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PubMed2000

Self-reported hearing handicap and audiometric measures in older adults.

As part of an epidemiologic study of hearing disorders in older adults, audiometric thresholds (250-20,000 Hz), word recognition performance (Northwestern University Auditory Test No. 6 word lists in quiet and in competing message), and Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) scores were evaluated for 3178 adults ranging in age from 48 to 92 years. Overall, higher HHIE-S scores were more prevalent for older age groups and for greater degrees of hearing loss. After adjusting for the degree of hearing loss, the probability of reporting a hearing disability (handicap) decreased with age.

Aged↗

PubMed2000

[How to calculate the completeness of ascertainment of a morbidity register? Example of the Isere childhood handicap register in Grenoble, France].

BACKGROUND: It should no longer be necessary to demonstrate the importance of knowing the completeness of ascertainment for a morbidity register, particularly with respect to the interpretation of prevalence rates and their trends, but also when using register data for etiological studies. METHOD: The study covered 9 generations of children born between 1980 and 1988. All of these children lived in the Isère department in SouthEast France, and each of them had at least one major deficiency, according to the inclusion criteria laid down by the RHEOP ("Registre des Handicaps de l'Enfant et Observatoire Périnatal", in French, or Childhood Handicap Register and Perinatal Observatory). These children were recruited from four different data sources. The completeness of ascertainment of the register was estimated first by means of the capturerecapture method, based on two sources that were shown to be independent by the Wittes method. Following this, loglinear models were used. The advantage of this was the absence of restrictions involved in adhering to the necessary validity conditions before applying the capture-recapture method, and the possibility of introducing heterogeneity variables, such as the number of deficiencies per child, for example. RESULTS: The applied capturerecapture method, with two main sources that have been found to be independent, gives an overall completeness of ascertainment of 86% CI(95%)[8291], with a variation of between 76% CI(95%)[6787] and 97% CI(95%)[93100] when the number of deficiencies per child is taken into account. After application of the loglinear models, the results obtained are very close to those obtained with the capture-recapture method, both in the case of estimation of the overall completeness of ascertainment and in the case of the completeness of ascertainment that is estimated according to the number of deficiencies variable. The similarity of the results obtained by the two methods appears to support our empirical study, but is only possible because of the validity of certain conditions (the interactions of the order of three were not significant) which can only be verified using statistical tests in the linear log models. CONCLUSION: If the application conditions of the capture-recapture method are carefully adhered to, it becomes possible, without the help of software, to produce a correct estimate of the number of missing cases. Nevertheless, it would be unreasonable to continue using this method alone since log linear models have been found to be independent of these validity conditions.

Child↗

PubMedDate not supplied

[An evaluation of interpersonal dependency in physically handicapped children].

In assessing the problems of handicapped persons, the social relations represents an important element. The emotional thrust in other persons put in evidence the need for assistance, only 25.1% of the subjects having normal affective relations. The lack of self-thrust and a choosing of a model from the closed community is met in 70.1% of the cases. The expression of the autonomy depends on the degree of motor handicap; 36.1% consider themselves as dependent, but a part of them have only a physical dependence.

Adolescent↗

PubMed1975

[Possibilities and limitations in the education of athe mentally handicapped (author's transl)].

The possibilities and limitations in the education of the mentally handicapped can today be defined in both medical and pedagogical terms. We think that the physician can create essential preconditions for optimal education of a mentally handicapped child by diagnostic retience, avoidance of negative suggestions, by observation of the possibilities which remain open, by concern for education as early as possible, by informing of special educational facilities and by emotional stabilization of the parents. This is the only way of attaining a successful upbringing with respect to a sufficient integration.

Child↗

PubMed1975

[Pilocarpine-ocusert-p-40 in the handicapped glaucoma patient (author's transl)].

A group of 15 patients with chronic open angle glaucoma had been selected for this study. All of them were handicapped in the long-term self-medication of their antiglaucomatous eye drops either by visual function loss or by, physical or mental disorders. A preliminary test was made in each patient whether there was an essential difference in the therapeutic effect after self-medication and after optimal local application of the miotics by the doctor. Each of the selected patients had profile tonometry after self-medication, after medication by the observer and after Pilocarpine-Ocusert-P-40. There was evidence that the most pronounced therapeutic effect could be achieved by the correct placement of the antiglaucomatous drug in the individual eye. The results on the ocusert system indicate that pilocarpine ocuserts are advantageous over the incorrect placement of different miotics by the handicapped patient. The results had been statistically evaluated using the t-test. The possibilities of using the ocuserts in the elderly glaucoma patient are discussed.

Adult↗

PubMed1999

Periodontal status and treatment needs of 12-15 year old institutionalized mentally handicapped school children in Ibadan, Nigeria.

