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PubMed1985

Handicap research in Denmark.

In connection with recent social developments in Denmark increasing interest has been shown in research in the area of handicaps. Three Danish Research Councils (for Medicine, the Humanities and the Social Sciences) appointed a Committee to investigate this area of research. A survey conducted in the relevant fields gave evidence of much activity in this area. Very few research projects, however, integrated educational, psychological, medical, technical and social aspects. The need for more cooperation, information and training was therefore stressed as a prerequisite for better interdisciplinary handicap research in Denmark. Research seminars and workshops held in 1982-83 supported the results of the survey, especially as regards the need for training in the methods of interdisciplinary research and understanding among professionals (nurses, teachers, social workers, therapists, etc.). A formal coordination agency is recommended in order to establish the necessary cooperation among researchers, planners and users in Danish handicap research.

Denmark↗
PubMed1987

Common vocational training project for the handicapped (CVTPH).

CVTPH is a special project imparting vocational training to leprosy patients as well as other categories of the handicapped under the same roof, in order to combat the leprosy stigma which is the major obstacle in all leprosy work and to aid rehabilitation by making the trainees economically self-sufficient. The project, which offers training in the industrial sector to leprosy patients, orthopaedically handicapped individuals and able-bodied but socio-economically disadvantaged individuals, began in a small way in 1977, but has grown considerably since then, thus demonstrating the effectiveness of the concept. There have been several problems--chief among which are the leprosy stigma and the reluctance of the trainees themselves to move out from a sheltered environment into the world outside--but these are slowly being overcome by the formation of co-operative societies controlled by the handicapped. This project is hoped to serve as a model for similar vocational training programs.

Combined Modality Therapy↗
PubMed1996

The International Classification of Impairments, Disabilities and Handicaps (ICIDH)--results and problems.

In 1980, the World Health Organization (WHO) published the International Classification of Impairments, Disabilities and Handicaps (ICIDH). Although these three concepts of impairment, of disability, and especially of handicap have been criticized for many reasons, the ICIDH has given rise to extensive research and other activities world-wide, resulting in more than a thousand publications. The ICIDH has been translated into numerous languages. The classification itself, developed for trial purposes, shows the large variety for the items of each basic term. Practical experience, however, has shown that the ICIDH cannot be applied without problems. This is especially true for the handicap concept.

Persons with Disabilities↗
PubMed1998

Social consequences of long term impairments and disabilities: conceptual approach and assessment of handicap.

OBJECTIVES: To present a conceptual model of disablement adapted from the WHO model and to conduct a pilot study with a measurement tool (LIFE-H) of the concepts of life habits and handicap situations. DESIGN: Content validity and test-retest reliability study. SETTING: General community. PARTICIPANTS: A panel of 12 experts of rehabilitation for the process of content validity and 49 individuals with spinal cord disorders (adults and children) for the reliability study. OUTCOMES MEASURES: a person's life habits (activities of daily living and social roles). RESULTS: The LIFE-H questionnaire was designed to assess the handicap situations observed in daily life of individuals with disability. The experts concluded that the LIFE-H items covered most of a person's life habits (ADL and social roles) and that it could be used to determine the appearance of handicap situations. The LIFE-H total score showed a good level of reliability for the children and the adult samples (ICC = 0.73 and 0.74, respectively). Taken individually, a majority of life habit categories have shown a moderate to high reliability level (ICC > or = 0.50) while a few life habit categories such as the interpersonal relationship or nutrition showed a lower reliability level. CONCLUSION: The development of LIFE-H allows fulfillment of the need to determine the disruptions in life habits of persons with disabilities.

Activities of Daily Living↗
PubMed2001

Aspects of the quality of life of chronically ill and handicapped children and adolescents in outpatient and inpatient rehabilitation.

The aim of psychosocial rehabilitation is to reduce handicaps as far as possible. One handicap in chronically ill adolescents is the impairment of quality of life. The quality of life of chronically ill or handicapped adolescents can be defined with a bio-psycho-social model. The connections between adaptivity level, severity of the physical disability and experienced helplessness of young wheelchair users with paraplegia or tetraplegia are demonstrated. Advantages of inpatient and outpatient rehabilitation with regard to quality of life are reported.

