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PubMed1993

[Statistical data on motor handicapped children, aged 0-18 years, based on a national survey].

A computer-based data processing was made at 6762 motor handicapped children. The data were obtained by questionnaires about the health status, educational, social level and rehabilitation of these children. The authors could state the use of therapeutical equipment, the further need for rehabilitation--specialists and the waiting list for the admission to institutions. The number of registered children was 2.4% of the specific population. The aim of the study was to promote the activity of local self governments, local--and national social security--and health authorities competent in the rehabilitation for the social integration of the Hungarian 0-18 years old motor handicapped persons.

Adolescent↗
PubMed1995

[A clinical study of sudden death in the severely handicapped persons].

A clinical study was performed on 8 cases of sudden death (9.0%) selected from a series of 89 patients with severe handicaps who died at the Metropolitan Medical Center of Severely Handicapped during the period from 1968 through 1986. 1) All suffered from profound mental retardation with motor disturbance, but were able to react to environmental stimuli. 2) Most had mixed quadriplegia showing athetosis-related hypertonus. 3) Severe physical deformation and chronic respiratory symptoms were present in 6 of 8 patients. 4) Most of them were adolescent. 5) Autopsy revealed no particular findings to which the expected death could be attributed except for the right cardiac enlargement in 5 cases. Four of the 8 patients were recovering from respiratory infection or were in the process of having their anticonvulsant doses tapered. These four cases had shown recent improvement in their general systemic condition. Sudden death occurred mainly during limited time periods in the early morning or in the evening and was not related to sleep. The authors suggest that the changes in the autonomic nervous system may precipitate them into sudden death.

Adolescent↗
PubMed1995

[Responsibility of youth assistance teams for rehabilitation of mentally handicapped young adults].

The change of responsibilities for the integration assistance of mentally handicapped young people from social welfare to youth care confronts the socio-pedagogical view with the child and youth psychiatric view. The advantages of the new order of responsibility, which is only a first step regarding the assignment of all handicapped young people to youth care, will only become visible if representatives of both disciplines are open for diverse procedures and work with children, youths, and parents as equals and as partners. The eighth, volume of the Social Welfare Law Book (Achtes Buch Sozialgesetzbuch, SGB VIII) supplies the necessary framework.

Adolescent↗
PubMed1996

Recall intervals: effect on treatment needs of the handicapped patient: a retrospective study.

The purpose of the retrospective study was to examine the effect of recall intervals on incidence of dental caries in handicapped patients. Data was collected from patient records of a private pediatric dental practice. Variables examined were time of the recall interval, age, race and sex of the patient, handicap, and whether the patient lived in a fluoridated area or not. Approximately six hundred charts were reviewed which resulted in 83 patients that qualified for the study. Of the 83 patients in the study, 57 did not have dental caries at the recall visit. The relationship between increased caries activity and recall interval was not significant. However, a trend indicating an increased chance of developing caries after a twelve month recall interval was detected.

Adolescent↗
PubMedDate not supplied

The effect of a handicapped child upon a family.

Each family is individual in the way it reacts and adjusts to a handicapped child. How and when staff first break the news is important. It can affect the way the parents are able to cope and adjust. If midwives and other staff handle and speak about the baby in a positive, accepting way, this will help the parents to do so too. Parents often need to grieve for the "normal" child they have lost. The parents' relationship may break down under the physical, social and financial strains. The health visitor or social worker may be able to help. Some families grow closer as a result of a handicapped child, others become dysfunctional. Siblings' needs may be overlooked. Here again, the health visitor or social worker may be able to help.

Adaptation, Psychological↗
PubMed1996

[Medical care at schools for children with physical handicaps].

As the number of heavily and diversely disabled children has been increasing in schools for physically handicapped children the so-called medical care has been taken up as the most important issue. Following the trend of normalization in social background, we defend children rights for education at the same time. We have to take up medical care at schools as a new educational issue to secure the quality of life for children with handicaps, however heavily and diversely disabled they may be. We have to realize the above urgently, since it is the matter of life and death for children. We have to cope with the problems of consolidation of faculties at schools, substantial in service training for teachers, cooperative work between medical facilities and schools, and other postponed measures.

