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PubMed2006

[Epidemiologic study on hearing impairment and ear diseases in old people].

OBJECTIVE: To investigate the prevalence of hearing impairment and ear diseases in old people and provide scientific data for drawing up the prevention and treatment strategies. METHODS: Using the probability proportion to size (PPS) method, 1261 people over 60 years were investigated in 40 clusters in Jiangsu Province with the WHO protocol. RESULTS: The prevalence of hearing impairment was 58.1% (the standardized rate: 59.5% in the whole country, 60.9% in Jiangsu province). Degrees of hearing impairment were mild (33.1%), moderate (17.8%), severe (5.9%) and profound (1.3%). The prevalence of hearing disability was 25.0% (the standardized rate: 26.6% in the whole country, 28.1% in Jiangsu province). There were significant difference of the prevalence between male and female, as well as urban and rural, and different ages. The prevalence of the ear diseases was auricle malformation (0.2%), wax (1.7%), otitis externa (0.1%), fungi (0.5%), serous otitis media (1.2%), chronic suppurative otitis media (1.6%), dry perforation of tympanic membrance (2.3%). The causes of hearing impairment were ear diseases (2.9%), non-infectious condition (92.6%), genetic condition (0.3%) and undetermined causes (4.2%). Of which, 31.1% of persons needed hearing aids while 2.3% of persons needed medicine treatment, but 0.9% of persons needed non-urgent surgery and 1.0% of persons needed other treatment. CONCLUSIONS: The prevalence of hearing impairment and disability in the old rised obviously than the last investigation in 1987. It was a heavy burden for social development in China. The government and the whole society should take more concern about the problem. The scientific strategies of prevention and treatment were urgently needed and implemented.

Aged↗
PubMed1991

Assessment of neurologic deficits in stroke. Acute-care and rehabilitation implications.

It has been estimated that half of all stroke patients who survive are left with some level of disability and that for some patients this disability is severe. Methods that maximize recovery and decrease complications are essential for all stroke patients, regardless of the level of disability. Rehabilitation philosophy and practices are applicable in all types of care settings. The Joint Committee for Stroke Facilities set the guidelines for stroke rehabilitation to provide the following: . Prevention of secondary complications . Compensation for sensory, perceptual, and motor loss . Environmental stimulation . Socialization . Development of motivation . Enablement of independent living and home living . Achievement of vocational rehabilitation when feasible In the acute-hospital setting, these guidelines can be incorporated into planning care for the stroke patient. Assessment of the patient on an ongoing basis provides a clear description of neurologic, cognitive, and functional status. With this information, the nurse can shape the patient's environment to provide for safety and stimulation, while encouraging maximum mobility and self-care. Within the stressful and busy environment of an acute-care unit, taking time to allow a patient to struggle with performing even simple tasks may be frustrating for the nurse. This frustration may be lessened through the recognition that every patient movement and activity can be viewed as therapeutic and that every improvement brings the patient closer to the reality of independence.

Activities of Daily Living↗
PubMedDate not supplied

[Euthanasia and the physician].

The problem of Euthanasia is approached in the light of the Hippocratic principles, which have not changed with time but have only been adapted to new scientific and social developments. The definition of what constitutes Euthanasia is clarified and the need to avoid that semantic mutations may manipulate ideas is stressed, so that what is certainly wrong does not seem to appear as right. The uniqueness and individuality of the human being is emphasized as well as the commitment of doctors to their patients wellbeing, although at times a balance may be needed in relation to some apparently conflicting interests of society as a whole. The importance of the doctor/patient relationship is stressed, particularly in the final stages of terminal disease. Decisions concerning life and death, although preferably to be shared, still rest most times upon the doctor's shoulders alone. The respect for the wishes of the patients, their right to know the truth and its limits, the use of the living will, the right to die in dignity, the use of ordinary or extraordinary means of treatment, the concept of brain death and the rules for resuscitation, are commented upon. In all cases, the need for a global and individualized approach is mandatory before any final decision is made. Total respect for human life, from its beginning to its end is emphasized, intentional killing, for whatever reason or motivation, is firmly rejected. Reference is made to national and international codes of ethics as well as to declarations and statements of the World Medical Association.(ABSTRACT TRUNCATED AT 250 WORDS)

Euthanasia↗
PubMedDate not supplied

[Health care of preschool-age children].

