WorldWideScience

Sample records for handicapped patients living

  1. Orthodontics for mentally handicapped patients [Orthodontie bij pati�nten met een verstandelijke handicap

    NARCIS (Netherlands)

    Remmelink, H.J.

    2006-01-01

    The mentally handicapped exhibit a 3 times higher incidence of malocclusions and related functional problems than the general population. In contrast there is little available literature relating to the orthodontic treatment of handicapped patients. Based on published articles on orthodontic

  2. The perceived handicap questionnaire: a self perceived handicap measurement in patients with spinal cord injury.

    Science.gov (United States)

    Kuptniratsaikul, Vilai; Smerasuta, Orawan; Klomjaiyen, Poungtong

    2002-08-01

    Handicap exists when individuals with impairment or disability are unable to fulfill one or more of the roles that are considered normal for their age, gender, and culture. In fact, handicap is one of the most poorly measured of all rehabilitation outcomes. This study was performed to measure the subjective experience of handicap in spinal cord injury (SCI) patients who had permanent disabilities and were often faced with environmental barriers. Eighty-three new traumatic SCI patients with a mean age of 33 years were interviewed during follow-up outpatient clinic visits using the Perceived Handicap Questionnaire (PHQ). This test provides a global measurement of the extent of self-perceived handicap across five dimensions based on the WHO's classification of handicap. When compared with normal persons, SCI subjects perceived themselves as more handicapped in all dimensions especially mobility and physical independence. In contrast, the majority of SCI subjects perceived themselves as less handicapped than others with SCI in physical independence, and equally handicapped in social integration and in economic self-sufficiency. In addition, the Barthel Index Score of self-care activities was negatively correlated with the PHQ score, but the depression score and hospitalization period were positively correlated with the PHQ score. Rehabilitation professionals should pay attention to the measurement of societal functioning or handicap in addition to disability.

  3. Disability in Activities of Daily Living and Severity of Dyskinesias Determine the Handicap of Parkinson's Disease Patients in Advanced Stage Selected to DBS.

    Science.gov (United States)

    Coelho, Miguel; Abreu, Daisy; Correia-Guedes, Leonor; Lobo, Patricia Pita; Fabbri, Margherita; Godinho, Catarina; Domingos, Josefa; Albuquerque, Luisa; Freitas, Vanda; Pereira, João Miguel; Cattoni, Begona; Carvalho, Herculano; Reimão, Sofia; Rosa, Mário M; Ferreira, António Gonalves; Ferreira, Joaquim J

    2017-01-01

    There is scarce data on the level of handicap in Parkinson's disease (PD) and none in advanced stage PD. To assess the handicap in advanced stage PD patients with disabling levodopa-induced motor complications selected to deep brain stimulation (DBS). Data was prospectively recorded during routine evaluation for DBS. Handicap was measured using London Handicap Scale (LHS) (0 = maximal handicap; 1 = no handicap). Disease severity was evaluated using the Hoehn & Yahr scale and the UPDRS/MDS-UPDRS, during off and on after a supra-maximal dose of levodopa. Schwab and England Scale (S&E) was scored in off and on. Dyskinesias were scored using the modified Abnormal Involuntary Movement Scale (mAIMS). Results concern cross-sectional assessment before DBS. 100 PD patients (mean age 61 (±7.6); mean disease duration 12.20 (±4.6) years) were included. Median score of motor MDS-UPDRS was 54 in off and 25 in on. Mean total LHS score was 0.56 (±0.14). Patients were handicapped in several domains with a wide range of severity. Physical Independence and Social Integration were the most affected domains. Determinants of total LHS score were MDS-UPDRS part II off (β= -0.271; p = 0.020), S&E on (β= 0.264; p = 0.005) and off (β= 0.226; p = 0.020), and mAIMS on (β= -0.183; p = 0.042) scores (R2  = 29.6%). We were able to use handicap to measure overall health condition in advanced stage PD. Patients were moderately to highly handicapped and this was strongly determined by disability in ADL and dyskinesias. Change in handicap may be a good patient-centred outcome to assess efficiency of DBS.

  4. Mortality of mentally handicapped patients after mass inter-hospital ...

    African Journals Online (AJOL)

    1990-08-18

    Aug 18, 1990 ... Mortality of mentally handicapped patients after mass inter-hospital relocation. ,. L. M. HERING, G. G. W. GEORGE. Summary. Patients and methods. In September 1987847 mentally handicapped patients were moved from A. J. Stals Care and Rehabilitation Centre to. Lentegeur Hospital. A study of the ...

  5. Perceived control and voice handicap in patients with voice disorders.

    Science.gov (United States)

    Frazier, Patricia; Merians, Addie; Misono, Stephanie

    2017-11-01

    The purpose of the study was to replicate and extend previous research on the relation between perceived present control and voice handicap and to further examine the psychometric properties of a present control scale adapted for patients with voice disorders (Misono, Meredith, Peterson, & Frazier, 2016). Sample 1 consisted of 1,129 patients recruited from a voice disorder clinic who completed measures of perceived present control, distress, and voice handicap in the clinic. Sample 2 consisted of 62 patients from the same clinic who completed measures of present control, distress, voice handicap, and general control beliefs online at baseline and measures of present control and voice handicap again 3 weeks later (n = 59). With regard to the psychometric properties of the voice-adapted present control scale, alpha coefficients were above .80 and the 3-week test-reliability coefficient was .69. There was mixed support for the hypothesized 1-factor structure of the scale. In Sample 1, present control was more strongly associated with lower voice handicap than was distress and accounted for significant variance in voice handicap controlling for distress. In Sample 2, present control at baseline predicted later voice handicap, controlling for general control beliefs and distress. Present control appears to be a promising target for adjunctive interventions for patients with voice disorders. An evidence-based online present control intervention (Hintz, Frazier, & Meredith, 2015) is being adapted for this patient population. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Mortality of mentally handicapped patients after mass inter-hospital ...

    African Journals Online (AJOL)

    In September 1987847 mentally handicapped patients were moved from A. J. Stals Care and Rehabilitation Centre to Lentegeur Hospital. A study of the death rates of patients for 4 years before the move and 18 months afterwards showed a rise in the death rate in the 6-month interval after the move.

  7. An Approximation of an Instructional Model for Developing Home Living Skills in Severely Handicapped Students.

    Science.gov (United States)

    Hamre, S.

    The author discusses the need for severely handicapped students to acquire basic home living skills, reviews task analysis principles, and provides sample instructional programs. Listed are basic grooming, dressing, domestic maintenance, and cooking skills. A sample task analysis procedure is demonstrated for the skill of brushing teeth. Reported…

  8. [Hygienic aspects with regard to nursing of home care patients with AIDS, chronic diseases and mental handicaps].

    Science.gov (United States)

    Sonntag, H G; Flassak, H; Throm, W

    1995-04-01

    A human handicap is defined as a broad, hard and long lasting restriction of the mental development and the social integration. Groups of handicapped persons can be divided into mentally, psychologically, physically, sensory (blind, deaf) handicapped as well as into multiple disabled and chronically sick persons and those in need of care (old). New groups with demands for aid are among others people suffering from AIDS, psychologically sick (old) and people getting old as well as mentally, physically und multiple handicapped persons, people suffering from cancer, severely ill and dying people. For all handicapped people should be demanded the possibility of living almost normal lives. For all persons directly concerned as well as their families such a normal life should include: the right of self-determination and autonomy, the demand for complex styles of living and nearby care/support, the providing of respective infrastructures such as barrier free living and access to public institutions, access to public transport and homes fitting for handicapped persons, the demand for out-patient treatment by a complex range of various possibilities of support and finally, the providing of alternative forms of living in contrast to the traditional way of life of handicapped people like families or homes. Three important living areas can be derived from these ideas, namely: living conditions, education/professional and working field, social life/social environment. These important living areas require preventive measures, mainly advice and information centres, places to go early recognition and early promotion of handicapped people and those in risk of a handicap (especially children) as well as medical, professional and social rehabilitation or integration. Concerning the spectrum of support, aid and care in the homely area up to now already exists a variety of offers by out-patient services (information services, social units, mobile support services

  9. Audiovestibular Handicap and Quality of Life in Patients With Vestibular Schwannoma and "Excellent" Hearing.

    Science.gov (United States)

    Tveiten, Oystein Vesterli; Carlson, Matthew L; Link, Michael J; Lund-Johansen, Morten

    2017-03-01

    Studies examining patient-reported outcomes in subjects with vestibular schwannoma (VS) and "excellent" hearing are lacking. To assess patient-reported audiovestibular handicap and overall quality of life (QoL) in VS patients with class A hearing in both ears. Among 539 VS patients treated during 1998 to 2008, we identified 296 patients with either bilateral class A (AA) hearing or 1 good ear and 1 deaf ear (AD) according to the American Academy of Otolaryngology-Head and Neck Surgery classification. Patients responded to validated hearing, tinnitus, and dizziness handicap inventories and 2 QoL questionnaires, and the 2 groups were compared. A reference group of 103 adults filled out the same questionnaires. Forty-nine patients (16.6%) had class AA and 247 patients (83.4%) had class AD hearing. AA patients scored poorer than control subjects without tumor on all handicap questionnaires ( P handicap. Patients with VS and bilateral class A hearing report significantly poorer hearing handicap than control subjects without tumor but better hearing than those with unilateral deafness. When patients with bilateral class A hearing are counseled, it should be noted that one-third of patients experience self-perceived hearing handicap.

  10. Dementia and severity of parkinsonism determines the handicap of patients in late-stage Parkinson's disease: the Barcelona-Lisbon cohort.

    Science.gov (United States)

    Coelho, M; Marti, M J; Sampaio, C; Ferreira, J J; Valldeoriola, F; Rosa, M M; Tolosa, E

    2015-02-01

    Handicap has not been explored as a patient-centred outcome measure in Parkinson's disease (PD). The clinical features and medication use in late stages of PD (LS-PD) were reported previously. Handicap, medical conditions, use of healthcare resources and the impact of LS-PD upon caregivers were characterized in a cross-sectional study of LS-PD stages 4 or 5 of Hoehn and Yahr (H&Y). Handicap was measured using the London Handicap Scale (LHS: 0, maximal handicap; 1, no handicap). The mean LHS score in 50 patients was 0.33 (SD ±0.15). The presence of dementia, the Unified Parkinson's Disease Rating Scale part I score and the H&Y stage in 'off' independently predicted the LHS score (adjusted R(2) = 0.62; P = 0.000). Comorbidities and past medical conditions were frequent. Thirty-five patients lived at their house. Forty-five received unpaid care. Mean visits to the family doctor in the preceding 6 months were 2.2 (SD ±3.0) and to a neurologist 1.7 (SD ±1.0). Use of other health resources was low. Unpaid caregivers spent much time with patients and reported a high burden. Handicap could be measured in LS-PD and the LHS was easily completed by patients and caregivers. The high handicap in our cohort was mostly driven by the presence of dementia, behavioural complaints and the severity of non-dopaminergic motor features. Patients visited doctors infrequently and made low use of health resources, whilst unpaid caregivers reported a high burden. © 2014 EAN.

  11. Assessment of auditory and psychosocial handicap associated with unilateral hearing loss among Indian patients.

    Science.gov (United States)

    Augustine, Ann Mary; Chrysolyte, Shipra B; Thenmozhi, K; Rupa, V

    2013-04-01

    In order to assess psychosocial and auditory handicap in Indian patients with unilateral sensorineural hearing loss (USNHL), a prospective study was conducted on 50 adults with USNHL in the ENT Outpatient clinic of a tertiary care centre. The hearing handicap inventory for adults (HHIA) as well as speech in noise and sound localization tests were administered to patients with USNHL. An equal number of age-matched, normal controls also underwent the speech and sound localization tests. The results showed that HHIA scores ranged from 0 to 60 (mean 20.7). Most patients (84.8 %) had either mild to moderate or no handicap. Emotional subscale scores were higher than social subscale scores (p = 0.01). When the effect of sociodemographic factors on HHIA scores was analysed, educated individuals were found to have higher social subscale scores (p = 0.04). Age, sex, side and duration of hearing loss, occupation and income did not affect HHIA scores. Speech in noise and sound localization were significantly poorer in cases compared to controls (p handicap. When present, the handicap is more emotional than social. USNHL significantly affects sound localization and speech in noise. Yet, affected patients seldom seek a rehabilitative device.

  12. Nursing-care dependency : Development of an assessment scale for demented and mentally handicapped patients

    NARCIS (Netherlands)

    Dijkstra, Ate; Buist, Girbe; Dassen, T

    1996-01-01

    This article describing the first phase in the development of an assessment scale of nursing-care dependency (NCD) for Dutch demented and mentally handicapped patients focuses on the background to the study and the content validation of the nursing-care dependency scale. The scale aims to

  13. Rasch analysis of the London Handicap Scale in stroke patients: a cross-sectional study.

    Science.gov (United States)

    Park, Eun-Young; Choi, Yoo-Im

    2014-07-31

    Although activity and participation are the target domains in stroke rehabilitation interventions, there is insufficient evidence available regarding the validity of participation measurement. The purpose of this study was to investigate the psychometric properties of the London Handicap Scale in community-dwelling stroke patients, using Rasch analysis. Participants were 170 community-dwelling stroke survivors. The data were analyzed using Winsteps (version 3.62) with the Rasch model to determine the unidimensionality of item fit, the distribution of item difficulty, and the reliability and suitability of the rating process for the London Handicap Scale. Data of 16 participants did not fit the Rasch model and there were no misfitting items. The person separation value was 2.42, and the reliability was .85; furthermore, the rating process for the London Handicap Scale was found to be suitable for use with stroke patients. This was the first trial to investigate the psychometric properties of the London Handicap Scale using Rasch analysis; the results supported the suitability of this scale for use with stroke patients.

  14. Efficacy of Autologous Microfat Graft on Facial Handicap in Systemic Sclerosis Patients.

    Science.gov (United States)

    Sautereau, Nolwenn; Daumas, Aurélie; Truillet, Romain; Jouve, Elisabeth; Magalon, Jéremy; Veran, Julie; Casanova, Dominique; Frances, Yves; Magalon, Guy; Granel, Brigitte

    2016-03-01

    Autologous adipose tissue injection is used in plastic surgery for correction of localized tissue atrophy and has also been successfully offered for treatment of localized scleroderma. We aimed to evaluate whether patients with systemic sclerosis (SSc) and facial handicap could also benefit from this therapy. We included 14 patients (mean age of 53.8 ± 9.6 years) suffering from SSc with facial handicap defined by Mouth Handicap in Systemic Sclerosis Scale (MHISS) score more than or equal to 20, a Rodnan skin score on the face more than or equal to 1, and maximal mouth opening of less than 55 mm. Autologous adipose tissue injection was performed under local anesthesia using the technique of subcutaneous microinjection. The main objective of this study was an improvement of the MHISS score 6 months after the surgical treatment. The procedure was well tolerated. We observed a mean decrease in the MHISS score of 10.7 points (±5.1; P handicap, skin sclerosis, mouth opening limitation, sicca syndrome, and facial pain. Thus, this minimally invasive approach offers a new hope for face therapy for patients with SSc.

  15. [Handicap and quality of life assessment in amyotrophic lateral sclerosis].

    Science.gov (United States)

    Danel-Brunaud, V

    2006-06-01

    Measures of handicap progression alone are insufficient for assessing what a patient experiences. Handicap results from the interaction between a person's disabilities and the social, familial and environmental factors which determine his or her living conditions. Other factors condition quality of life: of these, psychological and existential factors and an individual's ability to adapt play a fundamental role. Measuring handicap and quality of life must provide medical care providers with comprehensive knowledge of the way in which an individual experiences the disease, his or her handicap and the side effects and constraints of treatments within his or her own life context.

  16. Long-term dizziness handicap in patients with vestibular schwannoma: a multicenter cross-sectional study.

    Science.gov (United States)

    Carlson, Matthew L; Tveiten, Øystein Vesterli; Driscoll, Colin L; Neff, Brian A; Shepard, Neil T; Eggers, Scott D; Staab, Jeffrey P; Tombers, Nicole M; Goplen, Frederik K; Lund-Johansen, Morten; Link, Michael J

    2014-12-01

    (1) To characterize long-term dizziness following observation, microsurgery, and stereotactic radiosurgery (SRS) for small to medium-sized vestibular schwannoma (VS) using a validated self-assessment inventory; and (2) to identify clinical variables associated with long-term dizziness handicap. Cross-sectional observational study. Two independent tertiary academic referral centers: one located in the United States and one in Norway. All patients with sporadic VS of less than 3 cm who underwent primary microsurgery, SRS, or observation between 1998 and 2008 were identified. Subjects were surveyed via a postal questionnaire using the Dizziness Handicap Inventory (DHI) and a VS symptom questionnaire. The overall survey response rate was 79%. A total of 538 respondents (mean age, 64 years; 56% female) were analyzed, and the mean time interval between treatment and survey was 7.7 years. Pretreatment variables associated with greater dizziness handicap included female sex, older age, larger tumor size, preexisting diagnosis of headache or migraine, and symptoms of dizziness predating treatment. Significant posttreatment features strongly associated with poor long-term DHI scores included frequency and severity of ongoing headache. On multivariable analysis, treatment modality did not influence long-term dizziness handicap. At a mean of approximately 8 years following treatment, over half of patients with VS reported ongoing dizziness. The authors have identified several baseline features that may help predict the risk of lasting dizziness. Treatment modality does not appear to influence long-term DHI score. We found a strong association between posttreatment headache and poor dizziness handicap. Future study is needed to further define this relationship. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  17. Diskrimination og handicap

    DEFF Research Database (Denmark)

    Amilon, Anna; Larsen, Lena Bech; Østergaard, Stine Vernstrøm

    2017-01-01

    Formålet med dette notat er at undersøge, i hvilket omfang og i hvilke situationer, mennesker med handicap oplever, at de bliver diskrimineret. Notatet er baseret på SFI’s spørgeskemaundersøgelse SHILD – Survey of Health, Impairment and Living conditions in Denmark. Formålet med SHILD er at belyse...... forhold for mennesker med handicap sammenholdt med mennesker uden handicap og at følge udviklingen over tid. Sigtet er således at bidrage med viden om sammenhænge mellem handicap og levevilkår og udviklingen i disse sammenhænge....

  18. Health care screening for people with mental handicap living in the community.

    Science.gov (United States)

    Wilson, D N; Haire, A

    1990-01-01

    OBJECTIVE--To determine what contact people with mental handicap had had with their general practitioner in the previous year; what prescribed drugs they were taking and whether these had been reviewed; when hearing and vision had last been screened; and what medical problems were found on examination. DESIGN--Case series. SETTING-Day centre for adults with mental handicap. SUBJECTS--A balanced sample of 75 of the 150 people attending the day centre. 10 Were excluded because consent was not given. RESULTS--The subjects did not consult their general practitioners more frequently than the general population but were more likely to be taking prescribed drugs, and 57% of these prescriptions had not been reviewed by a doctor. Thirty three people failed vision screening, including 13 who wore glasses. Twenty seven of the 62 who were testable had a hearing impairment. CONCLUSIONS--As only eight out of 65 people examined in the study did not have an appreciable problem brought to light, screening seems to be worth while. Whether such screening needs to be done by a medically qualified person needs further research. PMID:2148703

  19. Como Trabajar y Vivir en la Realidad: Pasos Basicos Para Jovenes con Incapacidades, sus Padres y sus Profesores (How to Work and Live in the Real World: Basic Steps for Youth with Handicaps and Their Parents and Teachers).

    Science.gov (United States)

    Patton, Patricia L.; And Others

    This Spanish version of "How to Work and Live in the Real World: Basic Steps for Youth with Handicaps and Their Parents and Teachers" is for young people with handicaps who are getting ready to graduate from high school and begin working and living in the adult world. The booklet places a special focus on individuals with cultural…

  20. Nutritional status of patients in a long-stay hospital for people with mental handicap.

    Science.gov (United States)

    Molteno, C; Smit, I; Mills, J; Huskisson, J

    2000-11-01

    To investigate the general nutritional status of patients in Alexandra Hospital, Cape Town, and to determine whether dietary copper deficiency was causing anaemia in hospital patients. Descriptive and cross-sectional analytical studies. A long-stay hospital for people with mental handicap. Information was obtained from the total hospital population. In addition, groups of 15 patients were selected from each of two specific wards, one with active and the other inactive patients. To determine whether copper deficiency was causing anaemia, a sample of 30 patients, divided into three groups (a hypochromic microcytic, a normochromic anaemic and a non-anaemic group) was studied. Body mass indices (BMI) and daily dietary intakes were compared with Recommended Daily Allowance (RDA) values. Serum copper and serum caeruloplasmin levels were used to detect possible copper deficiency. A considerable number of patients were found to be underweight (32% of males and 26% of females had BMIs 30). Poor nutrition was more common in severely handicapped patients and those with acquired causes of their mental handicap. Subjects with Down syndrome were generally well nourished and occasionally obese. Poor dietary intakes of biotin, pantothenic acid, vitamin D and copper were encountered. The serum copper and caeruloplasmin values were found to be within normal limits. Patients with hypochromic, microcytic anaemia had higher serum copper and caeruloplasmin levels than those with normochromic anaemia and the control group. A number of nutritional problems among the inpatient population were found. Many were undernourished, while a smaller number of patients were overweight. In both the active and inactive wards macronutrient intakes were generally within normal limits. However, some micronutrient nutritional deficiencies were encountered. We were unable to establish that dietary copper deficiency was the cause of anaemia in our patients. Elevated serum copper and caeruloplasmin levels

  1. Margaret Holroyd Prize Essay. A patient-centred approach to evaluation and treatment in rheumatoid arthritis: the development of a clinical tool to measure patient-perceived handicap.

    Science.gov (United States)

    Carr, A J

    1996-10-01

    Assessment of patient-centered outcomes is of particular importance in a chronic disease such as rheumatoid arthritis (RA), where a major aim of treatment is a reduction of its disabling and handicapping effects. Rheumatology is reasonably well advanced in its deployment of such outcomes. Measurement of the patient's experience of disease has focused on the ability to perform daily living tasks and, latterly, on the more global effect on quality of life. Neither of these approaches is without conceptual and measurement problems. A new measure of patient-centred outcome in RA has been developed (Carr AJ, Br J Rheumatol 1994;33:378-82). This tool, the Disease Repercussion Profile (DRP), attempts to extend the measurement of outcome to incorporate the individual functional, social, psychological, emotional and economic disadvantage resulting from RA, i.e. patient-perceived handicap. It has been designed for use as a clinical tool, to allow patients to specify the problems and needs of most importance to them, and as such represents a new approach. This paper reviews the development of the DRP in the context of existing health status measures and examines its potential role as a routine measure in an out-patient setting.

