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PubMed1978

[Legal capacity to act and the sexual life of the mentally handicapped in Sweden (author's transl)].

In Sweden efforts are being made to integrate the mentally handicapped as much as possible into society. If these efforts are to be successful society must concede to them the same rights it does to its non-disabled citizens. On the basis of the terms "legal status" and "legal capacity act" the article examines the consequences which might arise for the mentally handicapped from their being granted these legal rights. As the Swedish society principally allows the mentally handicapped the right to sexual intercourse difficulties arise, in particular, if there is the possibility of procreation and, even more, if children are desired. The pros and cons of pregnancy and its consequences for mentally handicapped people are discussed. Old and modern countermeasures (marriage obstacles, sterilisation, abortion) and the alternatives (systematic sexual instruction, counselling as regards preventive measures and control of their use) are compared and examined in view of their applicability in accordance with the Swedish normalisation efforts. The study showed that mentally handicapped persons can live--also in the sexual area--according to the same principles that guide us all, if we help and advise them adequately and at the right time. Under these circumstances restrictions are no longer the rule, but the exception.

Abortion, Induced↗
PubMed1981

Perspectives of social status of learning handicapped and nonhandicapped students.

The social status of mildly learning handicapped and nonhandicapped students and their own perceptions of and their ideal preference for social status were investigated. In study 1 the social-status perspectives of handicapped vs. nonhandicapped students in a regular-class environment into which the mildly learning handicapped students had been mainstreamed was compared. Results indicated that the mildly handicapped children overestimated their social status in the direction of their ideal. In Study 2 the social-status perspectives of the same mildly learning handicapped students in two classroom settings were compared. Although these children overestimated their social status in the regular-class setting, their estimates and ideals were accurate in their special-class settings. Implications for intervention were discussed.

Attitude↗
PubMed1993

Analysis of humor skills among elementary school students: comparisons of children with and without intellectual handicaps.

Differences in the comprehension, production, and appreciation of humor were explored among students who were achieving normally (20 second graders, 21 fourth graders) or had learning disabilities (14 fourth graders) or developmental handicaps (12 fourth graders). Comprehension of humor was assessed by explanations of what made cartoons funny. Production was assessed by completion of captionless cartoons. Appreciation was evaluated by ratings of funniness and facial mirth. Results indicated that children without handicaps comprehended the cartoons better than did the students with intellectual handicaps. No production differences were observed. Students who had intellectual handicaps demonstrated age-appropriate appreciation ratings; however, students with developmental handicaps lacked differential sensitivity.

Cartoons as Topic↗
PubMed1994

[International classification of handicaps].

The International Classification of Impairments, Disabilities and Handicaps touches a field of increasing importance: the consequences of disease. Three levels can be distinguished: Impairments, Disabilities and Handicaps. Having define these three levels, we go on to show their significance and bring to light the relativity of the handicap, often according to non-medical data and having nothing to do with the handicapped person. The ICIDH broadens the medical evaluation by including these data and, in this way, fosters better understanding of handicaps. It should be more widely known in Switzerland.

Activities of Daily Living↗
PubMed1995

[Status of the teeth and degree of care in handicapped in Flanders].

In general, handicapped 12-year old do not show statistical relevant differences with non-handicapped age-matched children in Flanders regarding general caries prevalence, caries distribution and total caries experience. However, important differences were found for the restorative index showing a higher caries treatment need in handicapped children. When the results were analysed according to the type of handicapping condition, it was seen that children with borderline and mild mental handicap and children with speech-, language and/or learning difficulties show the most unfavorable picture. They have a high caries prevalence and caries experience and a low restorative index. Additional analysis of the results can throw some light on the presence of additional caries risk indicators and contributing caries risk factors.

Belgium↗
PubMed1996

[Cancer incidence in persons with a mental handicap; possibly increased risk of esophageal cancer].

