. Chronic diseases (eg, high blood pressure, diabetes, asthma) were prevalent in 35 of the households (9.7%). The major disease concern in relation to mosquito-borne illness was dengue (36.0 %). Access to healthcare was an issue in 44 of the 197 households (22.3%), with financial reasons being the most common barrier. Discussion Notably, there were no expressed needs for basic necessities such as food, water, and medication. This may be due to the help of state programs or a limitation of the survey format. Respondents were most concerned with dengue but are also at risk for other vector-borne diseases, such as malaria and chikungunya, highlighting the need to increase awareness and safety measures. Additionally, mental health problems represent a significant burden of disease.