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Biomedical subjects

M Vernon

Publications and source records attributed to M Vernon.

At least 19 recordsLinked to original sources
PubMed2005

Intravenous immunoglobulin for resistant Clostridium difficile infection.

Clostridium difficile (CD)-associated diarrhoea and colitis may relapse in up to 20% of treated patients. We present a patient who failed to respond over a 6-month period to treatment either singly or in combination with metronidazole, vancomycin, rifampicin, cholestyramine and probiotics. Her diarrhoea rapidly resolved after a 3-day course of intravenous immunoglobulin. This treatment may compensate for a failed immune response to CD toxin and should be considered for relapsing CD-associated diarrhoea where there is no response to conventional treatment strategies.

Clostridioides difficile↗
PubMed2004

How general practitioners promote 'lifestyle' physical activity.

We investigated how General Practitioners (GPs) promote lifestyle physical activity (PA) ('accumulate 30 min of at least moderate PA on 5 or more days per week': PA30 x 5) to patients in the different stages of change, using a range of counselling strategies. These strategies included six 'A' factors (Ask, Assess, Advise, Assure, Arrange a follow-up, and Applaud). In a postal questionnaire (68% return rate), 47% of GPs from a single UK health district reported regularly promoting PA30 x 5. A stepwise logistic regression identified three counselling strategies that predicted regularly promoting PA30 x 5: (1) arrange follow-ups for patient pre-contemplators (OR=4.93), (2) patient contemplators passed to GP exercise referral scheme (OR=2.34), and (3) asking relapsers about their PA30 x 5 (OR=2.61). GPs who regularly promote PA30 x 5 base their counselling on patients' pre-existing PA behaviour, using 'effortful', 'stage-matched' approaches. Since these are acceptable to GPs, in-service training may build on using these three factors.

Adult↗
PubMed2001

Linguistic diversity in deaf defendants and due process rights.

Historically, ensuring the due process rights of deaf defendants has been a problematic issue in the criminal justice system (McAlister, 1994; Smith, 1994; Vernon & Coley, 1978; Vernon & Greenburg, 1996; Vernon & Miller, in press; Vernon & Raifman, 1997; Whalen, 1981; Wood, 1984). Inadequate communication can radically affect a deaf defendant's interactions in the courtroom. Pursuant to the concepts of fairness enshrined in the U.S. Constitution and the specific statutory language contained in federal and state laws, the courts must provide equal access for deaf defendants (Berko, 1992; Gallie & Smith, 2000; McCoy, 1992; Simon, 1994; Vernon & Raifman, 1997). It is the responsibility of the court to ensure that the appropriate accommodation is provided in the language most readily understood by the defendant.When adjudicating a deaf criminal defendant, courts must make certain that the defendant has equal access to various due process activities, such as assisting counsel in the development of a defense, deciding whether to testify, deciding which plea to enter, understanding the charges, understanding one's position as defendant, and comprehending the role of the defense and prosecuting attorneys, and judge (Berko, 1994; King, 1990; Simon, 1994; Smith, 1994; Vernon & Coley, 1978; Vernon & Miller, in press; Vernon, Raifman, & Greenberg, 1996).However, complex linguistic issues that impinge on adjudicative competence are present in some deaf defendants (Vernon & Miller, in press; Vernon & Raifman, 1997). Adjudicative competence refers to an individual's ability to adequately comprehend and participate in legal proceedings and due process activities. When diverse language use is an issue, a deaf defendant's ability to participate in proceedings can be established by the court using the modern test of adjudicative competence (Dusky v. U.S., 1960). This test examines a defendant's state of mind at the time of trial rather than at the time of the offense in terms of these factors: a defendant's capacity to participate, reasonable understanding of the proceedings, and level of cognitive functioning, irrespective of any mental disorder. This article will outline linguistic barriers to due process for deaf defendants.

Journal Article↗
PubMed2001

Interpreting in mental health settings: issues and concerns.