OBJECTIVE: Prompted by a British study which revealed a raised frequency of oesophageal cancer as the cause of death among the mentally handicapped, a study was made of the cancer incidence among an institutionalized population with a mental handicap, which incidence was compared with that among the population in general. DESIGN: Retrospective follow-up study. METHODS: An inventory was made of the cytologically or histologically confirmed cancer diagnoses among persons living in an institute for the mentally handicapped during 1 January 1974 through 1 January 1994 (n = 1020). The incidence figures were compared with those for the general population (Netherlands Cancer Registration 1989) after indirect standardization. RESULTS: The total cancer risk among the population with a mental handicap was the same as that among the general population where women, and lower where men were concerned. This study brought to light a decreased risk of lung cancer (standardized morbidity rate (SMR): 0.33; 95% confidence interval: 0.33-0.97), while the SMR of oesophageal cancer showed no statistically significant increase. CONCLUSIONS: Cancer is not more frequent among the mentally handicapped than among the general population. Nevertheless, increased attention for occurrence of oesophageal cancer appears to be still indicated.

Adolescent↗
PubMedDate not supplied

Training for primary care of mentally handicapped patients in US family practice residencies.

BACKGROUND: As a result of managed care mandates for primary care and the growing community presence of the 6 million mentally handicapped persons in the United States, primary care of this population will increasingly be provided by family physicians. How much family practice residencies emphasize training for care of this population is the focus of this study. METHODS: A questionnaire was mailed to each family practice residency program in the United States asking about didactic teaching, clinical activities, and faculty and curriculum planning related to care of the mentally handicapped population. RESULTS: Seventy-one percent of questionnaires were returned. Only 32 percent of respondents teach related didactic sessions, 24 percent plan clinic patient care for this population, and 42 percent affiliate with a residential care facility. The most frequently listed didactic topics were delayed infant assessment and seizure care. Comprehensive management of the mentally handicapped adult, family issues, behavioral problems, and long-term planning had low ratings compared with the first two topics. Psychiatrists were rated higher than family practice faculty for training in this area. CONCLUSIONS: There is little enthusiasm among residency directors about the need for training in care of mentally handicapped patients. Topics that are most valued, however, were those that are generally within the purview of specialists. A low value was placed upon training for helping families access services, behavior management, or comprehensive long-term planning-areas most often addressed by family physicians. Further studies are needed to assess the training needs of family physicians in caring for mentally handicapped persons.

Adult↗
PubMed2001

Relationship between change in balance and self-reported handicap after vestibular rehabilitation therapy.

BACKGROUND AND PURPOSE: Dizziness and balance problems are two commonly reported symptoms of vestibular system disease, with subsequent alterations in lifestyle and reports of physical, functional and emotional handicap. Vestibular rehabilitation therapy (VRT) was developed to improve the functional status of patients with vestibular dysfunction. The aim of the present study was to investigate the relationship between change in balance performance and change in self-rated handicap after a four-week home exercise programme in 16 subjects with chronic vestibular disease. METHOD: Before and after the treatment intervention, balance was tested by use of a Smart Balance Master (SBM) system (Neurocom International, Clackamas, OR, USA) and self-rated handicap was measured by use of the Dizziness Handicap Inventory (DHI). RESULTS: Significant improvement was observed in both the SBM (p < 0.001) and DHI (p = 0.003) scores over the testing period. A moderately strong negative correlation existed between change in SBM and DHI scores (Spearman's r = -0.6). Further analysis using the DHI subscales indicated, however, that the emotional component showed no significant change over time, and a poor correlation with change in balance scores (Spearman's r = -0.39). CONCLUSIONS: These results indicate that a home-based exercise programme can significantly improve balance abilities in people with chronic vestibular dysfunction, but that outcomes may be enhanced by addressing the emotional issues associated with their disability.

Adult↗
PubMed1980

The pilot parent program: helping handicapped children through their parents.