  2. Determinants of handicap after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS).

    Science.gov (United States)

    Sturm, Jonathan W; Donnan, Geoffrey A; Dewey, Helen M; Macdonell, Richard A L; Gilligan, Amanda K; Thrift, Amanda G

    2004-03-01

    Handicap, although more relevant to the patient than impairment or disability, has received little attention in people with stroke. The aim of this study was to identify, in an unselected population, factors determining handicap at 2 years after stroke. All first-ever cases of stroke in a population of 306 631 over a 1-year period were assessed. Stroke severity, comorbidity, and demographic information was recorded. Among survivors, 2-year poststroke handicap was assessed with the London Handicap Scale. Disability, physical impairment, depression, anxiety, living arrangements, and recurrent stroke at 2 years were documented. If necessary, proxy assessments were obtained, except for mood. Linear regression analyses were performed to identify factors independently associated with handicap. First, all assessments (proxy and nonproxy) were examined; then, the nonproxy assessments were used to examine the effects of mood. Of 266 patients with incident stroke who were alive at 2 years, 226 (85%) were assessed. Significant determinants of handicap on univariable analysis were age, female sex, socioeconomic status, alcohol intake, stroke subtype, initial stroke severity; 2-year physical impairment, disability, depression and anxiety scores; institutionalization; and recurrent stroke. On multivariable analysis, the independent determinants of handicap were age and 2-year physical impairment and disability. In analysis restricted to nonproxy data, depression and anxiety were also independently associated with handicap. Age, concurrent disability, and physical impairment were more important determinants of handicap than other demographic factors or initial stroke severity. Because depression and anxiety were independently associated with handicap, their treatment may potentially reduce handicap in stroke patients.

  3. Children with Osteogenesis Imperfecta and Their Daily Living. Handicap Research Group Report No. 4.

    Science.gov (United States)

    Brodin, Jane

    The study examined aspects of daily living of Swedish children with osteogenesis imperfecta, a mineral deficiency in the skeleton which results in stunted growth and frequent fractures. A questionnaire was administered to 24 families with children under the age of 18 and 3 families were interviewed. The study found the families in great need of…

  4. Relationship between impairments, disability and handicap in reflex sympathetic dystrophy patients : a long-term follow-up study

    NARCIS (Netherlands)

    Geertzen, JHB; Dijkstra, PU; van Sonderen, ELP; Groothoff, JW; ten Duis, HJ; Eisma, WH

    1998-01-01

    Objective: To determine the relationship between impairments, disability and handicap in reflex sympathetic dystrophy (RSD) patients. Design: A long-term follow-up study of upper extremity RSD patients. Setting: A university hospital. Subjects: Sixty-five patients, 3-9 years (mean interval 5.5

  5. Comparison of Acoustic and Stroboscopic Findings and Voice Handicap Index between Allergic Rhinitis Patients and Controls.

    Science.gov (United States)

    Koç, Eltaf Ayça Özbal; Koç, Bülent; Erbek, Selim

    2014-12-01

    In our experience Allergic Rhinitis (AR) patients suffer from voice problems more than health subjects. To investigate the acoustic analysis of voice, stroscopic findings of larynx and Voice Handicap Index scores in allergic rhinitis patients compared with healthy controls. Case-control study. Thirty adult patients diagnosed with perennial allergic rhinitis were compared with 30 age- and sex-matched healthy controls without allergy. All assessments were performed in the speech physiology laboratory and the testing sequence was as follows: 1. Voice Handicap Index (VHI) questionnaire, 2. Laryngovideostroboscopy, 3. Acoustic analyses. No difference was observed between the allergic rhinitis and control groups regarding mean Maximum Phonation Time (MPT) values, Fo values, and stroboscopic assessment (p>0.05). On the other hand, mean VHI score (p=0.001) and s/z ratio (p=0.011) were significantly higher in the allergic rhinitis group than in controls. Our findings suggest that the presence of allergies could have effects on laryngeal dysfunction and voice-related quality of life.

  6. Relation between Voice Handicap Index (VHI) and disease severity in Iranian patients with Parkinson's disease.

    Science.gov (United States)

    Majdinasab, Fatemeh; Karkheiran, Siamak; Moradi, Negin; Shahidi, Gholam Ali; Salehi, Masoud

    2012-11-01

    One third of patients with Parkinson's disease (PD) have mentioned "dysphonia" as their most debilitating communication deficit. Patient-based measurements, such as Voice Handicap Index (VHI) add necessary supplementary information to clinical and physiological assessment. There are a few studies about relation between VHI and disease severity in PD, although none of them showed any significant correlation. The goal of this study was to find correlation between these variables in Iranian PD patients. This cross-sectional, analytical and non-interventional study was done on 23 PD patients who reported a voice disorder related to their disease. They were selected from attendants of movement disorders clinic of Hazrat Rasool Akram Hospital. The relationship between disease severity (according to Hoehn and Yahr/H&Y and Unified Parkinson's Disease Rating Scale-part3 /UPDRS-III) and VHI questionnaire (and its 3 domains) was investigated based on patients' sex, UPDRS-III score H&Y and VHI. Total VHI and its 3 domains had no relationship with disease severity (H&Y) in all patients and by sex separation. However, there was a positive correlation between VHI and disease severity (UPDRS-III) (r = 0.485). There was also a relation between physical and functional domains of VHI and UPDRS (rP=0.530, rF=0.479) while no relationship observed regarding sex differences. 9 out of 18 UPDRS-III items had strong relationship with VHI (total and 3subscales). Iranian PD patients feel handicap according to voice disorder caused by PD. Patient satisfaction of voice decreases with the disease severity and progression. A larger sample size is necessary to find relationship in genders. VHI is an important issue could be offered to be used in PD beside other assessments.

  7. Relation between Voice Handicap Index (VHI) and disease severity in Iranian patients with Parkinson's disease

    Science.gov (United States)

    Karkheiran, Siamak; Moradi, Negin; Shahidi, Gholam Ali; Salehi, Masoud

    2012-01-01

    Background One third of patients with Parkinson's disease (PD) have mentioned “dysphonia” as their most debilitating communication deficit. Patient-based measurements, such as Voice Handicap Index (VHI) add necessary supplementary information to clinical and physiological assessment. There are a few studies about relation between VHI and disease severity in PD, although none of them showed any significant correlation. The goal of this study was to find correlation between these variables in Iranian PD patients. Method This cross-sectional, analytical and non-interventional study was done on 23 PD patients who reported a voice disorder related to their disease. They were selected from attendants of movement disorders clinic of Hazrat Rasool Akram Hospital. The relationship between disease severity (according to Hoehn and Yahr/H&Y and Unified Parkinson's Disease Rating Scale-part3 /UPDRS-III) and VHI questionnaire (and its 3 domains) was investigated based on patients’ sex, UPDRS-III score H&Y and VHI. Results Total VHI and its 3 domains had no relationship with disease severity (H&Y) in all patients and by sex separation. However, there was a positive correlation between VHI and disease severity (UPDRS-III) (r = 0.485). There was also a relation between physical and functional domains of VHI and UPDRS (rP=0.530, rF=0.479) while no relationship observed regarding sex differences. 9 out of 18 UPDRS-III items had strong relationship with VHI (total and 3subscales). Conclusion Iranian PD patients feel handicap according to voice disorder caused by PD. Patient satisfaction of voice decreases with the disease severity and progression. A larger sample size is necessary to find relationship in genders. VHI is an important issue could be offered to be used in PD beside other assessments PMID:23482344

  8. Relationship between patient-perceived vocal handicap and clinician-rated level of vocal dysfunction.

    Science.gov (United States)

    Childs, Lesley F; Bielinski, Clifford; Toles, Laura; Hamilton, Amy; Deane, Janis; Mau, Ted

    2015-01-01

    The relationship between patient-reported vocal handicap and clinician-rated measures of vocal dysfunction is not understood. This study aimed to determine if a correlation exists between the Voice Handicap Index-10 (VHI-10) and the Voice Functional Communication Measure rating in the National Outcomes Measurement System (NOMS). Retrospective case series. Four hundred and nine voice evaluations over 12 months at a tertiary voice center were reviewed. The VHI-10 and NOMS scores, diagnoses, and potential comorbid factors were collected and analyzed. For the study population as a whole, there was a moderate negative correlation between the NOMS rating and the VHI-10 (Pearson r = -0.57). However, for a given NOMS level, there could be considerable spread in the VHI-10. In addition, as the NOMS decreased stepwise below level 4, there was a corresponding increase in the VHI-10. However, a similar trend in VHI-10 was not observed for NOMS above level 4, indicating the NOMS versus VHI-10 correlation was not linear. Among diagnostic groups, the strongest correlation was found for subjects with functional dysphonia. The NOMS versus VHI-10 correlation was not affected by gender or the coexistence of a psychiatric diagnosis. A simple relationship between VHI-10 and NOMS rating does not exist. Patients with mild vocal dysfunction have a less direct relationship between their NOMS ratings and the VHI-10. These findings provide insight into the interpretation of patient-perceived and clinician-rated measures of vocal function and may allow for better management of expectations and patient counseling in the treatment of voice disorders. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Hearing handicap in patients with chronic kidney disease: a study of the different classifications of the degree of hearing loss.

    Science.gov (United States)

    Costa, Klinger Vagner Teixeira da; Ferreira, Sonia Maria Soares; Menezes, Pedro de Lemos

    The association between hearing loss and chronic kidney disease and hemodialysis has been well documented. However, the classification used for the degree of loss may underestimate the actual diagnosis due to specific characteristics related to the most affected auditory frequencies. Furthermore, correlations of hearing loss and hemodialysis time with hearing handicap remain unknown in this population. To compare the results of Lloyd's and Kaplan's and The Bureau Internacional d'Audiophonologie classifications in chronic kidney disease patients, and to correlate the averages calculated by their formulas with hemodialysis time and the hearing handicap. This is an analytical, observational and cross-sectional study with 80 patients on hemodialysis. Tympanometry, speech audiometry, pure tone audiometry and interview of patients with hearing loss through Hearing Handicap Inventory for Adults. Cases were classified according to the degree of loss. The correlations of tone averages with hemodialysis time and the total scores of Hearing Handicap Inventory for Adults and its domains were verified. 86 ears (53.75%) had hearing loss in at least one of the tonal averages in 48 patients who responded to Hearing Handicap Inventory for Adults. The Bureau Internacional d'Audiophonologie classification identified a greater number of cases (n=52) with some degree of disability compared to Lloyd and Kaplan (n=16). In the group with hemodialysis time of at least 2 years, there was weak but statistically significant correlation of The Bureau Internacional d'Audiophonologie classification average with hemodialysis time (r=0.363). There were moderate correlations of average The Bureau Internacional d'Audiophonologie classification (r=0.510) and tritone 2 (r=0.470) with the total scores of Hearing Handicap Inventory for Adults and with its social domain. The Bureau Internacional d'Audiophonologie classification seems to be more appropriate than Lloyd's and Kaplan's for use in this

  10. You Should be Dancin:! The Role of Performing Arts in the Lives of the Severely and Profoundly Handicapped.

    Science.gov (United States)

    Barringer, Mary Dean

    The manual presents a program planning framework and teaching units for teaching dance and movement to severely and profoundly handicapped individuals. The planning framework contains four components: (1) aesthetic perception/multisensory integration; (2) creative expression; (3) dance heritage/historical and cultural; and (4) aesthetic…

  11. Patient characteristics and intervention effect as measured by Voice Handicap Index.

    Science.gov (United States)

    Hengen, Johanna; Peterson, Malin; McAllister, Anita

    2017-07-01

    To analyze patients with a confirmed voice disorder in order to identify patterns regarding age, gender, and occupation compared to the general public. To explore effects of voice therapy according to the Voice Handicap Index (VHI) score pre- and post-therapy in relation to the number of sessions, age, and gender. Prospective cohort study. This study was conducted as a collaborative project between Linköping University and hospitals in the south-east health care region in Sweden. Six voice clinics participated by asking their patients voluntarily to complete the Swedish version of the VHI at the beginning and end of therapy. The two most prevalent diagnoses were dysphonia (43%) and phonasthenia (25%). Among the working population, the three most common occupational fields were education, health care, and child-care. The majority of the patients were women (74.3%), and the mean age of all patients was 55 years. A significant improvement in VHI scores was found after therapy, with an average decrease of 19 median points in total score and a substantial effect size (0.55). The number of sessions did not significantly correlate with the mean VHI score difference but had a weak correlation to the start and end scores. Increasing age correlated with a higher median VHI score both at the start and end of therapy but did not affect the average decrease between the two measurements.

  12. Evaluation of headache intensity in migrainous patients with visual handicap through the tactile analogical scale (TAS

    Directory of Open Access Journals (Sweden)

    Piovesan Elcio Juliato

    2001-01-01

    Full Text Available The tactile analogue scale (TAS was elaborated to be used in blind subjects or those who can not use the vision during their crises. The objective of this study was to characterize, from TAS, the architecture of migraine attacks in subjects with visual disability. For that, 11 migrainous with visual disturb (MVD subjects were studied and 22 migrainous subjects with no visual disability as a control group. All patients fulfilled the criteria for migraine and the patients of the group studied showed visual acuteness less than 20/200. To evaluate the results, the patients of the group MVD were subdivide within two groups, according to their visual acuteness: subgroup A subjects with subnormal vision and subgroup B amaurotic ones. In subgroup A measurement 46 attacks with average of the migraine attacks of the 56.50 mm, in the subgroup B 45 attacks with average of the 59.58mm and in the control group 92 attacks with average of the 49.88mm. When subgroup B and control group were compared there was a significant statistic difference (p=0.022. Through these outcomes we can observe that the migrainous subjects with no visual afference show a higher pain intensity during the migraine crises comparing to those subjects with no visual handicap. The study suggests that, as in other forms of sensibility, the total visual loss can also interfere in the nociceptive control of the pain during the migraine attacks.

  13. Validation of the Persian version of the dysphagia handicap index in patients with neurological disorders

    Science.gov (United States)

    Barzegar-Bafrooei, Ebrahim; Bakhtiary, Jalal; Khatoonabadi, Ahmad Reza; Fatehi, Farzad; Maroufizadeh, Saman; Fathali, Mojtaba

    2016-01-01

    Background: Dysphagia as a common condition affecting many aspects of the patient’s life. The Dysphagia Handicap Index (DHI) is a reliable self-reported questionnaire developed specifically to measure the impact of dysphagia on the patient’s quality of life. The aim of this study was to translate the questionnaire to Persian and to measure its validity and reliability in patients with neurogenic oropharyngeal dysphagia. Methods: A formal forward-backward translation of DHI was performed based on the guidelines for the cross-cultural adaptation of self-report measures. A total of 57 patients with neurogenic dysphagia who were referred to the neurology clinics of Tehran University of Medical Sciences, Iran, participated in this study. Internal consistency reliability of the DHI was examined using Cronbach’s alpha, and test-retest reliability of the scale was evaluated using intraclass correlation coefficient (ICC). Results: The internal consistency of the Persian DHI (P-DHI) was considered to be good; Cronbach’s alpha coefficient for the total P-DHI was 0.88. The test-retest reliability for the total and three subscales of the P-DHI ranged from 0.95 to 0.98 using ICC. Conclusion: The P-DHI demonstrated a good reliability, and it can be a valid instrument for evaluating the dysphagia effects on quality of life among Persian language population. PMID:27648173

  14. Visual handicap in children.

    Science.gov (United States)

    Bull, M; Evans, P J; Maclean, H

    1982-05-01

    Vision is the primary mode of learning and if it is absent or impaired, other pathways must be stimulated. The range of appropriate services available to visually handicapped children is explained in relation to the school run by the Royal Victorian Institution for the Blind in Melbourne. A period of residential education may be needed for children with multiple impairment. Those whose handicap is primarily visual can usually live at home and have their education integrated with that of their normal peers. Home-based services and parent support systems for preschool and kindergarten age children are outlined. To be successful, they require sharing confidential medical and education information. The school provides a major input to a discussion group of all professionals dealing with such children. Information from the group includes the causes, and educational implications of visual handicap in Victorian children. The commonest pathologies are macular problems and congenital cataract.

  15. Impairment, disability, or handicap in peripheral neuropathy: analysis of the use of outcome measures in clinical trials in patients with peripheral neuropathies

    NARCIS (Netherlands)

    Molenaar, D. S.; de Haan, R.; Vermeulen, M.

    1995-01-01

    Outcome measures can be classified into measures of impairment, disability, and handicap. To investigate the biological effect of treatment, measures of impairment are appropriate. Studies investigating whether patients benefit from treatment in terms of improvement of functional health, however,

  16. Effect of a 0.5% chlorhexidine gel on dental plaque superinfecting microorganisms in mentally handicapped patients

    OpenAIRE

    Cláudio Mendes Pannuti; Roberto Fraga Moreira Lotufo; Silvana Cai; Maria da Conceição Saraiva; Nívea Maria de Freitas; Danilo Falsi

    2003-01-01

    A randomized clinical trial was conducted to investigate the effect of a 0.5% chlorhexidine (CHX) gel on dental plaque superinfecting microorganisms in mentally handicapped patients. Thirty inmates from the institution "Casas André Luiz" were assigned to either test group (CHX gel, n = 15) or control group (placebo gel, n = 15). The gel was administered over a period of 8 weeks. Supragingival plaque samples were collected at baseline, after gel use (8 weeks) and 16 weeks after baseline. The p...

  17. Living with HIV: Patients Perspective

    Centers for Disease Control (CDC) Podcasts

    2009-06-04

    This podcast showcases three people who are living with HIV. The patients share their experiences of being diagnosed with HIV, of the treatments they are undergoing, and on taking responsibility for their health.  Created: 6/4/2009 by Division of HIV and AIDS Prevention (DHAP), National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention ( NCHHSTP).   Date Released: 6/4/2009.

  18. Effect of intralaryngeal muscle synkinesis on perception of voice handicap in patients with unilateral vocal fold paralysis.

    Science.gov (United States)

    Lin, R Jun; Munin, Michael C; Rosen, Clark A; Smith, Libby J

    2017-07-01

    Intralaryngeal muscle synkinesis associated with unilateral vocal fold paralysis (UVFP) is thought to preserve thyroarytenoid-lateral cricoarytenoid muscle complex tone, resulting in a better voice despite the presence of vocal fold paralysis (VFP). This study compares voice handicap in patients with unilateral VFP (UVFP) with and without evidence of adductory synkinesis on laryngeal electromyography (LEMG). Retrospective review of LEMG data and Voice Handicap Index-10 (VHI-10) scores of patients diagnosed with permanent UVFP. LEMG was performed within 1 to 6 months post onset of UVFP. Patients were stratified into two groups: 1) recurrent laryngeal nerve (RLN) neuropathy with synkinesis and 2) RLN neuropathy without synkinesis. Synkinesis was diagnosed when the sniff to phonation maximum amplitude ratio was ≥0.65. VHI-10 scores at 6-month follow-up were recorded. Four hundred forty-nine patients with UVFP and who had an LEMG were reviewed. Eighty-three patients met the inclusion criteria, with 16 in group 1 and 67 in group 2. There was no significant difference between the groups with regard to age, timing of LEMG from onset of VFP, number of patients undergoing temporary vocal fold injection or use of off-label nimodipine. Average VHI-10 scores at 6 months post onset of VFP were 14.4 ± 10.6 for patients with LEMG-identified synkinesis (group 1) and 21.0 ± 10.1 for patients with no LEMG evidence of synkinesis (group 2). This was statistically significant (P = .02). Patients with unilateral vocal fold paralysis and LEMG evidence of laryngeal synkinesis are more likely to have less perceived voice handicap than those without synkinesis. 4. Laryngoscope, 127:1628-1632, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  19. Modulation of natriuretic peptide receptors in human adipose tissue: molecular mechanisms behind the "natriuretic handicap" in morbidly obese patients.

    Science.gov (United States)

    Gentili, Alessandra; Frangione, Maria Rosaria; Albini, Elisa; Vacca, Carmine; Ricci, Maria Anastasia; De Vuono, Stefano; Boni, Marcello; Rondelli, Fabio; Rotelli, Luciana; Lupattelli, Graziana; Orabona, Ciriana

    2017-08-01

    The B-type natriuretic peptide (BNP) hormone plays a crucial role in the regulation of cardiovascular and energy homeostasis. Obesity is associated with low circulating levels of BNP, a condition known as "natriuretic handicap." Recent evidences suggest an altered expression of BNP receptors-both the signaling natriuretic peptide receptors (NPR)-A and the clearance NPR-C receptor-in adipose tissue (AT) as one of the putative causes of natriuretic handicap. The current study aims at clarifying the molecular mechanisms behind the natriuretic handicap, focusing on NPR modulation in the AT of obese and control subjects. The study enrolled 34 obese and 20 control subjects undergoing bariatric or abdominal surgery, respectively. The main clinical and biochemical parameters, including circulating BNP, were assessed. In visceral (VAT) and subcutaneous AT (SAT) samples, collected during surgery, the adipocytes and stromal vascular fraction (SVF) expression of NPR-A and NPR-C and the SVF secretion of interleukin 6 (IL-6) were determined. Both VAT and SAT from obese patients expressed a lower NPR-A/NPR-C ratio in adipocytes and the SVF secreted a higher level of IL-6, compared with the controls. Moreover, NPR-A/NPR-C ratio expressed by VAT and SAT adipocytes negatively correlated with body mass index, insulin, the Homeostasis Model Assessment of Insulin resistance, and IL-6 secreted by SVF, and the expression of the clearance receptor NPR-C, in both the VAT and SAT adipocytes, showed a negative correlation with circulating BNP. Overall, insulin resistance/hyperinsulinemia and AT inflammation (ie, high level of IL-6) are the major determinants of the lower NPR-A/NPR-C ratio in adipocytes, thus contributing to the natriuretic handicap in obese subjects. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Social and psychological characteristics of elderly visually handicapped patients with the Charles Bonnet Syndrome

    NARCIS (Netherlands)

    Teunisse, R.J.; Cruysberg, J.R.M.; Hoefnagels, W.H.L.; Kuin, Y.; Verbeek, A.L.M.; Zitman, F.G.

