Significant Levels Of Disability Research Articles

Chronic Ankle Instability and Associated Self-Reported Function in South African Professional Ballet Dancers.

Ankle sprains are the most common acute injury among dancers and may result in the development of chronic ankle instability (CAI). Chronic ankle instability is characterized by recurrent ankle sprains, incidents of the ankle "giving way," and sensations of instability and has been reported to negatively impact functioning and psychosocial status. The large number of ankle sprains in addition to contextual factors relating to professional dancing, suggests that CAI may be a significant problem in professional ballet dancers. This study aimed to determine the prevalence of CAI and describe the ankle injury history and level of self-reported function in South African ballet dancers. This descriptive, cross-sectional study included all professional ballet dancers employed by three professional South African ballet companies (n = 65). The Identification of Functional Ankle Instability Questionnaire (IdFAI), Foot and Ankle Ability Measure (FAAM), Dance Functional Outcome Survey (DFOS), and a researcher-developed injury history questionnaire were completed by consenting participants. Descriptive statistics were calculated. A CAI prevalence of 73.3% CI [55.6%, 85.8%] was calculated among 30 participants. Twenty-five (83.3%) participants reported sustaining at least one significant ankle sprain with 88% (n = 22) indicating dance related activities as the cause. Dancers with CAI demonstrated a tendency to have less control over their ankles giving way and tended to take longer to recover from their ankles giving way than those dancers not affected. Eight participants (36.4%) with CAI were identified as having a significant level of disability on the FAAM activities of daily living (ADL) subscale and six participants (27.3%) on the sport subscale. Participants with CAI had a median total score of 83.5; IQR [80 - 90] on the DFOS. The self-reported function of South African professional ballet dancers is not severely affected, however, the high prevalence of CAI and reported symptoms is concerning. Education on CAI symptoms, prevention, and evidence-based management is recommended.

Effect of Core Muscle Stabilisation Exercises on Disability Associated with Non Specific Low Back Pain in Postmenopausal Women: A Prospective Longitudinal Study

Introduction: Non Specific Low Back Pain (NSLBP) is a frequent problem faced by the majority of postmenopausal women at some stage of their lives, resulting in a significant level of disability. Aim: To evaluate the effectiveness of core stabilisation exercises compared to traditional physical treatment in postmenopausal women with NSLBP. Materials and Methods: A prospective longitudinal study was conducted from January 2022 to August 2022, including 50 postmenopausal women aged 45-60 years with NSLBP. They were placed into two groups. Conventional LBP physical therapy methods were administered to group 2. The identical traditional and Core muscle Stabilisation Exercises (CSE) were implemented in the group 1. The Modified Oswestry Disability Index (MODI) was used for the assessment of disability. The Mann-Whitney U test and Friedman Analysis of Variance (ANOVA) were conducted to analyse changes in disability scores across and among groups at the ends of the second, fourth, and sixth weeks of treatment. Results: Of 50 patients initially enrolled in the study, 33 patients were available for the final follow-up. Group 1 consisted of 16 patients, while group 2 had 17 patients. Significant reduction in disability was found across the two groups at the second, fourth, and sixth weeks of treatment (p-value<0.05). In the sixth week of treatment, group 1 had a statistically greater decrease in ODI score (41.16±13.53) than group 2 (30.74±13.28) (p-value =0.003). Conclusion: CSE were found to be more effective than conventional physical therapy in reducing disability associated with NSLBP in postmenopausal women.

Outcome and characteristics of COVID-19 patients associated with stroke: a multicenter hospital-based study in Egypt

