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PubMedDate not supplied

The immunocompetence handicap hypothesis in two sexually dimorphic pinniped species--is there a sex difference in immunity during early development?

The 'immunocompetence handicap hypothesis' predicts that highly sexually dimorphic and polygynous species will exhibit sex differences in immunity. We tested this hypothesis in southern elephant and grey seals during their early development by measuring the following parameters: leucocyte counts, serum IgG levels, erythrocyte sedimentation rate and haematocrit. We failed to find any differences due to sex as assessed by the parameters investigated. Animals were sampled longitudinally during their development and there were significant age effects from birth to weaning in both species. Total and differential leucocyte counts and erythrocyte sedimentation rates increased just prior to weaning then decreased. Haematocrits declined whilst total circulating immunoglobulin G concentrations increased. Body temperatures remained constant throughout the postnatal period. Differences between the species were seen in total leucocyte counts and in polymorphonuclear cells and eosinophils. Southern elephant seals had higher concentrations than grey seals and total leucocyte counts in the former were among the highest reported for mammals.

Animals↗
PubMed1999

Early-onset intraventricular hemorrhage in preterm neonates: incidence of neurodevelopmental handicap.

The neurodevelopmental outcome of very low birth weight infants experiencing early-onset intraventricular hemorrhage (IVH) occurring within the first 6 postnatal hours was compared with that of their peers without early-onset IVH at 3 years corrected age. The 440 surviving preterm infants (birth weight 600 to 1,250 g) who had been enrolled in a multicenter, prospectively randomized, controlled trial evaluating the efficacy of postnatal indomethacin to prevent IVH were evaluated with the Stanford-Binet Intelligence Scale and neurological examinations at 3 years corrected age. All study infants had echoencephalography between 5 and 11 hours of life, and testing is reported for all children residing in English monolingual households at 3 years corrected age (i.e., from the obstetric due date). Fifty five of the 73 (75%) infants with IVH within the first 5 to 11 hours survived to 3 years of age, compared with 385 of the 432 (89%) children without early-onset hemorrhage who were alive at 3 years corrected age (P<.001). Eleven of the 29 (38%) English monolingual children with early-onset IVH had Stanford-Binet intelligence quotient scores of less than 70, compared with 47 of the 249 (19%) children without early IVH (P = .03). Similarly, 7 of 28 (25%) early IVH children were found to have cerebral palsy, compared with 20 of 241 (8%) children without early IVH (P = .01). These data suggest that infants who experience the early onset of IVH are at high risk for both cognitive and motor handicaps at 3 years corrected age.

Aging↗
PubMed1984

Hepatitis B in seven hospitals for the mentally handicapped.

Patients in seven hospitals for the mentally handicapped were screened for markers of hepatitis B infection. Of 2239 patients, 123 (5.5 per cent) were carriers of hepatitis B surface antigen (HBsAg) and a third of these were 'infectious' (negative for antibody to hepatitis B e antigen). Patients with Down's syndrome (DS) were 18 times more likely to be 'infectious' carriers than those without, and male patients were six times more likely to be 'infectious' carriers than female patients. There was a wide difference in carrier rate among the various hospitals. In the hospital with the highest carrier rate (12.5 per cent), 60 per cent of male patients with DS were carriers of HBsAg and of these two-thirds were 'infectious'. The carrier rate decreased with age, but the proportion of carriers who were hepatitis B e antigen positive was unaffected by age.

Adult↗
PubMed1983

A project in physical education for handicapped and health-risk groups.

An interdisciplinary project concerning the physical education and culture of handicapped and health-risk groups, conducted during the years 1976 to 1980 under the auspices of the Finnish Society for Research in Sports and Physical Education, is reported in this paper. The concept of special group used in connection with the project is relative and describes the groups of people who do not receive the normal services in the field of physical activities. The goals of the project were not only to provide these services but also to study the problems connected with the use and supply of these services for these groups. The project approached its goals from the point of view not only of the individuals concerned but also of the organizations involved. The project was conducted in two towns and one rural community in Finland. Twenty-eight groups were formed in these communities, comprising about 500 participants. Of these, 350 regularly took part in the exercises. About 250 participants and 28 group leaders were studied in more detail. The decision-making and administrative processes at both local and national levels were analyzed. The project resulted in considerable increased activity of the persons taking part in the exercises, most of whom reported favorable results. Most group leaders also gave positive responses when asked about the results of the project. The project also effected a change in the decision-making processes at local and national levels, as more resources were allocated for these purposes than before the project. In this sense, the project fulfilled its original mission as a change agent.

Community Health Services↗
PubMed1985

Riding and the handicapped.