    1999-01-01

    The Charles Bonnet syndrome (CBS) is characterized by the presence of complex visual hallucinations in psychologically normal people. The syndrome occurs predominantly in the visually handicapped elderly. Little is known about its etiology and pathogenesis. The aim of this study was to examine the

  1. The impact of vocal rehabilitation on quality of life and voice handicap in patients with total laryngectomy.

    Science.gov (United States)

    Ţiple, Cristina; Drugan, Tudor; Dinescu, Florina Veronica; Mureşan, Rodica; Chirilă, Magdalena; Cosgarea, Marcel

    2016-01-01

    Health-related quality of life (HRQL) and voice handicap index (VHI) of laryngectomies seem to be relevant regarding voice rehabilitation. The aim of this study is to assess the impact on HRQL and VHI of laryngectomies, following voice rehabilitation. A retrospective study done at the Ear, Nose, and Throat Department of the Emergency County Hospital. Sixty-five laryngectomees were included in this study, of which 62 of them underwent voice rehabilitation. Voice handicap and QOL were assessed using the QOL questionnaires developed by the European Organisation for Research and Treatment of Cancer (EORTC); variables used were functional scales (physical, role, cognitive, emotional, and social), symptom scales (fatigue, pain, and nausea and vomiting), global QOL scale (pain, swallowing, senses, speech, social eating, social contact, and sexuality), and the functional, physical, and emotional aspects of the voice handicap (one-way ANOVA test). The mean age of the patients was 59.22 (standard deviation = 9.00) years. A total of 26 (40%) patients had moderate VHI (between 31 and 60) and 39 (60%) patients had severe VHI (higher than 61). Results of the HRQL questionnaires showed that patients who underwent speech therapy obtained better scores in most scales ( P = 0.000). Patients with esophageal voice had a high score for functional scales compared with or without other voice rehabilitation methods ( P = 0.07), and the VHI score for transesophageal prosthesis was improved after an adjustment period. The global health status and VHI scores showed a statistically significant correlation between speaker groups. The EORTC and the VHI questionnaires offer more information regarding life after laryngectomy.

  2. The impact of vocal rehabilitation on quality of life and voice handicap in patients with total laryngectomy

    Directory of Open Access Journals (Sweden)

    Cristina Tiple

    2016-01-01

    Full Text Available Background: Health-related quality of life (HRQL and voice handicap index (VHI of laryngectomies seem to be relevant regarding voice rehabilitation. The aim of this study is to assess the impact on HRQL and VHI of laryngectomies, following voice rehabilitation. Materials and Methods: A retrospective study done at the Ear, Nose, and Throat Department of the Emergency County Hospital. Sixty-five laryngectomees were included in this study, of which 62 of them underwent voice rehabilitation. Voice handicap and QOL were assessed using the QOL questionnaires developed by the European Organisation for Research and Treatment of Cancer (EORTC; variables used were functional scales (physical, role, cognitive, emotional, and social, symptom scales (fatigue, pain, and nausea and vomiting, global QOL scale (pain, swallowing, senses, speech, social eating, social contact, and sexuality, and the functional, physical, and emotional aspects of the voice handicap (one-way ANOVA test. Results: The mean age of the patients was 59.22 (standard deviation = 9.00 years. A total of 26 (40% patients had moderate VHI (between 31 and 60 and 39 (60% patients had severe VHI (higher than 61. Results of the HRQL questionnaires showed that patients who underwent speech therapy obtained better scores in most scales (P = 0.000. Patients with esophageal voice had a high score for functional scales compared with or without other voice rehabilitation methods (P = 0.07, and the VHI score for transesophageal prosthesis was improved after an adjustment period. The global health status and VHI scores showed a statistically significant correlation between speaker groups. Conclusion: The EORTC and the VHI questionnaires offer more information regarding life after laryngectomy.

  3. [Handicapped patients and leisure sports--a chance for social integration].

    Science.gov (United States)

    Wilhelm, U

    2000-10-01

    Organizing leisure time in an active way with lots of experiences is getting more and more important in western society. Accordingly, sports activities and travelling as well as their combination, holiday sports activities, are in great demand. A general idea of the literature in that field with regard to the possibilities and difficulties of handicapped persons is that holiday sports activities are considered apt to offer outstanding prerequisites for handicapped and nonhandicapped people getting closer to each other. Starting out on this basis, this survey is mainly dedicated to the following questions: What is the situation for handicapped persons in holiday sports activities? Is holiday sporting in a position to meet the expectations of social integration, and to what extent? A questionnaire about these items was answered by wheelchair users, making it clear, on the one hand, that there are hardly any offers for disabled people to take part in holiday sporting activities. On the other hand, the survey confirms that holiday sports activities are well suited to answer major demands of the integration issue, i.e., communication and interaction as well as other factors conducive to social integration. Subsequently, the author formulates the request that access to and participation in holiday sporting activities be made easier for disabled people so that greater use can be made of these special opportunities for social integration.

  4. Quality of life, functional outcome, and voice handicap index in partial laryngectomy patients for early glottic cancer

    Directory of Open Access Journals (Sweden)

    Kandogan Tolga

    2005-05-01

    part 1. (p = 0. A statistically significant difference was also established between cordectomy and fronto-lateral laryngectomy groups, as well as between cordectomy and cricohyoidopexi groups in answers to the University of Washington- Quality of Life- Revised survey part 2. (p = 0,036 and p = 0.009, respectively. Cricohyoidopexi group has given the lowest scores and the cordectomy group has given the highest scores in three survey questions representing the quality of life, performances and new voices. These ranges are also consistent with the laryngeal tissue excised during surgery (cricohyoidopexi > fronto-lateral laryngectomy > cordectomy. There was no statistically significant difference between groups in Performance Status Scale for Head and Neck cancer patients instrument. The difference between the Voice Handicap Index and Voice Handicap Index (functional; Voice Handicap Index (physical and Voice Handicap Index (emotional scores in three patient groups was not significant either. All of the patients evaluated that their new voices have similar functional, physical and emotional impact on their life. Decanulation and oral feeding times of cricohyoidopexi and fronto-lateral laryngectomy patients are found to be significantly longer than cordectomy patients. Lastly, the removal of arytenoid does not have any significant adverse effects on the quality of life, the functional outcomes, or the quality of voice. Conclusion In the present study, all patients with early glottic cancer, treated with different surgical technics reported fairly good quality of life outcomes, functional results and voice qualities. This study also finds that the removal of arytenoid does not have any adverse effects on the quality of life and voice from the patients' point of view.

  5. Relation between Voice Handicap Index (VHI and disease severity in Iranian patients with Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Fatemeh Majdinasab

    2012-11-01

    Full Text Available  Abstract Background: One third of patients with Parkinson’s disease (PD have mentioned “dysphonia” as their most debilitating communication deficit. Patient-based measurements, such as Voice Handicap Index (VHI add necessary supplementary information to clinical and physiological assessment. There are a few studies about relation between VHI and disease severity in PD, although none of them showed any significant correlation. The goal of this study was to find correlation between these variables in Iranian PD patients. Method: This cross-sectional, analytical and non-interventional study was done on 23 PD patients who reported a voice disorder related to their disease. They were selected from attendants of movement disorders clinic of Hazrat Rasool Akram Hospital. The relationship between disease severity (according to Hoehn and Yahr/H&Y and Unified Parkinson’s Disease Rating Scale-part3 /UPDRS-III and VHI questionnaire (and its 3 domains was investigated based on patients’ sex, UPDRS-III score H&Y and VHI. Results: Total VHI and its 3 domains had no relationship with disease severity (H&Y in all patients and by sex separation. However, there was a positive correlation between VHI and disease severity (UPDRS-III (r=0.485. There was also a relation between physical and functional domains of VHI and UPDRS (rP=0.530, rF=0.479 while no relationship observed regarding sex differences. 9 out of 18 UPDRS-III items had strong relationship with VHI (total and 3subscales. Conclusion: Iranian PD patients feel handicap according to voice disorder caused by PD. Patient satisfaction of voice decreases with the disease severity and progression. A larger sample size is necessary to find relationship in genders. VHI is an important issue could be offered to be used in PD beside other assessments. 

  6. Achados oftalmológicos em pacientes com múltiplas deficiências Ophthalmologic findings in multiple handicapped patients

    Directory of Open Access Journals (Sweden)

    Maria Cecília Remígio

    2006-12-01

    Full Text Available OBJETIVO: Relatar os achados oftalmológicos em portadores de múltiplas deficiências. MÉTODOS: Foram estudados 274 usuários do Sistema Único de Saúde atendidos no Departamento de Oftalmologia Pediátrica e Estrabismo da Fundação Altino Ventura (FAV, no período de junho a setembro de 2004. RESULTADOS: A freqüência dos pacientes quanto ao gênero foi de 58,5% para o masculino e 41,5% para o feminino. A variação das idades foi de 0,1 a 20 anos com mediana de 5. A maioria (61,3% dos pacientes apresentava boa acuidade visual, contudo 38,7% apresentava baixa de visão (PURPOSE: To report the visual findings in patients with multiple handicaps. METHODS: Two hundred and seventy-four patients cared for at the Pediatric and Strabismus Ophthalmology Department of the "Fundação Altino Ventura" - Brazilian National Health System, were examined from June to September 2004. Age varied from 0.1 to 20 years with a median of 5. RESULTS: The majority of the patients (61.3% presented good visual acuity; however low visual acuity (< 20/80 was observed in 38.7% of the patients. Heterotropias were observed in 66 patients (24.0%; astigmatism (53.2% and hyperopia (29.0% were more frequent. CONCLUSION: Children with multiple handicaps need an early ophthalmologic diagnosis and treatment for better global development. The integration of a multidisciplinary team with pediatricians, pediatric ophthalmologists and specialists in low vision, may assure a better visual rehabilitation.

  7. Formation et insertion professionnelle des personnes handicapées ...

    African Journals Online (AJOL)

    Mots clés : Formation, insertion professionnelle, handicap mental, RBC, IMC, IMESFA. English Abstract The equal right stipulated by the 1990 Benin constitution, has never been a reality, especially, when we observe the living conditions reserved to the handicapped in general, and specifically to the mental handicapped: ...

  8. The Carcinologic Handicap Index (CHI): A disability self-assessment questionnaire for head and neck cancer patients.

    Science.gov (United States)

    Balaguer, M; Percodani, J; Woisard, V

    2017-12-01

    The present prospective study sought to draw up and validate a self-assessment questionnaire for disability following head and neck cancer treatment. The Carcinologic Handicap Index (CHI) was designed empirically based on the Voice Handicap Index. It comprises 9 dimensions, self-assessed by the patient: pain, swallowing, feeding, respiration, phonation, hearing, vision, olfaction-gustation, and psychosocial. For each dimension, 4 items are scored in terms of frequency, providing dimension and global scores. The CHI was tested on 86 head and neck cancer patients (pathologic group: male predominance; mean age, 59 years) and 18 control subjects, for validation. Global internal coherence was 0.905 (Cronbach alpha); content validity (r, between questionnaire scores and corresponding visual analog scales) ranged between 0.6 and 0.8 except for the vision dimension and for total score compared to general health rating on VAS (r≤0.5: i.e., the pathology did not directly impair vision and was only one factor among others affecting general health status); temporal validity was satisfactory (r>0.7; P<0.0001) except on the respiration dimension (r=0.624, probably due to fluctuation in pulmonary congestion). Impact on swallowing, feeding and respiration varied with lesion site. There were no significant differences between patients and controls on the pain, hearing and vision dimensions. The CHI showed acceptable psychometric qualities and can be considered as an authentic clinical tool for health professionals, assessing the impact of ENT pathology on quality of life, mainly in the functional domains directly affected by the pathology or treatment. Copyright © 2017. Published by Elsevier Masson SAS.

  9. Handicap and social status of adults with spina bifida cystica

    Science.gov (United States)

    Evans, Kathleen; Hickman, Veronica; Carter, C. O.

    1974-01-01

    The present physical handicaps and social status of 202 survivors of spina bifida cystica attending The Hospital for Sick Children, Great Ormond Street before 1954 are described. Ninety-three of the patients, mostly with uncomplicated meningocele, had escaped serious disability and were living normal lives. But 109 had a serious disability, including three who are mentally retarded. Some of the difficulties of living with spina bifida are described, and a record of work, marriage, and reproduction in the whole group of survivors is shown. Of the 106 with serious locomotor problems and/or incontinence, 58 work regularly, 17 have long spells off work, and 31 have never worked at all; 24 have married, 16 have 26 children none of whom has spina bifida. Of the 96 without physical handicap, 93 work regularly, 47 are married, and 34 have 75 children one of whom has spina bifida cystica and one anencephaly. PMID:4604518

  10. Live-case demonstrations: putting patients first.

    Science.gov (United States)

    Fajadet, Jean; Wood, Shelley; Wijns, William

    2017-11-07

    Live-case demonstrations have become essential teaching tools. Debate about their added educational value and risk-benefit considerations vis-à-vis patient safety demand that major interventional cardiology meetings offering live-case demonstrations carefully define and monitor the objectives and quality of the cases included at their meetings. To this end, Europa Organisation, the content-providing group that supports EuroPCR and other PCR conferences internationally, has convened the PCR VITAL-Live Workshop, bringing together senior interventional cardiologists and experienced live-case operators with the aim of defining and reviewing the key components and goals of valuable live-case demonstrations. The Vital-Live participants unanimously agreed that live cases provide an educational experience with an immediacy and intensity that is unmatched by taped cases, through audience engagement with unfiltered reality and participation in real-time decision-making. Best practices regarding case selection, preparation, objectives, delivery, and discussion of the demonstrations were designed to ensure that the lessons learned would be clear and implementable by audience members, leading to improved patient care and safety in their own practices. Today's on-line accessibility of live-cases underscores the need for operators, hospitals, panels, and meeting chairs to insure that the content, quality, and intent anticipate any public scrutiny. This requires putting patient outcomes first, both at the level of the live demonstration itself and its broader educational worth. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  11. Living with a terminal illness: patients' priorities.

    Science.gov (United States)

    Carter, Helen; MacLeod, Rod; Brander, Penny; McPherson, Kath

    2004-03-01

    Our understanding of terminal illness and its consequences has been predominantly based on models derived from expert definition, rather than the patient's perspective. More recently, quality of life tools have been developed to enable patient choice in responses. However, an even broader approach may be needed to help identify goals for care for patients who are terminally ill. The aim of this paper is to report on an exploratory, qualitative study exploring what people living with terminal illness considered were the areas of priority in their lives. Ten people living with terminal cancer were interviewed. Analysis of the interviews incorporated principles of narrative analysis and grounded theory. Over 30 categories were identified and collated into five inter-related themes (personal/intrinsic factors, external/extrinsic factors, future issues, perceptions of normality and taking charge) encompassing the issues of importance to all participants. Each theme focused on 'life and living' in relation to life as it was or would be without illness. Practical issues of daily living and the opportunity to address philosophical issues around the meaning of life emerged as important areas. The central theme, 'taking charge', concerned with people's levels of life engagement, was integrally connected to all other themes. The findings suggest that the way in which health professionals manage patients' involvement in matters such as symptom relief can impact on existential areas of concern. Understanding patients' perspectives in relation to each theme may assist health professionals to develop management strategies appropriate to their needs. The findings challenge some aspects of traditional 'expert-defined' outcome measures. As this was an exploratory study, further work is needed to test and develop the model presented.

  12. [A district psychiatric clinic and therapeutic pedagogic facility--development of a management concept for mentally handicapped patients].

    Science.gov (United States)

    Koester, H

    1988-11-01

    There is a general consensus of opinion that adult mentally handicapped persons--if we leave aside the treatment of severe and psychiatrically relevant concomitant diseases or abnormal behaviour--are misfits in a psychiatric hospital. The aim of an independent care of the mentally handicapped can be achieved in different ways based on medical paedagogy. The Home for Medical Paedagogy in Düren, Lower Rhine District, is a case in point. Despite many difficulties and conflicts this hospital attained an outstanding standard of medical care within just ten years. Its location is on the same site as that of the psychiatric hospital.

  13. [Cross-cultural adaptation and validation of the Dizziness Handicap Inventory: Argentine version].

    Science.gov (United States)

    Caldara, Betina; Asenzo, Adriana I; Brusotti Paglia, Gabriela; Ferreri, Eliana; Gomez, Ramiro S; Laiz, Mariela M; Luques, María L; Mangoni, Ana P; Marazzi, Carla; Matesa, María A; Peker, Guillermo; Pratto, Romina A; Quiroga, Cecilia E; Rapela, Laura; Ruiz, Vanesa R; Sanchez, Noelia; Taglioretti, Célide L; Tana, Andrés M; Zandstra, Ingrid V

    2012-01-01

    The Dizziness Handicap Inventory is a useful tool for quantifying self-perceived handicap in patients with vertigo, dizziness or unsteadiness and its impact on daily living activities. The Dizziness Handicap Inventory identifies functional, physical and emotional disorders related to balance disturbance. Our objective was to cross-culturally adapt the Peninsular Spanish version of the Dizziness Handicap Inventory for use in Argentina and validate the adapted Argentinian version. We included both healthy subjects and patients with vertigo, dizziness or unsteadiness, aged 18 to 85 years, native Spanish-speaking Argentinians. We introduced linguistic and cultural modifications to the Peninsular Spanish version to obtain the Argentinian one. This version was given twice to 108 patients, 24 to 72 h apart. Internal consistency, test-retest reliability and construct validity were assessed using a visual analogue scale, the Romberg test, the tandem Romberg test and the tandem gait test. We found high internal consistency (α=0.87) and very high test-retest reliability for the total Dizziness Handicap Inventory score (intraclass correlation coefficient: 0.98) and its subscales. The total Dizziness Handicap Inventory and the functional subscale were found to correlate significantly with the Romberg and tandem Romberg tests. The emotional subscale showed a significant correlation with the Romberg test and the eyes-open tandem Romberg test (PHandicap Inventory proved to be a reliable and valid tool to quantify self-perceived handicap resulting from vertigo, dizziness or unsteadiness. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  14. Voice restoration following total laryngectomy by tracheoesophageal prosthesis: Effect on patients' quality of life and voice handicap in Jordan

    Directory of Open Access Journals (Sweden)

    Wreikat Mahmoud M

    2008-03-01

    Full Text Available Abstract Background Little has been reported about the impact of tracheoesophageal (TE speech on individuals in the Middle East where the procedure has been gaining in popularity. After total laryngectomy, individuals in Europe and North America have rated their quality of life as being lower than non-laryngectomized individuals. The purpose of this study was to evaluate changes in quality of life and degree of voice handicap reported by laryngectomized speakers from Jordan before and after establishment of TE speech. Methods Twelve male Jordanian laryngectomees completed the University of Michigan Head & Neck Quality of Life instrument and the Voice Handicap Index pre- and post-TE puncture. Results All subjects showed significant improvements in their quality of life following successful prosthetic voice restoration. In addition, voice handicap scores were significantly reduced from pre- to post-TE puncture. Conclusion Tracheoesophageal speech significantly improved the quality of life and limited the voice handicap imposed by total laryngectomy. This method of voice restoration has been used for a number of years in other countries and now appears to be a viable alternative within Jordan.

  15. Living in a Patient-Centric Universe.

    Science.gov (United States)

    Kraus, Dennis H

    2016-12-01

    Patients with head and neck cancer face a number of challenges in terms of treatment, cure of their underlying malignant condition, and quality of survivorship. This presentation will focus on the patient perception of both the quality of care and the empathy and availability of the head and neck oncology team. It has become evident that the quality of survivorship plays a central role in the patient's decision-making process. The process of decision making by the patient facing head and neck cancer and the impact on treatment choices will be explored. The ability of the patient and her or his support system to navigate through the increasingly complicated health care system will be considered, with an emphasis on strategies for success. Finally, the role of the of the head and neck surgeon, and the need for physician wellness in predicating successful patient outcomes will be considered. The ultimate goal of achieving optimal care, superior patient outcomes, and patient satisfaction is the true objective of the concept of living in a patient-centric universe.

  16. Correlation between morphological characteristics in spectral-domain-optical coherence tomography, different functional tests and a patient's subjective handicap in acute central serous chorioretinopathy.

    Science.gov (United States)

    Gerendas, Bianca S; Kroisamer, Julia-Sophie; Buehl, Wolf; Rezar-Dreindl, Sandra M; Eibenberger, Katharina M; Pablik, Eleonore; Schmidt-Erfurth, Ursula; Sacu, Stefan

    2018-01-16

    The purpose of this study was to identify quantitatively measurable morphologic optical coherence tomography (OCT) characteristics in patients with an acute episode of central serous chorioretinopathy (CSC) and evaluate their correlation to functional and psychological variables for their use in daily clinical practice. Retinal thickness (RT), the height, area and volume of subretinal fluid (SRF)/pigment epithelium detachments were evaluated using the standardized procedures of the Vienna Reading Center. These morphologic characteristics were compared with functional variables [best-corrected visual acuity (BCVA), contrast sensitivity (CS), retinal sensitivity/microperimetry, fixation stability], and patients' subjective handicap from CSC using the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25). Data from 39 CSC patients were included in this analysis. Three different SRF height measures showed a high negative correlation (r = -0.7) to retinal sensitivity within the central 9°, which was also negatively correlated with SRF area and volume (r = -0.6). The CS score and fixation stability (fixation points within 2°) showed a moderate negative correlation (r = -0.4) with SRF height variables. Comparison of the subjective handicap with morphological characteristics in spectral-domain (SD)-OCT showed SRF height had the highest correlation (r = -0.4) with the subjective problems reported and overall NEI VFQ-25 score. In conclusion, SRF height measured in SD-OCT showed the best correlation with functional variables and patients' subjective handicap caused by the disease and therefore seems to be the best variable to look at in daily clinical routine. Even though area and volume also show a correlation, these cannot be so easily measured as height and are therefore not suggested for daily clinical routine. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. Monitoring the Hearing Handicap and the Recognition Threshold of Sentences of a Patient with Unilateral Auditory Neuropathy Spectrum Disorder with Use of a Hearing Aid.