Background Nearly 55 percent of patients are said to be affected by the neurological effects of COVID-19. COVID-19 was shown to be related with stroke in 0.9 to 5% of people. It's critical to assess the impact of COVID-19 on the outcomes of acute ischemic stroke. The goal of this study was to look at the outcomes and characteristics of patients who had an acute ischemic stroke due to covid-19 infection.Results The participants in this study were 399 people who had had a stroke. COVID-19 positivity was confirmed in 77 cases, while COVID-19 negativity was confirmed in 322. In the COVID-19 and control groups, the average age of the patients was 65.4 ± 10.2 and 65.3 ± 11.8, respectively. The Covid-19 and control groups had a mean stroke onset of 5.2 ± 2.1 and 5.7 ± 3.8 h, respectively (P = 0.12). There was a high in-hospital mortality rate among patients with COVID-19 with a rate of 11.7% compared to 4.04% among the control group (P = 0.02). At discharge, the number of patients with mRS > 2 was higher (P = 0.001) among the COVID-19. There was a correlation between the mean levels of D-Dimer (r = 0.668, P < 0.001), the severity of COVID-19 (r = 0.802, P < 0.001), and mRS > 2.ConclusionDespite receiving equal acute care as non-COVID-19 patients, COVID-19 patients had more severe strokes and had worse outcomes. This includes a high chance of death while in the hospital as well as a significant level of disability. Neurologists should use timely and effective therapies, particularly for patients who are at a higher risk of having a stroke. This includes elderly patients, patients with severe COVID-19, patients with high levels of D-Dimer, and those with high NIHSS.

Chronic Ankle Instability and Associated Self-Reported Function in South African Professional Ballet Dancers

Introduction: Ankle sprains are the most common acute injury among dancers and may result in the development of chronic ankle instability (CAI). Chronic ankle instability is characterized by recurrent ankle sprains, incidents of the ankle “giving way,” and sensations of instability and has been reported to negatively impact functioning and psychosocial status. The large number of ankle sprains in addition to contextual factors relating to professional dancing, suggests that CAI may be a significant problem in professional ballet dancers. This study aimed to determine the prevalence of CAI and describe the ankle injury history and level of self-reported function in South African ballet dancers. Methods: This descriptive, cross-sectional study included all professional ballet dancers employed by three professional South African ballet companies (n = 65). The Identification of Functional Ankle Instability Questionnaire (IdFAI), Foot and Ankle Ability Measure (FAAM), Dance Functional Outcome Survey (DFOS), and a researcher-developed injury history questionnaire were completed by consenting participants. Descriptive statistics were calculated. Results: A CAI prevalence of 73.3% CI [55.6%, 85.8%] was calculated among 30 participants. Twenty-five (83.3%) participants reported sustaining at least one significant ankle sprain with 88% (n = 22) indicating dance related activities as the cause. Dancers with CAI demonstrated a tendency to have less control over their ankles giving way and tended to take longer to recover from their ankles giving way than those dancers not affected. Eight participants (36.4%) with CAI were identified as having a significant level of disability on the FAAM activities of daily living (ADL) subscale and six participants (27.3%) on the sport subscale. Participants with CAI had a median total score of 83.5; IQR [80 - 90] on the DFOS.Conclusion: The self-reported function of South African professional ballet dancers is not severely affected, however, the high prevalence of CAI and reported symptoms is concerning. Education on CAI symptoms, prevention, and evidence-based management is recommended.

ПРОФИЛАКТИКА СПАЕЧНОЙ БОЛЕЗНИ БРЮШНОЙ ПОЛОСТИ: СОВРЕМЕННОЕ СОСТОЯНИЕ

Today, adhesive disease of the abdominal cavity is a disease characterized by a high risk of postoperative complications, a significant level of disability and the likelihood of death. The purpose of the article was to analyze the literature on the etiology, pathogenesis of abdominal adhesive disease, the results of prevention and treatment of this disease and its complications. It was found that at the moment there are no methods for the prevention of adhesive disease with proven effectiveness, and the proposed methods are often multidirectional, based on the subjective vision of the problem by the researcher. Analysis of foreign and domestic literature has shown the absence of barrier agents that meet safety requirements and have a significant preventive effect. Thus, there are currently no standard approaches to the treatment and prevention of abdominal adhesive disease. This issue requires further study.

The contemporary management of neck pain in adults.

Neck pain is a common condition with a high prevalence worldwide. Neck pain is associated with significant levels of disability and is widely considered an important public health problem. Neck pain is defined as pain perceived between the superior nuchal line andthe spinous process of the first thoracic vertebra. In some types of neck conditions, the pain can be referred to the head, trunk and upper limbs. This article aims to provide an overview of the available evidence on prevalence, costs, diagnosis, prognosis, risk factors, prevention and management of patients with neck pain.