Adaptation, Psychological↗
PubMed1986

Visibility of handicap, self-concept, and social maturity among young adult survivors of end-stage renal disease.

This study examined the relationship between visibility of handicap and both self-image and social maturity in young adult survivors of end-stage renal disease. Ratings of visibility of handicap, social maturity, and a self-report measure of self-image were obtained through interviews with 31 patients. Results showed that visibility was inversely correlated with identity stability (p less than 0.05), social maturity (p less than 0.025), and self-esteem (p greater than 0.10), while jointly controlling for patients' age and years since last transplant. Although patients with visible handicaps remain at risk for maladjustment, many developed positive coping strategies in order to face the developmental challenges of adulthood.

Adolescent↗
PubMed1976

4. Isslues in the assessment of the health status, needs, and treatment of the mentally and physically handicapped.

The importance of information for evaluating the health status, needs, and progress of the mentally and physically handicapped has been consistently argued. However, the varied nature of handicapping conditions, often aggravated by the presence of multiple conditions, the extended periods of treatment, the diverse professional groups involved, and the multiple uses and users of data pose difficult problems for uniform data collection. For these heterogenously disabled populations whose conditions are generally not fully remediable, it is especially important to have 1) data on functional ability, both current and potential, and 2) information characterizing the nature of the care environment in terms of its social and educational stimulus, barriers to functional development, and availability of supportive services in the community. In both areas, considerable work has been done to develop measurement instruments for the institutional and noninstitutional handicapped.

Community Health Services↗
PubMed1989

Visual assessment of the multiply handicapped patient.

The visual capabilities of the multiply handicapped and/or developmentally delayed patient are difficult to assess with methods that depend on the patient's subjective responses. Fifty-nine patients with multiple neurological handicaps and unknown visual capabilities were examined using a modified ophthalmic examination which included visual acuity measures using visual evoked potential (VEP) and preferential looking (PL) techniques. Patients ranged in age from 3 to 33 years; median age 9 years. Significant refractive error (in 73%) and strabismus (in 71%) were the most common ocular disorders. Of the 43 patients with a significant refractive error, only 16 (37%) were wearing their proper correction (ranging from -21 to +20 D). In 27 patients the uncorrected refractive error ranged from -10 to +20 D. Binocular acuities (with refractive correction) could be obtained from 56 patients (95%) using a spatial frequency sweep VEP technique, and in 41 patients (70%) using PL grating acuity cards. The VEP and PL grating acuity measures agreed to within 1 octave (a factor of 2 in minimum angle of resolution) in 27 of 41 patients. VEP acuity was 1.1 to 2.7 octaves higher in 12 patients. Grating acuity of at least 6/12 (20/40) was estimated in 12 patients. Residual vision can be measured in "difficult to examine" multiply handicapped patients with VEP and PL techniques.

Adolescent↗
PubMed1980

Patients in a clinic for children with multiple handicaps: a retrospective diagnostic evaluation.

This study illustrates the effectiveness of an outpatient facility in evaluating patients with a variety of handicapping disorders. A multidisciplinary approach, such as the one used in the Child Study Clinic, is the most effective and most efficient mode of evaluating handicapped children, though hospitalization is occasionally required to further evaluate such complicated problems. Every child with mental retardation, birth defects, or multiple handicaps requires a thorough evaluation for the purposes of diagnosis, treatment, and the prescription of long-term educational and occupational goals. Family history often indicates the need for genetic counseling.

Abnormalities, Multiple↗
PubMed2004

Is perception of handicap related to functional performance in persons with vestibular dysfunction?