    Science.gov (United States)

    Lima, Aline Patrícia; Mantello, Erika Barioni; Anastasio, Adriana Ribeiro Tavares

    2016-04-01

    Introduction Treatment for auditory neuropathy spectrum disorder (ANSD) is not yet well established, including the use of hearing aids (HAs). Not all patients diagnosed with ASND have access to HAs, and in some cases HAs are even contraindicated. Objective To monitor the hearing handicap and the recognition threshold of sentences in silence and in noise in a patient with ASND using an HA. Resumed Report A 47-year-old woman reported moderate sensorineural hearing loss in the right ear and high-frequency loss of 4 kHz in the left ear, with bilateral otoacoustic emissions. Auditory brainstem response suggested changes in the functioning of the auditory pathway (up to the inferior colliculus) on the right. An HA was indicated on the right. The patient was tested within a 3-month period before the HA fitting with respect to recognition threshold of sentences in quiet and in noise and for handicap determination. After HA use, she showed a 2.1-dB improvement in the recognition threshold of sentences in silence, a 6.0-dB improvement for recognition threshold of sentences in noise, and a rapid improvement of the signal-to-noise ratio from +3.66 to -2.4 dB when compared with the same tests before the fitting of the HA. Conclusion There was a reduction of the auditory handicap, although speech perception continued to be severely limited. There was a significant improvement of the recognition threshold of sentences in silence and in noise and of the signal-to-noise ratio after 3 months of HA use.

  18. Handicap og samfundsdeltagelse 2006

    DEFF Research Database (Denmark)

    Bengtsson, Steen

    Denne rapport giver en basal viden om praktiske, sociale og psykiske følger af handicap, som kan ligge til grund for en vurdering af, om mennesker med handicap har mulighed for at udfolde sig og deltage i samfundet på lige vilkår med mennesker uden handicap. Rapporten viser, at handicap på alle...... punkter virker begrænsende for deltagelse i samfundslivet. Det gælder kontakten til andre, også nære venner og familie, arbejdsmarkedet og udadrettede aktiviteter. Handicap virker også negativt på oplevelsen af meningsfuldhed, forståelse og lykkefølelse. SFI har i 1962 og 1995 gennemført lignende...... undersøgelser. Men denne er den første, der viser, hvad handicap på ben, arme, hænder, syn, hørelse, adfærd og intellekt, betyder hver for sig. Rapporten belyser også handicappedes boligindretning, deres mulighed for at komme omkring og deres brug af rådgivning og støtteforanstaltninger. Rapporten bygger på 9...

  19. Factors related to tinnitus and hyperacusis handicap in older people.

    Science.gov (United States)

    Aazh, Hashir; Lammaing, Karen; Moore, Brian C J

    2017-09-01

    The aim was to assess factors related to tinnitus and hyperacusis handicap in older people. Retrospective cross-sectional. Data were gathered for 184 patients with an average age of 69 years. Tinnitus handicap as measured via the Tinnitus Handicap Inventory (THI) was significantly predicted by tinnitus annoyance as measured via the visual analogue scale (VAS) (regression coefficient, b = 2.9, p handicap as measured via the Hyperacusis Questionnaire (HQ) was significantly predicted by the score on the depression subscale of the Hospital Anxiety and Depression Scale (HADS) (b = 0.8, p handicap, it is important to explore factors associated with annoyance that may be useful in designing appropriate rehabilitative interventions aimed at reducing tinnitus handicap in older people. Future studies should explore whether hyperacusis and insomnia in older people with tinnitus need to be managed in conjunction with treatment for depression.

  20. Starting with a handicap: effects of asynchronous hatching on growth rate, oxidative stress and telomere dynamics in free-living great tits.

    Science.gov (United States)

    Stier, Antoine; Massemin, Sylvie; Zahn, Sandrine; Tissier, Mathilde L; Criscuolo, François

    2015-12-01

    A trade-off between resource investment into growth rate and body self-maintenance is likely to occur, but the underlying molecular mediators of such a trade-off remain to be determined. In many altricial birds, hatching asynchrony creates a sibling competitive hierarchy within the brood, with first-hatched nestlings enjoying substantial advantages compared to last-hatched nestlings. We used this opportunity to test for a trade-off between growth and self-maintenance processes (oxidative stress, telomere erosion) in great tit nestlings, since resource availability and allocation are likely to differ between first-hatched and last-hatched nestlings. We found that despite their starting competitive handicap (i.e. being smaller/lighter before day 16), last-hatched nestlings exhibited growth rate and mass/size at fledging similar to first-hatched ones. However, last-hatched nestlings suffered more in terms of oxidative stress, and ended growth with shorter telomeres than first-hatched ones. Interestingly, growth rate was positively related to plasma antioxidant capacity and early life telomere length (i.e. at 7 days old), but among last-hatched nestlings, those exhibiting the faster body size growth were also those exhibiting the greatest telomere erosion. Last-hatched nestlings exhibited elevated levels of plasma testosterone (T), but only at day 7. T levels were positively associated with oxidative damage levels and plasma antioxidant capacity, the latter being only significant for first-hatched nestlings. Our results suggest that last-hatched nestlings present a specific trade-off between growth rate and self-maintenance processes, which is possibly driven by their need to compete with their older siblings and potentially mediated by elevated levels of T.

  1. Spiroergometric and spirometric parameters in patients with multiple sclerosis: are there any links between these parameters and fatigue, depression, neurological impairment, disability, handicap and quality of life in multiple sclerosis?

    Science.gov (United States)

    Rasova, K; Brandejsky, P; Havrdova, E; Zalisova, M; Rexova, P

    2005-04-01

    One-hundred and twelve patients with multiple sclerosis were selected as population-based sample and examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), the quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer). The aim of the study was to examine and analyse (descriptive statistics) spiroergometric and spirometric parameters in patients with multiple sclerosis. Firstly, we tested the hypothesis whether spiroergometric and spirometric parameters are decreased and whether there are any correlations between these parameters and measures of impairment, depression, disability, handicap and quality of life. Secondly, we tested the hypothesis whether there is any correlation between a possible deconditioning and fatigue, and between a possible respiratory dysfunction and fatigue in multiple sclerosis. It results from this study that many spiroergometric parameters in patients with multiple sclerosis are significantly lowered in comparison to the population norm. A link can be found between some spiroergometric parameters and neurological impairment, disability, handicap and quality of life. It is not possible to prove any correlation between spiroergometric parameters and depression. From the spirometric parameters, these are expiratory flows that are significantly lowered in MS patients. It is not possible to prove any correlation between spirometric parameters and fatigue, depression, neurological impairment, duration of the disease, disability, handicap and quality of life in multiple sclerosis.

  2. Facilitating creativity in handicapped and non-handicapped children ...

    African Journals Online (AJOL)

    The prime objective of this paper is to create awareness on the presence of the handicapped in Nigeria and the need to facilitate creative potentials in handicapped and non-handicapped children. Various factors that could facilitate creativity and other factors that could inhibit creativity were discussed. The implications for ...

  3. A standardised assessment of personality disorder in mental handicap.

    Science.gov (United States)

    Ballinger, B R; Reid, A H

    1987-01-01

    Forty patients with mild or moderate mental handicap were assessed by two psychiatrists using the scale devised by Mann et al, 1981 which describes abnormalities of personality. Analysis by weighted Kappa showed excellent agreement for some items (introversion, hysterical explosive, sociopathic, anankastic and affective). This questionnaire may be useful in the evaluation of personality in the mentally handicapped.

  4. Radiotherapy for T1-2N0 glottic cancer: a multivariate analysis of predictive factors for the long-term outcome in 1050 patients and a prospective assessment of quality of life and voice handicap index in a subset of 233 patients.

    Science.gov (United States)

    Al-Mamgani, A; van Rooij, P H; Woutersen, D P; Mehilal, R; Tans, L; Monserez, D; Baatenburg de Jong, R J

    2013-08-01

    To evaluate the outcomes of patients with early stage glottic cancer (GC) treated with radiotherapy (RT). The current study report on a retrospective analysis of oncologic outcome of 1050 patients with T1-2N0 glottic cancer treated with radiotherapy. Prospective assessment of quality of life (QoL) and voice handicap index (VHI) was performed in all patients treated from 2006 onwards (n = 233). Local control (LC), regional control (RC), disease-free survival (DFS), overall survival (OS), quality of life and voice handicap index. After a median follow-up of 90 months (range 3-309), the actuarial rates of local control, regional control, disease-free survival and overall survival were 85%, 99%, 84% and 81% at 5 years and 82%, 98%, 80% and 61% at 10 years, respectively. On multivariate analysis, T2 tumours, smoking after radiotherapy and conventional radiation scheme correlated significantly with poor local control. Patients who continued smoking after radiotherapy had also significantly lower overall survival rates (OR 4.3, P handicap index improved significantly from 37 at baseline to 18 at 48 months. Patients with T2b and those who continued smoking had significantly worse voice handicap index. In the current study, excellent outcome with good quality of life and voice handicap index scores were reported. T2 tumours, in particular T2b, and continuing smoking after radiotherapy correlated significantly with poor local control and worse voice handicap index. © 2013 John Wiley & Sons Ltd.

  5. The caregiver's burden of Alzheimer patients: differences between live-in and non-live-in.

    Science.gov (United States)

    Raccichini, Alessandra; Castellani, Simona; Civerchia, Patrizia; Fioravanti, Paola; Scarpino, Osvaldo

    2009-01-01

    The objective of our study was to describe the burden of a sample of 208 live-in/non-live-in caregivers of patients with Alzheimer's disease (AD). We analyzed the statistical correlation between Caregiver Burden Inventory (CBI) and the live-in/non-live-in caregiver status, and between the ''objective burden,'' the cognitive deterioration, functional ability, and psychic and behavioral disorders. Using analysis of variance (ANOVA), the live-in groups of caregivers were compared to each subscale and to the total CBI. Living with a patient causes a bigger burden associated to the ''developmental and physical burden,'' which is affected more by the functional impairment than by the cognitive-behavioral aspect. Understanding the aspects of this burden in the initial-intermediate phase of the disease and being able to monitor it over time could contribute to improving the interventions already in place, which affect burden, stress, and quality of life of caregivers and their sick family members.

  6. Handicap som risikofaktor?

    DEFF Research Database (Denmark)

    Bøttcher, Louise; Dammeyer, Jesper Herup

    2010-01-01

    Børn med handicap er generelt i større risiko for at udvikle psykopatologi. Men risikoen for fejludvikling er ikke enkelt forbundet med graden af handicappet. F.eks. oplever børn med hørehandicap næsten fire gange så hyppigt psykosociale vanskeligheder sammenlignet med hørende børn, men det er ikke...... psykopatologi etableres. I artiklen vil vi præsentere en almen model til forståelse af mennesker med handicap og deres udviklingsmuligheder – en handicappsykologisk udviklingsmodel ud fra et dialektisk kultur-historisk perspektiv (Vygotsky, (1924-31) 1993). Ved hjælp af empiriske studier vil vi eksemplificere...... forskellige typiske udviklingsmæssige problemer, der ofte opstår blandt børn med forskellige typer af handicap. At studere børn med handicap og deres psykiske udvikling kan være et vigtigt forskningsmæssigt vindue til at forstå udviklingspsykopatologi generelt....

  7. Personer med handicap

    DEFF Research Database (Denmark)

    Amilon, Anna; Larsen, Lena Bech; Østergaard, Stine Vernstrøm

    Danmark har været omfattet af FN’s handicapkonvention siden 2009. I tråd med konventionen har den danske handicappolitik til hensigt at skabe lige muligheder for mennesker med handicap og den øvrige befolkning. Denne undersøgelse belyser, i hvilket omfang dette sigte er opfyldt for mennesker med...... handicap i 2016, sammenholdt med den øvrige voksne befolkning. Undersøgelsen sætter fokus på forhold omkring uddannelse, beskæftigelse, forsørgelse, livskvalitet og sundhed, deltagelse og tilgængelighed samt sagsbehandling og diskrimination. Rapporten giver på den måde et bredt billede af, dels hvordan...... forholdene er for mennesker med handicap i 2016, og dels hvordan forholdene har udviklet sig siden den første undersøgelsesrunde i 2012. Undersøgelsen viser, at der er store forskelle på mennesker med og uden handicap, også når det gælder helt fundamentale områder for velfærdssamfundet så som uddannelse og...

  8. Med handicap i vuggestuen

    DEFF Research Database (Denmark)

    Bendix-Olsen, Kurt

    2017-01-01

    Artiklen udforsker det deltagelsesmæssige råderum, som vuggestuebørn med handicap har i hverdagens inklusionspraksis i ressourcebørnehuse. Ressourcebørnehusenes inklusionsarrangementer er i fokus med henblik på at undersøge, på hvilke måder børn med handicap deltager i hverdagen og får erfaringer...... med og mulighed for at udvikle rådighed. Artiklen fremanalyserer, at inklusionsarrangementer tilvejebringes gennem tre væsensforskellige organiseringer af pædagogisk praksis, der hver på sin måde tilbyder børn med handicap særlige deltagelsesbetingelser: 1) Et kapacitetsfokuseret arrangement 2) Et...... rummende omsorgsarrangement 3) Et repertoireskabende arrangement. De to førstnævnte arrangementer peger på, at handicap er knyttet til binære forståelser af børns behov som almene eller særlige. Hvor de professionelle i det kapacitetsfokuserede arrangement vægtlægger udvikling af barnets kropsfunktioner og...

  9. The Handicap Principle

    Indian Academy of Sciences (India)

    IAS Admin

    The Handicap Principle is an idea proposed by the husband and wife scientist team of Amotz and Avishag Zahavi from. Israel in the 1970's. It is among the most innovative ideas of the 20th century in the field of behavioural biology and attempts to explain several long-standing puzzles that have baffled naturalists since the ...

  10. Personer med handicap

    DEFF Research Database (Denmark)

    Amilon, Anna; Larsen, Lena Bech; Østergaard, Stine Vernstrøm

    Danmark har været omfattet af FN’s handicapkonvention siden 2009. I tråd med konventionen har den danske handicappolitik til hensigt at skabe lige muligheder for mennesker med handicap og den øvrige befolkning. Denne undersøgelse belyser, i hvilket omfang dette sigte er opfyldt for mennesker med ...

  11. Transporting Handicapped Students.

    Science.gov (United States)

    Turner, Dayton Ray

    The book presents guidelines for adaptive transportation measures for handicapped students. Part 1 considers the transportation cycle as a means to evaluate individual student competencies at all logical points during the transportation experience. The transportation cycle is reviewed from deciding to transport the student to gaining access to…

  12. Prevalence of Impairments, Disabilities, Handicaps: A Study From Kayseri Province

    Directory of Open Access Journals (Sweden)

    Melis Nacar

    2012-02-01

    Full Text Available Impairment and disability and handicap are most important problems all the world. This survey was conducted in centre of Kayseri province to obtain the prevalence of impairment, disability and handicap. The survey also aimed to identify the causes of impairments and to analyse the nature and extent of the handicaps resulting from these impairments. WHO’s impairment, disability and handicap classification was used and it was applied to those living in dwellings located in districts selected according to the population 3443 person residing selected using a multistage cluster sampling method were screened. It was found that 10.5% of the population had impairment and 5.0% of the population had a disability and 4.2% of them had a handicapped. The prevalence of impairment, disability and handicap was higher in women (12.7–6.3–5.6% than men (8.3–3.6–3.4%. Result of this study estimated, the educational and social levels were low among all the disables Educational problems and rehabilitation requirements were the major problems. A high proportion of person with impairment and handicap were not given any rehabilitation services. So that, the results of our study shows us that we have to give more importance to disables educational and occupational problems in our country. [TAF Prev Med Bull 2012; 11(1.000: 71-80

  13. Benefits for handicapped children

    CERN Document Server

    2003-01-01

    The introduction of long-term care benefits within the CERN Health Insurance Scheme requires the coordination of the benefits foreseen for handicapped children. Measures were adopted by the Management following the recommendation made by the Standing Concertation Committee on 26 March 2003. A document clarifying these measures is available on the Web at the following address: http://humanresources.web.cern.ch/humanresources/external/soc/Social_affairs/social_affairs.asp Social Affairs Service 74201

  14. 45 CFR 1151.11 - Handicapped person.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Handicapped person. 1151.11 Section 1151.11 Public... HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS NONDISCRIMINATION ON THE BASIS OF HANDICAP Standards for Determining Who Are Handicapped Persons § 1151.11 Handicapped person. (a) Handicapped person means any person...

  15. 28 CFR 41.31 - Handicapped person.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Handicapped person. 41.31 Section 41.31... THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Standards for Determining Who Are Handicapped Persons § 41.31 Handicapped person. (a) Handicapped person means any person who has a physical or mental...

  16. Drug Extends Lives of Patients with Advanced Prostate Cancer: Studies

    Science.gov (United States)

    ... Extends Lives of Patients With Advanced Prostate Cancer: Studies Findings could 'change clinical practice overnight,' leading oncologist ... when added to standard androgen deprivation therapy, both studies found. Abiraterone also appeared to more than double ...

  17. 38 CFR 21.58 - Redetermination of employment handicap and serious employment handicap.

    Science.gov (United States)

    2010-07-01

    ... employment handicap and serious employment handicap. 21.58 Section 21.58 Pensions, Bonuses, and Veterans... of employment handicap and serious employment handicap. (a) Prior to induction into a program. A determination as to employment handicap, serious employment handicap, or eligibility for a program of employment...

  18. Living with an Alzheimer patient in Turkey.

    Science.gov (United States)

    Taşc, Sultan; Tekinsoy Kartn, Pnar; Ceyhan, Ozlem; Sungur, Gönül; Göriş, Songül

    2012-08-01

    The research was performed to determine the problems that caregivers experience with patients with Alzheimer disease. The research was carried out qualitatively with those who were responsible for the care of eight Alzheimer patients who were being treated at the Neurology Polyclinics of Gevher Nesibe Hospital at Erciyes University in Kayseri, Turkey. Research data were collected through questionnaires designed to understand the characteristics of the individuals who provided care and focus group interviews. A written consent from the institution and an oral as well as written consent of the individuals were obtained. Focus groups were interviewed in the same setting at different times with two different groups, including four people who agreed to participate in the research. Each interview was conducted by three personnel: a moderator, a reporter, and an observer. Interviews were structured under four main titles: "The changes seen in the individual with Alzheimer disease"; "Physical, social, psychological, and socioeconomical problems that caregivers experienced"; "Precautions taken against the problems"; and "Patients' expectations of the care". The interviews lasted for approximately 2 hours. A voice recorder and a written registration form were also used to collect information. Six women and two men constituted the research group. The caregivers stated that the patients had such difficulties as forgetfulness, nervousness, jealousy, childish behavior, deterioration in speech, fear of water, hallucinations, and difficulty in carrying out daily life activities. Caregivers emphasized the fact that they perceived the changes in the patients as deliberate behaviors and thus became annoyed and quarreled with them before diagnosis; however, after diagnosis, they felt remorse and experienced guilt because of their ill-treatment of them. In addition, the caregivers hid the patients and their disease from social surroundings. Caregivers mentioned that they had felt as

  19. Experience of handicap and anxiety in phobic postural vertigo.

    Science.gov (United States)

    Holmberg, Johan; Karlberg, Mikael; Harlacher, Uwe; Magnusson, Mans

    2005-03-01

    We found a difference in gender distribution in a population of phobic postural vertigo patients compared with dizzy patients seen in general neuro-otological practice. It appears as if women with phobic postural vertigo suffer more and are more handicapped by dizziness than both men with phobic postural vertigo and a population with dizziness. These differences may reflect other causes of phobic postural vertigo besides anxiety, such as gender-related coping behaviour and postural strategy. Anxiety influences the degree of suffering and handicap in dizzy patients. Experiences of anxiety and handicap were investigated among a population with phobic postural vertigo. Using the Dizziness Handicap Inventory, the Vertigo Symptom Scale and the Vertigo Handicap Questionnaire, 34 consecutive patients with phobic postural vertigo were compared with a population of 95 consecutive patients seen at a balance disorder clinic. Patients with phobic postural vertigo scored higher than the control subjects with respect to all parameters with the exception of the physical subscale of the Dizziness Handicap Inventory. Because there were significantly more women in the control group we performed a gender-specific analysis of the results. The higher test scores among patients with phobic postural vertigo can be explained by the higher scores among women in this group, while the test results for men were more similar to those of the control group.

  20. Understanding the will to live in patients nearing death.

    Science.gov (United States)

    Chochinov, Harvey Max; Hack, Thomas; Hassard, Thomas; Kristjanson, Linda J; McClement, Susan; Harlos, Mike

    2005-01-01

    This study examined concurrent influences on the will to live in 189 patients with end-stage cancer The authors found significant correlations between the will to live and existential, psychological, social, and, to a lesser degree, physical sources of distress. Existential variables proved to have the most influence, with hopelessness, burden to others, and dignity entering into the final model. Health care providers must learn to appreciate the importance of existential issues and their ability to influence the will to live among patients nearing death.

  1. Assessment of Living Skills in Schizophrenic Patients by Kohlman Evaluation

    Directory of Open Access Journals (Sweden)

    Leila Kazazi

    2012-09-01

    Full Text Available Background: The living skills of schizophrenic patients are disrupted due to cognitive, perceptual, sensory-motor, psychological, and psychosocial problems. Therefore, the identification of some aspects of living skills that require medical intervention is essential in these patients. Accordingly, in this study, the living skills of schizophrenic patients were investigated with the Kohlman Evaluation of Living Skills.Materials and Methods: This study was conducted by using the cross-sectional descriptive and analytic approach in which 35 hospitalized and 51 outpatient schizophrenic patients and 35 healthy individuals were compared and the areas of living skills that needed help were determined.Results: According to the Kruskal-Wallis test, there was a significant difference between the mean scores of healthy, hospitalized and outpatients subjects, whereas the difference in the means scores was not significant between the two groups of patients (p=0.693. Schizophrenic patients showed more than 50% requirement for help in the following subscales; appearance, awareness of dangerous household situations, appropriate action for sickness and accidents, obtaining and maintaining a source of income, budgeting their monthly income, and leisure activities. Employment had a direct effect on the living skills of the subjects and the test mean scores of employed people (2.409 was better than unemployed persons (7.083.Conclusion: The living skills of schizophrenic patients are damaged in some areas through the course of the disease and its symptoms. Based on the Kohlman Evaluation of Living Skills, these people require most help in self-care, safety health, money management, and leisure activities.