The predictors of proxy- and self-reported quality of life among individuals with acquired brain injury

Purpose Acquired brain injury (ABI) diminishes quality of life (QoL) of affected individuals and their families. Fortunately, new multidimensional instruments such as the calidad de vida en daño cerebral (CAVIDACE) scale are available. However, differences in self- and proxy-reported QoL remain unclear. Therefore, this study examined these differences and identified predictors of QoL among individuals with ABI. Materials and methods This cross-sectional study comprised 393 adults with ABI (men: 60%; M age = 54.65, SD = 14.51). Self-, family-, and professional-reported QoL were assessed using the CAVIDACE scale. Other personal and social variables were assessed as predictors of QoL. Results Professionals had the lowest QoL scores (M = 1.88, SD = 0.45), followed by family members (M = 2.02, SD = 0.44) and individuals with ABI (M = 2.10, SD = 0.43). Significant differences were found for almost all QoL domains, finding the highest correlations between family and professional proxy measures (r = 0.63). Hierarchical regression analysis revealed that sociodemographic, clinical, rehabilitation, personal, and social variables were significant predictors of QoL. Conclusions It is necessary to use both self- and proxy-report measures of QoL. Additionally, the identification of the variables that impact QoL permits us to modify the interventions that are offered to these individuals accordingly. Implications for rehabilitation Acquired brain injury (ABI) causes significant levels of disability and affects several domains of functioning, which in turn can adversely affect quality of life (QoL). QoL is a multidimensional construct that is affected by numerous factors: sociodemographic, clinical, personal, social, etc; and also, with aspects related to the rehabilitation they receive after ABI. Rehabilitation programs should address the different domains of functioning that have been affected by ABI. Based on research findings about the QoL’s predictors, modifications could be made in the rehabilitation process; paying special attention to the depressive- and anosognosia process, as well as the importance of promoting social support, community integration, and resilience.

A review of upadacitinib in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disease primarily affecting the joints and is associated with significant levels of disability and reduced quality of life. Janus kinase (JAK) inhibitors are a relatively new class of small molecule oral treatments and offer an alternative for patients with RA who do not respond to conventional or biologic therapy. Upadacitinib is a JAK inhibitor engineered to be selective for JAK1, and has recently been approved for use in patients with moderate-to-severe RA. The purpose of this article is to provide a comprehensive review of upadacitinib, including preclinical development and characterization, phase I and II studies, and the phase III SELECT program. Ongoing trials of upadacitinib in additional indications, including spondyloarthritis, inflammatory bowel disease, and atopic dermatitis, are also discussed.

SAT0515 COMPLEX HYPERMOBILITY EHLERS-DANLOS SYNDROME (HEDS): MAPPING THE PATIENT’S JOURNEY OVER 40 MONTHS IN A TERTIARY REFERRAL CENTRE

Background:Ehlers-Danlos Syndromes are heritable connective tissue disorders.They are multisystemic and patients can present with several symptoms such as joint pain and instability, visceral and autonomic dysfunction, as well as significant psychosocial sequela. Managing this cohort of young patients is usually challenging as many patients present late due to delayed diagnosis, often with several complications, problems with mobility and opioid use. Furthermore, there is often a prolonged lack of coordinated healthcare and access to social care services. A recent parliamentary debate in the U.K. highlighted that hEDS services are excluded from specialist Rheumatology commissioning services. In order to ascertain the relevance and utility of specialist services in this population, we conducted this study.Objectives:The objective of this study was to map the patient experience following a referral to the specialist clinic in order to assess the need for an integrated, multidisciplinary approach to treating patients with hypermobility EDS.Methods:We retrospectively reviewed the records of 50 patients with the diagnosis of hypermobility EDS who were seen in a specialist hypermobility clinic at University College Hospital UCLH between January 2016 and March 2016. Relevant data was collected regarding their medical care in our hospital up to October 2019.Results:The median age was 37 (range 21-59). We had 10 males and 40 females. The diagnosis of hypermobility EDS was based on the 1997 criteria as these patients were seen prior to the 2017 classification. Overall, the study yielded 6 key themes: 1. All patients experienced chronic pain, with 36% reporting use of opioids for pain management. 2. Patients were referred to multiple medical specialities within the same hospital trust, (22% patients were referred to ≥5 specialities). 3. Patients required a high number of follow up appointments (28% of patients required ≥20 follow-up visits). 4. Failed discharges were common; patients were often referred back to the Rheumatology Clinic despite being discharged to primary care. 5. Patients had a significant number of comorbidities, reflected by polypharmacy. (36% of patients were prescribed ≥5 medications). 6. Disability was high (20% of patients reported severe mobility problems).Conclusion:This study shows that patients with hEDS referred to UCLH have significant levels of disability, opioids use and polypharmacy especially for a relatively young population of patients. They need a complex interdisciplinary approach in a timely manner. In order to minimise delays and allow earlier diagnosis and intervention, we have recently adopted a multidisciplinary team approach, including pain specialists, rheumatologists, psychologists, physiotherapists, nurse specialists, urogynaecologists and neurogastroenterologists. This allows more coordinated and efficient care and incorporates an EDS-specific pain management programme. Specialised services for complex hEDS cases should be established and adequately resourced. Moreover, it would be cost effective to commission a patient-centred “one-stop-shop” service, where patients, who often travel from long distances with severe disabilities, can be seen by multiple specialities in a single visit.

