Orla Killeen

Physical activity levels of children with juvenile idiopathic arthritis

Abstract Children with juvenile idiopathic arthritis (JIA) have lower levels of moderate to vigorous physical activity (MVPA) and spend longer in sedentary activities than their peers. A study to assess the physical activity levels at a tertiary Irish centre was undertaken to compare children with JIA in Ireland against the international experience. Children with JIA completed a nine-item validated questionnaire, the Physical Activity Questionnaire for Children (PAQ-C). Pain, medication use and disease subtype were recorded. PAQ-C scores were compared against UK threshold values. Estimated %MVPA and time (min/day) were calculated using a published formula. Fifty-three children with JIA (33 female, 20 male, mean 11.4 years) completed the PAQ-C. Mean PAQ-C level was 2.7 for males and 2.4 for females. One-third of children met the threshold levels for being sufficiently active (normative values 2.9 males, 2.7 females). Using estimated %MVPA, one-third did not achieve 30 min of MVPA. There was no significant difference in PAQ-C levels between children with active disease (active joint count >1, self-reported visual analogue scale pain >1 and elevated erythrocyte sedimentation rate/C-reactive protein) and those without active markers. Using both the PAQ-C and estimated MVPA, only one-third of children with JIA met the recommended 60 min of daily MVPA. This needs to be validated against objective measures, e.g. accelerometers.

Self-management needs of children with JIA in Ireland: a qualitative survey of families

Abstract Aim: To explore the self-management needs and coping activities of children with JIA and their parents. Families and children with JIA experience many different challenges with the diagnosis. One of the long-term therapy aims is to assist individuals to develop self-management and coping skills. Methods: Twenty-six face-to-face interviews were conducted at an outpatient tertiary hospital in Ireland using a semi-structured format. Results: Children and families were happy with sources of information about JIA and expressed confidence in the information provided. Parent of younger children felt that information about tricks or tips that other people used could be provided in anticipation of changing medications or flare-ups. Older children expressed a desire to be treated normally and that the means of expressing or illustrating the variable nature of the disease was needed to people outside of the immediate family, i.e. teachers, as this would assist with their coping skills. Discussion: All children refer to the impact of JIA in terms of loss of function and the effect on their role within their society. Families trusted information from medical sources, but there is a need for improving knowledge and skills for unexpected events and changing the perception of exercise and physical activity.

Internet access and utilisation of adolescents attending a national centre for paediatric rheumatology

With emerging interactive and communication technologies now available, the internet has become one of the top health information resources for adolescents (Stinson et al., 2010). Adolescents are typically the early adapters of new technologies, with in particular, the internet providing innovative opportunities for engaging youths. Traditional sources of health information are now becoming defunct and young people are increasingly going online for health related information.

Clinical and radiological features of down's arthropathy

The ‘Arthropathy of Down syndrome’ was first described in 1984. Three decades on we still have limited literature on the clinical and radiological features of this arthritis, despite the fact that it is thought to be 3-6 times more common than JIA in the general paediatric population. Down’s Arthropathy (DA) is rarely recognised at onset, and remains under-diagnosed and largely under-reported in this population group. Ireland has one of the highest Trisomy 21 birth rates in Europe (1/547), & therefore provides an ideal setting for such a study. Research Qs - 1. What are the clinical & radiological features of DA? 2. Is DA missed, leading to a delay in dx?

Musculoskeletal anomalies in a national cohort of children and adolescents with trisomy 21

Musculoskeletal complications of Down syndrome are common. Joint laxity, which may be associated with delayed ambulation, is almost universal. The combination of this ligamentous laxity and low muscle tone contribute to an increased risk of a number of musculoskeletal disorders in children with Down syndrome.

Myeloid related proteins 8 and 14 (mrp 8/14) - potential biomarkers of disease activity of arthritis in children with trisomy 21

JIA is an umbrella term used to describe a heterogeneous group of diseases. To date no specific markers exist in clinical practice to predict disease activity & outcome. MRP 8/14 are calcium-binding proteins secreted by infiltrating phagocytes in synovial inflammation. Studies have shown that serum (Se) concentrations correlate sensitively & specifically with synovial inflammation in JIA. It is believed that they are predictive biomarkers that can identify subclinical disease activity, patients at risk of relapse during times of clinically inactive disease, and patients more likely to respond to Rx with MTX. To date there have been no studies looking specifically at their use in DA. Research Q(s) - 1. Are MRP8/14 accurate markers of inflammation in DA? 2. Do MRP 8/14 levels in Se correlate to Synovial Fluid (SF)?

Cyberbullying in adolescents: the next transition frontier

Cyberbullying, particularly among adolescents, is an emerging issue within our society. Cyberbullying shares similar characteristics with traditional bullying such as repetition, power imbalance and intention. However, it differs in the fact that it is anonymous and rapid, with its victims unable to escape. The effects of cyberbullying on young people may have serious negative affects on their confidence, self-esteem, and emotional and mental wellbeing.