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Yumusakhuylu Y, Caglar Yagci H, Bayindir SN. Lower Urinary Tract Symptoms in Patients With Chronic Low Back Pain: A Cross-Sectional Study. Cureus 2023; 15:e45939. [PMID: 37885563 PMCID: PMC10599597 DOI: 10.7759/cureus.45939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION This study aimed to determine the extent of lower urinary tract symptoms (LUTS) in patients with chronic low back pain (CLBP) and the relationship between LUTS and patients' clinical and functional factors. METHODS Patients aged 40 to 80 who were admitted with CLBP were included. Demographic data and the duration of CLBP and LUTS were noted. Anteroposterior and lateral lumbar radiographs and lumbar MRI findings were recorded. Short Form 36 (SF-36) and the Oswestry Disability Index (ODI) were used for functional status assessment. For the LUTS evaluation, patients were asked to tick the symptoms from the list of LUTS prepared. RESULTS We included 90 patients with CLBP. The frequency of urinary incontinence was 81.1%. The mean number of LUTS was 2.81±3.22. The LUTS rates were higher in patients with vertebral height loss (p = 0.03), with central (p = 0.02) and lateral spinal narrow canals (p = 0.03), and with facet hypertrophy (p = 0.04). The rates of LUTS were lower in patients with decreased lumbar lordosis (p = 0.02). The ODI and LUTS were found to be related (p = 0.01). The role limitations due to physical problems of the SF-36 subgroups and LUTS were significantly correlated (p = 0.01). CONCLUSION The incidence of the coexistence of CLBP and LUTS is high. Patients cannot match and report LUTS among their complaints, so physicians should inquire about LUTS in patients with CLBP and carry out the appropriate diagnosis and treatment.
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Affiliation(s)
- Yasemin Yumusakhuylu
- Physical Medicine and Rehabilitation, Istanbul Medeniyet University, Istanbul, TUR
| | - Hanife Caglar Yagci
- Physical Medicine and Rehabilitation, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR
| | - Seyma N Bayindir
- Physical Medicine and Rehabilitation, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR
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Manual Physiotherapy Combined with Pelvic Floor Training in Women Suffering from Stress Urinary Incontinence and Chronic Nonspecific Low Back Pain: A Preliminary Study. Healthcare (Basel) 2022; 10:healthcare10102031. [PMID: 36292479 PMCID: PMC9601851 DOI: 10.3390/healthcare10102031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/01/2022] [Accepted: 10/11/2022] [Indexed: 11/17/2022] Open
Abstract
Stress urinary incontinence (SUI) represents one of the most common subtypes of urinary incontinence (UI) reported by women. Studies have shown an association of SUI with nonspecific low back pain (NSLBP). The primary aim of the present study was to explore the long-term effects of a combined treatment of manual techniques and pelvic floor muscle (PFM) training in women suffering from SUI associated with NSLBP. The secondary aim was to evaluate which manual approach combined with PFM rehabilitation is more effective in improving symptoms related to SUI and in reducing pain perception related to NSLBP. Twenty-six patients suffering from SUI associated with chronic NSLBP were randomly assigned to one of two groups: the postural rehabilitation group (PRg) or the spinal mobilization group (SMg). Both groups performed a manual approach combined with PFM rehabilitation. All patients were evaluated before the treatment (T0), after 10 sessions (T1) and after 30 days from the end of the treatment (T2). The results showed an improvement in both groups in all of the investigated outcomes. Combining manual therapy and PFM training within the same therapy session may be useful for improving both SUI and NSLBP and increasing the quality of life of women suffering from SUI associated with NSLBP.
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Barbosa JMM, de Amorim JSC, de Jesus Moraleida FR, Rocha VTM, Silva JPD, de Professor BZ, Felício DC, Assis MG, Pereira LSM. Urinary symptoms in older people with low back pain: Prevalence, clinical, and functional factors associated. Neurourol Urodyn 2021; 40:1999-2007. [PMID: 34481418 DOI: 10.1002/nau.24782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/05/2021] [Accepted: 08/16/2021] [Indexed: 11/07/2022]
Abstract
AIMS To identify the prevalence, clinical and functional factors associated with urinary symptoms (US) in community-dwelling older adults with acute low back pain (LBP). METHODS This was a cross-sectional study of data's baseline of Back Complaints in the Elders Consortium. All elders had LPB heightened. We analyzed data on urinary symptoms, intensity of pain (Numerical Rating Scale (NRS), disability (Roland Morris [RM]), depressive symptoms (CES-D), and gait speed (m/s) in the Brazilian older adults. The sample was of 586 consecutive participants of BACE-Study. Ethical approval was obtained. In addition to the prevalence analysis, logistic regression analysis was performed. RESULTS The prevalence of US was 18.4% and were associated with CES-D (odds ratio [OR] = 2.84; 95% confidence interval [CI] 1.66-4.86), slower gait speed (OR = 0.33; 95% CI 0.14-0.78), and LBP-related disability (OR = 1.09; 95% CI 1.04-1.13) after adjusting for radiculophaty and other confounding factors. CONCLUSIONS In community-dwelling older people with LBP, US were associated with depressive symptoms, gait speed, and disability. Our findings may provide a new framework for US management with respect to clinical and functional capacity. Specific physical examinations should be encouraged to assess the with acute LBP and US. Others factors can be associated with US in elders with LBP.