The problems of parents whose child is diagnosed or newly identified as mentally retarded or otherwise developmentally delayed are varied and difficult. As many authors have pointed out, the manner in which parents deal with this initial crisis of acceptance can have long term consequences for the parents, the family, and the handicapped child. In the past, neither psychiatry nor the other helping professions did much to provide parents with the elements they need in this profound emotional crisis: continuing emotional support and role modeling, information about the child's handicap, and information about service programs for handicapped persons. The Omaha Nebraska Pilot Parent Program is a volunteer program of parents of handicapped children whose purpose is to provide these supports to parents in need. After seven years such a program appears to provide satisfaction for its members, help to fellow parents, and an important resource to the human services systems in the community.

Attitude↗
PubMed1993

Physical morbidity in older people with moderate, severe and profound mental handicap, and its relation to psychiatric morbidity.

This report describes a study of physical health problems and their relation to psychiatric morbidity in a community sample of 105 people with severe mental handicap and over the age of 50 years from a Metropolitan Borough. An extensive outreach exercise ensured that almost 100% of people fulfilling the age and ability criteria were included in the study. All the physical and mental health assessments were carried out by a psychiatrist at senior registrar level. Physical assessments used a combination of physical examination and access to the subject's medical records. Results showed that, with minor exceptions, the physical health of the handicapped population was no worse than that of controls. Contrary to expectation, no relationship was demonstrated between physical and psychiatric morbidity. However, this may be due to the greater difficulty in identifying psychiatric morbidity in people who are more severely handicapped. Since physical health problems increase with level of handicap, the potential relation between physical and mental health is masked.

Aged↗
PubMed1984

The structure and function of social support networks in families with handicapped children.

Three structural characteristics of social support networks (size, density, and boundary density) and two relationship characteristics (reciprocity and dimensionality) were assessed in a sample of 56 families with a child with spina bifida and 53 matched comparison families. The results indicate that social networks of families with handicapped children tended to be smaller than the networks of comparison families, particularly with regard to mothers' total and friendship networks. The networks of families with handicapped children were more dense as well. As predicted, there was greater boundary density in spousal networks in families with handicapped children. Differences in network reciprocity were inconclusive while the results indicate that families with handicapped children tended to rely more heavily upon multidimensional network contacts than did comparison families. The results are discussed in light of our understanding of stress, social support, and the social ecological context of families.

Adolescent↗
PubMed1979

[The Honeylands Project, Exeter: care for mentally, physically and socially handicapped children and their families].

The Children's Hospital Honeylands is taking care of some 250 mentally, physically and socially handicapped 0 to 12 years old children and their families. It provides overnight hospital accommodation for thirty, and day care facilities for up to fifty children. Services provided are specific therapy, playgroups, education and regular home-visiting for the preschool children, and residential relief for the families. There are 6000 day and 6000 night attendances a year. The support service has evolved from the children's ward of a District Hospital, located in a city of 100,000 and serving a district of 300,000. Expressed parental needs have been the source of evolutionary change. A ten-year experience has shown that early and active involvement of the parents in the therapy and planning for their child keeps the demand for permanent residential placements of handicapped children very low. There are one quarter the number of mentally handicapped children in permanent residential care in the Exeter & East Devon Health District, compared to the national average. Whether Honeylands represents a model within the National Health Service for the family orientated care of handicapped children is at present under evaluation.

Child↗
PubMed2004

Age- and sex-stratified prevalence of physical disabilities and handicap in the general population.