Mentally handicapped children are known, to have poor periodontal health. But previous studies lack conformity due to the use of different indices by the different authors. Twenty-five institutionalized mentally handicapped school children in Ibadan, Nigeria were studied with the aim of assessing their periodontal health and per treatment needs using the CPITN which is known to be simple and has international uniformity. The result showed that none of the children had healthy periodontium and all the children will need oral hygiene care with a significant percentage (8%) requiring complex periodontal care. The need for comprehensive preventive dental program is discussed since the hallmark of management of the children is prevention.

Adolescent↗

PubMed1975

[Rehabilitation of visually handicapped persons (author's transl)].

Appropriate measures of rehabilitation are needed not only persons having lost their sight but also by those who have become severely visually handicapped through illness or injury and thereby have difficulties in carrying out their occupation and in everyday life. The way of proceeding depends on the general factors of the country in question and on the special situation of the individual. Besides Medical care retraining is most important in a general and special way. In order to attain these objectives the supply also of technical aids of various character necessary. The person afflicted should be rehabilitated in a complete way, which means he should be re-introduced into employment as well as into the society and his personal sphere of life. The body responsible for carrying the cost, which is not low, of all measures of rehabilitation is determined by the cause of sight loss or of the handicap.

Adult↗

PubMed2001

[Tubal sterilization in mentally handicapped women].

ETHICAL ISSUES: When performed for contraception purposes, tubular sterilization for mentally handicapped women poses important ethical issues, including patient's rights, body integrity, and the notion of informed consent. French law guarantees the respect and safety of all patients, but in everyday practice, patient's rights must be upheld by family and healthcare workers searching for the most adapted solutions for each individual situation. PROPOSITIONS: We present here our proposals for everyday practice. Our conclusions are based on an analysis of the notion of handicap as defined by the WHO and on the observed sexual activities of this type of patient. In this context, informed consent involves a number of subjective factors pointing out the difficulty encountered in providing dear comprehensible information. Finally we discuss the ethical issue of tubular sterilization which many consider to be a masked form of eugenism.

Ethics, Medical↗

PubMed1975

Behavioral skills for employment of the intellectually handicapped.

Parents, teachers, and supervisors in competitive industry and sheltered workshops ranked the same behavioral items. Each group followed different directions. The items, thought to be basic requirements for successful employment of the intellectually handicapped, were sorted into four categories corroborated by university students. Chi-square analysis showed many significant differences in ranking among samples at p less than .0005. Parents and teachers emphasized items in the job-task category significantly less than did industry and workshop supervisors. Parents stressed basic reading skills more than other samples. Occupational therapists aware of the handicapped person's potential for employment could take the role of providing experiences stressing behaviors sought by employers.

Achievement↗

PubMed2001

Caries prevalence amongst handicapped children of South Canara district, Karnataka.

This epidemiological investigation was carried out among 524 handicapped children in the age group of 3-30 years, attending 8 different non-residential special schools in South Canara district, Karnataka. The examination procedure and criteria were those recommended by W.H.O. in 1997. The total caries prevalence was found to be 71.56%. The mean deft in the primary dentition was found to be 3.06 +/- 3.14. The mean deft and DMFT in the mixed dentition were 3.32 +/- 2.82 and 1.14 +/- 1.08 respectively. The mean DMFT in the permanent dentition was 4.51 +/- 3.17. The prevalence of dental caries was higher in the mentally subnormal and handicapped children. The decayed component constituted the majority of the dental caries index. Lack of conservative approach to the treatment had been confirmed in the study.

Adolescent↗

PubMed2001

[Meconium and postnatal neurologic handicaps].

OBJECTIVE: A review of meconium pathophysiology and its contribution to the incidence of postnatal neurological handicap. DESIGN: Reviewed article. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic. SUBJECT AND METHOD: Meconium can be a cause of infant neurological handicap. Two main pathogenetic pathways are mentioned. 1. Meconium (and its components: bile acids) may have a direct vasoconstrictive effect on umbilical and placental vessels. This way still remains controversial. 2. Meconium as a possible cause of intraamniotic infection results in a release of fetal cytokines (TNF alpha, IL-1 beta, IL-6), which can damage myelinogenesis in periventricular white matter. RESULTS: Meconium in premature labour is a higher risk factor compared to term delivery. 41% of premature infants were diagnosed as having CP when meconium was present compared to 10% in the same group with clear amniotic fluid. The incidence in term pregnancy with meconium present is 0.4% compared to 0.3% in a population without any obstetrical risk. CONCLUSION: Ultrasonographically found periventricular leukomalacia is the most reliable sign of subsequent cerebral palsy or other neurological sequelae.