OBJECTIVE: The purpose of this study was to determine if scores between 0 and 30 (mild), 31 and 60 (moderate), and 61 and 100 (severe) on the Dizziness Handicap Inventory (DHI) differentiated a person's functional abilities. STUDY DESIGN: Retrospective case series. SETTING: Tertiary balance outpatient center. PATIENTS: Patients (n = 85; mean age, 61 years) with a variety of vestibular diagnoses participated. INTERVENTIONS: Patients completed the DHI, the Dynamic Gait Index (DGI), the 5 times sit to stand test (FTSST), the Activities-specific Balance Confidence (ABC) scale, gait speed, and the Timed "Up & Go" (TUG) during the same session. Reported numbers of falls within the last 4 weeks were recorded. MAIN OUTCOME MEASURES: The DGI, FTSST, ABC, gait speed, TUG, and gait speed were compared among DHI groups. RESULTS: Significant differences were identified using an analysis of variance between DHI groups on the DGI, the FTSST, ABC, and number of falls (p < 0.05). A significant difference was found between DHI groups (mild vs. severe and moderate vs. severe) on the DGI (p < 0.05) with greater DHI scores exhibiting more impaired walking. The FTSST was different between DHI groups mild and severe and DHI groups moderate and severe (p < 0.05), with slower FTSST scores with higher DHI scores. Reported falls were higher among the severe DHI group and the other 2 DHI groups (p < 0.05). All 3 DHI groupings were different from each other on the ABC (p < 0.001). CONCLUSION: Patients who perceive a greater handicap as a result of dizziness demonstrate greater functional impairment than patients who perceive less handicap from dizziness.

Adolescent↗
PubMed1999

The immunocompetence handicap hypothesis: testing the genetic predictions

The immunocompetence handicap hypothesis suggests that the immune system competes for resources with sexually selected ornaments; variation in ornaments might reflect genetic variation for immunocompetence. We tested this genetic prediction by mating scorpionfly females to males differing in the expression of a condition-dependent ornament trait, saliva secretion, and then comparing offspring immunocompetence. We found several indications of an immunocompetence handicap in our study: females had superior immunocompetence compared with males, the different immune traits were positively correlated, and there were indications of genetic variation in immune traits. However, we found no significant difference in the immunocompetence of offspring derived from males differing in ornament expression, only a tendency for sons of ornamented males to possess slightly better immunocompetence. The estimated effect of fathers on offspring immunocompetence was rather small, but it might be a sufficient benefit of female choice, provided that the costs of choice are small. We conclude that the genetic benefit of female choice is small concerning offspring immunocompetence, but the immunocompetence handicap principle might nevertheless work in scorpionflies.

Journal Article↗
PubMed2003

Lizard threat display handicaps endurance.

Honest-signalling theory asserts that threat displays reliably advertise attributes that influence fighting success. Endurance, as measured by treadmill performance, predicts the outcome of agonistic interactions among lizards. If threat displays in lizards function to advertise endurance capacity then variation in threat displays should correlate with endurance. I tested this prediction for the duration of threat posturing in male side-blotched lizards (Uta stansburiana) and examined whether threat displays act as quality handicaps, reliable signals that expend the attribute that is advertised. Individual variation in the duration of threat posturing correlated with endurance, while an experimental reduction of endurance diminished the duration of threat posturing. As expected of a quality handicap, endurance fell below baseline after display production. A restriction of aerobic metabolism can account for this effect. In threat posturing, lateral compression of the thorax may interfere with respiration or with circulation, limiting aerobic metabolism and causing a compensatory increase in anaerobic metabolism, thereby generating lactate and diminishing locomotor capacity. Concentrations of lactate measured after display production were higher than baseline, consistent with the proposed mechanism. By restricting aerobic metabolism, the threat posture can act as a quality handicap, simultaneously advertising and expending the endurance capacity of displaying lizards.

Aggression↗
PubMed2003

The role of juvenile hormone in immune function and pheromone production trade-offs: a test of the immunocompetence handicap principle.

