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PubMedDate not supplied

Program priorities of crippled children's agencies: a survey.

State Crippled Children's (CC) programs are known for their diversity in organization and varying coverage of diagnostic categories. Relatively little information is available concerning the programmatic priorities of CC agencies. To identify the activities central to the mission of State CC agencies, a survey was undertaken. Results from the survey revealed considerable unanimity among CC directors in identifying activities deemed to be very important to their agencies' missions. However, CC program directors indicated that their agencies were unable to spend sufficient amounts of time working on many of these activities. With few exceptions, the same activities were accorded high priority regardless of the particular organizational type of CC program and regardless of the tenure of the director. Directors of CC programs were also consistent in identifying activities that were relatively less important to their agencies' missions, including activities related to community-based care. Together with improvements in the treatment of childhood chronic illness, changes in the availability and financing of specialty medical care have substantially altered the problems that now face State CC programs. Despite major differences across the State CC programs, survey results reflect a broad consensus among CC directors concerning the current role of their agencies in the care of children with special health needs. Such a consensus may be an important element in gaining the additional resources needed to address current problems and to ensure high quality of care for these children and their families.

Ambulatory Care Facilities↗
PubMed1981

Services for children with congenital facial clefts through a state Crippled Children's Service Program.

A study to analyze the involvement of the Maryland State Crippled Children's Services (CCS) with children with congenital facial clefts was conducted in two parts. The first phase identifies all children born to Maryland residents over a three-year period to measure the incidence by type of the cleft condition. Phase two examines CCS involvement for 816 children with congenital facial clefts, including 114 of the Phase 1 cohort group. Diagnostic and demographic data are analyzed with specific attention to services involved in the child's entry into, flow through, and discharge from the CCS program. The 816 study cases known to the Maryland CCS Program during the period of study were characterized by the presence and type of parental congenital malformations, reasons for termination of CCS services, number of professional encounters, age at entry, distances to CCS care providers, demographic characteristics, and hospitalization history. Data analysis suggests that the age at which a child first becomes known to the CCS Program is significantly associated with areas of residence, presence of other malformations, type of cleft, and presence of other malformations in the family. The data further suggest that CCS Programs reassess their capacity to develop administratively useful data for use in program planning, evaluation, and research. The present systems appear to require further alteration for updating and expansion to increase the availability of useful, timely, and accurate programmatic data.

Adolescent↗
PubMed1981

Hypospadias cripples.

The term "hypospadias cripple" is an apt one. The successful surgery of this condition requires radical correction of all deformities, preferably in a single stage. In doing this one must be conversant with virtually all the existing methods of hypospadias repair and be able to apply them appropriately.

Disorders of Sex Development↗
PubMed1980

Crippled lung: variations on a theme by Macleod.

We have studied nine male patients (age 18 to 68 years) with radiographic and physiologic evidence of an abnormally small lung on one side (three right and six left). All had had a childhood pneumonia or bronchiolitis and eight had chronic or recurrent bronchitis and exertional dyspnea. Radiography showed two of the small lungs to be hypolucent while seven were hyperlucent. Bronchography revealed evidence of bilateral chronic bronchitis in all with saccular bronchiectasis in three. Angiography showed strikingly diminished vascularity to the smaller lung. Spirometry revealed airway obstruction in seven of the patients. All had pulmonary arterial hypertension. Radiospirometry showed that the small lung had on the average 30% of the total ventilation but only 15% of the perfusion. Washout of 133 Xe was extremely slow in radiolucent regions. We suggest the name "crippled lung" syndrome for this entity because it is purely descriptive and encompasses several clinical variants. It also avoids the pitfalls of etiologic implication (acquired-congenital). Clinical or subclinical bronchitis seems to be common in these patients and the prime goal in therapy must be to combat the tendency towards airway infection.

Adolescent↗