Centres that work with cochlear implants listen to views of deaf community.
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A prelingually deaf man developed a brief reactive psychosis that was influenced by sociocultural, community, and interpersonal conflicts. Resolution of symptoms followed interventions that addressed all areas of conflict.
The unique treatment needs of psychiatric inpatients who are deaf require added dimensions to their care. Because of the scarcity of specialized units for persons who are deaf, descriptions of these treatment needs are infrequent. This study assessed diagnoses and linguistic and cognitive comorbidities in this population. A total of 62 percent of the inpatient sample had major mental illnesses, 58 percent had psychotic illnesses, and 26 percent had a dual diagnosis of a mental disorder and substance use disorder. Case examples illustrate some of the unique characteristics of these patients. The broad reasons for admission are illustrated, as are some of the treatment adaptations made by a specialized unit for deaf persons.
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This report describes the authors' experience in providing medical and contraceptive care to a profoundly hearing impaired adolescent in a hospital setting. Ways to communicate effectively with the hearing impaired are described.
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High school youths who were prelingually and profoundly deaf, hearing elementary-school-age youths, and hearing reading-disabled high school youths read expository texts and filled in deleted words and phrases. After making word replacements, they explained their decisions in sign or verbally. As expected, the hearing youths had an easier time filling in the deleted portions and explaining what strategies they were using. While the deaf youths reported using similar strategies as the hearing youths, the frequency of each type of strategy differed. Deaf readers more often relied on rereading and background knowledge, while the hearing readers made greater use of context clues. The results suggest that instruction for deaf readers should include more effective comprehension strategies.
This article describes the development and preliminary psychometric properties of the Transition Competence Battery for Deaf Adolescents and Young Adults (TCB). The TCB includes three subtests on employment and three subtests on independent living, in a 3-option multiple-choice format and with both written and videotaped instructions. The TCB was standardized on students from both mainstreamed and residential settings (n ranged from 180 to 230 for the different subtests). Overall, the item statistics and subtest reliabilities were adequate. An initial study of the battery's construct validity was conducted. Results demonstrated the power of all of the TCB subtests to differentiate among various groups.
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Subjects, including 17 deaf and 10 hearing students in Grades 11 and 12, completed a test for memory of lists of 6 words (presented visually for 10 sec.). Subjects recalled the words in writing after a distracting task of adding pairs of digits for 10 sec. Word lists are categorized as signable with a single sign, compound or combination of signs, or finger-spelling signs only. Hearing subjects recalled significantly more words in each category than did deaf subjects. Deaf subjects recalled significantly more single-signed words than either of the other two categories. Deaf subjects did not recall more compound/combination signed words than words that could only be finger-spelled. Hearing subjects also recalled significantly more single-signed words than either of the other two categories and were not superior in either of the other categories.
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The psychiatric literature on deaf children is sparse. Even less attention has been paid to the more common situation of the hearing child raised by deaf parents. Such a child is deprived of the parents' hearing and often the parents' speech. The oldest hearing child in the family often takes on the role of family interpreter which may be a source of both pride and resentment. This can contribute to role reversal leading to a frustration of the child's dependency needs and bitter sibling rivalry. Other problems may result from the parents' ambivalence towards their child. The available literature is surveyed and case illustrations are provided. Suggestions to therapists working with similar families are made.
Crimes of violence are recorded increasingly frequently, including those involving health professionals. We reviewed records of violent incidents kept for a major Accident and Emergency Department over a ten-year period. Details were recorded in a Violent Incident Book by all grades of A/E staff, and separate records were kept by hospital security officers. A total of 407 incidents were recorded. Numbers, rank and sex of staff assaulted, types of assault, injuries received, weapons used and characteristics and disposal of perpetrators were recorded. Many were young males who had been drinking: others were regular attenders, of whom three subsequently died and one convicted of murder. Nurses and male doctors appeared to be at the greatest risk of assault and receptionists at the least risk. Recording of violent incidents and subsequent prosecution seemed inconsistent, and may have reflected the lack of a code of practice in this area. Suggestions are made about preventing, predicting and dealing with violence, and its aftermath, in the A and E department, including the use of security officers and closed circuit television, waiting room design, the recognition of body language and signs of alcohol or substance intoxication. The importance of staff support after an assault is emphasized, including immediate and long-term counselling, provision of legal advice, criminal or civil court action, victim support schemes and the workings of the Criminal Injuries Compensation Board. Free legal advice for staff assaulted at work should be included in the terms of service of NHS staff.
The 1982 Canadian Charter of Rights and Freedoms provided political actors with the opportunity to make rights-based challenges to public policy decisions. Two challenges launched by providers and consumers of health care illuminate the impact of judicial review on health care policy and the institutional capacity of courts to formulate policy in this field. The significant impact of rights-based claims on cross-jurisdictional policy differences in a federal regime is noted.