  2. Getting to Know Patients' Lived Space

    African Journals Online (AJOL)

    Christopher R Stones

    nursing is to optimize a healing environment in which patients are offered the best possible conditions in order to allow 'nature' to act upon them (Nightingale. 1859/1969). Since then, several other health care theorists have investigated the interaction between human beings and their environment. In the 1970s and 1980s ...

  3. Inclusion Body Myositis: What Most Impacts Patients' Lives.

    Science.gov (United States)

    Gibson, Cynthia; Johnson, Nicholas E; Eastwood, Eileen; Heatwole, Chad

    2016-12-01

    Inclusion body myositis (IBM) is the most common form of idiopathic inflammatory myopathy in adults older than 50 years. Few studies have focused on the functional, physical, and social limitations of this disease. This study identifies pertinent symptoms that impact the health and daily function of patients with IBM. We used semistructured interviews with 10 biopsy-confirmed adults with IBM to identify the psychological, physical, and functional limitations that have the greatest impact on the lives of patients with IBM. Participants with IBM provided 644 direct quotes identifying issues that have the greatest effect on their lives. Two hundred nine individual symptoms and 17 symptomatic themes were identified by patients as having a significant impact on their lives. The symptomatic themes mentioned most frequently involved mobility and ambulation, emotional distress, and activity impairment. Identifying critical issues to patients with IBM is potentially useful for clinicians whose aim is to provide optimal care to patients with IBM.

  4. Quality of life in oncological patients with oropharyngeal dysphagia: validity and reliability of the Dutch version of the MD Anderson Dysphagia Inventory and the Deglutition Handicap Index.

    Science.gov (United States)

    Speyer, Renée; Heijnen, Bas J; Baijens, Laura W; Vrijenhoef, Femke H; Otters, Elsemieke F; Roodenburg, Nel; Bogaardt, Hans C

    2011-12-01

    Quality of life is an important outcome measurement in objectifying the current health status or therapy effects in patients with oropharyngeal dysphagia. In this study, the validity and reliability of the Dutch version of the Deglutition Handicap Index (DHI) and the MD Anderson Dysphagia Inventory (MDADI) have been determined for oncological patients with oropharyngeal dysphagia. At Maastricht University Medical Center, 76 consecutive patients were selected and asked to fill in three questionnaires on quality of life related to oropharyngeal dysphagia (the SWAL-QOL, the MDADI, and the DHI) as well as a simple one-item visual analog Dysphagia Severity Scale. None of the quality-of-life questionnaires showed any floor or ceiling effect. The test-retest reliability of the MDADI and the Dysphagia Severity Scale proved to be good. The test-retest reliability of the DHI could not be determined because of insufficient data, but the intraclass correlation coefficients were rather high. The internal consistency proved to be good. However, confirmatory factor analysis could not distinguish the underlying constructs as defined by the subscales per questionnaire. When assessing criterion validity, both the MDADI and the DHI showed satisfactory associations with the SWAL-QOL (reference or gold standard) after having removed the less relevant subscales of the SWAL-QOL. In conclusion, when assessing the validity and reliability of the Dutch version of the DHI or the MDADI, not all psychometric properties have been adequately met. In general, because of difficulties in the interpretation of study results when using questionnaires lacking sufficient psychometric quality, it is recommended that researchers strive to use questionnaires with the most optimal psychometric properties.

  5. Hand Hygiene Saves Lives: Patient Admission Video

    Centers for Disease Control (CDC) Podcasts

    2008-05-01

    This podcast is for hospital patients and visitors. It emphasizes two key points to help prevent infections: the importance of practicing hand hygiene while in the hospital, and that it's appropriate to ask or remind healthcare providers to practice hand hygiene.  Created: 5/1/2008 by National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID).   Date Released: 6/19/2008.

  6. The validity and reliability of tinnitus handicap inventory Thai version.

    Science.gov (United States)

    Limviriyakul, Siriporn; Supavanich, Walop

    2012-11-01

    Demonstrate the reliability and validity of the Tinnitus Handicap Inventory Thai Version (THI-T), a self-report measure of tinnitus. A cross-sectional psychometric validation study was used to determine internal consistency reliability and validity of the Tinnitus Handicap Inventory Thai Version at the Otoneurology clinic at Tertiary care center The cross-cultural adaptation of the Tinnitus Handicapped Inventory English version (Newman et al, 1996) was translated into Thai version following the steps indicated by Guillemin et al. The reliability was constructed by using Cronbach's coefficient alpha. The validity was analyzed by the correlation between Tinnitus Handicap Inventory Thai version and the 36-items short form health survey and visual analog scale using Spearman and Pearson test. The result showed good internal consistency reliabilities of total, functional, emotional, and catastrophic scale (a = 0.902, 0.804, 0.831 and 0.661, respectively) of Tinnitus Handicap Inventory Thai Version. Spearman correlation showed the significant correlation of Tinnitus Handicap Inventory to 36-items short form health survey and visual analog scale. Tinnitus Handicap Inventory Thai Version will be a vigorous tool in evaluating tinnitus patients as well as monitoring the progress of their symptoms.

  7. The lived experience of Lebanese family caregivers of cancer patients.

    Science.gov (United States)

    Doumit, Myrna A A; Huijer, Huda Abu-Saad; Kelley, Jane H; Nassar, Nada

    2008-01-01

    The purpose of this study was to explore, through in-depth semistructured interviews, the lived experience of Lebanese family caregivers of cancer patients and acquire a better knowledge of the meaning and interpretation of their experience. The study design was based on the Utrecht School of Phenomenology. This study followed purposeful sampling, in which 9 participants with a mean age of 51 years were selected. Data were analyzed using the hermeneutic phenomenological approach based on the Utrecht School of Phenomenology. Eight core themes describing the participants' lived experience emerged from the interviews: living with fears and uncertainty, loss of happiness, feeling of added responsibility, living in a state of emergency, sharing the pain, living the dilemma of truth telling, disturbed by being pitied, and reliance on God. The results of this study challenge nurses to be conscious of the nature and difficulties that family caregivers are encountering.

  8. Living with Atrial Fibrillation: An Analysis of Patients' Perspectives

    Directory of Open Access Journals (Sweden)

    Meral Altiok, PhD

    2015-12-01

    Conclusions: Patients need to be provided with relevant individual training and counselling so that they lead more satisfactory lives. In addition, appropriate health appointment and monitoring systems should be developed for patients to reduce the problems associated with frequent follow-up appointments.

  9. Consensus report of the XI Congress of the Spanish Society of Odontology for the handicapped and special patients.

    Science.gov (United States)

    Machuca-Portillo, Guillermo; Cabrerizo-Merino, Carmen; Cutando-Soriano, Antonio; Giménez-Prats, María-José; Silvestre-Donat, Farncisco-Javier; Tomás-Carmona, Inmaculada

    2014-09-01

    This article summarizes the findings of consensus of the XI congress of the SEOEME. All of these conclusions are referring to the review articles responsible to the general rapporteurs in order to bringing up to date knowledge with regard to the use of implants in patients medically compromised and with special needs and, in the dental management of autism and cerebral palsy, in the dental treatment of patients with genetic and adquired haematological disorders, the dental implications of cardiovascular disease and hospital dentistry.

  10. Consensus Report of the XI Congress of the Spanish Society of Odontology for the Handicapped and Special Patients

    OpenAIRE

    Machuca Portillo, Guillermo; Cabrerizo Merino, María del Carmen; Cutando Soriano, Antonio; Giménez Prats, Mª José; Silvestre Donat, Francisco Javier; Tomás Carmona, Inmaculada

    2014-01-01

    This article summarizes the findings of consensus of the XI congress of the SEOEME. All of these conclusions are referring to the review articles responsible to the general rapporteurs in order to bringing up to date knowledge with regard to the use of implants in patients medically compromised and with special needs and, in the dental management of autism and cerebral palsy, in the dental treatment of patients with genetic and adquired haematological disorders, the dental implications of car...

  11. Living with a diagnosis of non-small cell lung cancer: patients' lived experiences.

    LENUS (Irish Health Repository)

    McCarthy, Ita

    2012-01-31

    The aim of this study was to explore patients\\' experience of living with non-small cell lung cancer (NSCLC). Patients diagnosed with NSCLC know that their treatment is not with curative intent and can expect distressing symptoms. In this phenomenological study, six adults with a diagnosis of NSCLC were interviewed. Data was analysed guided by van Manen\\'s six-step process. Four main themes were interpreted: \\'Maintaining my life\\'; \\'The enemy within\\'; \\'Staying on the train\\

  12. Management of lipid disorders in patients living with HIV.

    Science.gov (United States)

    Myerson, Merle; Malvestutto, Carlos; Aberg, Judith A

    2015-09-01

    Since the discovery and development of antiretroviral therapy (ART), HIV has become a chronic disease with patients living longer lives and to ages where co-morbidities, such as cardiovascular disease (CVD) are prevalent. Diagnosis and management of risk factors for CVD, in particular dyslipidemia, have become an important part of the overall care for patients living with HIV infection. Existing guidelines and recommendations for the management of dyslipidemia for persons with HIV infection are largely based on guidelines for the general population. Clinical and epidemiologic research efforts are ongoing to provide information specific to patients living with HIV. This review offers a detailed guide for clinicians who manage dyslipidemia in patients infected with HIV. The first sections provide background information on dyslipidemia, risk stratification, and targets for lipid therapy. This is followed by a step-by-step approach for diagnosis and treatment with specific information on lipid drug use for patients with HIV. The recommendations presented here are based on existing guidelines for the general population, evidence from research in patients infected with HIV, and the clinical experience of the authors. Management issues for which little or no information is available specific to this patient population are noted and serve to highlight the many gaps in our knowledge that will need to be addressed. © 2015, The American College of Clinical Pharmacology.

  13. Health-related Quality of Life as Studied by EORTC QLQ and Voice Handicap Index Among Various Patients With Laryngeal Disease.

    Science.gov (United States)

    Karlsen, Tom; Sandvik, Lorentz; Heimdal, John-Helge; Hjermstad, Marianne Jensen; Aarstad, Anne Kari Hersvik; Aarstad, Hans Jørgen

    2017-03-01

    Patients with voice-related disorders are often treated by a multidisciplinary team including assessment by patient-reported outcome measures. The present paper aims at documenting the importance of including general health-related quality of life (HRQoL) measures to clinical investigations. The participants (N = 80 larynx cancer, N = 32 recurrent palsy, N = 23 dysfunctional, N = 75 degenerative/inflammation, N = 19 various) were included consecutively at the laryngology clinic at Haukeland University Hospital. In addition, HRQoL data were included from one national group with laryngectomies (N = 105), one group with various patients formerly treated for head and neck squamous cell carcinoma (N = 96), and one population-based reference group (N = 1956). Obtained were the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ), the Voice Handicap Index (VHI), and the Eysenck Personality Inventory (EPI) neuroticism scores. By analysis of variance, we have determined significant dependence of groups analyzing the sum global QoL/health index (F = 9.47; P <0.001), the functional HRQoL sum score (F 5,2373  = 7.14, P <0.001), and the symptom sum HRQoL scores (F 7,2381  = 8.13; P <0.001). In particular, patients with recurrent palsy and laryngeal cancer had lowered HRQoL. At the index levels, in particular dyspnea scores, were scored depending on larynx disease group (F 7,2288  = 24.4; P <0.001). The VHI score correlated with the EORTC H&N35 "speech" index with a common variance of 52%. VHI scores correlated with level of neuroticism with 8% common variance (P <0.001) and EORTC scores with 22% (P <0.001). In particular, among patients with voice-related disease, those with recurrent palsy and laryngeal cancer had lower HRQoL. Furthermore, the HRQoL and VHI scores were inversely tied to neuroticism. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc

  14. Hospital Patients and Handicapped Readers Section and Round Table of Libraries for the Blind. Libraries Serving the General Public Division. Papers.

    Science.gov (United States)

    International Federation of Library Associations, The Hague (Netherlands).

    Papers on hospital and health libraries and library services to the blind and deaf which were presented at the 1982 International Federation of Library Associations conference include: (1) "Leisure Pursuits of the Blind" by Antun Lastric (Yugoslavia); (2) "Library Services for the Handicapped in Canada: An Overview" by…

  15. Handicap visuel et administration

    OpenAIRE

    Sicard, Mathilde

    2016-01-01

    Introduction du mémoire : Aujourd’hui, on compte en France 1,7 million de déficients visuels. Près de 3 Français sur 100 sont ainsi confrontés à des problèmes de vision. Parmi eux, 207 000 sont malvoyants profonds et aveugles. De plus, ce handicap connait une progression importante en raison de l’accroissement générale de l’espérance de vie de la population française : la déficience visuelle étant une déficience dont la fréquence augmente considérablement avec l’âge.Dans ce contexte, il est i...

  16. 29 CFR 779.409 - Handicapped workers.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Handicapped workers. 779.409 Section 779.409 Labor... Students, Learners, and Handicapped Workers § 779.409 Handicapped workers. Regulations have been issued... handicapped workers at wages lower than the minimum wage applicable under section 6 of the Act. These...

  17. Does live music benefits patients with brain and spinal injury?

    Science.gov (United States)

    Zhang, C-C; Mou, L; Wang, X; Guo, D

    2015-09-01

    The purpose of this study is to examine the feasibility and prospective success associated with implementing and evaluating a six-week live music intervention on an inpatient neurorehabilitation ward. In total 26 patients were included in this study. Out of which, 15 were patients and 11 were staff members. Staff participants completed wellbeing measures at before and after music. Patients completed an assortment of validated measures at five consecutive time points from baseline to follow-up. Staff participants experienced a minor decrease in wellbeing over time. The majority of the data collected from patients illustrated positive trends, with improvements in wellbeing, pain, cognition functioning, independent functioning, and mobility. The feasibility indicates that with modifications that this project is a viable venture. We found that live music appears to be promising new addition to neurorehabilitation.

  18. Synchronic Distance Education from the Perspective of a Handicapped Person

    Science.gov (United States)

    Karal, Hasan; Cebi, Ayca; Turgut, Yigit Emrah

    2011-01-01

    Nowadays knowledge and communication technologies are developing rapidly and changing people's lives. With the help of the developing technologies, people can access knowledge independent of time and place and distance education technologies offer handicapped students a range of opportunities in order that they may access a better level of…

  19. Creating Visual Materials for Multi-Handicapped Deaf Learners.

    Science.gov (United States)

    Hack, Carole; Brosmith, Susan

    1980-01-01

    The article describes two groups of visual materials developed for multiply handicapped deaf teenagers. The daily living skills project includes vocabulary lists, visuals, games and a model related to household cleaning, personal grooming, or consumer skills. The occupational information project includes visuals of tools, materials, and clothing…

  20. Patient and alograft survival after transplantation with a living donor ...

    African Journals Online (AJOL)

    BACKGROUND: Late allograft loss remains a key area of concern. This study Was aimed at determining the patient and renal allograft outcome and identifying the factors responsible for survival following transplantation with a living-related donor kidney at the Nairobi Hospital, Kenya. METHODS: Follow-up data for ...

  1. Maintaining the will to live of patients with advanced cancer.

    Science.gov (United States)

    Khan, Luluel; Wong, Rebecca; Li, Madeline; Zimmermann, Camilla; Lo, Chris; Gagliese, Lucia; Rodin, Gary

    2010-01-01

    The will to live is a natural instinct experienced by all human beings. It tends to persist in humans, despite marked adversity such as that associated with advanced cancer. The will to live may be measured directly, or indirectly, by assessing the desire for hastened death. Factors that may affect it include age, life stage, and physical and psychological distress. In particular, states of depression and hopelessness may precede the loss of the will to live. Other psychosocial variables that may affect the will to live include physical suffering, attachment security, self-esteem, and spiritual well-being. A number of screening tools are available to identify risk factors for the loss of the will to live. Awareness of these factors can guide interventions to preserve morale and maintain hope in patients faced with a terminal illness. Critical among these are the alleviation of physical and psychosocial distress and the establishment of a therapeutic alliance that is sensitive to the specific support needs of individual patients. Comfort and facility with such supportive interventions in oncology will require greater attention to the development of communication and relationship skills at both undergraduate and postgraduate levels of training.

  2. LOGO Helps Remove Children's Handicaps.

    Science.gov (United States)

    Gray, Lovett

    1984-01-01

    Discusses the philosophy behind LOGO and presents several examples of how it has been adapted for use with physically and mentally handicapped and learning disabled children to promote academic and social development through computer programing. (MBR)

  3. Woodworking for Preschool Handicapped Children.

    Science.gov (United States)

    Kulla-Branz, John

    1984-01-01

    Woodworking experiences based on a task analysis approach can be motivating instructional experiences for preschool handicapped children. The article presents sequentially ordered hammering and sawing skills adaptations for specific disability groups. (CL)

  4. The Handicapped Can Dance Too!

    Science.gov (United States)

    Lloyd, Marcia L.

    1978-01-01

    A program of dance therapy activities can offer handicapped individuals positive experiences in such areas as body image, spatial awareness, self-confidence, hand-eye/foot-eye coordination, visual focusing, balance and social relations. (Author/MJB)

  5. Living with Atrial Fibrillation: An Analysis of Patients' Perspectives.

    Science.gov (United States)

    Altiok, Meral; Yilmaz, Mualla; Rencüsoğullari, Ibrahim

    2015-12-01

    The aim of this study was to determine the perceptions of patients with atrial fibrillation regarding the disease, to reveal their feelings, thoughts and wishes, and to investigate their perspectives and coping behaviors towards their condition. Phenomenological methodology was used. The study population consisted of a total of 225 patients treated by the cardiology department of a university hospital, while the study sample consisted of 32 patients who met the inclusion criteria. A semistructured interview addressed perceptions of patients with atrial fibrillation regarding the disease. Data were collected by asking the participants the three questions on the In-depth Individual Interview Form. Data were analyzed using the continuous comparative method of Colaizzi. In the study sample, 50.0% of participants were female, 69.0% were married, and the mean age was 66.90 years (± 7.90 years). As a result of the content analysis, four main themes and 15 subthemes were identified: patient's mental status regarding the disease, patient's social status regarding the disease, patient's physical condition regarding the disease, and disease management and coping with the disease. The study found that individuals with atrial fibrillation faced major limitations in their daily living activities and social lives due to the disease symptoms and warfarin use. Patients need to be provided with relevant individual training and counselling so that they lead more satisfactory lives. In addition, appropriate health appointment and monitoring systems should be developed for patients to reduce the problems associated with frequent follow-up appointments. Copyright © 2015. Published by Elsevier B.V.

  6. Hearing function in patients living with HIV/AIDS.

    Science.gov (United States)

    Luque, Amneris E; Orlando, Mark S; Leong, U-Cheng; Allen, Paul D; Guido, Joseph J; Yang, Hongmei; Wu, Hulin

    2014-01-01

    During the earlier years of the HIV/AIDS epidemic, initial reports described sensorineural hearing loss in up to 49% of individuals with HIV/AIDS. During those years, patients commonly progressed to advanced stages of HIV disease and frequently had neurological complications. However, the abnormalities on pure-tone audiometry and brainstem-evoked responses outlined in small studies were not always consistently correlated with advanced stages of HIV/AIDS. Moreover, these studies could not exclude the confounding effect of concurrent opportunistic infections and syphilis. Additional reports also have indicated that some antiretroviral medications may be ototoxic; thus, it has been difficult to make conclusions regarding the cause of changes in hearing function in HIV-infected patients. More recently, accelerated aging has been suggested as a potential explanation for the disproportionate increase in complications of aging described in many HIV-infected patients; hence, accelerated aging-associated hearing loss may also be playing a role in these patients. We conducted a large cross-sectional analysis of hearing function in over 300 patients with HIV-1 infection and in 137 HIV-uninfected controls. HIV-infected participants and HIV-uninfected controls underwent a 2-hr battery of hearing tests including the Hearing Handicap Inventory, standard audiometric pure-tone air and bone conduction testing, tympanometric testing, and speech reception and discrimination testing. Three-way analysis of variance (ANOVA) and logistic regression analysis of 278 eligible HIV-infected subjects stratified by disease stage in early HIV disease (n = 127) and late HIV disease (n = 148) and 120 eligible HIV-uninfected controls revealed no statistically significant differences among the three study groups in either overall 4-frequency pure-tone average (4-PTA) or hearing loss prevalence in either ear. Three-way ANOVA showed significant differences in word recognition scores in the right ear

  7. Performance of activities of daily living among hospitalized cancer patients

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; Wæhrens, Eva Ejlersen

    2015-01-01

    and characterize ADL task performance problems among a group of adult disabled hospitalized cancer patients using interview and questionnaire data. METHODS: Cross-sectional study on prevalence of ADL task performance problems experienced by disabled hospitalized cancer patients using the Activities of Daily Living...... when using only one of the instruments. CONCLUSION: Adult hospitalized disabled cancer patients experience a high degree and variation in difficulties performing ADL, illustrating the need for a comprehensively planned assessment of problems and needs....... Questionnaire (ADL-Q) (n = 118) and the Canadian Occupational Performance Measure (COPM) (n = 55). RESULTS: All 118 patients reported problems with ADL task performance. Based on the ADL-Q patients reported more problems within instrumental (I-)ADL than personal (P-)ADL. In both I-ADL and P-ADL the results...

  8. Adequacy of the Simplified Version of the Tinnitus Handicap Inventory (THI-S) to Measure Tinnitus Handicap and Relevant Distress.