BACKGROUND AND AIMS: Our aim was to provide age- and sex-stratified prevalence estimates of physical disabilities and handicap in the general Belgian population. METHODS: A cross-sectional and demographically representative health interview survey was conducted nationwide in Belgium in 1997. The 8836 persons aged 15 years and over who answered the health interview were included in this study. Seventeen items from the survey encompassing main activities of daily living (ADL) and confining were analyzed. To provide prevalence estimates as detailed as possible, neither aggregation nor dichotomization were applied. RESULTS: Women consistently reported more disability than men: mobility (p < 0.001), transfer in-out bed (p < 0.001), transfer in-out chair (p < 0.001), dressing (p = 0.004), washing hands and face (p = 0.029), getting to and using toilet (p = 0.003), continence (p < 0.001), seeing (p < 0.001) and mastication (p < 0.001). As expected, there was a marked trend for increased prevalence of disability with increasing age for both sexes. Moderate disability arose mainly from the 25-34 age group for both sexes. For both genders, severe disability appeared mainly at higher ages, particularly for the 65-74 age group. Nevertheless, the data suggest that continence problems for women, mobility and transfer issues for men, as well as mastication problems for both genders, clearly emerge earlier than age 65. Regarding handicap, observed prevalence rates were increasing, in age as was the case for disability, but no differences were found between men or women, except for confinement to house/garden, for which women presented a higher rate in general (p < 0.001) and in the 75-84 age group (p = 0.036) in particular. CONCLUSIONS: This study shows the wide range of disability types in the general population and their association with handicap. While elderly individuals consistently report higher degrees of disability and handicap, attention should also be paid to younger age groups. Disability calls for wide, coherent and relevant medical as well as social responses.

Activities of Daily Living↗
PubMed2004

[Voice handicap in patients with organic and functional dysphonia].

BACKGROUND: The goal of this study was to assess and compare voice handicap in patients with benign organic and functional dysphonia. PATIENTS AND METHODS: Voice handicap was assessed using a German version of the Voice Handicap Index. A total of 108 German speaking patients, 64 women and 44 men aged 45.3+/-15.1 years with benign organic ( n=69) or functional ( n=39) voice disorders completed the questionnaire immediately after clinical examination and without knowing their individual diagnosis. Fifty individuals without voice complaints and normal voice status, 28 women and 22 men aged 47.1+/-15.5 years, served as controls. RESULTS: Significant differences ( P<0.001) were found between all dysphonic patients and the control group. When comparing dysphonic patients according to their gender and diagnosis group (organic or functional) no significant differences were detected. CONCLUSION: It can no longer be assumed that patients with functional voice disorders over emphasize their disease. The data obtained in this study prove that there are no gender specific differences in the way a voice disorder is experienced. There are also no differences in the way patients with a different language background experience their voice handicap.

Adult↗
PubMed2001

[Is the ICIDH (International Classification of Impairments, Disabilities and Handicaps) suitible for geriatric rehabilitation?].

The International Classification of Impairments, Disabilities, and Handicaps (ICIDH), a manual of disease consequences issued by WHO, at present exists in two versions. ICIDH-1, issued in 1980, has been under revision since 1993. This revision process will result in a more sophisticated and more comprehensive ICIDH-2 in 2001. The ICIDH, based on the biopsychosocial disease model, describes disease consequences in three dimensions: Structural and functional body impairments. Disabilities (ICIDH-1) or restrictions of activities (ICIDH-2) in activities of daily living. Handicaps (ICIDH-1) or participation limitations (ICIDH-2) in social integration. In the field of geriatrics ICIDH is also helpful as a coherent conceptual framework and reference manual to determine and code the disabilities and handicaps with regard to daily living competence. Geriatric assessment instruments are no alternative, but complementary to the ICIDH. In view of the high frequency of geriatric patients with multimorbidity, i.e. multiple impairments, disabilities, and handicaps, the utility of the ICIDH in geriatric care is highly dependent on the flexible application of this classification system.

Activities of Daily Living↗
PubMed1994

Prediction of stature from knee height for black and white adults and children with application to mobility-impaired or handicapped persons.

