Background
Malnutrition is a common complication in children with chronic diseases. Sarcopenia is one component of malnutrition, characterized by reduced skeletal muscle mass (SMM) and muscle function. The presence of sarcopenia is associated with adverse outcomes in children. Although there is growing research interest in sarcopenia, no review has been done on this novel concept in pediatrics. The purpose of this review was to explore current evidence in sarcopenia with and without obesity and to evaluate the knowledge gaps in the assessment of childhood sarcopenia.
Methods
A total of 12 articles retrieved from PubMed or Web of Science databases were included.
Results
Limited studies have elucidated sarcopenia in pediatrics. Challenges in sarcopenia assessment include heterogeneity in definition and absence of standardized body composition methods used to measure SMM and muscle function tests. There is a lack of age‐specific and gender‐specific normative data for SMM, particularly in young children and infants. None of the studies incorporated muscle function assessment, causing potential bias and misclassification of sarcopenia. The research in childhood sarcopenia is also hampered by low study quality, limited number of outcomes‐based research, and lack of longitudinal data.
Conclusion
Consensus needs to be reached in methodological approaches in sarcopenia diagnosis, body composition measurements, and age‐appropriate muscle function tests in pediatrics. Careful considerations on growth, neurocognitive status, and factors influencing development in various clinical populations are warranted. Early identification of sarcopenia is crucial to enable targeted treatment and prevention to be carried out across the pediatric clinical populations.
Background: Goal setting in paediatric rehabilitation is influenced by shifting parent, sibling, caregiver, and child roles over time and evolving child developmental capacity for participation in the process. A theoretical and evidence-informed approach to goal setting, specific to paediatrics, would provide a framework for goal setting in practice and facilitate systematic evaluation of the effects of goal-setting processes on child and family outcomes. Objective: To provide an overview of relevant goal-setting theories and their implications for paediatric rehabilitation. Methods: Prevalent theories were identified from relevant rehabilitation, motivation, behaviour change, and goal-setting literature. Implications for goal setting in paediatrics are summarized according to goal-setting and action-planning phases: (1) preparation, (2) formulation of goals, (3) formulation of action plan, (4) coping planning, and (5) follow up. Results: Social cognitive theory, self-determination theory, Health Action Process Approach, Mastery Motivation, and goal-setting theory are reviewed. Examples of implications for goal setting include, sharing information with families about the purpose of goal setting; identifying goals that are specific, proximal, challenging, and important to the child; and addressing self-efficacy. Conclusion: The theories reviewed have clear implications for paediatric rehabilitation research and practice. They address considerations not typically discussed in adult rehabilitation such as observing children to obtain information about meaningful goals when they are unable to communicate them directly and the importance of establishing flexible processes that will accommodate changing family roles over time. Research is needed to evaluate the effects of goal-setting processes and strategies on outcomes in paediatric rehabilitation.
BACKGROUND: Adults with developmental disabilities are significantly un-and under-employed. Little is known about the relationship between visibility of a disability and employment. OBJECTIVE: To explore how visibility of a disability influences employment for adults with developmental disabilities. METHODS: In-depth interviews were done with caregivers, adults with developmental disabilities, and employment support professionals. Content related to visibility/invisibility of disability was thematically analyzed. RESULTS: Three main themes, with 10 sub-themes, emerged: (i) Dispelling Myths: Assumptions Related to Disability; (ii) Rock and a Hard Place: Disclosing 'Invisible' Disability; (iii) Finders-Keepers: Easier to find, but not keep, a job with invisible disability. CONCLUSIONS: Assumptions about disability underpinned employment-related challenges experienced by adults with developmental disabilities. Our findings highlight the need for employment initiatives that go beyond skill-based training to target social barriers of employment, such as stigma and lack of disability knowledge.
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