    Science.gov (United States)

    Lee, Jae Hee; Ra, Jin-Ju; Kim, Young Ho

    2014-04-01

    The Tinnitus Handicap Inventory (THI) often requires patients to devote their time to complete the questionnaire than they expect. Given that it limits the effectiveness of THI in a busy clinical practice that desires a quick and easy assessment of tinnitus handicap, this study evaluated clinical usefulness of a Simplified version of Tinnitus Handicap Inventory (THI-S) in measuring the severity of tinnitus handicap as well as predicting the psychological distress associated with tinnitus. A total of 129 outpatients suffering from tinnitus (61 with normal hearing and 68 with hearing loss) participated in this study. The responses of THI-S (10 items) and THI (25 items) were evaluated to quantify the subjective handicap of tinnitus. The self-perceived level of stress, anxiety, and depression of all participants was measured with a series of self-report questionnaires such as Korean version of Brief Encounter Psychosocial Instrument (BEPSI), State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively. All the questionnaire responses were analyzed using non-parametric analyses to examine the convergence, comparability, internal consistency reliability and validity of THI-S. The severity of tinnitus handicap and the relevant psychological distress greatly varied across individuals. The THI-S responses were comparable to original THI responses, regardless of hearing status of patients. The internal consistency of THI-S responses was found to be good for total score (Cronbach's α=0.83-0.91), with moderately high consistency for the emotional, functional, and catastrophic subscales. Significant (phandicap as well as predict psychological distress. Three factors were extracted through factor analysis, which explained 73% of the total variance. Despite reducing the length of 25 items of THI to 10 items, the THI-S can be used as s a simple but reliable and valid tool for evaluating severity of tinnitus handicap as well as detecting its negative

  9. Handicap og ligebehandling i praksis

    DEFF Research Database (Denmark)

    Bonfils, Inge Storgaard; Bengtsson, Steen; Olsen, Leif

    Handicap er et af de områder, hvor den sociale indsats har været stigende gennem mange år. Flere forskellige professionsgrupper, som socialrådgivere, pædagoger, ergoterapeuter og fysioterapeuter arbejder med området, og derfor er der behov for, at de fagprofessionelle – både igennem deres...... uddannelsesforløb og efterfølgende – opnår viden om emnet handicap og ligebehandling. Med denne antologi sætter vi fokus på ligebehandling. Undersøgelser har vist, at kun få af de offentligt ansatte, der har ansvaret for indsatsen i forhold til handicap, har viden om dansk handicappolitik og dens principper....

  10. The Barthel index as predictor of handicap in stroke survivors: a ...

    African Journals Online (AJOL)

    Aim: Handicap post stroke is likely to be more relevant to patients and family than impairment or disability. The purpose of this study was to assess the Barthel index as a predictor of handicap. Method: One hundred and twelve participants with a diagnosis of stroke were prospectively enrolled. Fifteen clinical variables, the ...

  11. Validation of a Korean Version of the Tinnitus Handicap Questionnaire

    Science.gov (United States)

    Yoo, Ik Won; Hwang, Sun Jin; Hwang, Soon Young

    2015-01-01

    Objectives The goal of the present study was to evaluate the reliability and validity of the Korean version of the tinnitus handicap questionnaire (THQ-K). Methods A total of 60 patients were included in this study. Patients responded to the THQ-K, the tinnitus handicap inventory (THI), Beck's depression index (BDI), and the visual analogue scale (VAS) for loudness and pitch, loudness match, and minimum masking level (MML) test were performed. Results Internal consistency of the THQ-K was examined using Cronbach coefficient alpha. Cronbach alpha was 0.96. The THQ-K showed a significant correlation with THI, BDI, VAS for distress, and VAS for loudness, but no significant correlation with psychoacoustic measurement of tinnitus, such as loudness match, pitch match, and MML. Conclusion The THQ-K is a reliable and valid test for evaluating the degree of handicap due to tinnitus for both research and clinical use. PMID:26330911

  12. Validation of a Korean Version of the Tinnitus Handicap Questionnaire.

    Science.gov (United States)

    Jun, Hyung Jin; Yoo, Ik Won; Hwang, Sun Jin; Hwang, Soon Young

    2015-09-01

    The goal of the present study was to evaluate the reliability and validity of the Korean version of the tinnitus handicap questionnaire (THQ-K). A total of 60 patients were included in this study. Patients responded to the THQ-K, the tinnitus handicap inventory (THI), Beck's depression index (BDI), and the visual analogue scale (VAS) for loudness and pitch, loudness match, and minimum masking level (MML) test were performed. Internal consistency of the THQ-K was examined using Cronbach coefficient alpha. Cronbach alpha was 0.96. The THQ-K showed a significant correlation with THI, BDI, VAS for distress, and VAS for loudness, but no significant correlation with psychoacoustic measurement of tinnitus, such as loudness match, pitch match, and MML. The THQ-K is a reliable and valid test for evaluating the degree of handicap due to tinnitus for both research and clinical use.

  13. Handicap questionnaires: what do they assess?

    NARCIS (Netherlands)

    Cardol, M.; Brandsma, J. W.; de Groot, I. J.; van den Bos, G. A.; de Haan, R. J.; de Jong, B. A.

    1999-01-01

    There is an increasing need to get insight into the social and societal impact of chronic conditions on a person's life, i.e. person-perceived handicap. The purpose of this study is to report how current handicap questionnaires assess handicap. A literature search using both Medline and the database

  14. Nutrition of Children with Severely Handicapping Conditions.

    Science.gov (United States)

    Sobsey, Richard J.

    1983-01-01

    Nutritional needs of severely handicapped children are examined as they are affected by specific handicapping conditions, medications commonly used with severely handicapped children, special diets, and behavior influences. The potential for interaction among these factors is discussed, and six guidelines are provided to help ensure improved…

  15. Aphasia and activities of daily living in stroke patients.

    Science.gov (United States)

    Gialanella, Bernardo; Prometti, Paola; Vanoglio, Fabio; Comini, Laura; Santoro, Raffaele

    2016-12-01

    Few studies have investigated the relationships between aphasia and activities of daily living (ADLs) in stroke patients. This study was aimed firstly to determine which task within the ADLs has poorer functional recovery in stroke patients with aphasia after rehabilitation, second to identify which specific task is related to aphasia. This is a prospective and observational study. Inpatients of our Rehabilitation Unit. The study was carried out in 219 patients with primary diagnosis of stroke with (104) and without aphasia (115). All patients underwent usual rehabilitation. Aachen Aphasia Test and Functional Independence Measure scale were used to assess severity of aphasia and ADLs, respectively. Gain in ADLs was the main outcome measure. At the end of rehabilitation patients with aphasia had lower gain in bathing, dressing upper body, dressing lower body, toileting, stair climbing, and higher gain in social interaction, problem solving, and memory with respect to patients without aphasia. However, when data were adjusted for side of hemiplegia, Fugl-Meyer score and trunk control test, patients with aphasia showed lower gain in dressing upper body (P=0.027), dressing lower body (P=0.009), lower toileting (P=0.027), and higher gain in social interaction (Paphasia was an important determinant of gain in bathing (β=0.26), dressing upper body (β=0.24), dressing lower body (β=0.22), lower toileting (β=0.22), and social interaction (β=-0.29). The current study points out that, after usual rehabilitation, the patients with aphasia show a poor gain in personal care activities and higher gain in social interaction. Knowledge of these findings: 1) can guide the rehabilitation team in selecting specific and appropriate therapies aimed to give patient with aphasia the highest possible functional independence in ADLs; 2) is useful to family members and social rehabilitation services for domiciliary management of patients with aphasia.

  16. Inter-relationship of intelligence-quotient and self-concept with dental caries amongst socially handicapped orphan children

    Directory of Open Access Journals (Sweden)

    PKS Virk

    2012-01-01

    Full Text Available Context : India has been the focus of many health surveys among normal, physically, and mentally handicapped children. However, the data, concerning oral health conditions of socially handicapped children living in orphanages, are scanty. Aims: To study the effect of parental inadequacy, environmental deprivation, and emotional disturbances on dental caries through intelligence quotient (IQ and self-concept in orphan children and also to co-relate dental caries with different levels of IQ and self-concept. Settings and Design: The study was carried out amongst socially handicapped children living in orphanages. Patients and Methods: 100 children in the age group of 10-14 years from orphanages were selected. Malin′s Intelligence Scale for Indian Children (MISIC was used to assess the intelligence quotient; self-concept questionnaire to assess self-concept of the child and recording of dental caries status of children was done as per WHO Index (1997. StatisticaL Analysis Used : To assess the relationship of dental caries with IQ, student′s unpaired t-test was used and; to find the relationship between self-concept and dental caries, Karl-Pearson′s coefficient of co-relation was applied. Results: the children in orphanages had a lower IQ and high caries experience but had an above average self-concept. There was also no co-relation between dental caries and self-concept. Conclusions: Orphan children, being socially handicapped, are at an increased risk for dental caries due to a lower IQ level, parental deprivation, and institutionalization. Moreover, lack of co-relation between dental caries and self-concept could be explained by the fact that dental caries is a lifelong process whereas different dimensions of self-concept are in a state of constant flux.

  17. Ouderlijke mediasocialisatie : hulpbron of handicap?

    NARCIS (Netherlands)

    Notten, Natascha; kraaykamp, Gerbert; Ultee, Wout

    2008-01-01

    Summary Media socialization: help or handicap? A study of the long term effects of parental media socialization on children’s educational success In this article we analyzed the long term effects of parental media socialization on educational success. We employed information on 7838 individuals from

  18. Educating Handicapped Children: Whose Responsibility?

    Science.gov (United States)

    Burns, Harriet P.

    1977-01-01

    In 1836, a young Swiss physician, Johann Jacob Guggenbuhl, introduced a residential setting for a handicapped child and attempted to develop a well-designed program and philosophy for the local retarded population. Some of the same problems that he faced are still being discussed. Here the costs of such programs are considered in terms finance,…

  19. Handicap og ligebehandling i praksis

    DEFF Research Database (Denmark)

    Bengtsson, Steen; Bonfils, Inge; Olsen, Leif

    Handicap er et af de områder, hvor den sociale indsats har været stigende gennem mange år. Flere forskellige professionsgrupper, som socialrådgivere, pædagoger, ergoterapeuter og fysioterapeuter arbejder med området, og derfor er der behov for, at de fagprofessionelle – både igennem deres...... uddannelsesforløb og efterfølgende – opnår viden om emnet handicap og ligebehandling. Med denne antologi sætter vi fokus på ligebehandling. Undersøgelser har vist, at kun få af de offentligt ansatte, der har ansvaret for indsatsen i forhold til handicap, har viden om dansk handicappolitik og dens principper. Med en...... artikel om ligebehandling og handicappolitik håber vi at give fagpersoner og andre interesserede indsigt i de grundlæggende principper og dynamikker i dansk handicappolitik. Der er skrevet meget lidt om mennesker med handicap med anden etnisk oprindelse end dansk og de problemer, de møder i det offentlige...

  20. The Intellect and Intellectual Handicaps.

    Science.gov (United States)

    Kylen, Gunnar

    This guide describes, from the perspecitve of J. Piaget's theories, the nature of intellectual handicaps and their significance for cognitive development, personality development, and interaction with the environment. A description of intellectual capacity and intellectual development is followed by an analysis of the role of intellectual capacity…

  1. Psychology and the Handicapped Child.

    Science.gov (United States)

    Sherrick, Carl E., Ed.; And Others

    Reviewed in seven author contributed chapters are findings of experimental psychology relevant to the education of handicapped children in the areas of sensory processes, visual perception, memory, cognition and language development, sustained attention and impulse control, and personality and social development. Noted in an introductory chapter…

  2. Handicap, uddannelse og beskæftigelse

    DEFF Research Database (Denmark)

    Høgelund, Jan; Larsen, Malene Rode

    Denne rapport belyser uddannelsesniveauet og uddannelsesaktiviteten og beskæftigelsen blandt personer med handicap. Den giver en detaljeret, landsdækkende beskrivelse af, hvilke uddannelser personer med handicap har og er i gang med, og hvor ofte personer med forskellige uddannelser er beskæftiget....... Der er en væsentlig mindre andel blandt personer med et handicap der har en kompetencegivende uddannelse eller er i gang med en sammenlignet med personer uden handicap. Rapporten viser, at for stort set alle uddannelsesniveauer er beskæftigelsesandelen væsentlig lavere blandt personer med handicap end...... blandt personer uden handicap. Rapportens resultater tyder dermed på, at der er et potentiale for en bedre udnyttelse af de uddannelseskompetencer, som ikke-beskæftigede personer med handicap har, og dermed for en samfundsmæssig gevinst. Sandsynligheden for at være i beskæftigelse vokser med uddannelsens...

  3. Quality of life outcomes in patients living with stoma

    Directory of Open Access Journals (Sweden)

    Fakhrialsadat Anaraki

    2012-01-01

    Full Text Available Background: Despite efforts to maintain the intestinal tissue and treat gastrointestinal disease, a large number of patients undergo ostomy surgery each year. Using stoma reduces the patient′s quality of life (QOL greatly. Although there are approximately 3000 patients in Iran; there is little information about the impact of stoma on their QOL. Aims: The study aims to evaluate QOL of stoma patients using a special measurement tool. Settings and Design: This survey was a cross-sectional study that was conducted on 102 random samples of stoma patients. Materials and Methods : The City of Hope Quality of Life-Ostomy Questionnaire was used for collecting demographic and clinical information and evaluating QOL. Statistical Analysis Used: Univariate and multiple regression analyses were performed to identify predictors of QOL. Results: The mean score for the overall QOL for stoma patients was 7.48 ± 0.9. 70% of patients were dissatisfied with sexual activities. More than half of them reported feelings of depression following stoma surgery. Univariate analysis indicated that factors such as the type of ostomy (temporary/permanent, the underlying disease that had led to the stoma, depression, problem with location of ostomy, and change in clothing style had significant effects on overall QOL and its subscales ( P < 0.05. The results of the regression analyses showed that only depression and problem with the location of ostomy were statistically significant in predicting patients′ QOL and its subscales ( P < 0.05. Conclusions: The findings demonstrated that living with stoma influences the overall aspect of QOL. Education for the patients and their families is important for improving the stoma patients′ QOL. Sexual and psychological consultation may also improve patients′ QOL.

  4. The Lived Experiences of Nurses Caring For Dying Pediatric Patients.

    Science.gov (United States)

    Curcio, Danna L

    2017-01-01

    Nurses and healthcare professionals may have difficulty adjusting to and comprehending their experiences when a patient’s life ends. This has the potential to interfere with patient care. Reflection on past events and actions enables critical discovery of strategies to benefit both nurses and patients. This qualitative phenomenological study explores the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of van Manen (1990), was used for this study. The Roy Adaptation Model (RAM) (Roy, 2009; Roy & Andrews, 1991) was the nursing model that guided the study to help understand that nurses are an adaptive system, using censoring as a compensatory adaptive process to help function for a purposeful cause. Nine female nurse participants with one to four years of experience were interviewed. The context of the experiences told by nurses caring for dying pediatric patents uncovered seven essential themes of empathy, feelings of ambivalence, inevitability, inspiration, relationship, self-preservation, and sorrow, and these themes demonstrated a connection formed between the nurse and the patient.

  5. Reliability and Validity of the Chinese (Mandarin) Tinnitus Handicap Inventory

    Science.gov (United States)

    Meng, Zhaoli; Zheng, Yun; Wang, Kai; Kong, Xiudan; Tao, Yong; Xu, Ke; Liu, Guanjian

    2012-01-01

    Objectives The Tinnitus Handicap Inventory (THI) is a commonly used self-reporting tinnitus questionnaire. We undertook this study to determine the reliability and validity of the Chinese-Mandarin version of the Tinnitus Handicap Inventory (THI-CM) for measuring tinnitus-related handicaps. Methods We tested the test-retest reliability, internal reliability, and construct validity of the THI-CM. Two-hundred patients seeking treatment for primary or secondary tinnitus in Southwest China were asked to complete THI-CM prior to clinical evaluation. Patients were evaluated by a clinician using standard methods, and 40 patients were asked to complete THI-CM a second time 14±3 days after the initial interview. Results The test-retest reliability of THI-CM was high (Pearson correlation, 0.98), as was the internal reliability (Cronbach's α, 0.93). Factor analysis indicated that THI-CM has a unifactorial structure. Conclusion The THI-CM version is reliable. The total score in THI-CM can be used to measure tinnitus-related handicaps in Mandarin-speaking populations. PMID:22468196

  6. Violence, death and associated factors on a mental handicap ward.

    Science.gov (United States)

    Shah, A K

    1992-06-01

    The characteristics of all the patients admitted to a high-dependency mental handicap ward over a 21-month period were examined. The patients that had been responsible for acts of violence on the ward were compared with those who had not. Violent patients were significantly younger and more likely to have an abnormal electroencephalogram. Meningoencephalitis as the aetiology of mental handicap was over-represented in the violent group. The level of violence was alarmingly high with 620 violent incidents over 21 months (30 per month). Four patients accounted for 74% of the violence and two of these four patients suffered sudden, unexpected deaths. The relationship between violence and sudden death is examined, and the implications of pharmacological intervention with anticonvulsants for violent patients with abnormal electroencephalogram results are discussed.

  7. Enhancing the doctor-patient relationship: Living, dying and use of ...

    African Journals Online (AJOL)

    This article aims to establish whether processes around the consideration and execution of the living will help enhance the doctor-patient relationship. Studies indicate that the living will is not used frequently, and that the doctor-patient relationship is often deficient. The article explores the two primary topics – the living will, ...

  8. The development of a new tool for the evaluation of handicap in elderly: the Geriatric Handicap Scale (GHS).

    Science.gov (United States)

    Verrusio, Walter; Renzi, Alessia; Spallacci, Giulia; Pecci, Maria Tecla; Pappadà, Maria Antonella; Cacciafesta, Mauro

    2018-02-10

    To date, the comprehensive geriatric assessment (CGA) does not include an evaluation tool for handicap. To develop a new instrument for assessing handicap in the elderly: the Geriatric Handicap Scale (GHS). 656 community-dwelling elderly were enrolled in this study. We identified the thematic areas investigated by the CGA which showed a significant correlation with the handicap condition (handicap yes/not) to be included in our scale (Phase 1). Afterwards, we evaluated the possible correlations between: (1) the score obtained in each area of GHS and those obtained in CGA tests investigating similar dimensions, (2) GHS total score and the Multidimensional Prognostic Index (MPI) total score (Phase 2). In Phase 1, data analysis showed several significant correlations between the handicap condition and the scores obtained to the CGA tests exploring cognition, mood, functional impairment, comorbidity, social and environmental variables. Thus, we developed a tool considering five variables: (1) cognition and mood; (2) functional impairment; (3) hearing/visual impairment; (4) any additional comorbidity factors; (5) environmental/social risk factors. In Phase 2, data analysis showed significant correlations between the score obtained in each area of GHS and those obtained in the CGA tests investigating similar dimensions. A positive correlation between GHS total score and MPI total score (r = 68; p = 0.001) was also reported. Cut-off score for the GHS was established. Psychometric properties of GHS were also investigated and adequate estimates of internal reliability were demonstrated. Our tool could prove useful to correctly categorize the disadvantageous condition related to patient's disability.

  9. Quantitative MRI in hypomyelinating disorders: Correlation with motor handicap.

    Science.gov (United States)

    Steenweg, Marjan E; Wolf, Nicole I; van Wieringen, Wessel N; Barkhof, Frederik; van der Knaap, Marjo S; Pouwels, Petra J W

    2016-08-23

    To assess the correlation of tissue parameters estimated by quantitative magnetic resonance (MR) techniques and motor handicap in patients with hypomyelination. Twenty-eight patients with different causes of hypomyelination (12 males, 16 females; mean age 10 years) and 61 controls (33 males, 28 females; mean age 8 years) were prospectively investigated. We quantified T2 relaxation time, magnetization transfer ratio, fractional anisotropy, mean, axial, and radial diffusivities, and brain metabolites. We performed measurements in the splenium, parietal deep white matter, and corticospinal tracts in the centrum semiovale. We further analyzed diffusion measures using tract-based spatial statistics. We estimated severity of motor handicap by the gross motor function classification system. We evaluated correlation of handicap with MR measures by linear regression analyses. Fractional anisotropy, magnetization transfer ratio, choline, and N-acetylaspartate/creatine ratio were lower and diffusivities, T2 values, and inositol were higher in patients than in controls. Tract-based spatial statistics showed that these changes were widespread for fractional anisotropy (96% of the white matter skeleton), radial (93%) and mean (84%) diffusivity, and less so for axial diffusivity (20%). Correlation with handicap yielded radial diffusivity and N-acetylaspartate/creatine ratio as strongest independent explanatory variables. Gross motor function classification system grades are in part explained by MR measures. They indicate that mainly lack of myelin and, to a lesser degree, loss of axonal integrity codetermine the degree of motor handicap in patients with hypomyelinating disorders. These MR measures can be used to evaluate strategies that are aimed at promotion of myelination. © 2016 American Academy of Neurology.

  10. The impact of tinnitus characteristics and associated variables on tinnitus-related handicap.

    Science.gov (United States)

    Degeest, S; Corthals, P; Dhooge, I; Keppler, H

    2016-01-01

    This study aimed to determine the characteristics of tinnitus and tinnitus-related variables and explore their possible relationship with tinnitus-related handicap. Eighty-one patients with chronic tinnitus were included. The study protocol measured hearing status, tinnitus pitch, loudness, maskability and loudness discomfort levels. All patients filled in the Tinnitus Sample Case History Questionnaire, the Hyperacusis Questionnaire and the Tinnitus Handicap Inventory. The relationship of each variable with the Tinnitus Handicap Inventory score was evaluated by univariate and multivariate analyses. Five univariables were associated with the Tinnitus Handicap Inventory score: loudness discomfort level, subjective tinnitus loudness, tinnitus awareness, noise intolerance and Hyperacusis Questionnaire score. Multiple regression analysis showed that the Hyperacusis Questionnaire score and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score. Hyperacusis and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score. Questionnaires on tinnitus and hyperacusis are especially suited to providing additional insight into tinnitus-related handicap and are therefore useful for evaluating tinnitus patients.

  11. 28 CFR 41.32 - Qualified handicapped person.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Qualified handicapped person. 41.32..., NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Standards for Determining Who Are Handicapped Persons § 41.32 Qualified handicapped person. Qualified handicapped person means: (a) With respect...

  12. Ophthalmological profile of patients living with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Janković-Terzić Katarina

    2010-01-01

    Full Text Available Introduction. Serbia has 2.287 registered HIV positive persons. A certain number has ocular complications which are mainly the result of opportunistic infections accompanying this illness. Due to a highly stigmatizing environment for people living with HIV/AIDS in Serbia, they do not always seek doctors assistance despite the fear of losing their sight. Case report. We presented ophthalmologic status of nine HIV positive persons, all at the different phases of the illness. The decrease in the visual acuity was the first symptom which led to the diagnosis of HIV infection in two of our patients. Conclusion. Ophthalmologist has an important role in the multidisciplinary approach to patients with HIV/AIDS from introducing the diagnosis to the follow-up and the treatment of ocular complications which may accompany this chronic illness. With the active involvement of eye professionals serious consequences can be prevented, which have not only medical but also social and economic implications on the individual and the society as a whole.