Sign language interpreters in mental health settings face extreme linguistic and cultural difficulties in interpreting basic, everyday language used in these settings. This is particularly true when deaf clients have limited English proficiency, which often requires interpreters to use expansion techniques in order to render messages successfully. To examine how diagnostics may be affected by interpretation, Brauer (1993), Montoya et al. (2001), and Steinberg, Lipton, Eckhardt, Goldstein, and Sullivan (1998) translated two widely used psychological screening instruments into American Sign Language (ASL). The Minnesota Multiphasic Personality Inventory (MMPI) and the Diagnostic Interview Schedule-IV (DIS-IV) were selected for translation, and data from the three studies are presented and discussed. Their implications in terms of the expectations and stresses placed on interpreters are described within a framework of demand and control theory. Finally, sections of the Code of Ethics of the Registry of Interpreters for the Deaf (RID) are examined relative to both the issue of confidentiality and what the interpreter's contribution should be in mental health settings.

Deafness↗
PubMed2001

Organized sports for children and preadolescents.

Participation in organized sports provides an opportunity for young people to increase their physical activity and develop physical and social skills. However, when the demands and expectations of organized sports exceed the maturation and readiness of the participant, the positive aspects of participation can be negated. The nature of parental or adult involvement can also influence the degree to which participation in organized sports is a positive experience for preadolescents. This updates a previous policy statement on athletics for preadolescents and incorporates guidelines for sports participation for preschool children. Recommendations are offered on how pediatricians can help determine a child's readiness to participate, how risks can be minimized, and how child-oriented goals can be maximized.

Age Factors↗
PubMed1999

Deaf murderers: clinical and forensic issues.

Data are reported on 28 deaf individuals who were convicted, pled guilty, or have been charged and awaiting trial for murder. The unique forensic issues raised by these cases are discussed, and their clinical picture presented. A significant percentage of these deaf murderers and defendants had such severely limited communication skills in both English and American Sign Language that they lacked the linguistic ability to understand the charges against them and/or to participate in their own defense. As such, they were incompetent to stand trial, due not to mental illness or mental retardation, but to linguistic deficits. This form of incompetence poses a dilemma to the courts that remains unresolved. This same linguistic disability makes it impossible for some deaf suspects to be administered Miranda Warnings in a way comprehensible to them. This paper identifies the reasons for the communication problems many deaf persons face in court and offers remedial steps to help assure fair trials and police interrogations for deaf defendants. The roles and responsibilities of psychiatric and psychological experts in these cases are discussed. Data are provided on the etiology of the 28 individuals' hearing losses, psychiatric/psychological histories, IQs, communication characteristics, educational levels, and victim characteristics.

Adolescent↗
PubMed1999

Historical overview of inpatient care of mental patients who are deaf.

A review of published studies of deaf mentally ill inpatients is reported. While there are conflicts in the findings of some of the studies, several generalizations seem fairly universal across countries and time periods. For example, the data indicate a greater overall prevalence of mental illness in the deaf population than in the general population as a whole, based on the relative number of each group who are patients in psychiatric hospitals. In general, deaf patients have longer hospital stays. Characteristics symptoms leading to hospitalization of deaf people tend to be different from those of hearing patients. It was thought by most investigators that restriction of sign language use in schools was one reason for these differences. For both hearing and deaf inpatients, dual diagnosis (mental illness and substance abuse) is far more common today than in years past. All investigators found frequent misdiagnoses among deaf patients. The paucity of research on deaf inpatients over the last 2 decades is noted.

Deafness↗
PubMed1998

Managed care, school health programs, and adolescent health services: opportunities for health promotion.

The rapid expansion of managed care creates opportunities and dilemmas for those involved in school health and adolescent health promotion. Managed care organizations (MCOs), public health agencies, and school and adolescent health providers share certain common goals and priorities including an emphasis on prevention, cost-effectiveness, and quality of care--and a willingness to explore innovative approaches to health promotion and disease prevention. However, MCOs often face conflicting challenges, balancing the goals of cost containment and investment in prevention. In considering support for school health programs, MCOs will be interested in evidence about the effectiveness of services in improving health and/or reducing medical expenditures. Mechanisms for improving prevention efforts within MCOs include quality assurance systems to monitor the performance of health plans, practice guidelines from professional organizations, and the contracting process between payers and health care providers. Development of partnerships between MCOs and schools will be a challenge given competing priorities, variation in managed care arrangements, structural differences between MCOs and schools, and variability in services provided by school health programs.