The immunocompetence handicap hypothesis postulates that secondary sexual traits are honest signals of mate quality because the hormones (e.g. testosterone) needed to develop secondary sexual traits have immunosuppressive effects. The best support for predictions arising from the immunocompetence handicap hypothesis so far comes from studies of insects, although they lack male-specific hormones such as testosterone. In our previous studies, we found that female mealworm beetles prefer pheromones of immunocompetent males. Here, we tested how juvenile hormone (JH) affects male investment in secondary sexual characteristics and immune functions in the mealworm beetle, Tenebrio molitor. We injected male mealworm beetles with JH (type III) and found that injection increased the attractiveness of male pheromones but simultaneously suppressed immune functions (phenoloxidase activity and encapsulation). Our results suggest that JH, which is involved in the control of reproduction and morphogenesis, also plays a central role in the regulation of a trade-off between the immune system and sexual advertisement in insects. Thus, the results reflect a general mechanism by which the immunocompetence handicap hypothesis may work in insects.

Animals↗
PubMedDate not supplied

The handicapped child.

This article is not about specific conditions such as cerebral palsy, or deafness, or mental retardation, it is about every handicapped child; that is every child whose development and life fulfillment are restricted and who requires help to overcome or to reduce the effects of his handicaps. The picture and principles described below apply to all handicapped children whatever the nature of their basic disorder.

Child↗
PubMedDate not supplied

A review of the medical, educational and social needs of 207 handicapped children.

The Mary Sheridan Centre serves the needs of two health districts with a population of over half a million. The assessment of the handicapped child is combined with a Day Nursery and Observation Unit which provides therapeutic, educational and supportive guidance. During the year May 1973-74, 207 children were referred for assessment of whom only 11 were found to have no handicap. One-third of these referrals were from the hospital follow-up baby clinic and two-thirds came from community and general practitioner sources. The average age of referral was two years for girls and two and a half years for boys. Of the 196 handicapped children, 33 had neurological disorders, 30 congenital anomalies and 50 an adverse perinatal history. Social factors were thought to contribute significantly in 72; 35 children came from single parent families. Behaviour problems were noticed in a high proportion (68). Forty-four children regularly attend the Centre's day nursery whose staff include preschool teacher, occupational therapists and trained nurses for play, speech stimulation and specific therapy; 48 attend for speech therapy and 19 for physiotherapy. The prime aim is to help the parents continue with the therapy and care of their child in their own home.

Child Day Care Centers↗
PubMedDate not supplied

Dental care for the handicapped-ambulatory and hospital considerations.

Estimates of the incidence of handicap are totally confused, and there is little coordination in provision of information as to types of disability. The author attempts to distinguish between the various handicaps from a standpoint of dental services delivery. Some of the psycho-social problems of the handicapped are discused in relation to dental care, and distinction is made between those who can be treated on an ambulatory basis and those who have to be hospitalized. Guidelines are established for each of the aforementioned techniques in order to make the experience more bearable for patient, parent and dentist.

Aged↗
PubMedDate not supplied

Physically handicapped children in long-stay hospitals.

Six thousand five hundred handicapped children live permanently in long-stay hospitals, where their needs may not be met because of lack of resources within the hospital, eg. there is a shortage of therapy staff in long-stay hospitals. These children could be accommodated in the community if local authorities were prepared to make adequate residential provision for them. The children are likely to suffer emotional distress in hospital, because there is a grave shortage of nursing staff and very little understanding about the mothering needs of children in institutions. This paper is based on some of the findings of a 2-year study into the care of 223 multiply handicapped children in eight mental handicap hospitals. The study was financed by the Spastics Society, and undertaken from the Thomas Coram Research Unit at the University of London Institute of Education.

Adolescent↗
PubMedDate not supplied

The meaning of handicap in children.

An examination is made of factors that contribute to handicap in children with impairments. Handicap is seen to be caused by a complex coalescence of factors which can be divided into three groups associated directly and indirectly with the presenting disability. It is argued that, for there to be a reduction in the level of handicap experienced by the impaired child, then consideration must be given to intervention in all aspects of the contributing factors and not just in the treatment of the impairment itself.

Attitude↗