  13. [Sexual function, physical handicap].

    Science.gov (United States)

    Sevène, Arnaud

    2014-10-01

    While the right to a sexual life for disabled people is not contested, their sexuality cannot be summed up in a debate for or against sexual assistance. In a similar way, sexual function can only be understood in light of all the difficulties related to disability. Medical progress can improve sexual function and solve many problems in order to facilitate access to procreation. However, these are not well known and are reserved to specialized teams. Many disabled persons are totally autonomous in their sexuality, but for some who require medical assistance, it is necessary to support them in a process of creation where therapeutic interventions consist of facilitating or stimulating the patient's own resources. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Reliability and validity of a Danish adaptation of the Tinnitus Handicap Inventory.

    Science.gov (United States)

    Zachariae, R; Mirz, F; Johansen, L V; Andersen, S E; Bjerring, P; Pedersen, C B

    2000-01-01

    The objective of this study was to determine the reliability and validity of a Danish translation of the Tinnitus Handicap Inventory (THI), a self-report measure of perceived tinnitus handicap. The Danish version of the THI was administered to 50 patients reporting tinnitus as their primary complaint or secondary to hearing loss. Construct validity was assessed using tinnitus symptom rating scales, the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Tinnitus Coping Style Questionnaire (TCSQ), the Eysenck Personality Questionnaire (EPQ), and perceived tinnitus loudness and pitch. The Danish translation of the THI and its subscales showed good internal consistency reliabilities (c = 0.93 to alpha = 0.74) comparable to those of the original version. High to moderate correlations were observed between THI and psychological distress, tinnitus symptom ratings, neuroticism and maladaptive tinnitus coping. A confirmatory factor analysis failed to validate the three subscales of THI, and high intercorrelations found between the subscales question whether they represent three distinct factors. The results suggest that the Danish THI-Total scale may be a reliable and valid measure of general tinnitus related distress that can be used in a clinical setting to quantify the impact of tinnitus on daily living.

  15. The activities-specific balance confidence scale and the dizziness handicap inventory: a comparison.

    Science.gov (United States)

    Whitney, S L; Hudak, M T; Marchetti, G F

    1999-01-01

    Vestibular dysfunction can have a tremendous impact on an individual's quality of life. The purpose of this paper is to determine if the level of handicap reported by individuals on the Dizziness Handicap Inventory (DHI), an inventory developed for use with individuals with complaints of dizziness symptoms, will be consistent with that reported on the Activities-specific Balance Confidence Scale (ABC), a tool developed for use with elderly individuals that attempts to assess a person's confidence level in performing activities of daily living (ADL's). A sample of convenience was used consisting of 71 subjects (15 males and 56 females) from a local Balance and Vestibular Clinic. The subjects ranged in age from 26 to 88 years of age. Both the DHI and the ABC were administered as part of an initial physical therapy evaluation to new patients at the clinic. A moderately strong negative correlation was found between the scores of the two inventories (Ts = -0.6350). The results suggest that the ABC is a valid tool for use with individuals with complaints of dizziness.

  16. Diabetic polyneuropathy may increase the handicap related to vestibular disease.

    Science.gov (United States)

    Aranda, Catalina; Meza, Anabel; Rodríguez, Raymundo; Mantilla, María Teresa; Jáuregui-Renaud, Kathrine

    2009-04-01

    We undertook this study to assess the influence of diabetic peripheral neuropathy on self-reported disability and postural control during quiet stance of patients with peripheral vestibular disease, before and after a standardized program of vestibular rehabilitation (Cawthorne & Cooksey exercises). Twenty patients with peripheral vestibular disease participated in the study (mean age 56+/-7.8 years), 10 with and 10 without peripheral neuropathy (age matched). The Dizziness Handicap Inventory and static posturography (eyes open/closed and firm/soft surface) were evaluated prior to rehabilitation and at week 7 of follow-up. Compared to patients without neuropathy, patients with neuropathy had more time elapsed since the diabetes was diagnosed, higher glycemia and HbAc level and higher composite scores on the Dizziness Handicap Inventory, but similar results on static posturography. After rehabilitation, although scores on the Dizziness Handicap Inventory decreased in the two groups, the difference between them persisted. In patients with neuropathy, static posturography showed improvement of postural control only with the eyes closed and soft surface, whereas in patients without neuropathy the postural control improved during all sensory conditions (eyes open/closed and firm/soft surface). In diabetic patients with peripheral vestibular disease, peripheral neuropathy contributes to self-reported disability and may interfere with complete balance recovery.

  17. Exploring Knowledge About Dialysis, Transplantation, and Living Donation Among Patients and Their Living Kidney Donors

    NARCIS (Netherlands)

    L. Timmerman (Lotte); S.Y. Ismail (Sohal); A.E. Luchtenburg; W.C. Zuidema (Wilij); J.N.M. IJzermans (Jan); J.J. van Busschbach (Jan); W. Weimar (Willem); E.K. Massey (Emma)

    2015-01-01

    textabstractBackground: In order to make a well-considered decision and give informed consent about renal replacement therapy, potential living kidney donors and recipients should have sufficient understanding of the options and risks. Purpose: We aimed to explore knowledge about Dialysis &

  18. Handicap i beskæftigelsesindsatsen

    DEFF Research Database (Denmark)

    Kjeldsen, Lena; Amby, Finn

    Ledige med handicap er omfattet af de samme krav og tilbudsmuligheder som andre ledige. Først efter længere tids offentlig forsørgelse, kan særlige indsatser komme på tale. Det er overladt til de kommunale jobcentre, hvilken rolle handicap skal spille i beskæftigelsesindsatsen. Praksis på området...

  19. Malocculusion pattern among Handicapped children in Ibadan ...

    African Journals Online (AJOL)

    Objective: There is paucity of information in Nigeria concerning the occlusal characteristics of handicapped children, yet they need functional and aesthetic consideration comparable to that of 'normal' persons. The aim of this study was to investigate the pattern of malocclusion among the handicapped children in Ibadan, ...

  20. Prevalence Of Dental Abnormalities Among Handicapped Children ...

    African Journals Online (AJOL)

    Efforts to improve the quality of life of handicapped people are on the increase world wide, their oral health inclusive. Relevant data is required for adequate planning for this purpose. A survey of 579 handicapped children was carried out in Lagos to assess the various dental abnormalities among them. Over 34% of them ...

  1. Wage Discrimination against Handicapped Men and Women.

    Science.gov (United States)

    Johnson, William G.; Lambrinos, James

    1985-01-01

    The extent of discrimination against handicapped men and women is estimated in this article. Observed wage differentials are corrected for selectivity bias. Results indicate that almost one-third of the wage differential for men and close to one-half for women can be attributed to discrimination. Handicapped women are also subjected to sex…

  2. Personality and Social Development of Handicapped Children.

    Science.gov (United States)

    Baldwin, Clara P.; Baldwin, Alfred L.

    Discussed are the personality and social development of children with physical handicaps, intellectual difficulties, or social and emotional disturbances, and recommended is the actual observation of the interactions of handicapped children with others in naturalistic situations. Stressed is the importance of pathological social interactions to…

  3. Calcineurin activity in children with Mental handicap.

    Science.gov (United States)

    Bindu, L Hema; Rani, P Usha; Reddy, P P

    2007-09-01

    Calcineurin, a Ca(2+)-Calmodulin dependent protein phosphatase, is important for Ca(2+) mediated signal transduction. The main objective of this study was to examine the potential role of calcineurin in idiopathic mental handicap. Calcineurin levels were estimated in 20 children in the age group of 5-16 years with idiopathic mental handicap attending the Special. Education Centre for the Mentally Handicapped in Hyderabad. The results of the present study showed decreased activity of serum calcineurin in children with idiopathic mental handicap compared to those of normal subjects in the same age group. The observations thus suggest impaired calcineurin activity in children with mental handicap. Calcineurin that is involved in biosynthesis and release of neurotransmitters at the synaptic terminal brain is affected thereby causing brain damage and leading to mental handicap. Impaired calcineurin activity was already indicated in many human diseases such as Down's syndrome, Alzheimers, Brain ischemia, cardiac hypertrophy etc. It is therefore necessary to check the calcineurin levels in children with mental handicap to understand the role of calcineurin in the causation of Mental handicap.

  4. Educating the Handicapped in Biomedical Instrumentation

    Science.gov (United States)

    Rosenbrier, Gilbert N.

    1974-01-01

    Handicapped community college students recruited for a one-year pilot career program (Biomedical Equipment Technology) proved that when architectual barriers are removed, educational and career fulfillment become possible. Innovations introduced to assist handicapped students now benifit every college student; new programs for paraplegics and the…

  5. Euthanasia of Severely Handicapped Infants: Ethical Issues.

    Science.gov (United States)

    Cohen, Libby

    Ethical decisions are involved in life and death decisions for severely handicapped infants. Although it has become common practice for physicians not to treat severely handicapped infants, the ethical considerations involved in euthanasia are complex. A review of the literature reveals that concerns center around the quality of life of the…

  6. Handicap i beskæftigelsesindsatsen

    DEFF Research Database (Denmark)

    Kjeldsen, Lena; Amby, Finn

    2016-01-01

    Ledige med handicap er omfattet af de samme krav og tilbudsmuligheder som andre ledige. Først efter længere tids offentlig forsørgelse, kan særlige indsatser komme på tale. Det er overladt til de kommunale jobcentre, hvilken rolle handicap skal spille i beskæftigelsesindsatsen. Praksis på området...

  7. Individual Educational Programs for Handicapped Learners

    Science.gov (United States)

    Hasbargen, Arthur; Hasbargen, Janet L.

    1978-01-01

    Public Law 94-142, the Education for All Handicapped Children Act, will require home economics teachers to participate in preparing individual educational programs for their handicapped students. The article gives requirements of the law and an example of a teacher-made check list for bathroom skills. (MF)

  8. Student Projects Designed to Aid Handicapped People.

    Science.gov (United States)

    President's Committee on Employment of the Handicapped, Washington, DC.

    Intended for college and university students, the booklet contains ideas for school and community projects to help eradicate the attitudinal and architectural barriers that encumber handicapped individuals. One such project, "Handicap Awareness Week", is described in terms of definition, rationale, objective, and general considerations.…

  9. Physician perceptions about living organ donation in patients with Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Ansari, S; Bromberg, M B; Gibson, S B

    2017-09-01

    Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists. An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure. 52 complete responses were received from 121 invites. 67% (35/52) of neurologists expressed no concerns about living organ donation in ALS patients, and 33% had concerns. The concerns related to respiratory failure, anesthesia exposure and renal dysfunction. With their concerns addressed, 71% of neurologists reported that they would endorse living organ donation. 49% of neurologists reported being asked by a patient for information regarding living organ donation. ALS neurologists felt that 22.8% of ALS patients (median 19%) would be interested in learning more about organ donation, while only 6% of neurologists broach this subject with their patients. Our results indicate that 1 in every 4 ALS patients may be interested in exploring options for living organ donation, and this topic is not routinely addressed by ALS clinics. These results indicate an unexplored area of patient interest. To honor a patient's wishes to donate, the transplant community will have to accommodate living organ donation from terminally ill patients, and address neurologist concerns. Such a practice could benefit two groups of patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Comparison of Voice Handicap Index Scores Between Female Students of Speech Therapy and Other Health Professions.

    Science.gov (United States)

    Tafiadis, Dionysios; Chronopoulos, Spyridon K; Siafaka, Vassiliki; Drosos, Konstantinos; Kosma, Evangelia I; Toki, Eugenia I; Ziavra, Nausica

    2017-09-01

    Students' groups (eg, teachers, speech language pathologists) are presumably at risk of developing a voice disorder due to misuse of their voice, which will affect their way of living. Multidisciplinary voice assessment of student populations is currently spread widely along with the use of self-reported questionnaires. This study compared the Voice Handicap Index domains and item scores between female students of speech and language therapy and of other health professions in Greece. We also examined the probability of speech language therapy students developing any vocal symptom. Two hundred female non-dysphonic students (aged 18-31) were recruited. Participants answered the Voice Evaluation Form and the Greek adaptation of the Voice Handicap Index. Significant differences were observed between the two groups (students of speech therapy and other health professions) through Voice Handicap Index (total score, functional and physical domains), excluding the emotional domain. Furthermore, significant differences for specific Voice Handicap Index items, between subgroups, were observed. In conclusion, speech language therapy students had higher Voice Handicap Index scores, which probably could be an indicator for avoiding profession-related dysphonia at a later stage. Also, Voice Handicap Index could be at a first glance an assessment tool for the recognition of potential voice disorder development in students. In turn, the results could be used for indirect therapy approaches, such as providing methods for maintaining vocal health in different student populations. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  11. Patient's Guide to Living Confidently with Chronic Heart Failure

    Science.gov (United States)

    ... A Patient’s Guide to Living Confidently With Chronic Heart Failure Samuel F. Sears , Lawrence Woodrow , Katherine Cutitta , Jessica ... References Figures & Tables Info & Metrics eLetters Introduction Chronic heart failure (CHF) refers to the ongoing condition of your ...

  12. Employment among Spinal Cord Injured Patients Living in Turkey: A Cross-Sectional Study

    Science.gov (United States)

    Gunduz, Berrin; Erhan, Belgin; Bardak, Ayse Nur

    2010-01-01

    The aim of this study was to determine the rate of employment and to establish the factors affecting vocational status in spinal cord injured patients living in Turkey. One hundred and fifty-two traumatic spinal cord injured patients older than 18 years with injury duration of at least 1 year and living in the community were included in the study;…

  13. Voice handicap and health-related quality of life after treatment for small laryngeal carcinoma.

    Science.gov (United States)

    Killguss, Helen; Gottwald, Frank; Haderlein, Tino; Maier, Andreas; Rosanowski, Frank; Iro, Heinrich; Psychogios, Georgios; Schuster, Maria

    2011-01-01

    Treatment of small carcinoma of the larynx may lead to voice handicap and restricted quality of life. The relationship between the two is revealed. Sixty-five patients aged 62.1 ± 10.0 years rated their voice handicap and quality of life after treatment of T1 (n = 35) or T2 (n = 30) laryngeal carcinoma during regular out-patient examinations. For the self-assessment of the voice, the Voice Handicap Index (VHI) and the disease-independent Short Form-36 Health Survery (SF-36) questionnaires were used. Voice handicap (total score 38.9 ± 26.0) did not differ in the two tested groups, T1 and T2, and the data of SF-36 (physical score 43.0 ± 10.7; mental score 50.2 ± 9.1) showed significant differences for the mental score. Patients rated their voice handicap worse than healthy persons did after treatment of laryngeal carcinoma. VHI and SF-36 data were strongly correlated. Voice handicap is significantly related to the quality of life, especially affecting the mental domain. Thus, the rehabilitation of voice disorders should have a beneficial impact on quality of life. Copyright © 2010 S. Karger AG, Basel.

  14. Patients' knowledge and attitudes regarding living with implantable electronic devices

    DEFF Research Database (Denmark)

    Haugaa, Kristina Hermann; Potpara, Tatjana S; Boveda, Serge

    2018-01-01

    The purpose of this patient survey was to analyse the knowledge, experiences, and attitudes regarding cardiac implantable electronic devices (CIED) in patients with pacemakers, implantable cardioverter-defibrillators (ICDs), or cardiac resynchronization devices. Of the 1644 patients with CIEDs fr...

  15. Development of bladder control in mentally handicapped children

    Directory of Open Access Journals (Sweden)

    Bruschini Homero

    2003-01-01

    Full Text Available PURPOSE:To analyze the role of mental handicap as a possible source of lack of development of bladder control and to find out the chance of continence to advise future patients. MATERIALS AND METHODS: The parents and relatives of 100 consecutive mentally handicapped patients were inquired by a personal interview. Questions included the age when they stopped using diapers, enuretic events, frequency, urgency and leakage episodes, urinary infections. Etiology of their mental problem was unknown in 34, perinatal anoxia in 17, Down syndrome in 15, phenylketonuria in 18 and others minors causes. The grade of mental deficiency were profound in 1, severe in 10, moderate in 39, mild in 33 and normal inferior value in 17. The age varied from 7 to 37 years old, with an average of 14 by the time of the interview, comprising 60 males and 40 females. RESULTS: All profound and severe patients presented leakage episodes regardless of the age. The mild and normal inferior value acquired progressive urinary control with aging, and 33% still remain with urinary symptoms above 16 years old. Urinary infection was similar in males and females, around 29%. The most committed group presented less urinary infections. The etiology of the mental handicap was not correlated to the incidence of urinary leakage. CONCLUSIONS: The lack of bladder control was correlated to the grade of mental handicap. In severe and profound groups, the expectancy of control is disappointing. In the less compromised groups, there is a delay in bladder training, with achievement of control in 2/3 after 16 years of age. Those in the normal inferior value have a chance of postponed urinary control, easily misdiagnosed by normal urological interviews.

  16. 49 CFR Appendix A to Part 609 - Elderly and Handicapped

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Elderly and Handicapped A Appendix A to Part 609..., DEPARTMENT OF TRANSPORTATION TRANSPORTATION FOR ELDERLY AND HANDICAPPED PERSONS Pt. 609, App. A Appendix A to Part 609—Elderly and Handicapped The definitions of the term elderly and handicapped as applied under...

  17. 45 CFR 1151.12 - Qualified handicapped person.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Qualified handicapped person. 1151.12 Section 1151... AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS NONDISCRIMINATION ON THE BASIS OF HANDICAP Standards for Determining Who Are Handicapped Persons § 1151.12 Qualified handicapped person. Qualified...

  18. Handicapped Adolescents and Young Adults in the Justice System.

    Science.gov (United States)

    Keilitz, Ingo; Miller, Susan L.

    1980-01-01

    Questions considered include where in the justice system the handicapped youths are, who they are, how prevalent handicapping conditions are among juvenile offenders, how handicapped youth get in trouble with the law, what is being done to educate handicapped youths in the justice system, and what can be done. (DLS)

  19. Development and validation of a scale for mouth handicap in systemic sclerosis: the Mouth Handicap in Systemic Sclerosis scale

    Science.gov (United States)

    Mouthon, L; Rannou, F; Bérezné, A; Pagnoux, C; Arène, J‐P; Foïs, E; Cabane, J; Guillevin, L; Revel, M; Fermanian, J; Poiraudeau, S

    2007-01-01

    Objective To develop and assess the reliability and construct validity of a scale assessing disability involving the mouth in systemic sclerosis (SSc). Methods We generated a 34‐item provisional scale from mailed responses of patients (n = 74), expert consensus (n = 10) and literature analysis. A total of 71 other SSc patients were recruited. The test–retest reliability was assessed using the intraclass coefficient correlation and divergent validity using the Spearman correlation coefficient. Factor analysis followed by varimax rotation was performed to assess the factorial structure of the scale. Results The item reduction process retained 12 items with 5 levels of answers (total score range 0–48). The mean total score of the scale was 20.3 (SD 9.7). The test–retest reliability was 0.96. Divergent validity was confirmed for global disability (Health Assessment Questionnaire (HAQ), r = 0.33), hand function (Cochin Hand Function Scale, r = 0.37), inter‐incisor distance (r = −0.34), handicap (McMaster‐Toronto Arthritis questionnaire (MACTAR), r = 0.24), depression (Hospital Anxiety and Depression (HAD); HADd, r = 0.26) and anxiety (HADa, r = 0.17). Factor analysis extracted 3 factors with eigenvalues of 4.26, 1.76 and 1.47, explaining 63% of the variance. These 3 factors could be clinically characterised. The first factor (5 items) represents handicap induced by the reduction in mouth opening, the second (5 items) handicap induced by sicca syndrome and the third (2 items) aesthetic concerns. Conclusion We propose a new scale, the Mouth Handicap in Systemic Sclerosis (MHISS) scale, which has excellent reliability and good construct validity, and assesses specifically disability involving the mouth in patients with SSc. PMID:17502364

  20. Living with systemic lupus erythematosus: A patient engagement perspective.

    Science.gov (United States)

    Mazzoni, Davide; Cornet, Alain; van Leeuw, Bernadette; Myllys, Kirsi; Cicognani, Elvira

    2017-07-07

    Patient engagement is recognized as a crucial component of high-quality healthcare services. Among rheumatic diseases, systemic lupus erythematosus (SLE) appears particularly challenging for the engagement of patients in their own care. According to the patient health engagement (PHE) model, patient engagement is a dynamic phenomenon that proceeds through four experiential positions (blackout, arousal, adhesion and eudaimonic project). The aim of the present study was to describe the engagement process from the point of view and the experiences of SLE patients. Ten in-depth interviews and four focus groups were conducted with an international sample of SLE patients from different European countries. Transcripts were analysed through thematic content analysis. Findings showed that a fully engaged patient results from reframing emotional, cognitive and behavioural dimensions. The advances along the process depends on how the patient succeeds in each position. In conclusion, PHE represents an appropriate model by which to understand the engagement process of SLE patients. In order to meet patients' needs, healthcare providers and patient support groups should consider the specific position of SLE patients, providing adequate and tailored support. Copyright © 2017 John Wiley & Sons, Ltd.

  1. The lived experience of patients on mechanical ventilation: research ...

    African Journals Online (AJOL)

    Patients connected to a mechanical ventilator have to endure various experiences and emotions, which are unique to each patient. These patients are subjected to physical and emotional stress, which is related to the unfamiliar surroundings of the intensive care environment and the limitations caused by the process of ...