Adolescent↗
PubMed1997

Pedophilia and deafness.

Data from 22 cases of deaf individuals suffering from pedophilia are presented along with a tabular summary of recent articles from the deaf press, about deaf victims of pedophilia and deaf pedophiles. Results indicate a number of factors that distinguish deaf pedophiles from hearing pedophiles. First is the prevalence of Primitive Personality Disorder in the deaf group. Corollary to this, with a significant number of pedophiles, competence to stand trial is a major issue. Other significant differences include a high rate of brain damage, illiteracy, poor communication skills, and other psychiatric illnesses. Two of the 22 cases were deaf females with pedophilia. The mean performance IQ of the sample was 102.8 and the distribution of scores was bimodal. Case histories are presented and discussed, and legal issues, prevention, and punishment are addressed.

Adolescent↗
PubMed1996

New rights for deaf patients; new responsibilities for mental hospitals.

In an era in which mental hospital administrators are confronted by shrinking budgets and cost containment strategies in order to survive, the recently enacted Americans with Disabilities Act requires their special attention. This article addresses the anticipated effect of the ADA upon inpatient psychiatric facilities. We assume that adminstrators should anticipate increased ligation and settlement costs associated with specialized services to deaf and other qualifying patients who seek equal access to psychiatric services provided in mental hospitals. It is our view that administrators can reduce the cost of implementing specialized services to deaf patient by developing a proactive plan of implementation. The authors analyze recent court consent decrees, and offer a three step plan for implementation.

Communication Barriers↗
PubMed1996

Cochlear implants in prelingually deaf children.

All private and public residential and day schools for the deaf in the U.S. that have 100 or more students were surveyed to see how many prelingually deafened students they had with cochlear implants and how many of these students were still using the device. Responses came from 70% (45 of 64) of those schools surveyed. Of the 151 implanted children identified, 71 (47%) were no longer using the cochlear implant. Of the remaining 80 children (53%) still wearing the device, we could not specifically determine by survey the percentage who derived significant benefit from the device and the percentage who did not. However, numerous comments by those returning the questionnaires indicated despondency over the results of the implant.

Child↗
PubMed1994

Case report: the anticardiolipin (antibody) syndrome.

The anticardiolipin antibody syndrome is relatively uncommon. It should be suspected mostly in young people with unexplained embolic or thrombotic events. A young patient with an abnormal prothrombin time, partial thromboplastin time, or venereal disease research lab test with one of the above noted vascular events would be a suspect for this disorder. Though an antibody test that will qualitatively and quantitatively measure antiphospholipid antibodies is available, its clinical application is not entirely clear. The presence of the antibody will support a diagnosis but cannot be used alone for diagnosis or treatment.

Adult↗
PubMed1994

Issues in the use of cochlear implants with prelingually deaf children.

Approved for use by the Food and Drug Administration with deaf adults and prelingually deafened children above age two, the success of cochlear implants lacks supporting independent evaluative documentation. Allen et al (1993) compared hearing thresholds of profoundly deaf children with and without implants. Children with implants had an unaided threshold of 109.8 dB, which improved with the implant to 56.0 dB. Children without implants had an unaided threshold of 105.1 dB, which improved to 61.8 dB with conventional aids. Pure tone thresholds of 56.0 dB or 61.8 dB does not mean a child can process speech at that level. Lennenberg's critical stage theory (1967) represents the theoretical rationale for early implanting of prelingually deaf children. The flaw in this rationale rests on the fact that prelingually deaf children would not be acquiring English as a second language, even if the implant gave them adequate perception of English. There are strong, legitimate reasons to question the experimental implantation of prelingually deaf children, just as there are factual reasons to support it that should be considered by parents along with the possible benefits.

Auditory Threshold↗
PubMed1994

Classification by the states of deaf and hard of hearing students. It's not how much you hear, but where you live.

The terminology currently used by the U.S. Department of Education and by the 50 states in gathering data on deaf and hard-of-hearing children and in determining eligibility for services varies widely. That variability results in meaningless, often erroneous and inconsistent statistics, which can lead to invalid research, wasted money, and poor program planning. The problem is documented and recommendations are made for achieving uniformity in defining and applying the terms deaf and hard of hearing.

Deafness↗