The past period since 1953 is characterized with decreasing of the number of children in the Republic of Croatia with a trend of mortality decrease in this age group. For the further improvement of health in this children population, it is necessary to direct attention to priority problems: decreasing of respiratory diseases, injuries, improving the psycho-social development of the children, better health care in preschool institutions, and early prevention of diseases and creating the adequate habits of a healthy life.

Child Health Services↗
PubMed1990

[Dubowitz syndrome: a dysmorphism syndrome with developmental delay, transitory short stature, hyperactive behavior and atopic dermatitis].

The Dubowitz-syndrome, a rare, autosomal-recessive condition, was seen in a 6-year-old female patient. Verbal, fine motor, and social development were severely retarded. Behavioral disturbances, predominantly hyperactivity were apparent. Short stature of unknown origin became evident during infancy and early childhood. Atopic dermatitis and specific sensitivity to inhalant and nutritive allergens was found. A pattern of minor anomalies included inner epicanthic folds, hypertelorism, flat nasal bridge, globular nasal tip, coarse lips, and retrogenia as well as pes planovalgus, and a sacral dimple.

Abnormalities, Multiple↗
PubMed1990

[Psychotherapy in atopic diseases].

Atopic diseases show many attributes and risk factors of psychosomatic diseases. The skin, on of our most essential organ of senses, is of considerable importance in the "dermatogenic state" of psychological and social development, as well as breathing. Children with atopic dermatitis and asthma bronchiale are very sensible and irritable. They divert their sick identity to the skin or to the lungs. Psychotherapy is therefore for many cases of atopic children and essential part of treatment, especially as a systemic therapy.

Adaptation, Psychological↗
PubMedDate not supplied

[Language acquisition in cleft lip-palate (CLP) children. 2. Linguistic diagnosis and therapeutic approaches].

The major tests and methods used in language acquisition diagnosis in CLP children of 3 months to 6 years of age are described. Apart from methods for phonetic analysis, such as spectrography, emphasis is being placed on the assessment of listening by hearing and of semantic and meta-linguistic acquisition. Additional information is obtained on the motoric, cognitive and social development (for detecting any possible multiple handicaps in these areas). In this context the major problems covered in cleft palate parent groups are also pointed out. Finally, the speech therapy provided for preschool children with severe speech problems (as compared with the control group) is outlined.

Child↗
PubMed1990

Mothers' assessments of the impact of children with spina bifida on the family.

This exploratory, descriptive study examined mothers' assessments of the impact of children with spina bifida on the family. A review of the literature indicated that families can be conceptualized as systems and that the impact of a child with spina bifida is experienced throughout the system. The subjects were a convenience sample of ten mothers of children ages 5 to 11 with spina bifida. Three instruments were used to collect data. The Child Health History and Demographic Questionnaire; the Impact on Family Scale (Stein & Riessman, 1980); and the Parent Concern Questionnaire. The instruments were administered to subjects in fixed order. Demographic and family impact data were collected in writing. Parent concern data were collected through audiotaped interviews. Demographic data were summarized for frequencies. Impact on Family scores were tabulated and compared to the score of a reference group using a two-tailed student's t-test and a p value of p less than or equal to .05. Wilcoxon rank-sum tests were run on the Impact on Family scores to examine for differences by income, presence of siblings, child's educational setting, and marital status. Parent concern data were content analyzed for themes. Mean scores of Impact on Family dimensions were not significantly different from a reference sample of mothers of children with chronic conditions. Within the sample, positive relationships were found between financial impact and the presence of siblings, impact on social relations and both single parenthood and having a child in special education, and coping and higher incomes. Mothers' concerns included their children's social development, rehabilitation, and independence issues. Impact issues included sibling protectiveness, conflicts with grandparents over the child with spina bifida, and financial costs. Most mothers reported optimism about their child with spina bifida.

Adult↗
PubMed1990

Assessment of quality of life in school-aged children: a method--phase I.