Acceptance in chronic neck pain: associations with disability and fear avoidance beliefs

Chronic neck pain can result in significant levels of disability. Physiotherapy treatments often aim to modify cognitive factors and this approach benefits some, but not all, patients. Research from other pain conditions suggests that acceptance may be related to disability; however, it is unclear whether these associations exist in patients with neck pain. Moreover, it is unclear to what extent other cognitive factors are related to acceptance. Feasibly, if these factors are related, existing treatments may already be indirectly modifying acceptance. The aim of this study was therefore to establish the associations between acceptance and disability, and between acceptance and other cognitive factors. Cross-sectional data were collected from 149 patients and regression analyses were carried out. In the first analysis, disability was the dependent variable and the proportion of variance explained by two acceptance subscales (activities engagement and pain willingness) was calculated. In the second analyses, the acceptance subscales were the dependent variables. Measures of pain-related fear, catastrophizing and pain vigilance and awareness were entered as explanatory variables and the proportion of variance explained was calculated. In the first analysis, acceptance explained 18% of variance in disability (P<0.001). In the second analysis, cognitive factors explained 7% (P<0.05) of variance in activities engagement and 58% (P<0.001) of pain willingness. On this basis, treatments that enhance acceptance may reduce disability. Moreover, as cognitive factors were strongly related to pain willingness, but not activity engagement, alternative treatments may be required to maximize acceptance. Further studies are warranted to assess acceptance-based treatments in patients with neck pain.

Research Findings Using Mindfulness-Based Interventions for Chronic Pain

Chronic pain is a complex condition that is very detrimental to physical and psychological wellbeing. It carries a significant level of disability and economic burden. Pain patients frequently experience comorbid mental illness (e.g. depression, anxiety, PTSD, insomnia) and often require psychotherapeutic interventions in addition to medication management. Mindfulness-based interventions (MBIs) have emerged as a means to treat several chronic conditions (e.g. chronic pain, depression, anxiety, substance abuse, stress, insomnia). The objective of this review is to evaluate the current research on the use of MBIs in chronic pain managment. Although there are several controlled trials on the use of MBIs in chronic pain management, only a few studies were found that demonstrated significant effects on pain intensity, quality of life, as well as physical and psychological functioning. Therefore, the current evidence is mixed and there are insufficient data to definitively confirm the full impact of the use of MBIs in chronic pain conditions such as fibromyalgia, chronic low back pain, rheumatoid arthritis, and chronic musculoskeletal pain. The lack of compelling evidence at this time signals a demand for higher quality investigations in this area. Research examining MBIs and concomitant CBT may be of great value in order to synergize and strengthen patient outcomes.