OBJECTIVE: No adequate methods exist for predicting stature to help assess the growth of handicapped (including mobility-impaired) children or to help in developing indexes of obesity or equations for estimating basal energy expenditure for adults. In this project, equations were developed to predict stature in white and black adults and children from nationally representative samples for application to mobility-impaired and handicapped persons. SAMPLES: Samples of healthy adults (n = 5,415) and children (n = 13,821) were selected from cycles I, II, and III of the National Health Examination Survey (NHES) conducted by the National Center for Health Statistics from 1960 to 1970. Balanced validation and cross-validation groups were created with regard to age, ethnic group, and sex. OUTCOME MEASURES: The NHES is the only national survey that contains body measurements biologically appropriate for predicting stature. These measurements include stature, sitting height, knee height, and buttocks to knee length. STATISTICAL ANALYSIS: Equations were computed from an all-possible-subsets of weighted regression procedure to select the predictor variables in the validation group based on the values of R2 and the root mean square error. RESULTS: Knee height predicted stature for white and black men, but the predictor variables for white and black women were knee height and age. For predicting stature in children 6 to 18 years of age, the predictor variable was knee height for all children. APPLICATIONS: The equations presented here were developed for use with mobility-impaired or handicapped persons, but the measurements were collected from ambulatory people by means of standard techniques. The use of recumbent anthropometric data from mobility-impaired or handicapped persons in the equations will expand the errors of prediction over those presented in this report. The standard error for a person is a guide to the range of probability within which a predicted value can occur.

Adolescent↗
PubMed1989

Protective efficacy of a recombinant deoxyribonucleic acid hepatitis B vaccine in institutionalized mentally handicapped clients.

Mentally handicapped clients in institutions are at high risk for hepatitis B virus (HBV) infection. In 1985, 770 mentally handicapped residents from four institutions in the Antwerp area were screened for HBV markers. The prevalence of hepatitis B surface antigen was 10.3 percent (range, 6.1 to 15.2 percent); 42.3 percent (range, 11.5 to 60.1 percent) had antibodies to hepatitis B surface antigen and the hepatitis B core antigen. In 1986, 275 seronegative mentally handicapped residents were vaccinated intramuscularly in the deltoid region with 20 micrograms (1.0 ml) of a recombinant deoxyribonucleic acid yeast-derived hepatitis B vaccine (Engerix-B, SmithKline Biologicals, Rixensart, Belgium) on a zero-, one-, six-month schedule. Serum samples were collected at Months 1, 2, 7, 12, and 24 and were tested for HBV markers by radioimmunoassay. The seroconversion rates for hepatitis B surface antigen antibodies were 39 percent at Month 1 (geometric mean concentration, 6.4 IU/liter), 82 percent at Month 2 (geometric mean concentration, 23.4 IU/liter), 97 percent at Month 7 (geometric mean concentration, 1,034 IU/liter), and 96 percent at Month 12 (geometric mean concentration, 269 IU/liter). Among the 214 residents evaluated at Month 12, 69 percent had hepatitis B surface antigen antibody levels greater than 100 IU/liter (geometric mean concentration, 603 IU/liter). No significant adverse reactions were observed. Within the first seven months of observation, HBV infection was detected in eight of 271 subjects (estimated annual incidence of 5 percent). During this period, none of the clients developed clinical hepatitis or showed biochemical evidence of liver damage. Between eight and 24 months, no additional HBV infections were detected. These data can be compared with an annual incidence of HBV infection of 8.7 percent in a historical cohort of mentally handicapped residents in one of the four institutions.

Adolescent↗
PubMed1985

Impact of physical handicaps on operators of agricultural equipment.

Physically handicapped farm operators and agricultural workers face barriers which make the completion of many essential farm-related tasks difficult or even impossible. These barriers are especially burdensome with respect to the operation and maintenance of agricultural equipment. This paper reports on work being done at Purdue University to assist handicapped farmers and agricultural workers who wish to continue working in spite of their disabilities. The nature of physical handicaps and proportion of farmers affected by these handicaps is discussed. Potential health and safety risks that these operators are exposed to when operating agricultural equipment are addressed. In addition, a brief overview of the Purdue project and recent activities is provided.

Journal Article↗