This is part one of a programme of research directed toward the assessment of the Quality of Life (QOL) in chronically ill school-aged children. Phase I empirically derived QOL indicators of specific value to school-aged children. The ultimate purpose is to help health care professionals reduce or eliminate adverse consequences of chronic illnesses and their treatment in school-aged children through systematic identification and evaluation of these consequences as perceived by children. A convenience sample of 96 well children, aged 7 through 12 years, were interviewed to identify QOL indicators. Data collected included: demographic profiles of the child and parents; three wishes projective question (obtains data about the child's fantasies and wishes); semi-structured interviews (obtains information regarding the physical, psychosocial, and social development while focusing on the child's activities, family life, and home environment); and What Worries You (Your Child) the Most Questionnaire (lists 30 anxiety-provoking childhood experiences). Descriptive and nonparametric statistics will be used to describe the sample and compare the child and parent's responses, respectively. Data from the interviews will be analyzed to identify common themes. A category system was inductively derived to from the themes. The specific QOL indicators will be derived from the categories to provide a foundation for an instrument to psychometrically tested. This instrument will then be modified for use with children with chronic illness.

Child↗
PubMedDate not supplied

[Local health systems: challenges for the 90's].

This article gives a general overview of present local health systems and their possible future. It reviews the background that led the countries of the Americas to make plans to transform their national health systems and points out the key role played by local health systems in this undertaking. In addition to summarizing the basic conditions necessary for setting up a local health system, the authors define these local systems as instruments for decentralization of the State and the expression of democratic action. They consider it an imperative for the 1990s to ensure that the services are improved in terms of equity and quality, democratization and social participation, economic and social development and transformation, and efficiency and use of appropriate technology. Stress is placed on the comprehensive concept of health, well-being, and development, as well as on health promotion by the population itself, while taking into account the responsibilities that correspond to national sector agencies and to local communities.

Delivery of Health Care↗
PubMedDate not supplied

Kaduna beggar children: a study of child abuse and neglect in northern Nigeria.

Kaduna State, Nigeria serves as an example of a third world state that in the wake of rapid change and the weakening of traditional forms of welfare has created an underclass of beggars, many of whom are children. Lack of a comprehensive welfare system in general, and more specifically, protective services for minors, has resulted in the neglect of some children who are exploited by poor families for street begging. Although laws exist to protect minors and prevent street begging by children, they are seldom enforced. Perhaps this is due to the absence of a governmental agency solely responsible for child welfare. In light of the need to assist beggar children, the following measures are recommended: Establish a Bureau for the Protection of Beggar Children. Establish a Division of Protective Services in the Ministry of Social Development. Establish advocacy programs for street children by voluntary agencies.

Adolescent↗
PubMed1990

The cost of acquired immunodeficiency syndrome in northern California. The experience of a large prepaid health plan.

We studied the cost of acquired immunodeficiency syndrome (AIDS) in the Kaiser Permanente Medical Care Program (KPMCP), northern California region. We report the costs of care to the KPMCP and introduce an innovative application of survival methods to cost analysis. From the beginning of the AIDS epidemic in 1981 to the end of June 1987, 866 cases of AIDS were recorded among members of the KPMCP. Estimates of the costs of care of these patients were derived from comprehensive chart reviews of a random sample of 71 patients whose conditions were diagnosed from January 1984 through June 1987. Total mean lifetime costs per patient were $32,816 (median, $28,677), whereas the mean hospital per diem cost was $20,446 per patient. As more care was shifted to outpatient services overtime, overall costs dropped, despite marked increases in the cost of outpatient medications such as zidovudine. The overall estimate of cost compared closely with other estimates of the cost of care in San Francisco, Calif, and it is lower than estimates from elsewhere in the United States, probably because of the low proportion of cases associated with intravenous drug use and the well-developed social support networks available to patients with AIDS in the San Francisco Bay Area.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Coping with a handicapped child].

The birth of a handicapped child is a non-normative event the mother has to come to terms with individually. It has been examined whether mothers who had contacts with the handicapped before the birth of their handicapped child had acquired qualifications to cope with this situation. A group of twelve mothers with specific experience was compared to a group of twelve mothers without any much experience, under consideration of control variables involved. Changes in the self-image, the mood and the choice of existence techniques were assessed in a longitudinal and a cross section survey over a period of seven years using standardized methods and a semistructured self report. Evaluation by non-parametric and variance analyses showed that women who disposed of experience data before the occurrence of the critical event coped with the new experience of being personally concerned with small identity restriction over a limited period of time. The social development of their children was significantly better. Though not showing any pathological reactions, women without any prior experience showed less confidence in their own possibilities, tended towards a rather anxious and depressive general mood, and confined themselves to a narrowed range of contact experiences. Learning by practical experience proved to be more helpful in the mastery of this non-normative event than information, the activating moment not being the novelty of the situation but the specific experiences made.

