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Introduction: This study aimed to i) identify the care needs of families experiencing cardiac arrest; and ii) co-identify strategies for meeting the identified care needs. Cardiac arrest survivors and family members (of survivors and non-survivors) were engaged as "experience experts," collaborators and co-researchers in this study., Methods: A qualitative study using semi-structured interviews of cardiac arrest survivors and family members was conducted. Participants were recruited from the membership of the Family Centred Cardiac Arrest Care Project. Interviews were recorded, transcribed, and analysed using Framework analysis., Results: Twenty-eight participants described 22 unique cardiac arrest events. We identified five primary care need themes: 1) "Help us help our loved one"; 2) "Work with us as a cohesive team"; 3) "See us: treat us with humanity and dignity"; 4) "Address our family's ongoing emergency"; and 5) "Help us to heal after the cardiac arrest" as well as 29 subordinate care need themes. We performed touchpoint mapping to identify key moments of interaction between patients and families, and the health system to highlight potential areas for improvement, as well as strategies for meeting family care needs., Conclusion: Our participants identified varied family care needs during and long after cardiac arrest. Fortunately, many proposed strategies are inexpensive and have low barriers to adoption. However, some unmet care needs identified suggest larger systemic issues such as service gaps that leave families feeling abandoned and isolated. Overall, our findings suggest that care during and after cardiac arrest are critical components of a comprehensive cardiac arrest care system., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Objective: Back pain in adults is common and well studied. In contrast, back pain in children has received comparatively little scientific study, despite recent media attention. The purpose of this study is to see what factors influence the prevalence of back pain in middle school children, with particular attention to the weight of children's backpacks and the availability of school lockers., Methods: A population-based sample of 1540 children ages 11-14 years in a large metropolitan area was studied. A questionnaire was used to determine presence and severity of back pain, availability of lockers, backpack use, use of 1 or 2 straps to carry backpack, activity limitations due to back pain, and use of pain medication for back pain. Gender, age, weight of the child, and weight of his or her backpack were recorded. Results of scoliosis screening were evaluated with regard to the above information. Data were analyzed using the chi test and univariate or multivariate logistic regression analysis as appropriate., Results: Overall, 37% of the children reported back pain. Backpacks were used by 97% of children, hence there were too few students not using backpacks to treat backpack use as an independent variable. Multivariate analysis found back pain associated with use of a heavier backpack (P=0.001), younger age (P<0.001), female sex (P<0.001), and a positive screening examination for scoliosis (P=0.009). Children with lockers available reported less back pain (P=0.016). The use of 1 or 2 straps to carry the backpack did not have a significant association with back pain (P=0.588). Of the children who reported back pain, 34% limited their activity due to the pain, 14% use medication for pain relief, and 82% believed their backpack either caused or worsened their pain., Conclusions: The incidence of back pain in early adolescence approaches that seen in adults. Recommendations for an "acceptable" weight of backpacks cannot be made from this study, as the weights of students' backpacks seem directly proportional to the likelihood of back pain. This study identifies 2 factors associated with self-reported back pain in early adolescents that are amenable to change: availability of school lockers and lighter backpacks. These findings may be useful in advising families and influencing school policies.

Childhood diskitis may occur in the thoracic, lumbar, or sacral spine and can affect children of all ages, but it is most common in the lumbar region in children younger than 5 years. Physical examination, laboratory tests, and radiologic studies all aid in the diagnosis of this clinical syndrome, and proper use can prevent unnecessary invasive intervention. Presentation varies with age; the child may refuse to bear weight on the lower extremities or may present with back pain, abdominal pain, a limp, or, if an infant or toddler, with irritability. The etiology appears to be a bacterial infection, usually caused by Staphylococcus aureus. Most children improve rapidly with a 4- to 6-week course of antibiotics. Although not routinely necessary, immobilization decreases symptoms and, in the case of osseous destruction, prevents progression of spinal deformity. Biopsy of the infected disk space is reserved for children refractory to intravenous antibiotics. Follow-up should include plain radiographs at regular intervals for 12 to 18 months to ensure resolution of the destructive process.

A slipped capital femoral epiphysis was created in 12 matched pairs of immature bovine femora using an anterior-to-posterior-directed shear force. All soft tissues, with the exception of the perichondrial ring, were removed before testing. One specimen from each pair was fixed with a single cannulated screw in standard fashion, whereas the contralateral specimen was fixed with a single screw that compressed the physis. The amount of compression achieved was quantified using Fuji film. Standard fixation yielded 1.4 MPa of pressure across the physis; compression fixation yielded 3.2 MPa, a 2.3-fold difference (p = 0.0001). The compression fixation was 47% more stiff than standard technique (p = 0.030), yet the differences in ultimate strength (p = 0.180) and energy absorbed at failure (p = 0.910) were not statistically significant. The stiffness of the compressed specimens remained less than that of the intact femora. Single-screw compression fixation of in vitro bovine femora was significantly more stiff than the current, widely used noncompression fixation technique, yet does not compromise the ultimate strength, energy absorbed, or the technical ease of single-implant fixation.

Seven adult males with rigid, severe equinovarus deformities underwent single-stage corrective surgery. The procedure included extensive soft tissue release, talectomy and tibiocalcaneal, calcaneocuboid, and tibionavicular fusion. All seven patients fused successfully at an average of 3.5 months with a plantigrade foot. All feet were stiff and had an average of 3.5 cm limb length discrepancy. All of the patients were satisfied with the surgery and would choose to have the procedure again. This small series represents one method of achieving a plantigrade foot in patients with severe, rigid equinovarus deformities.