SCREENING TECHNIQUES TO IDENTIFY OCCURRENCE OF DIABETIC FOOT ULCERATION AMONG PEOPLE AT HIGH RISK

Background Foot ulceration is an important health issue associated with significant levels of disability, pain and financial expense for those affected. Furthermore, foot ulcers can become life threatening when complicated by infection and might result in amputation when lesions don’t heal. Aim: -. Screen the occurrence of diabetic foot ulceration among people at high risk. Subjects and methods Prospective (cohort) study at Port Said city, 300diabetic patients were screened and followed twice, after three and six months. Three tools were used for data collection. Diabetic patient knowledge schedule, diabetic foot examination checklist, and foot ulcer checklist assessment. The patients were examined for presence of diabetic peripheral neuropathy , autonomic neuropathy ,sensory deficit , peripheral vascular disease , foot deformity , skin and nail problems . Patients were graded using (The international consensus on diabetic foot risk category 1999), according to their risk category. Results: - The following variables were significant risk factors with occurrence of diabetic foot ulcerations: previous foot ulcer, peripheral neuropathy, autonomic neuropathy, presence of other diabetic complications, retinopathy, diabetes duration and mean age group (53.14 ± 9.20). Ulcerations occur in 7.3% of studied sample after three and six months. Assessment of foot perception using monofilament had the best sensitivity. Peripheral neuropathy was observed in (27.3%) ,peripheral vascular disease was diagnosed in (40% ) of studied sample , foot deformity ( 10.3% ) .Recommendations .All patients with diabetes should be screened at least annually for evidence of risk factors for foot ulceration including neuropathy and vascular disease. Foot screening programs that identify those feet at risk should to be taught to all health care professionals involved in the care of the diabetic patient . Conclusion:-previous foot ulcer, peripheral neuropathy, autonomic neuropathy, presence of diabetes complications, retinopathy , mean age group (53.14 ± 9.20) and long duration of diabetes were significant risk factors related to occurrence of diabetic foot ulceration

The patient with Acute Muscular Weakness

Proximal muscle weakness can present acutely or subacutely to the Acute Medical Unit. Early diagnosis of the underlying pathology is essential due to life threatening complications such as respiratory failure and cardiac disturbances as well as causing significant levels of disability. The diagnosis requires thorough history-taking and examination to discern evidence of true weakness, assess its onset, distribution and severity followed by extensive investigations including a CK level, which if high should raise suspicion of rhabdomyolysis. Assessment of respiratory function should be done promptly to identify patients with associated respiratory muscle weakness and treatment should not be delayed waiting for definitive and confirmatory investigations. Poor response to treatment is unusual when diagnosis is correct; this raises the possibility of an alternative diagnosis.

Endurance and resistance training in rehabilitation of patients with multiple sclerosis

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Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: A randomized clinical trial

Low Back Pain (LBP) results in significant level of disability, producing significant restriction on usual activity such as an inability to work. Nearly two third of the adults are affected by non-specific low back pain at some point in their lives. The purpose of the study was to determine the effect of core stabilization exercises in comparison with conventional exercises on pain, functional status in patients with non-specific LBP. Thirty patients diagnosed with non-specific LBP participated with age group between 20-50 years and divided in to 2 groups, one with core stabilization exercises and other conventional exercises, 15 subjects each. Three months study, pre and post treatment outcome measures used were VAS for pain intensity and Modified Oswestry Low Back Pain Disability Index for functional status (disability). Data were analyzed using student 't' test (paired and unpaired). Whereas both groups improved significantly from the initiation of treatment, a between-group comparison revealed significantly greater (p<0.001) improvements regarding pain and functional status for experimental group compared to control group. Core stabilization exercises were found to be more effective in reducing pain and improving functional status by decreasing disability of patients with non-specific low back pain in comparison with conventional exercises.

SELENIUM PREPARATIONS IN THERAPEUTIC PRACTICE: PHARMACOLOGICAL EFFECTS IN PATIENTS WITH CHRONIC PANCREATITIS ON THE BACKGROUND OF DIABETES MELLITUS TYPE 2

The medical and social significance of the problem under study is largely due to a significant level of disability and mortality due to the development of late complications of type 2 diabetes mellitus, which affects about 3% of the Ukrainian population. In diabetes mellitus, both the endocrine and exocrine functions of the pancreas are secondarily affected, leading to the development of chronic pancreatitis. The frequency of this pathology in general clinical practice ranges from 0.2 to 0.6%.

People living with diabetes resident in nursing homes—assessing levels of disability and nursing needs

To describe the degree of disability and nursing need of people living with diabetes resident in nursing homes in one Primary Care Trust in the UK. A retrospective case notes review of 75 people with known diabetes who were resident in the 11 nursing homes in Coventry Teaching Primary Care Trust. Very significant levels of disability and nursing need were documented in areas of continence, feeding, mobility and communication. Each individual had a mean of four co-morbidities (range 1-8), excluding diabetes. Using the definition of terminal illness based on a negative answer to the question 'would I be surprised if my patient were to die in the next 12 months' it is likely that the majority of individuals described in this study would be classified as being terminally ill. Using four practical clinical measures, this study has shown very significant levels of disability and nursing care need in this population of mainly elderly people resident in nursing homes in Coventry. In addition, it has demonstrated that a large proportion of nursing home residents with diabetes can be considered to be in the terminal phase of life, a period where many other factors interplay in how care should be delivered and what outcomes are appropriate. In fact, residents in this category may well be candidates for a considered withdrawal of treatments, but not of care.