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Affiliation(s)
- Juliana M M Barbosa
- Department of Physiotherapy, Postgraduation Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Physical Therapy Course, Centro Universitário de Belo Horizonte, Centro Universitário UNA, Belo Horizonte, Minas Gerais, Brazil
| | - Juleimar S C de Amorim
- Physical Therapy Course, Rio de Janeiro Federal Institute of Education, Science and Technology, Rio de Janeiro, Brazil
| | - Fabianna R de Jesus Moraleida
- Department of Physiotherapy, Postgraduation Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Physical Therapy, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Vitor T M Rocha
- Department of Physiotherapy, Postgraduation Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Juscelio P da Silva
- Department of Physical Therapy, Universidade Federal de Alfenas, Alfenas, Minas Gerais, Brazil
| | - Bárbara Z de Professor
- Department of Physiotherapy, Postgraduation Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Diogo C Felício
- Department Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Marcela G Assis
- Department of Physiotherapy, Postgraduation Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leani S M Pereira
- Department of Physiotherapy, Postgraduation Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Hughes C, May S. A directional preference approach for chronic pelvic pain, bladder dysfunction and concurrent musculoskeletal symptoms: a case series. J Man Manip Ther 2020; 28:170-180. [PMID: 31702976 PMCID: PMC7480605 DOI: 10.1080/10669817.2019.1668994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Chronic pelvic pain (CPP) with concurrent musculoskeletal and bladder symptoms is a complex and challenging problem. However, clinically the co-existence of these symptoms is not routinely questioned, and their musculoskeletal source is not investigated thoroughly. The purpose of this case series is to present the use of Mechanical Diagnosis and Therapy (MDT) principles in seven patients with concurrent chronic pelvic pain, bladder dysfunction and musculoskeletal symptoms. CASE DESCRIPTIONS Seven patients with coexisting pelvic health and musculoskeletal signs and symptoms were retrospectively reviewed. Most common symptoms were urinary frequency, incontinence, pelvic pain, nocturia, dyspareunia, bladder dyssynergia, and lumbar, pelvic or hip pain. All patients failed to recognize the possible interconnectedness of the two sets of symptoms. Each exhibited a directional preference (DP) and subsequent MDT provisional classification of derangement was established; the use of DP forces abolished or dramatically improved both symptoms and mobility impairments. In all cases DP was for sustained sagittal forces initially, but ultimately lateral forces and mobilization were indicated. OUTCOMES Changes in Pelvic Floor Impact Questionnaire, Care Connections Pelvic Floor and Lumbar spine were all clinically significant and exceeded minimally Clinical Important Differences several times. Average of 5.8 sessions per patient was noted. Follow-up at an average of 3.3 years revealed ongoing satisfaction and confidence in independent self-management. DISCUSSION These case studies highlight the importance of ensuring expansion of intake questions for possible co-existence of symptoms in both pelvic and musculoskeletal patients, possibly suggesting a mechanical intervention is indicated. Provisional subclassification into 'Mechanical Pelvic Syndrome' is proposed. Level of Evidence: 4.
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Affiliation(s)
| | - Stephen May
- Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
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Association of Physical Activity With Urinary Incontinence in Older Women: A Systematic Review. J Aging Phys Act 2019; 27:906-913. [PMID: 30859902 DOI: 10.1123/japa.2018-0313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyze the scientific evidence on the association of physical activity with urinary incontinence in older women. DESIGN Searches were performed in MEDLINE, PubMed, CINAHL, Web of Science, SCOPUS, and ScienceDirect. Observational studies were included. The following search terms were used: urinary incontinence, older adult, and physical activity. Methodological quality was assessed using the checklist proposed by Downs and Black. RESULTS Ten articles were included. Sedentary lifestyle and <150 min/week of physical activity are at risk of developing urinary incontinence. Walking (at least 30 min) and physical activities (600-1,500 and 600 METs/min per week) prevent urinary incontinence. Seven of the 10 studies indicated a good level of methodological quality. CONCLUSIONS Sedentary lifestyle is at risk of urinary incontinence, and walking, moderate and vigorous physical activities are associated with prevention of urinary incontinence.