When we speak of riding for handicapped, it is evident that this term embodies a wide range of possibilities as far as the type of therapy used and the benefits gained. The needs of the student dictate which therapy is selected and implemented. The effects of therapeutic riding have not been subjected to scientific scrutiny. However, the benefits do have a physiologic basis that needs to be analyzed further. More empirical studies are required, using sound research methodology. Both the physical parameters (range of motion, balance, flexion, and so on) and the psychosocial parameters (risk, self-esteem, behavior, and so on) should be explored and documented. Until then, Robert Mayberry leaves us with this thought: "Is it the unique movement of the horse, the psychodynamics involved or a primal atavistic need for experiencing controlled risks? Perhaps it is all or none of these: suffice to say, the mystique of the horse is strong medicine."

Adult↗
PubMed2000

[Practical usefulness of genogram in the handicapped patient care].

OBJECTIVE: To know the practical use of genogram in the handicapped patient care, describing their characteristics and those of their families and to obtain the prevalence of bad care immobilized patients belonging to the health centre. DESIGN: Descriptive observational. SETTING: Urban health centre. PARTICIPANTS: People of both sexes registered at the health centre, immobilized in their houses, with a disability score of three or more in the physical disability scale of the Red Cross. MEASUREMENTS AND RESULTS: The most important features of our immobilized people, obtained from the genogram, are: women (63.5%), with mean age of 78.8 +/- 13.2 years old (CI, 76.5-81.17), with disability score of 3 (46.8%), immersed in a nuclear family (34.9%), in phase VI of dissolution of the vital cycle (45.2%), with very closed relations (45.2%), with arthrosis (23.8%) as the most frequent immobilized cause, and with one unique home career only (72%). The prevalence of bad care immobilized patients was 25.4%. CONCLUSIONS: The genogram is an excellent tool for describing immobilized people and their family nucleus, allowing the definition of an immobilized profile. If the patient is bad cared, he will need an special consideration. The immobilized score and the family relations ship may complicate their care, conditioning a worse prognosis. We wish to emphasize the importance of carrying out the genogram in the initial moment of the immobilization, because it establishes a dialogue route between the families and the sanitary professionals to improve the attention of these patients.

Aged↗
PubMedDate not supplied

[Evaluation of the quality of attention given to the chronically handicapped patient at a health center].

This study was carried out with the aim of evaluating the handicapped care quality in a Primary Health Care Centre. This was a two phase evaluation (both of a year): first evaluation with 4 quality indicators and 142 patients; and the reevaluation with 10 quality indicators and 203 patients. We used explicits and normatives indicators of basic medical care procedure. The main carried out results were: annual medical exploration 62% (evaluation) and 70% (reevaluation), bringing up to date problems paper 65% and 53%, to plan nurses activities 61% and 62%, and carrying out nurses activities 57% and 68%. We detected we have to improve these patients medical care quality.

Attitude of Health Personnel↗
PubMed1984

Training and preparing physicians to care for mentally retarded and handicapped children.

With the recent significant changes in the care of mentally retarded and handicapped children, the role of the physician has concomitantly changed. There is an increasing need to provide generic health care for affected children living in the community and counselling and guidance to the families. Medical trainees must, therefore, be furnished with both technical skills to diagnose and treat, as well as with an understanding of the philosophical basis for changing practices in the field. An approach to training used at our Center is described which includes specific goals and educational objectives for physicians-in-training including medical students, house officers (residents) and fellows. The training is based on an understanding of the skills, of the level of sophistication, and of the pressures felt as a result of competing priorities that the various trainees bring to their training experience. Based on the evaluation information available about the training format, which includes interdisciplinary team experiences, demonstration and observation sessions, didactic presentations and visits to a variety of programs, the approach to training has been proven to be successful in achieving its goals.

Child↗
PubMed1985

The social status-socioempathy relationship among mildly handicapped and nonhandicapped children: analysis of the person X environment fit.

The notion of person X environment fit was explored as a framework for understanding the relationship between the social status and socioempathy abilities of 234 nonhandicapped and 85 mildly handicapped children in special- and regular-education settings. The results revealed that the amount of discrepancy between actual and estimated social status varied according to child characteristics and the classroom placement settings in which those measurements were taken. Additionally, the person X environment fit model was found to be appropriate for describing the relationship between social status and socioempathy. That is, accurate estimators of social status were significantly more popular than underestimators or overestimators. In turn, underestimators were more popular than overestimators. The same relationships were found for estimates of rejection. The above relationships were examined for integrated and segregated classroom settings.

Awareness↗
PubMed1985

Increasing independent mobility skills for a woman who was severely handicapped and nonambulatory.