Does depression mediate the relation between fatigue severity and disability in chronic fatigue syndrome sufferers?

Objective Chronic fatigue syndrome (CFS) is often associated with significant levels of disability. Although fatigue and depression have been found to be independently related to severity of disability, it is not clear how these three factors are mutually related. The present study sought to address this issue by specifically testing a model of mediation whereby depression was hypothesized to influence relations between fatigue and disability. Methods Participants included 90 individuals seeking treatment for CFS at a tertiary care facility. Each provided demographic information and completed standardized measures of depression and fatigue severity, as well as a measure of disability, which assessed difficulties in physical, psychosocial, and independence domains. Results Analyses indicated that depression and fatigue were positively correlated with one another, as well as all three disability domains. Analyses of mediation indicated that depression completely mediated the relation between fatigue and psychosocial disability and partially mediated the relation between fatigue and the other two disability domains. Indirect effects tests indicated that the inclusion of depression in the statistical models was statistically meaningful. Conclusions These results replicate previous findings that fatigue and depression are independently related to disability in those with CFS. A more complex statistical model, however, suggested that depression severity substantially influenced the strength of the relation between fatigue and disability levels across a range of domains, including complete mediation in areas involving psychosocial functioning. These results may aid in clarifying contemporary conceptualizations of CFS and provide guidance in the identification of appropriate treatment targets.

Use of osteopathic or chiropractic services among people with back pain: a UK population survey

Questionnaires covering health and the use of complementary, alternative and conventional health services were mailed to a random sample of 14 868 adults aged 18-64 years living in four counties of England in 1997. The present study examined the use of osteopathy/chiropractic among the 15% (n = 1377) of respondents reporting back pain. Osteopaths/chiropractors were seen by 13.4% (n = 184) of respondents with back pain during the past 3 months compared with 9.8% (n = 135) who consulted physiotherapists. The presence of back pain and non-manual social class were the strongest predictors of consultation with both types of practitioner. Women, older respondents, non-smokers and those who exercised for 30 minutes at least once a week were more likely to use osteopathy/chiropractic. The only other significant predictor of physiotherapy use was desire for more physical exercise. While those reporting back pain had Short-Form 36 (SF-36) scores suggesting very significant levels ofdisability, respondents with back pain who consulted osteopaths/chiropractors reported better health in all dimensions of the SF-36 than those using physiotherapy services. Although they reported worse pain scores than people not consulting any practitioners, their mental health, physical functioning, energy and health perception were better. It is impossible to disentangle cause and effect in this cross-sectional study, but the data suggest that people who can afford to pay are more likely to choose osteopath/chiropractor treatments than physiotherapy. The possibility that osteopath/chiropractor treatment has a generalised positive effect on health, allowing people with back pain to function better than those not receiving such treatment, warrants further investigation.

Long-term follow-up of 246 adults with juvenile idiopathic arthritis: functional outcome.

To examine the clinical and functional outcome of adults with juvenile idiopathic arthritis (JIA) using the recent World Health Organization/International League Against Rheumatism (ILAR) classification. Two hundred and fifty-nine adults with long-standing JIA (average disease duration 28.3 yr) were eligible for the study; 246 (95%) attended for an interview, clinical examination and notes review and 231 (89.2%) returned a comprehensive functional and psychosocial self-assessment questionnaire. Of all patients, 43.3% had active arthritis clinically and 54.4% on laboratory measures (C-reactive protein). Clinical inflammation was less common in systemic-onset JIA. The percentage of all patients with severe disability (Health Assessment Questionnaire score >1.5) was 42.9. Uveitis occurred frequently in the oligoarticular-onset and enthesitis-related subsets. Over 30% of the extended oligoarticular group with uveitis developed glaucoma compared with none of the enthesitis group. Adults with JIA often have significant levels of disability, often related to continuing active disease over prolonged periods. There is a clear need for good transition from paediatric to high-quality adult rheumatology care.