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Doualla M, Aminde J, Aminde LN, Lekpa FK, Kwedi FM, Yenshu EV, Chichom AM. Factors influencing disability in patients with chronic low back pain attending a tertiary hospital in sub-Saharan Africa. BMC Musculoskelet Disord 2019; 20:25. [PMID: 30646894 PMCID: PMC6334448 DOI: 10.1186/s12891-019-2403-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 01/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Very little is known about the burden of chronic low back pain in Africa. This study aimed at assessing disability and associated factors in chronic low back patients in Cameroon. METHODS We carried a hospital-based cross-sectional study including patients suffering from low back pain (LBP) of at least 12 weeks' duration. Disability was assessed using the Roland Morris Disability Questionnaire (RMDQ). RMDQ > 4 described persons with dysfunctional levels of disability. Multivariable linear regression was used to investigate factors associated with higher RMDQ scores hence greater disability. Variables investigated included; gender, age, marital status, employment status and type, smoking history, alcohol consumption, income, pain intensity, LBP duration, psychological wellbeing, sleep satisfaction, leg pain, numbness/paresthesia, bowel/bladder dysfunction symptoms (BBDS), body mass index (BMI), and days of work absence. RESULTS A sample of 136 adults (64% female) with a mean age of 50.6 ± 12.2 years participated in the study. Median duration of LBP was 33 (25th - 75th percentile: 12-81) months. Mean RMDQ score was 12.8 ± 6. In multivariable linear regression, pain intensity (β = 0.07, p = 0.002), longer days of work absence (β = 0.15, p = 0.003) and BBDS (β =2.33, p = 0.029) were associated with greater disability. Factors such as consumption of alcohol (β = - 3.55, p = 0.005) and higher psychological wellbeing scores (β = - 0.10, p = 0.004) significantly contributed to less disability (lower RMDQ scores). Dysfunctional levels of disability were present in 88.1% of patients. CONCLUSION CLBP is associated with significant disability and this relationship is driven by several factors. Multidisciplinary management strategies especially those targeted to improve pain control, manage BBDS and improve psychological wellbeing could reduce disability and improve quality of life.
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Affiliation(s)
- Marie Doualla
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Douala General Hospital, Douala, Cameroon
| | - Jeannine Aminde
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Leopold Ndemnge Aminde
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Fernando Kemta Lekpa
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Douala General Hospital, Douala, Cameroon
| | - Felix Mangan Kwedi
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Douala General Hospital, Douala, Cameroon
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de Abreu DL, Rodrigues PTV, Amaral Corrêa L, Lacombe ADC, Andreotti D, Nogueira LAC. The relationship between urinary incontinence, pelvic floor muscle strength and lower abdominal muscle activation among women with low back pain. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2018.1435720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Douglas Lima de Abreu
- Rehabilitation Science Postgraduation Progam at Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | | | - Leticia Amaral Corrêa
- Rehabilitation Science Postgraduation Progam at Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | | | | | - Leandro Alberto Calazans Nogueira
- Rehabilitation Science Postgraduation Progam at Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
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Rejano-Campo M, Desvergée A, Pizzoferrato AC. [Relationship between perineal characteristics and symptoms and pelvic girdle pain: A literature review]. Prog Urol 2018; 28:193-208. [PMID: 29307482 DOI: 10.1016/j.purol.2017.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 12/04/2017] [Accepted: 12/12/2017] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Pelvic girdle pain (PGP) is characterized by the presence of pain in the posterior pelvic area, distally and laterally to the fifth lumbar vertebra, and/or at the pubic symphysis. PGP is a very common pain condition in women, especially during pregnancy and postpartum. After delivery, pain prevalence decreases to 7 % in the first three months. The current literature describes an association between pelvic girdle pain and different perineal characteristics and symptoms. OBJECTIVES A better understanding of perineal structures influence on PGP could assist towards the management of this condition. The aim of this review is to describe the peer-reviewed literature about perineal function in patients with PGP. METHODS A bibliographic search on PubMed was conducted. The key words used were: pelvic girdle pain, pregnacy-related low back pain, lumbopelvic pain, posterior pelvic pain, peripartum pelvic pain, pelvic girdle relaxation, pelvic joint instability, peripartum pelvic pain, sacroiliac joint pain, sacroiliac joint dysfunction, sacroiliac-joint related pelvic pain and pelvic floor. Two hundred and twenty-one (221) articles were identified. Out of them, a total of nine articles were selected. The level of evidence was determined using Oxford's scale. RESULTS Patients with PGP showed increased activity of the pelvic floor muscles (P=0.05) (LE3), decreased urogenital hiatus area (PGP 12.4 cm2±2.7, control 13.7 cm2±2.8, P=0.015) (LE3), shorter endurance time (PGP 17.8 s; control 54.0 s, P=0.00) (LE3), significantly later onset time during affected side leg elevation (PGP 25ms, control -129ms, P=0.01) (LE3), levator ani and obturator internus tenderness (PGP 25/26; control 5/25, P<0.001) (LE3) and a higher prevalence of vesico-sphincteric disorders compared to asymptomatic subjects (LE3). CONCLUSION This review confirms that subjects suffering PGP present particular perineal characteristics regarding morphology and biomechanics. It would be interesting to develop clinical research concerning pelvic floor release effect in PGP.