Adolescent↗
PubMed1996

[The handicaps and the need for services among the aged detected in the health survey OARS-Vigo].

BACKGROUND: In populational studies the standardized questionnaires of multidimensional functional evaluation, particularly the Older Americans Resources and Services Program-Multidimensional Functional Assessment Questionnaire (OARS), have shown to be the most adequate tools to evaluate the elderly persons living within the community. METHODS: A health care survey was performed by personal interview in the homes of a stratified randomized sample of people over the age of 65 years in Vigo, Galicia, Spain obtained from the Municipal Inhabitants Patronage (n = 841) using complete validated versions of OARS in the Spanish and Gallician languages. RESULTS: The prevalence of severe/absolute handicap in the basic functional areas among this population over 65 years was 7.7% in physical health, 6.2% in mental health, 5.2% in economic resources, 6.7% in social work, and 9.5% in daily life activities (DLA). Twenty-two percent of the population presented severe/absolute handicaps in at least one of the dimensions. One point nine percent of the population studied required institutionalization: 2.6% required economic aid, 1.4% required home help for the instrumental DLA and 1.1% required help for both the basic and the instrumental DLA although these were not being provided. One point three percent were found to be ideal candidates for a telealarm/teleaid program. CONCLUSIONS: The use of the OARS questionnaire in Spain is useful to obtain information to be applied in the planning of health care services directed at elderly people.

Aged↗
PubMed1995

[Parapsychotic disorders in mentally handicapped (particularly in Down's syndrome)].

Para psychotic troubles in Mentally Handicapped Persons (particularly in Down syndrome)-Clinical examples of M.H.P. which had no trouble until their 25-40 (years) except their intellectual defect and then, slide in psychiatric or para psychiatric behaviour. It starts with loosing vital aim and long lasting soliloquy. Then starting with an emotional frustration. Special reflexion about pseudo intellectual deterioration considered as, almost Alzheimer which is often a kind of familial contage of loosing vital impulse. It seems obvious for M.H.P. that realising their handicap without being prepared nor psychologically accompanied lead a possible trigger for loosing psychological control. Sports or leisure activities with other M.H.P. are most inefficient but a prevention often appears possible.

Adult↗
PubMed1996

[The blink reflex in severely handicapped patients with dysphagia].

We investigated the blink reflex in 27 severely handicapped patients. 15 males and 12 females, from 5 to 60 years old. They were divided into three groups; the tube-feeding group (9 patients), the oral-feeding group (9 patients), and the mixed-feeding group (9 patients). Seven normal subjects also were included in this study. There was a significant difference in the late ipsilateral component (R2) between the tube-feeding and oral-feeding groups. The average R 2 time were 43.0 msec. in the tube-feeding group and 36.7 msec. in the oral feeding group. The auditory brainstem response (ABR) showed no significant difference between the two groups. These results suggested that the swallowing function in the patients needed for tube feeding was affected by not only the cortical lesions but also the brainstem ones. Furthermore, it is speculated that the degree of brainstem dysfunction in the tube-feeding group was more severe than in the non-tube-feeding group. The blink reflex is one of the useful electrophysiological parameters for evaluating the brainstem function in severely handicapped patients with dysphagia.

Adolescent↗
PubMed1996

Seroprevalence of hepatitis B and C virus in two institutions caring for mentally handicapped adults.

Hepatitis B virus infection is common in institutions caring for the mentally handicapped. Hepatitis B virus and hepatitis C virus share routes of transmission but the prevalence of hepatitis C virus infection in this population is unknown. We have tested 101 patients from two institutions in South-East England caring for adults with mental handicap for the presence of hepatitis C antibody, hepatitis B core antibody, and if necessary hepatitis B surface antigen. None tested positive for hepatitis C antibody, but 43 had hepatitis B core antibody of whom 14 were chronic carriers positive for hepatitis B surface antigen. Unlike hepatitis B virus, hepatitis C virus infection appears to be uncommon in UK institutions.

Adult↗
PubMed1996

[Auditory perception in patients with multiple and severe handicaps: study of mismatch negativity to speech sounds].

