PURPOSE: To evaluate a children's version of the ICF that takes children's dependency on their parents and a developmental perspective into consideration. METHOD: This study explored how 91 parents perceived child participation in terms of parent/child immediate interaction, and desires for ideal interaction in relation to body impairments and activity limitations. Similarities and differences were investigated in three matched groups of families through questionnaires. Group 1 consisted of parents of children with profound multiple disabilities, Group 2 was developmentally matched and Group 3 was matched according to chronological age. RESULTS: The children with profound multiple disabilities expressed the same amount of emotions as the other groups, but they had difficulties expressing more complex emotions. Parents perceived the children's behaviour styles in a similar way in the three groups. There were significant differences in how the immediate interaction was perceived with parents to children of Group 1 perceiving difficulties in maintaining joint attention and directing attention. CONCLUSIONS: The results suggest that parental perceptions of the interaction with their children with profound multiple disabilities in the immediate setting to a certain extent are related to the body impairments of the children but not strongly to communicative skills /activity limitations. Thus, to focus communication intervention on participation and interaction, assessment and questions to parents have to be focused directly on these issues.

Abnormalities, Multiple↗

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[The law of initial values in psychiatry].

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Behavior↗

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Splenectomy in cancer surgery: diminishing indications?

The diminishing enthusiasm towards performing splenectomy (SPL) either as an integral part of surgical cancer management (SCM), or for staging/management (ST) of lymphoma, warranted our assessment of the extent of this trend in a minority population. We retrospectively analysed all SPL submitted to Surgical Pathology for histological processing over a 24-year period (1/1/70-12/31/93) at the Howard University Hospital, a predominantly African-American institution. Of the 446 SPL performed during the period, sixty-nine (15.5%) were performed as part of SCM/ST. Seventy-five per cent (52/69) were for solid intra-abdominal cancers (SIC) and 25% (17/69) for lymphoma. As a group, the patients were older, 71% over 40 years old) and showed a male predominance (61% males). Sixty-two per cent (43/69) of the SPL were performed in the decade 1970-1979. In the following decade 1980-1989, the frequency with which SPL was performed, had dropped to 33% (23/69). Four years into the current decade, 1990-1993, only 5% (3/69) of the SPL were performed for SCM/ST. These findings suggest that in African-Americans, the performance of SPL in ST/SCM has been declining over the years, which is in agreement with the current growing trends in cancer treatment i.e. to avoid unnecessary operations, limit morbidity, preserve important organs, maintain immunocompetence of the patient and to utilize advanced imaging techniques in ST/SCM.

Academic Medical Centers↗