3,272 research outputs found
Primary Care and Linked Secondary Care Encounters for Foot and Ankle Problems in Children and Young People: A Population‐Based Cohort Study in England
No full textBackground: In the United Kingdom, foot and ankle problems in children and young people are typically seen by the general practitioner in primary care and referred to secondary care or community services for specialist assessment and intervention. Following initial presentation to primary care, we have described the secondary care services accessed by children and young people with foot and ankle problems. We have also explored the sociodemographic variables associated with referrals to secondary care. Method: This was a population‐based cohort study using the UK Clinical Practice Research Datalink (CPRD) Aurum primary care database and linked Hospital Episode Statistics (HES) Outpatient database. We extracted data for all children and young people up to 18 years of age with a consultation for a foot and ankle problem from 1st January 2015 to 31st December 2021 (CPRD) and included those with linked data in secondary care (HES database) in our analyses. Results: 346,454 children and young people aged 0–18 years were identified in CPRD and eligible for linkage; 5030 had at least one referral within 18 weeks. The most common reason for referral was musculoskeletal or unspecified pain and 2935 had a referral to trauma and orthopaedics, 1314 for paediatric services, 678 for physiotherapy and 274 for diagnostic imaging. Odds for referrals were higher among younger age groups (odds ratio (OR) 1.29 and 95% confidence interval (CI) 1.25–1.33). Those in other (OR 0.77 and 95%CI 0.72–0.82), Asian (OR 0.81 and 95%CI 0.77–0.86) and Black (OR 0.85 and 95%CI 0.8–0.91) ethnic groups had lower odds of referral compared to those in the White group. Conclusion: These findings represent the first analyses of secondary care referrals for children and young people with foot and ankle problems. We have identified that musculoskeletal symptoms were most common reason for referral and the most common speciality involved in assessing foot and ankle problems was trauma and orthopaedics. We have reported sociodemographic differences in secondary care referrals and these findings could be indicative of inequalities in access to care and should be a priority for further research
Emma Bell Miles journal, 1908-1911
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1908 May 24 to 1911 April 25
Emma Bell Miles journal, 1911-1914
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1911 January 9 to 1914 May 3
Emma Bell Miles journal, 1915-1918
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1915 November 11 to 1918 August 8
Emma Bell Miles journal, 1915-1918
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1915 November 11 to 1918 August 8
Emma Bell Miles journal, 1911-1914
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1911 January 9 to 1914 May 3
Emma Bell Miles journal, 1908-1911
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1908 May 24 to 1911 April 25
Emma Bell Miles journal, 1915
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1915 June 15 to 1915 September 22. The journal also includes newspaper clippings of Miles' Fountain Square Conversation column authored for the Chattanooga News
Emma Bell Miles journal, 1915
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1915 June 15 to 1915 September 22. The journal also includes newspaper clippings of Miles' Fountain Square Conversation column authored for the Chattanooga News
Foot and ankle problems in children and young people: a population-based cohort study
No full textThe aim of this research was to describe the epidemiology, presentation and healthcare use in primary care for foot and ankle problems in children and young people (CYP) across England. We undertook a population-based cohort study using data from the Clinical Practice Research Datalink Aurum database, a database of anonymised electronic health records from general practices across England. Data was accessed for all CYP aged 0–18 years presenting to their general practitioner between January 2015 and December 2021 with a foot and/or ankle problem. Consultation rates were calculated and used to estimate numbers of consultations in an average practice. Hierarchical Poisson regression estimated relative rates of consultations across sociodemographic groups and logistic regression evaluated factors associated with repeat consultations. A total of 416,137 patients had 687,753 foot and ankle events, of which the majority were categorised as “musculoskeletal” (34%) and “unspecified pain” (21%). Rates peaked at 601 consultations per 10,000 patient-years among males aged 10–14 years in 2018. An average practice might observe 132 (95% CI 110 to 155) consultations annually. Odds for repeat consultations were higher among those with pre-existing diagnoses including juvenile arthritis (OR 1.73, 95% CI 1.48 to 2.03). Conclusions: Consultations for foot and ankle problems were high among CYP, particularly males aged 10 to 14 years. These data can inform service provision to ensure CYP access appropriate health professionals for accurate diagnosis and treatment
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