Adaptation, Psychological↗
PubMed1989

[Development of a moral consciousness in medical schools].

In the conditions of developed socialism, changes in social consciousness are also reflected in one of its forms - the morals. The problems of moral education as an inseparable part of communist education is coming to the foreground. It plays its role in all the stages of the education system, having its unsubstitutable place also in the conditions of universities and technical colleges, the faculties of medicine not excluding. It is its task to form the personality of the student and graduate, to make them, among others, acquire the moral codex of a builder of communism (habits of moral behaviour in professional activities - medical ethics). Such crucial situations must be found that are of cardinal importance for the formation of the medical student's moral profile (transition from the secondary school to university, entering the clinic, meeting the patient, running health institutions, positive and negative influences in the health service). The student must live the moral situation, obtain the experience from moral acting on his own self and be an active participant in the events creating his moral qualities, primarily in collective conditions. We stress the necessity of engagement - mobilisation of students to all-round social activities, connection of the theoretical findings of marxist ethics with their particular problems and actual activities. A special accent is laid on the method of personal example, the moral example of the university teacher himself, in the first place his authority based on all the progressive components of his personality.(ABSTRACT TRUNCATED AT 250 WORDS)

Communism↗
PubMed1989

[Household survey of diarrhoeal disease control in P.R. china].

126,965 population, including 10,987 children less than 5 years in 20 provinces were visited, and 7,681 cases due to diarrhoea, including 1 800 cases less than 5 years were found during the survey in Aug 1988. According to the calculating methods recommended by WHO, the morbidity is 0.70 episodes/person/per year in China, 1.90 episodes/per child/per year in children less than 5 years. The highest morbidity, 2.44 episodes/per child/per year, is in the age group from 6 months to 2 years. 37.86% of all cases went to health facilities, among them 62.24% were treated in village health facilities. 63.36% of all cases received treatment. The use rate of ORT was 14.24%, including 1.98% of using ORS and 12.26% of using home fluids. The use rate of antibiotics was 55.16%. The use rate of traditional medicine was 8.07%. From Sep 1987 to Aug 1988, there were 605 deaths in 102,470 population. The death rate was 5.9 per 1,000 population. With 15 deaths due to diarrhoea, the mortality of diarrhoea was 0.002% 76.18% of 1,247 children under 7 months were breast-fed, and 19.49% of them were partially breast-fed, and 4.33% of them were bottle-fed. The result of the survey indicates that diarrhoeal disease is a major constraints to people's health and social development, and the character of high morbidity and low mortality determines that the strategy of diarrhoeal diseases Control will be prevention, and the situation of low ORT use rate and abuse of antibiotics should be improved, and it should be emphasized to train health workers of village facilities.

Adolescent↗
PubMed1989

Older populations, aging individuals and health for all.

Family planning and reduced infant mortality have led to an explosion in the number of elderly people. There are already 300 million people aged 65 and over and by the year 2000 there will be over 400 million, two-thirds or more of them in the developing countries. Great gaps still exist in our knowledge of health and disease in the elderly, of how best to prevent or treat illness among them, and of how to care for those who become dependent. Although the precise impact of aging on societies awaits clarification, governments will undoubtedly have to develop social and health policies so as to adapt equitably to the forces of change.

Activities of Daily Living↗
PubMed1989

Osteogenesis imperfecta. Perspectives.

Osteogenesis imperfecta is a heterogenous group of inherited conditions arising from a variety of biochemical and morphological collagen defects. The broad manifestations of abnormalities in bones, teeth, scleri, ligaments, and other collagen-containing tissues point to the heterogeneity of the condition. Diagnosis in the neonatal period is based on clinical characteristics, roentgenograms, and a detailed family history. Treatment is conservative when possible, and particular attention is paid to the social development of the growing child as well as to genetic counseling for parents. Modes and surgical treatment include osteoclasis and percutaneous pinning for long-bone deformities in the infant and, in the child older than two years of age, segmentation and the use of telescoping rods. Surgical treatment of spinal deformity is dependent on the age of the patient and the severity of the condition. Biochemical research is being conducted using direct tissue analyses and analyses of cultured fibroblasts and osteoblasts.

Child↗