We have found that the mismatch negativity (MMN) of event-related potentials (ERPs) to the tone burst sound is generated passively in some multiple and severe handicapped patients. This study investigated whether 10 patients with severe handicaps, whose auditory perception is hard to be evaluated clinically, exhibited MMN to the speech sound (SS). The stimuli included tone bursts of 700 and 1000 Hz in frequency, and 4 patterns of SS (1 phoneme: [a, ae], [a, o]; and 2 phonemes: [amo, ano], [ao, aka]) presented at an 85: 15 occurrence with 75 dBSPL. In the tone burst paradigm, 7 patients had a definite MMN wave followed by an N1 wave. However, a few patients showed MMN to some patterns of SS. The latency of MMN to SS was almost within normal limits. These results suggest that these patients could discriminate subtle differences of frequency in some speech sounds, although their auditory response to actual speech sounds were poor.

Adolescent↗
PubMedDate not supplied

Study of the incidence of intestinal and systemic parasitoses in a group of children with handicaps.

A high incidence of parasitic infections was shown by the study of children with physical and psychic handicaps. In 231 children examined we diagnosed 294 parasitic infections as follows: 42 (18.1%) with Giardia intestinalis 6 (2.59%) with Entamoeba histolytica 36 (15.5%) with Hymenolepis nana 21 (9.9%) with Strongyloides stercoralis 16 (6.9%) with Ascaris lumbricoides 92 (39.86%) with Tricocephalus dispar 38 (16.4%) with Enterobius vermicularis 7(3.03%) with Cryptosporidium sp. Also, by immunodiagnosis 29 cases of Toxoplasmosis (12.5%) and 7 cases of Toxocarosis (3.03%) were pointed out. The clinical examination revealed that the main symptoms were troubles of appetite (both anorexia and hyperorexia)-67.9% intestinal transit disorders-48.4% cutaneous rash (4.7%). Two series of specific treatments diminished the incidence at 38% (after the first) and at 28.5% (after the second). By disappearance of the troubles due to the parasitic infections, the state of children with physical and psychic handicaps clinically improved; so, we may consider as a further necessity the screening of all those children for such diseases.

Anti-Infective Agents↗
PubMed1996

[Vascular reconstruction and/or amputation in severely handicapped patients].

In the course of demographic ageing with a growing number of handicapped and people in need of care the vascular surgeon will be confronted more and more with the question whether to perform a leg-saving vascular reconstruction or a primary amputation, when treating such patients. This question is discussed by analyzing the parameters benefit, risk and costs. On balance the conclusion is made, that considering nursing, medical and psychological aspects also the seriously handicapped will benefit from the leg-saving procedure. Also the risk of a vascular reconstruction is justifiable, when the procedure has a real chance of success. Concerning the costs the question is still unanswered, if in consideration of the dictated economical commulsions it is allowed to perform an expensive reconstructive procedure, when the primary amputation is the substantially "cheaper" solution.

Aged↗
PubMed1997

[Status of severely mentally and physically handicapped children of school age in Nagano prefecture].

Prevalence rate and etiology were studied in severely handicapped children of school age in Nagano prefecture as of July, 1994. Severely retarded children were defined as those whose IQ's were lower than 35 and who were unable to walk. The total number of severely retarded children was 165. The prevalence rate was 0.71/1000, 90% of them being in class 1 or 2 of Oshima's classification (bedridden or unable to sit alone and with IQ less than 20), and 26% being cared for at home. Their average gestational age was 38.5 weeks, and the average birthweight 2,772 g. At birth none of them had extremely low birth weight. Etiology of the handicaps was classified as follows; congenital 26.1%; maternal infection 3.0%; prenatal 3.6%; perinatal 27.3%; postnatal 13.9% and unknown 26.1%. Asphyxia decreased gradually but the number of low birth weight premature infants increased. When postnatal etiologies were excluded, the patients with unknown etiology occupied 30.3%, 23.3% of them being light-for-dates baby. The examination of the case histories revealed that causes of unknown etiology are prenatal. If we add unknown etiology to congenital, maternal infection, and prenatal etiology, the prenatal origin is 68%.

