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PubMed1982

Apnoea of immaturity. 2. Mortality and handicap.

One hundred and three consecutive infants less than or equal to 32 weeks' gestation with recurrent apnoea of immaturity were reviewed, and survival was assessed and related to timing of treatment. The sickest infants were treated after between one and three episodes of apnoea with bradycardia, and mortality was 70%. Of those in whom treatment was postponed because apnoea was considered mild, 34% subsequently required mechanical ventilation, and 23% died. Among a small group of 20 survivors seen at ages 9-24 months, 4 (20%) have major handicaps. The possible place for earlier treatment is discussed.

Apnea↗
PubMed1983

Neonatal tetanus--long-term residual handicaps.

Thirty-eight survivors of neonatal tetanus were assessed, 5 to 12 years after recovery, for neurological sequelae, physical growth, and maturation. Apart from appreciable handicaps (cerebral palsy, mental deficit, behavioural disturbances) in 4 cases, no harmful effect on physical growth or development was found. The fact that affected patients had frequent and prolonged bouts of spasms and apnoea suggests that anoxia was the main cause of brain damage.

Body Height↗
PubMed1985

Severe handicap in spina bifida: no bar to intermittent self catheterisation.

The practicability of introducing clean intermittent self catheterisation to 24 severely handicapped children with spina bifida was studied. Twenty one children achieved complete or nearly complete continence, which was sustained successfully in 14. The difficulties they overcame and the reasons for failure are analysed.

Adolescent↗
PubMed1982

Counselling the parents of handicapped children.

The parents of handicapped children have to adjust to a wide variety of emotional and psychological problems when first confronted with the failure of their reproductive expectations. Counselling is a formal procedure or transaction in which both counsellor and parents aim to find a mutually acceptable plan of adjustment. Parents may need support to cope with their own personal inadequacies as well as with their own personal inadequacies as well as with the needs of the child. Counselling should be a continuous process, in which the parents can learn to accept the child as a different rather than a lesser person.

Counseling↗
PubMed1990

Conductive education for physically handicapped children: parental expectations and experience.

Conductive education, an educational approach devised by Andras Petö in Hungary after the second world war, has attracted considerable media attention. Eight Northern Ireland families who recently had treatment for their disabled child at the Petö Institute in Budapest were identified. Six families returned postal questionnaires designed to look at parental experience of conductive education. An improvement in existing local services, as opposed to the wholesale introduction of this facility was the commonest parental hope for future provision for physically handicapped children.

Cerebral Palsy↗
PubMed1995

Parental factors in cognitive outcome of non-handicapped low birthweight infants.

A population based cohort of 144 children weighing less than 2000 g who were without major handicap, and a random control sample of 163 children born at term and weighing over 3000 g were investigated. The aim was to assess the relative importance for cognitive development at 5 years of age, of birthweight, parental demographic factors, and factors related to the environment in which the child was reared. The mean non-verbal IQ was 6.1 points lower (95% CI, 2.3 to 10) for the low birthweight (LBW) group, but the difference was reduced to 4.8 points (95% CI, 1.1 to 8.5) after adjusting for confounding parental demographic and childrearing factors. The verbal IQ was similar for the two groups after such adjustment. Paternal education was the main confounding variable, and demographic factors such as parental education and family income were much stronger predictors of child IQ than birthweight or factors related to the childrearing environment. There was no evidence that the cognitive development of low birthweight children was more sensitive to a non-optimal childrearing environment than that of normal birthweight children. These findings indicate that the risk of impaired cognitive development increases with decreasing socioeconomic status, and that this risk is much larger than, and independent of, the small risk attributable to low birthweight.

Case-Control Studies↗
PubMed1986

Informed dissent: the views of some mothers of severely mentally handicapped young adults.

Much of the discussion since the Arthur case has centred round the rights of handicapped infants to medical treatment. Little has centred round the question of how far one person can rightly be required to sacrifice her life for another, when she has not been consulted beforehand. This may be due to the fact that most of the discussants are men, while nearly all the carers are women. This small study attempts to redress this balance by asking mothers who have cared for 20 years, whether they felt it was worthwhile.

Abortion, Induced↗
PubMed1988

Handicapped infants: medical ethics and the law.

The main purpose of this paper (1) is to draw attention to a gap between the principles of Common Law and the principles accepted by many leading medical practitioners on the ethics of allowing severely handicapped infants to die. The Common Law principles are shown in Court of Appeal judgements on two cases. The contrasting principles of many paediatricians were illustrated at the trial of Dr Leonard Arthur. The paper suggests that the gap could be closed by statutory guidance on general principles. It also argues that utilitarian concepts misrepresent the ethical issues of medical dilemmas like this one.

