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Biomedical subjects

D Stephens

Publications and source records attributed to D Stephens.

168 records · Page 10Linked to original sources

Determination and classification of the problems experienced by hearing-impaired elderly people.

The aim of this study was to determine whether participation restrictions and contextual factors could be elicited in an elderly hearing-impaired population using an open-ended questionnaire. The study also tested the value of the World Health Organization's ICF in the classification of the problems experienced by the elderly hearing-impaired. To this end, we administered the 'Life Effects Questionnaire', in which the subjects were asked to list the effects of their hearing loss on their lives. With this approach, significantly more participation restrictions, environmental factors and personal factors were elicited than with a traditional approach. ICF proved useful in classifying these, but the Activity and Participation Scales had a major weakness in terms of non-communication-related hearing problems. Furthermore, a high proportion of the responses came into the personal factors, for which a formal classification does not exist within ICF. This highlights a significant need in that classification.

Activities of Daily Living↗

Is there an association between noise exposure and King Kopetzky Syndrome?

The condition in which individuals with normal pure tone audiograms complain of hearing difficulties, especially in the presence of background noise, (normal pure tone audiograms), has had a number of different names. The present term King-Kopetzky Syndrome was coined by Hinchcliffe in 1992. This is a common condition reported in 5 - 10% of those attending clinics complaining of hearing problems. A dominant genetic aetiology has been found in a proportion of cases. It may be associated with minor peripheral or central auditory dysfunction, and frequently the individuals exhibit anxious or depressive personalities. We found no relationship with noise exposure in a series of patients compared with matched controls. Here we review the evidence for and against such an influence and present fresh data in an attempt to define the role of noise, if any, in the causation of this condition. Our final conclusion is that there is no clear association between KKS and noise exposure

Adolescent↗

The diversity of case management needs for the care of homeless persons.

Health care providers have been attempting to meet the special needs of homeless people on a national level since 1984. The need to implement strategies specific to serving the diversity of services required by homeless people has been apparent. To devise appropriate strategies, clinical information was drawn from the Health Resources and Services Administration-Health Care for the Homeless (HRSA-HCH) projects, which were created in 1987 primarily to fill such a need. In addition, data gathered by the HCH projects (1984-87) funded by the Robert Wood Johnson and Pew Memorial Trust were used. It is suggested that the past mode of providing health care for the homeless has been found to be inadequate when confronting the complex problems of the homeless person of today. In general, health care providers need to focus more on case management activities, which may include activities not necessarily associated with the provision of health care services (for example, finding and providing food, clothing, shelter, and assessing entitlement eligibility) to achieve the ultimate goal--stabilization--and when possible, reintegration of the homeless person back into society.

Adolescent↗

Does 'normal' vision improve with spinal manipulation?

OBJECTIVE: To discuss a patient whose spinal abnormalities may have caused subliminal visual field loss. CLINICAL FEATURES: A 22-yr-old man suffered from a painful neck. His vision was in the normal range, as measured by computerized static perimetry. INTERVENTION AND OUTCOME: To define a guideline for a proposed investigation into visual field changes with spinal adjustment, his visual fields were tested before and after a normal office spinal manipulation. After this procedure, there was a measurable rise in the visual sensitivity of both eyes. CONCLUSION: The use of computerized static perimetry changes to measure the cerebral effects of spinal manipulation is recommended for future chiropractic research.

Adult↗

Subclinical vitamin A deficiency: a potentially unrecognized problem in the United States.

Vitamin A deficiency in its subclinical form is a world health problem in young children. The problem is probably under recognized in the United States and other developed countries who do not normally consider their citizens to be malnourished. Lack of a simple screening test to measure subclinical deficiency adds to this problem. Consequently, focused dietary assessment of vitamin A intake by a Food Frequency Questionnaire (FFQ) is a necessary component of health care maintenance, especially for toddlers and preschool age children. Dietary counseling and vitamin supplementation for high risk children is a necessary health promotion intervention.

Adolescent↗

The step phenomenon in the recovery of vision with spinal manipulation: a report on two 13-yr-olds treated together.

OBJECTIVE: To discuss the immediate increment of improvement in vision that occurs when the spine is manipulated. CLINICAL FEATURES: Two juvenile patients (13-yr-old female cousins) were found to have constricted visual fields and diminished visual acuities. INTERVENTION AND OUTCOME: Spinal manipulation was associated with recovery of normal vision over seven treatment sessions. It was noted that significant improvement in vision occurred immediately after the spinal manipulation treatments. Full recovery of vision was attained by series of these steps. In addition, both patients reported significant constitutional benefits after the treatment in addition to the improved vision. CONCLUSION: The change in visual function immediately related to spinal manipulation has been described as the "step phenomenon." The step phenomenon raises questions about the nature of the condition that may be treated by spinal manipulation and the method of action of the treatment. A vascular hypothesis is mentioned that could explain these events. The consistent occurrence of the step phenomenon indicates that spinal manipulation may have an effect on brain function.

Adolescent↗