Persons with Disabilities↗
PubMed1997

[Translation and validation of the questionnaire "Tinnitus Handicap Questionnaire, 1990].

OBJECTIVE: The Tinnitus Handicap Questionnaire (THQ) measures subjective tinnitus handicap in terms of emotional, social, and health impact (factor 1), hearing (factor 2), and perception of tinnitus (factor 3). A French version of the THQ was used with 178 tinnitus sufferers in ENT consultation. Internal validity was confirmed by correlations between (i) semigroups of items (Cronbach's alpha), (ii) item and total scores, and (iii) individual items, for each factor (Pearson's r), and was found to be strong (alpha = .90). All items (except 25 and 26) showed strong total-score correlations (.30 < or = r < or = .74). All factor 1 items intercorrelated strongly (.34 < or = r < or = .70). The factor 2 axis was coherent, with interitem correlations between .46 and .74, and its concurrent validation in strong factor 2 items correlations with hearing loss, if any (multiple linear regression: r = .67, p < .0001). Moreover, hearing-impaired (mean = 44.47 +/- 31.13) and normal-hearing (mean = 15.2 +/- 21.10) factor 2 scores were significantly different. CONCLUSION: As with the original THQ, factor 3 items were not strongly intercorrelated; moreover, items 25 and 26 failed to correlate with total score, suggesting that factor 3 is to be regarded with great caution.

Adolescent↗
PubMed1997

High prevalence of antibody against hepatitis A virus in an institution for the mentally handicapped.

Hepatitis A virus infection constitutes a world-wide public health problem, predominantly in developing countries. Mentally handicapped children, due to their incapacity for looking after themselves, comprise one of the high risk groups for hepatitis A virus infection. The aim of the present study was to determine the prevalence of hepatitis A virus antibody (anti-HAV) among the children and adults in the Institute for the Mentally Handicapped located in Nonthaburi, Thailand. The prevalence of anti-HAV IgG antibody was 92%. Immunity acquired against HAV was shown to increase in direct proportion to the age. To prevent future outbreaks of hepatitis A, water supply, sanitary conditions and personal hygiene should be improved at this and similar institutions. Furthermore, persons new to the institution (patients and staff) should be screened for anti-HAV and vaccinated with hepatitis A vaccine if nonimmune.

Adolescent↗
PubMed1997

[Diabetic foot syndrome and its risks: amputation, handicap, high-cost sequelae].

Amputation, Handicap, High Subsequent Costs. Lack of "Outpatient Wards for Diseases Involving the Feet" in German hospitals. A Challenge to Prevention: In consequence of diabetic polyneuropathy, about 25% of all diabetics develop neuropathic foot complications often resulting in amputation (about 30,000 cases in Germany per annum). Suffering and handicaps of the patients, as well as the high costs involved (estimated at 800 million Deutsche Mark per annum) systematic prophylaxis and early identification of patients at risk are imperative. According to experts every second amputation could be avoided if treatment of diabetic foot complications is started as early as possible. To prevent expensive in-hospital treatment, an outpatient clinical treatment may be offered on an interdisciplinary basis (internist, neurologist, orthopaedist, surgeon, radiologist). About 50 "outpatient wards for diseases involving the feet" exist up to now in German hospitals. Appropriate fees, subsidy by sick funds (and if necessary by politicians) and co-operation with general practitioners, internists etc. are indispensable. Other important co-operators are the family doctors. With regard to health care, preventive activities and publicity, co-operation of the local Public Health departments would also be feasible.

Ambulatory Care↗
PubMed1997

[Problems in the care of mentally handicapped adults in general hospitals].

The care of the mentally handicapped with their special needs and problems represents (despite written nursing theories and conceptions) a situation of stress and burden in the everyday life of a general hospital. The nursing staff organises their work with the mentally retarded often only on the basis of common sense without any specific professional knowledge. This analysis shows that a professional attitude has to deal with different phenomenon such as perception, communication, human dignity, but also with feelings of disgust when working with patients and being confronted with their problems. It is important to have basic knowledge on the mentally handicapped to understand their specific needs. This knowledge is essential in order to accept and tolerate mentally retarded people as a part of our social life.

Adult↗