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Affiliation(s)
- M Rejano-Campo
- Service de médecine physique et de réadaptation, CHU de Caen, CHU de Caen Normandie, 14000 Caen, France.
| | - A Desvergée
- Service de médecine physique et de réadaptation, CHU de Caen, CHU de Caen Normandie, 14000 Caen, France
| | - A C Pizzoferrato
- Service de gynécologie obstétrique et médecine de la reproduction, CHU de Caen, CHU de Caen Normandie, 14000 Caen, France
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Leirós-Rodríguez R, Romo-Pérez V, García-Soidán J. Prevalence of urinary incontinence and its relation with sedentarism in Spain. Actas Urol Esp 2017; 41:624-630. [PMID: 28587843 DOI: 10.1016/j.acuro.2017.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To determine the prevalence of urinary incontinence in the elderly Spanish population of both sexes and identify a possible relationship between physical activity habits and the presence of urinary incontinence in the elderly. MATERIAL AND METHODS We used data from 8146 individuals older than 60 years (age range, 60-94 years), from which data from a 15-year cohort were obtained. Of these, 4745 (58.2%) were women and 3401 (41.8%) were men. We analysed the presence of urinary incontinence, physical activity habits and the influence of other variables such as sex, age, weight and body mass index. RESULTS We detected a prevalence of urinary incontinence of 15% for the women and 11.6% for the men. Those with urinary incontinence had a greater average age, weight and body mass index than the healthy participants. At the same time, the patient group with incontinence showed more sedentary habits compared with the healthy participants. CONCLUSIONS A strong relationship was observed between the body mass index and prevalence of urinary incontinence. Urinary incontinence was also related to attitudinal aspects such as physical inactivity, a behaviour that predisposes the elderly to developing incontinence. For the first time, we observed a reduction in the prevalence of incontinence compared with previous studies.
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Mannion CA, Vinturache AE, McDonald SW, Tough SC. The Influence of Back Pain and Urinary Incontinence on Daily Tasks of Mothers at 12 Months Postpartum. PLoS One 2015; 10:e0129615. [PMID: 26083252 PMCID: PMC4471341 DOI: 10.1371/journal.pone.0129615] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 05/11/2015] [Indexed: 11/24/2022] Open
Abstract
Objective The present study examined back pain (BP) and/or urinary incontinence (UI) impact on the ability to perform daily tasks at 12 months after childbirth in healthy reproductive women who sought maternity care in community based family practice clinics. Methods This study is a secondary analysis from the All Our Babies Study, a prospective, community-based pregnancy cohort in Calgary, Alberta. Maternal self-reported information on demographics, lifestyle, experiences with pregnancy and childbirth, occurrence of BP, UI and consequent impairment of daily tasks were collected by questionnaires administered before 25 weeks, at 34-36 weeks gestation and at 4 and 12 months postpartum. The occurrence and severity of BP and UI at one year after childbirth was assessed using descriptive and bivariate analyses. Logistic regression models examined the association between demographic and obstetrical variables and the severity of functional impairment due to UI and BP. Results From 1574 women with singleton pregnancies included in the study, 1212 (77%) experienced BP, 773 (49%) UI, and 620 (40%) both BP and UI. From the 821 women reporting impairment of daily tasks due to BP, 199 (24 %) were moderately and 90 (11%) severely affected with the remainder, 532 (64%) being mildly affected. From 267 women with functional impairment due to UI, 52 (19%) reported moderately to severe impairment in their ability to perform daily tasks. Obesity and parity were risk factors for impairment of daily functioning due to BP, whereas obesity and vaginal delivery increased the risk of moderate to severe impairment due to UI. Conclusions BP and UI are common occurrences 1 year after childbirth. Maternal performance of daily tasks and women’s health and quality of life are more often impaired due to BP than UI. Our study brings new evidence of the risk factors that predict severity and impact of these conditions on women functioning at 12 months postpartum.
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Affiliation(s)
| | - Angela E. Vinturache
- Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - Sheila W. McDonald
- Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne C. Tough
- Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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