In this study, a woman who was nonambulatory and severely handicapped was taught to get out of her wheelchair and cruise around a table. She was provided with instructional feedback, repeated practice, and appropriate social reinforcement to acquire the cruising skill. Repeated practice was provided when she was unable to perform the behavior independently. Data were collected on the following behavior clusters: Look (look forward, hold on to the chair, and slide forward); Put (put your feet down, stand up, and put your hands down); and Move (move your feet, move your hands, repeat, and sit down). The results of the multiple-baseline/withdrawal design indicated that instructional feedback, repeated practice, and appropriate social reinforcement were sufficient to teach the cruising skill. Future research was suggested in instructional feedback, repeated practice, and appropriate social reinforcement.

Activities of Daily Living↗
PubMed1999

Models of disablement, universalism and the international classification of impairments, disabilities and handicaps.

A review and critique of models of disability is presented, tracing the development of frameworks and classificatory instruments (International Classification of Impairments, Disabilities and Handicaps) over the past 20 years. While the 'social' model is now universally accepted, it is argued that universalism as a model for theory development, research and advocacy serves disabled persons more effectively than a civil rights or 'minority group' approach. The development of the revised International Classification (ICIDH-2) is discussed in this light.

Activities of Daily Living↗
PubMed1997

Borjeson-Forssman-Lehmann syndrome: two severely handicapped females in a family.

We report on a case of Borjeson-Forssman-Lehmann syndrome (BFS) in which two sisters appear with the clinical picture of severe mental handicap, dysmorphic features and grand mal seizures. Their mother presents the above symptomatology in a milder degree. It is one of the few reports in literature where females develop BFS in its typical clinical form.

Craniofacial Abnormalities↗
PubMed2000

Haloperidol-induced rhabdomyolysis without neuroleptic malignant syndrome in a handicapped child.

A 6-year-old severely handicapped boy with haloperidol-induced mild rhabdomyolysis without neuroleptic malignant syndrome is reported. He had suffered from frontal lobe epilepsy, severe mental retardation and involuntary movements. To reduce the involuntary movements, oral administration of haloperidol was started. Haloperidol was effective for the involuntary movements, and he became well. However, his urine was sometimes dark brown, and the myoglobin level in his urine was increased. After discontinuation of haloperidol, his urine never became dark brown. It was suspected that haloperidol might cause mild rhabdomyolysis without neuroleptic malignant syndrome. Neuroleptic malignant syndrome is a rare but severe adverse effect of neuroleptics, and is usually accompanied by rhabdomyolysis. Although there have been a few adult cases presenting rhabdomyolysis without neuroleptic malignant syndrome, this patient might be the first child case with such symptoms. We have to pay attention to this syndrome when using haloperidol even in children.

Anti-Dyskinesia Agents↗
PubMed1990

Respiratory function in handicapped children.

The aim of this study was to evaluate respiratory function of severely handicapped children. Tidal volumes and respiratory rates were determined in a total of 130 children with different clinical motor abilities. Tidal volume of non-sitters (n = 39) was significantly lower than ambulators (n = 49) or sitters (n = 42) (p less than 0.01). There was no difference in respiratory rate among the three groups. Among 45 children whose vital capacity could be determined, the tidal volumes showed a significant correlation with vital capacity (r = 0.56, p less than 0.001). Among four children whose tidal volume was less than 200 ml and respiratory rate was more than 30 cpm, blood gas analysis revealed hypoxia in three of them. The tidal volumes, therefore, would be a useful guide to estimate respiratory functions. It was concluded that the respiratory function in a non-sitter with reduced tidal volume is impaired, and that preventive measures must be taken against respiratory infection.

Adolescent↗
PubMed1980

The chronically Ill, handicapped, dying child and his family: need for total care and support.

It is stressed that the best possible medical care is the basic need and an absolute pre-requisite for the total care of a family with a chronicall ill, handicapped or dying child. However, this is not enough. The family will need something more than just strict medical care. This paper is concerned with the "something more," stressing the family's need for measures helping them to work with the crisis reaction, elicited by the information they have received about the child's diagnosis and prognosis. The methods of bringing the family help is discussed in relation to the time-schedule of the disorder. The importance of how the first information is given is particularly stressed.

Child↗
PubMed2005

[Demographic and socioeconomic factors associated with needs for home assistance among community-dwelling elderly: a study from the French Home Survey Handicaps-Disabilities-Dependence].