Amniotic Fluid↗

PubMedDate not supplied

Evaluation of hearing handicaps and presbyacusis using World Wide Web-based calculators.

This article is a clinical report on the applicability of computer software in determining hearing handicaps and presbyacusis. The software is now World Wide Web based and can be implemented in a clinical setting by using JavaScript calculators housed on the World Wide Web at . Added features consist of calculating the maximum recommended allowable noise exposure using the National Institute of Occupational Safety and Health 1997 frequencies in handicap determination and the projection of future audiometric thresholds using the International Standards Organization 1999 compression factor. A review of the literature and the theoretical and clinical applications of these new features are discussed. A guide in the selection of Web-based development software is also presented in the hope of encouraging other researchers to develop Web-based versions of their software applications.

Audiometry↗

PubMed1996

[Intravenous sedation with propofol in dental treatment. Experience in mentally handicapped patients].

Simple dental procedures in mentally handicapped patients can be facilitated by the use of intravenous sedation. This article describes our experiences with eleven such patients undergoing a total of eighteen procedures in 1994-1995. Sedation was administered by a consultant anesthetist using propofol in 'Sterrenberg'--a home for the mentally handicapped in the Netherlands. The article describes the organization of the patients selection and pre- per- and post-sedation care using a management protocol. It is concluded that the technique is effective and safe for simple dental procedures such as examination, removal of tartar, radiography and the treatment of cavities, provided that patients selection and care are meticulous.

Adult↗

PubMed1975

Play as occupation: implications for the handicapped.

That play is a need-fulfilling and appropriate occupation in the life of every person, and particularly in the life of the handicapped, is the basic assumption of this paper. Play is defined, characterized, and discussed in relationship to its role in the treatment process. Various classical and modern theories of play are presented, with the optimum arousal theory of play presented as most significant in the rehabilitation process of the handicapped individual. The approach to this assumption is basically theoretical, and concludes with pragmatic suggestions for optimizing the meaningful involvement of patients in play.

Arousal↗

PubMed2003

['Tired of life': a reason to evaluate physical handicaps].

A 91-year-old woman was admitted to a nursing home because of functional deterioration: poor vision and hearing, and diminished mobility. She had been widowed for 30 years, had no children and a very small social network. She described herself as 'tired of life', and alluded to the assisted suicide of the former senator Brongersma, where this term was the trigger to the administration of assistance. The Supreme Court however ruled afterwards that a physician has no capacity in 'questions of life and death', but only in requests for help with a medically classifiable underlying disorder. The patient was not assisted in dying and her condition deteriorated further. Some time later she fell and contracted a clinical hip fracture. She refused to be brought to hospital and was given fentanyl plasters. A week later she died. The question on how to respond to the very elderly who seek help because they wish to die, is being discussed in the Netherlands. The term 'tired of life' appears to be rather confusing, as it has no medical connotation. It is recommended that elderly persons who ask for help in dying because they are 'tired of life', based on physical handicaps, are evaluated carefully to determine the severity of the handicaps and the hopelessness and unbearableness of the suffering. This could lead to the patient receiving assistance in dying.

Aged↗

PubMed2003

[Terminal care for handicapped newborns and grief care for their families].

Terminal care for the handicapped newborns and the grief care for their families have recently emerged as a medical problem. Questionaires to 13 parents who lost their children showed that they were unsatisfied with the care from doctors and nurses before and after the child's death. Medical approach to grief care includes changes in the quality of medicine for handicapped newborns. A system should be created to improve the relationship between the NICU pediatricians/nurses and the staffs engaged in early intervention prior to the newborns' death, which in turn strengthen the ties with a network supporting the families who have lost their newborns.

Child, Preschool↗

PubMed2003

Prevalence of intestinal parasitic infection among Thai people with mental handicaps.

The prevalence of intestinal parasitic infection was studied by stool examination in institutionalized and non-institutionalized Thai people with mental handicaps. It was found that the prevalence of infection was much higher in institutionalized (57.6%) than in non-institutionalized people (7.5%). The common parasites found in institutionalized people were Trichuris trichiura (29.7%), Entamoeba coli (23.1%), Giardia intestinalis (8.0%), Hymenolepis nana (7.8%), and Entamoeba histolytica/dispar (7.1%). Institutionalized mentally handicapped people should be considered as a high risk group for intestinal parasitic infection and a parasitic control measure should be emphasized.

Adolescent↗

PubMed1992

Consent and the handicapped patient.

Changes in the care of handicapped people has resulted in them being more evenly distributed within the community. This increases the likelihood that they, or their carers, will seek treatment from general dental practitioners. It is, therefore, important to be aware of the regulations and forms involved in consent of a handicapped patient.

Comprehension↗