Congenital Abnormalities↗
PubMed1988

Infanticide for handicapped infants: sometimes it's a metaphysical dispute.

Since 1973 the practice of infanticide for some severely handicapped newborns has been receiving more open discussion and defence in the literature on medical ethics. A recent and important argument for the permissibility of infanticide relies crucially on a particular concept of personhood that excludes the theological. This paper attempts to show that the dispute between the proponents of infanticide and their religious opponents cannot be resolved because one side's perspective on the infant is shaped by a metaphysics that is emphatically rejected by the other. In such a situation philosophical argument is powerless to bring about a resolution because there can be no refutation of one side by the other.

Persons with Disabilities↗
PubMed1989

Pregnancy in a severely mentally handicapped adult.

What happens when we discover that a severely mentally handicapped girl, resident under our care, is heavily pregnant? What options are open to us in her management? What are the legal and ethical issues involved? How do we ensure that she receives the best possible care and protection and will the involvement of the police actually make the situation worse? Few of us have had the experience of working through such dilemmas, and little help can be found in consulting 'experts' who are awaiting the result of 'test cases' in the High Courts. This article highlights some of the problems we encountered with such a case.

Abortion, Induced↗
PubMed2001

Impairment, disability and handicap--old fashioned concepts?

The drawbacks of using the concepts of models in discussing the problems of disabled people are discussed. It is suggested that the terms "impairment", "disability", and "handicap" can unify the different models and enhance the position of people with disabilities in society.

Chronic Disease↗
PubMed1981

Ethical problems in the management of some severely handicapped children.

This paper examines some of the arguments advanced and acted upon by doctors concerned in decisions about whether severely handicapped patients should live or die. It criticises the view that 'selective treatment' is morally preferable to infanticide and shows how the standard arguments advanced for this preference fail to sustain it. It argues that the self-deception, which is sometimes cited as a sign of humanity in these cases, and which is implicit in the term 'selective treatment' is more dangerous than is the remote chance of brutalisation which is often cited as the danger of active euthanasia.

Child↗
PubMed1989

Chromosome studies of males in an institution for the mentally handicapped.

Karyotypes were examined in 512 (91.9%) of 557 male patients in an institution for the mentally handicapped. A total of 110 (21.5%) had an abnormal karyotype: 65 (12.7%) with Down's syndrome, 30 (5.9%) with the fragile X syndrome, 13 (2.5%) with autosomal anomalies other than Down's syndrome (12 unbalanced, one balanced), and two (0.4%) with sex chromosome anomalies.

Aneuploidy↗
PubMed1978

A new device to support handicapped patients during venography or myelography.

The authors describe a seating device which holds the patient in position when the x-ray table is tilted and permits non-weight-bearing venograms to be obtained in handicapped as well as normal patients. Simultaneous bilateral venography reduces the study time considerably. The device is also helpful in lumbar myelography in paraplegics.

Persons with Disabilities↗
PubMed2005

[Varicella outbreak in a work center for psychologically handicapped adults].

BACKGROUND AND OBJECTIVE: An outbreak of varicella is described in a training and work center for psychologically handicapped adults with a high susceptibility to the disease. PATIENTS AND METHOD: Descriptive and case-control study. A questionnaire self-complimented by parents and staff of the center was used. A serologic study in order to determine antibodies againts varicella was carried out for people without varicella vaccination or disease history. RESULTS: Four cases of varicella occurred among 56 students of the center and none among the staff (12 people). 51.8% of students had not history of varicella versus 8.3% of staff (p = 0.009). A recommendation of vaccination against varicella was made for people without history of varicella, and 52.2% were vaccinated. After vaccination, no new cases occurred. In the serological study (11 students and 1 staff), 5 students were sero-negative. In the case-control study, risk of suffering varicella was lower for students with history of varicella, those vaccinated against varicella and those attending less commonly the center. CONCLUSIONS: The outbreak occurred in a high susceptible population, and it is suggested that it is a previously unidentified group of risk. Serological studies of varicella with vaccination of susceptible individuals in these populations may be indicated.

Adult↗
PubMed2001

Handicap of walking by a huge paratesticular liposarcoma.

We describe the case of a 71-year-old male with a huge left-sided paratesticular tumour, whose walking was increasingly handicapped by this vast mass. Two palliative excisions of tumour tissue were performed. Histology revealed a poorly differentiated paratesticular liposarcoma. The patient achieved satisfying mobility for several months before he died of cachexia.

Aged↗