BACKGROUND: Gains in life expectancy in western countries have mainly come hand in hand with growing chronic diseases and disabilities related to the activities of daily living (ADL) and instrumental activities of daily living (IADL). Although these disabilities have been identified as predictors of institutionalization, the elderly in France continue to live at home, in the community, alone or with others. This work aims at identifying and assessing their needs for assistance and looks especially at the demographic and socioeconomic associated features. METHODS: Reported needs for assistance with ADL and IADL are studied through a representative sample of 8,745 people aged 60 years and older and living at home in 1999, taken from the French cross-sectional "Handicaps-Disabilities-Dependence" survey. Statistical associations (non-adjusted and adjusted Odds-Ratio-OR) have been computed in a conceptual framework derived from Andersen and Newman's behavioural model. RESULTS: More than 1 million people aged 60 years and older need assistance from another person to perform at least one ADL (bathing, dressing, going to toilet, eating, transferring, getting outside) and about 2.5 millions persons for at least one IADL (shopping, food preparation, housekeeping). Need for assistance for at least one ADL is associated with age (OR=1.4 for 70-79, 3.6 for 80+); male aged 80 and older (OR=0.5); low educational status (OR=1.5); being married (OR=1.7) or living with an other person (OR=2); a disposable income less than 540 euro per capita and per month or between 540 and 1,080 euro (OR=1.3); impairments: motor (OR=3), language (OR=2.1), visual (OR=1.7), mental (OR=1.5) and other (OR=1.2); availability of home equipment devices (OR=3.5), technical devices for moving inside (OR=3) and others (OR=2.1). Need for assistance is especially high among those who required assistance (OR=4) or proxies (OR=5.5) to answer. Declared need for assistance for at least one IADL is roughly associated with the same factors. CONCLUSION: These results suggest that the declared needs for human assistance are based not exclusively on functional limitations but are also related to the social and environmental setting.

Activities of Daily Living↗
PubMed1999

The attitude of young adults with chronic disease or handicaps towards enforced treatment and euthanasia.

One hundred fifty-nine young adults in the 17-18 year old age group suffering from chronic disease or handicap participated in this study which examined their attitudes towards enforced treatment and euthanasia in terminal patients. The comparison group included 120 healthy high school pupils of the same age group. A total of 42.6% of the chronic patients thought that enforced treatment was justified even if the patient didn't understand its importance and didn't want treatment (in comparison with 23.3% of the healthy pupils who felt the same way). Of the chronic patients, 54.4% thought that euthanasia was justified in consenting terminal patients (in comparison with 74.2% of the healthy pupils who felt the same way; P < 0.01). This may be explained by the feeling of total dependency of chronic patients upon medication and treatment. On the other hand, they may be opposed to euthanasia because of their own personal hope that a cure would be found for their severe and chronic condition. Both groups studied believed that physicians should always consider the subjective suffering of the patient and his family, as well as the short and long term prognosis when deciding about therapy.

Adolescent↗
PubMed2003

Evaluation of wrist and hand handicap and postoperative outcome in rheumatoid arthritis.

Functional instruments in rheumatology should use standardized procedures and should be quantifiable, valid, reliable, and responsive/sensitive to change. For most assessment tools, these aspects have been considered and tested. One of the most important questions in assessing hand involvement in patients with RA is what the single assessment should be used for. There could be a substantial difference should hand assessment be done in a routine way in a hand practice or should it be performed within scientific studies on disease progression or the effect of operative interventions. Among other points, answering this question has a significant impact on the time the patient has to spend with the tests and on the time the hand therapist or hand surgeon is involved with it. In addition to aspects such as accuracy, reliability, and validity, therefore, in some evaluation tools the time needed to perform the clinical examination and assessment of hand function has also been considered to be of importance. In addition, it has to be considered that description of the anatomic status, measurements of impairment, and assessment of disability cannot simply be replaced by each other, and even measurements of single aspects often are not sufficient. It has been stated, therefore, that the combination of different discrete hand-function assessment methods provides a more complete picture of hand ability. Moreover, although better responsiveness of disability outcome measures over impairment measures has been demonstrated previously (eg, in patients treated for Colle fracture), the relationship between disability and impairment measures is not clearly established. Although some studies reported significant correlations between impairment and disability tests, other studies showed only poor or moderate correlations between disability scores, impairment, and disease activity measures when rheumatoid hands were assessed. It has been concluded that the relationship between impairment and disability is not straightforward. The new ICF-model addresses these two levels of health-related quality of life by different concepts of assessment. Because impairment reflects the consequences of the disease at the organ level, whereas disability reflects the consequences of the disease for functional performance and activity, for comprehensive assessment of hand handicap, measurement of disability is more comprehensive and closer to the patient's needs for performing ADLs.

Activities of Daily Living↗