  2. Would You Want to Be the Patient? "Live Surgical Broadcast" or "As-Live Unedited Surgical Broadcast".

    Science.gov (United States)

    Finch, William; Masood, Junaid; Buchholz, Noor; Turney, Benjamin W; Smith, Daron; Wiseman, Oliver

    2015-07-01

    To evaluate patient safety, educational value, and ethical issues surrounding "Live surgical broadcast" (LSB) and "As-live surgical broadcast" (ALB) using data obtained from urologic delegates attending two recent endourology meetings in the United Kingdom. Two hundred twelve delegates at the UK section meeting of the Société Internationale d'Urologie (SIU) were invited to complete an online survey using SurveyMonkey(®) to compare their previous perceptions of LSB and ALB, and to compare their current experience of ALB to previous experience of LSB. One hundred three delegates at the British Association of Urological Surgeons (BAUS) Endourology meeting used live voting keypads to compare their experience of LSB and ALB simultaneously, as well as comparing their current experience of ALB to previous experience of LSB. Responses were recorded using a Likert scale. One hundred sixty-five responses were analyzed from the meetings. Most delegates were in specialist practice as a consultant or trainee (89.1%). LSB had been witnessed more than ALB (87.1% vs 66.6%, p=0.049). Based on previous experiences, the educational value of both formats was felt similar, but delegates felt there were significant patient safety benefits with ALB over LSB. Delegates were significantly less likely to recommend a friend or family, or volunteer themselves to be a patient in an LSB setting. On-the-day comparison of LSB and ALB shows a similar educational value to both formats, but with significantly less concern for the surgeon and patient's outcome with ALB. ALB offers similar educational opportunities to delegates when compared with LSB, while appearing to offer significant welfare benefits to both surgeon and patient. Further studies are required to objectively quantify these subjective observations.

  3. Correlating voice handicap index and quantitative videostroboscopy following injection laryngoplasty for unilateral vocal paralysis.

    Science.gov (United States)

    Lau, David Pang Cheng; Zhang, Edward Zhiyong; Wong, Seng Mun; Lee, Gwyneth; Chan, Yiong Huak

    2010-08-01

    1) Determine the correlation between voice handicap index and quantitative videostroboscopy for patients undergoing injection laryngoplasty for unilateral vocal paralysis; 2) assess which videostroboscopy measurements correlate best with voice handicap index in patients demonstrating progressive improvement beyond six months following injection laryngoplasty. Case series with chart review. Patients undergoing outpatient injection laryngoplasty with hyaluronic acid between 2005 and 2007. Twenty-eight patients were assessed preoperatively and postoperatively using voice handicap index and videostroboscopy. Various videostroboscopy measurements were quantified: glottic open area (ratio of open to total glottic area during closed phase of phonation), glottic closed phase (frame ratio of closed phase to total glottic cycle), supraglottic compression (percent encroachment of supraglottis onto best-fit ellipse around glottis), wave amplitude (difference in glottic open area between open and closed phases), and wave duration (number of frames per glottic cycle). Correlation coefficients were calculated using Spearman's r. One hundred seventeen separate recordings were analyzed. Correlation coefficients between voice handicap index (normalized to preoperative values) and glottic closed phase showed moderate-strong correlation (r = -0.733, P handicap index improvement beyond six months showed highest correlation with supraglottic compression (r = 0.504, P handicap index correlates best with glottic closed phase, suggesting duration of vocal fold closure during the glottic cycle best represents patients' subjective outcome post-procedure. Progressive improvement in voice handicap index beyond six months may relate to gradual reduction in compensatory supraglottic compression, with moderate correlation. Copyright (c) 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  4. Tinnitus: patients do not have to 'just live with it'.

    Science.gov (United States)

    Newman, Craig W; Sandridge, Sharon A; Bea, Scott M; Cherian, Kay; Cherian, Neil; Kahn, Karyn M; Kaltenbach, James

    2011-05-01

    Tinnitus is distressing and affects the quality of life for many patients. Because primary care physicians may be the entry point for patients seeking help for tinnitus, we urge them to acknowledge this symptom and its potential negative impact on the patient's health and quality of life. Physicians should actively listen to the patient and provide hope and encouragement, but also provide realistic expectations about the course of treatment. The patient must also understand that there may be no singular "cure" for tinnitus and that management may involve multidisciplinary assessment and treatment.

  5. Beskæftigelse og handicap

    DEFF Research Database (Denmark)

    Mølgaard Miiller, Max

    2007-01-01

    SFI udgav i efteråret 2006 rapporten ”Handicap og beskæftigelse” (Miiller m.fl.: 2006), hvis formål var at afdække hvilken udvikling, der har været i handicappedes arbejdsmarkedstilknytning mellem 2002 og 2005. Rapporten viste bl.a., at ca. tre procentpoint flere personer med handicap var kommet i...... arbejde fra 2002 til 2005. Dette notat belyser, hvorvidt den ovennævnte beskæftigelsesudvikling blandt personer med handicap også gælder, når vi iagttager specifikke grupper af handicappede - eksempelvis personer med mobilitetsproblemer eller personer med en psykisk lidelse. Vi har derfor afgrænset...... personer med handicap ud fra fire typer af funktionshæmning (Mobilitetsproblemer, Sanse- og kommunikationsproblemer, Psykiske lidelser, Andre sygdomme) og på den baggrund undersøgt udviklingen i gruppernes tilknytning til arbejdsmarkedet fra 2002 til 2005....

  6. Creative Dramatics: An Outlet for Mental Handicaps

    Science.gov (United States)

    Blumberg, Marvin L.

    1976-01-01

    The United Cerebral Palsy of Queens Center conducted a creative dramatics workshop for mental handicaps. Main objectives of the workshop were personality development and social improvement toward better job potential in the outside employment situation. (TA)

  7. Driver's Licences for the handicapped in Canada.

    Science.gov (United States)

    Csapo, Marg; Clarke, Bryan R.

    1985-01-01

    The article reviews Canada's Guide for Physicians in Determining Fitness to Drive a Vehicle and then considers sections of provincial motor vehicle acts that regulate the issuance of licenses to the handicapped. (CL)

  8. Telling the story and re-living the past: How speech analysis can reveal emotions in post-traumatic stress disorder (PTSD) patients

    NARCIS (Netherlands)

    van den Broek, Egon; van der Sluis, Frans; Dijkstra, Ton; Westerink, Joyce; Krans, Martijn; Ouwerkerk, Martin

    A post-traumatic stress disorder (PTSD) is a severe stress disorder and, as such, a severe handicap in daily life. To this date, its treatment is still a big endeavor for therapists. This chapter discusses an exploration towards automatic assistance in treating patients suffering from PTSD. Such

  9. Quality of life outcomes in patients living with stoma.

    Science.gov (United States)

    Anaraki, Fakhrialsadat; Vafaie, Mohamad; Behboo, Roobic; Maghsoodi, Nakisa; Esmaeilpour, Sahar; Safaee, Azadeh

    2012-09-01

    Despite efforts to maintain the intestinal tissue and treat gastrointestinal disease, a large number of patients undergo ostomy surgery each year. Using stoma reduces the patient's quality of life (QOL) greatly. Although there are approximately 3000 patients in Iran; there is little information about the impact of stoma on their QOL. The study aims to evaluate QOL of stoma patients using a special measurement tool. This survey was a cross-sectional study that was conducted on 102 random samples of stoma patients. The City of Hope Quality of Life-Ostomy Questionnaire was used for collecting demographic and clinical information and evaluating QOL. Univariate and multiple regression analyses were performed to identify predictors of QOL. The mean score for the overall QOL for stoma patients was 7.48 ± 0.9. 70% of patients were dissatisfied with sexual activities. More than half of them reported feelings of depression following stoma surgery. Univariate analysis indicated that factors such as the type of ostomy (temporary/permanent), the underlying disease that had led to the stoma, depression, problem with location of ostomy, and change in clothing style had significant effects on overall QOL and its subscales (P patients' QOL and its subscales (P stoma influences the overall aspect of QOL. Education for the patients and their families is important for improving the stoma patients' QOL. Sexual and psychological consultation may also improve patients' QOL.

  10. Changes in the Tinnitus Handicap Questionnaire After Cochlear Implantation

    Science.gov (United States)

    Pan, Tao; Tyler, Richard S.; Ji, Haihong; Coelho, Claudia; Gehringer, Anne K.; Gogel, Stephanie A.

    2010-01-01

    Purpose To determine (a) changes in the Tinnitus Handicap Questionnaire (THQ) for patients using cochlear implants, (b) differences between patients who receive total or partial relief, and (c) identifiable characteristics of those who report tinnitus after implantation. Method Pre- and postoperatively, 244 adults were administered the THQ when they reported tinnitus. Results Of the 153 patients who had tinnitus preoperatively, 94 (61%) patients reported total suppression and 59 (39%) reported a partial reduction. In 91 patients who did not have tinnitus before implantation, 11 (12%) reported tinnitus postimplantation. The THQ score decreased from 41% preimplant to 30% postimplant. The largest reductions involved social handicap and hearing. Patients with a more severe hearing loss might be more likely to experience an exacerbation of their tinnitus. We were not able to clearly identify differences between patients who received total or partial relief and the characteristics of patients who reported tinnitus after implantation. Those who acquired tinnitus had the shortest duration hearing loss (5.6 years) and were the oldest (63 years). The average THQ score of patients getting tinnitus was 29%. Conclusions Most tinnitus patients benefit from receiving a cochlear implant. PMID:19949236

  11. Handicap principle implies emergence of dimorphic ornaments.

    Science.gov (United States)

    Clifton, Sara M; Braun, Rosemary I; Abrams, Daniel M

    2016-11-30

    Species spanning the animal kingdom have evolved extravagant and costly ornaments to attract mating partners. Zahavi's handicap principle offers an elegant explanation for this: ornaments signal individual quality, and must be costly to ensure honest signalling, making mate selection more efficient. Here, we incorporate the assumptions of the handicap principle into a mathematical model and show that they are sufficient to explain the heretofore puzzling observation of bimodally distributed ornament sizes in a variety of species. © 2016 The Author(s).

  12. Impact of a temporary stoma on patients' everyday lives

    DEFF Research Database (Denmark)

    Danielsen, Anne K; Soerensen, Erik E; Burcharth, Kirsten

    2013-01-01

    -focused coping strategies. These strategies may be supported when patients have a high sense of coherence. Furthermore, patients' disclosure of the stoma as a way to master feelings of stigma should be facilitated. Stoma education is central for patients, and group-based learning that involves lay educators...... perspective. METHODS: Data were processed using qualitative content analysis. RESULTS: The creation of a temporary stoma led to feelings of uncertainty related to being in an undecided situation. Stoma creation led to feelings of stigma and worries about disclosure. Patients proposed group-based patient...... education with lay educators with a stoma to make sure that information about the stoma was based on real-life experiences. CONCLUSIONS: Creation of a temporary stoma was linked to uncontrollable feelings of uncertainty. Professionals should assist patients with focus on coping strategies...

  13. Handicap Labelings of 4-Regular Graphs

    Directory of Open Access Journals (Sweden)

    Petr Kovar

    2017-01-01

    Full Text Available Let G be a simple graph, let f : V(G→{1,2,...,|V(G|} be a bijective mapping. The weight of v ∈ V(G is the sum of labels of all vertices adjacent to v. We say that f is a distance magic labeling of G if the weight of every vertex is the same constant k and we say that f is a handicap magic labeling of G if the weight of every vertex v is l + f(v for some constant l. Graphs that allow such labelings are called distance magic or handicap, respectively. Distance magic and handicap labelings of regular graphs are used for scheduling incomplete tournaments. While distance magic labelings correspond to so called equalized tournaments, handicap labelings can be used to schedule incomplete tournaments that are more challenging to stronger teams or players, hence they increase competition and yield attractive schemes in which every games counts. We summarize known results on distance magic and handicap labelings and construct a new infinite class of 4-regular handicap graphs.

  14. The Complexity of the Patient Perspective of Living with Atrial Fibrillation

    DEFF Research Database (Denmark)

    Høgh, Vibeke; Riahi, Sam; Delmar, Charlotte

    2017-01-01

    ’ perspective of living with atrial fibrillation by combining qualitative and quantitative data sources and methods. Related to a one-year patient journey of living with paroxysmal atrial fibrillation it is here illustrated how scores from questionnaires can be explored by supporting the scores with qualitative...

  15. Pre-Placement Program for Severely Multi-Handicapped Blind Children. 1974-1975 School Year. Evaluation Report.

    Science.gov (United States)

    Silverman-Dresner, Toby

    Presented is an evaluation of a pre-placement program designed to improve the performance of 15 multi-handicapped blind children (4-10 years old) in activities of daily living, and to involve the parents in the children's education. Among findings reported are that all but one of the Ss improved in activities of daily living as measured by the…

  16. Quality of Life Outcomes in Patients Living with Stoma

    Science.gov (United States)

    Anaraki, Fakhrialsadat; Vafaie, Mohamad; Behboo, Roobic; Maghsoodi, Nakisa; Esmaeilpour, Sahar; Safaee, Azadeh

    2012-01-01

    Background: Despite efforts to maintain the intestinal tissue and treat gastrointestinal disease, a large number of patients undergo ostomy surgery each year. Using stoma reduces the patient's quality of life (QOL) greatly. Although there are approximately 3000 patients in Iran; there is little information about the impact of stoma on their QOL. Aims: The study aims to evaluate QOL of stoma patients using a special measurement tool. Settings and Design: This survey was a cross-sectional study that was conducted on 102 random samples of stoma patients. Materials and Methods: The City of Hope Quality of Life-Ostomy Questionnaire was used for collecting demographic and clinical information and evaluating QOL. Statistical Analysis Used: Univariate and multiple regression analyses were performed to identify predictors of QOL. Results: The mean score for the overall QOL for stoma patients was 7.48 ± 0.9. 70% of patients were dissatisfied with sexual activities. More than half of them reported feelings of depression following stoma surgery. Univariate analysis indicated that factors such as the type of ostomy (temporary/permanent), the underlying disease that had led to the stoma, depression, problem with location of ostomy, and change in clothing style had significant effects on overall QOL and its subscales (P ostomy were statistically significant in predicting patients’ QOL and its subscales (P Sexual and psychological consultation may also improve patients’ QOL. PMID:23439841

  17. The lived experience of patients on mechanical ventilation: research ...

    African Journals Online (AJOL)

    1994: 152). An independent coder verified the identified major themes, namely: experiences of patients related to the process of ventilation, as well as their experiences of the environment while connected to the ventilator. A literature control ...

  18. State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma.

    Science.gov (United States)

    Saman, Yougan; Mclellan, Lucie; Mckenna, Laurence; Dutia, Mayank B; Obholzer, Rupert; Libby, Gerald; Gleeson, Michael; Bamiou, Doris-Eva

    2016-01-01

    Evidence is emerging for a significant clinical and neuroanatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety, and there is a relationship between increased state anxiety and worsening balance function. (1) To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit. (2) To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. Two separate cohorts of vestibular schwannoma (VS) patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials, and caloric responses) and questionnaire assessments [vertigo handicap questionnaire (VHQ), vertigo symptom scale (VSS), and state-trait anxiety inventory (STAIY)]. Fifteen post-resection VS patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1). Forty-five patients with VS in situ formed the cohort for Experiment 2 (Aim 2). Experiment 1: VS subjects (N = 15) with a complete post-resection unilateral vestibular deafferentation completed a state anxiety questionnaire before caloric assessment and again afterward with the point of maximal vertigo as the reference (Aim 1). Experiment 2: state anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of patients with VS in situ presenting with balance symptoms (Group 1, N = 26) and without balance symptoms (Group 2, N = 11) (Aim 2). The presence of balance symptoms was defined as having a positive score on the VSS-VER. In Experiment 1, a significant difference (p handicap (p < 0.001). Anxiety

  19. Effect of a 0.5% chlorhexidine gel on dental plaque superinfecting microorganisms in mentally handicapped patients Efeito do gel de clorexidina a 0,5% em microrganismos superinfectantes da placa bacteriana de portadores de necessidades especiais

    Directory of Open Access Journals (Sweden)

    Cláudio Mendes Pannuti

    2003-09-01

    Full Text Available A randomized clinical trial was conducted to investigate the effect of a 0.5% chlorhexidine (CHX gel on dental plaque superinfecting microorganisms in mentally handicapped patients. Thirty inmates from the institution "Casas André Luiz" were assigned to either test group (CHX gel, n = 15 or control group (placebo gel, n = 15. The gel was administered over a period of 8 weeks. Supragingival plaque samples were collected at baseline, after gel use (8 weeks and 16 weeks after baseline. The presence of Gram-negative Enterobacteriaceae, Staphylococcus and yeasts was evaluated. No significant growth of any superinfecting microorganism was observed in the CHX group, when compared to the placebo group. The results indicated that the 0.5% chlorhexidine gel did not produce an undesirable shift in these bacterial populations.Foi conduzido um ensaio clínico aleatório com objetivo de investigar o efeito do gel de clorexidina (CHX a 0,5% sobre microorganismos superinfectantes da placa bacteriana de pacientes especiais. Trinta internos da instituição "Casas André Luiz" foram aleatoriamente divididos em grupo teste (gel de CHX, n = 15 e controle (gel placebo, n = 15. O gel foi utilizado por oito semanas. Amostras de placa supragengival foram coletadas no início do estudo, após o uso do gel (oito semanas e 16 semanas após o início do estudo. Foi avaliada a presença de bacilos entéricos Gram-negativos, Staphylococcus e leveduras. Não houve diferença entre os grupos quanto à presença desses microorganismos em qualquer momento do estudo. Os resultados indicam que o gel de CHX não provocou mudanças significativas na composição desses microorganismos.

  20. Does surgery improve live birth rates in patients with recurrent miscarriage caused by uterine anomalies?

    Science.gov (United States)

    Sugiura-Ogasawara, M; Lin, B L; Aoki, K; Maruyama, T; Nakatsuka, M; Ozawa, N; Sugi, T; Takeshita, T; Nishida, M

    2015-02-01

    We found that congenital uterine anomalies have a negative impact on reproductive outcome in recurrent-miscarriage couples, being associated with further miscarriage with a normal embryonic karyotype. There has been no study comparing live birth rates between patients with and without surgery. We conducted a prospective study to prove that surgery for a bicornuate or septate uterus might improve the live birth rate. A total of 170 patients with congenital uterine anomalies suffering two or more miscarriages were examined. The live birth rate after ascertainment of anomalies, cumulative live birth rate and infertility rate, were compared between patients with and without surgery. In patients with a septate uterus, the live birth rate (81.3%) at the first pregnancy after ascertainment of anomalies with surgery tended to be higher than that (61.5%) in those without surgery. The infertility rates were similar in both groups, while the cumulative live birth rate (76.1%) tended to be higher than without surgery (60.0%). Surgery showed no benefit in patients with a bicornuate uterus for having a baby, but tended to decrease the preterm birth rate and the low birth weight. The possibility that surgery has benefits for having a baby in patients with a septate uterus suffering recurrent miscarriage could not be excluded.

  1. Pathogenic Free-Living Amoebae Isolated From Contact Lenses of Keratitis Patients

    Directory of Open Access Journals (Sweden)

    Elham HAJIALILO

    2015-12-01

    Full Text Available Background: Free-living amoeba (FLA-related keratitis is a progressive infection of the cornea with poor prognosis. The present study aimed to investigates the con­tact lenses of patients with keratitis for pathogenic free-living amoebae.Methods: Overall, 62 contact lenses and their paraphernalia of patients with kerati­tis cultured and tested for the presence of free-living amoebae using morphological criteria. Unusual plates including plates containing mix amoebae and Vermamoeba were submitted to molecular analysis. Results: Out of 62 plates, 11 revealed the outgrowth of free living amoeba of which 9 were Acanthamoeba, one plates contained mix amoebae including Acan­thamoeba and Vermamoeba and one showed the presence of Vermamoeba. These two latter plates belonged to patients suffered from unilateral keratitis due to the mis­used of soft contact lenses. One of the patients had mix infection of Acanthamoeba (T4 and V. vermiformis meanwhile the other patient was infected with the V. vermiformis. Conclusion: Amoebic keratitis continues to rise in Iran and worldwide. To date, various genera of free-living amoebae such as Vermamoeba could be the causative agent of keratitis. Soft contact lens wearers are the most affected patients in the country, thus awareness of high-risk people for preventing free-living amoebae re­lated keratitis is of utmost importance.

  2. Effect of live music therapy for patients undergoing magnetic resonance imaging.

    Science.gov (United States)

    Walworth, Darcy D

    2010-01-01

    The purpose of the current study was to identify the effects of live music therapy interventions compared with preferred recorded music for patients undergoing MRI scans. To date, there has not been a published study involving the use of live music therapy during MRI scans. The current study investigated the differences between teenage through adult patients receiving live music therapy intervention during outpatient MRI scans versus the standard protocol of care listening to recorded music (N = 88). Subjects ranged in age from 15 to 93 years old. Results indicated subjects who received the live music therapy protocol reported significantly better perception of the MRI procedure (p music therapy protocol had fewer scans repeated due to movement. Of the repeated images, 26% occurred in the live music group and 73% occurred in the recorded music group. Subjects receiving live music therapy also requested less breaks from the scan. Two percent of the live music subjects requested a break and 17.6% of the control patients requested breaks. When comparing the same type of scan between groups, subjects receiving the live music protocol required less time to complete the scans. For lumbar scans without contrast (N = 14, n = 7, n = 7), live music subjects spent an average of 4.63 less min per scan for a total of 32 less min for 7 subjects. For brain scans (N = 8, n = 4, n = 4), live music subjects spent an average of 5.8 less min per scan for a total of 23 less min for 4 subjects. Results of the current study supports the use of live music therapy intervention for teenage and adult patients undergoing MRI scans to reduce patient anxiety and improve patient perception of the scan experience. Additionally, live music therapy has the potential to shorten the length of time required for patients to complete MRI scans due to decreased patient movements and fewer breaks requested during the scans. The cost savings impact of reduced procedure time can positively impact the

  3. A Retrospective Study Concerning the Psychosocial Impact of Voice Disorders : Voice Handicap Index Change in Patients With Benign Voice Disorders After Treatment (Measured With the Dutch Version of the VHI)

    NARCIS (Netherlands)

    Bouwers, Frans; Dikkers, Frederik G.

    The goal of this study was to gain better understanding of psychosocial effects of benign voice problems as measured with the Dutch version of the Voice Handicap Index (VHI). The effect of voice problems on daily life differs from person to person. Over the last few decades there has been a growing

  4. Living with a parastomal bulge - patients' experiences of symptoms

    DEFF Research Database (Denmark)

    Krogsgaard, Marianne; Thomsen, Thordis; Vinther, Anders

    2017-01-01

    by the stoma. To cover the physical disfigurement, new clothing solutions, garment wear and creativity were essential in everyday life. Patients gradually adapted to the bulge over time. Easy access to professional help was crucial in order to find the best appliance and garment solution in relation...... is limited and highly warranted to improve clinical outcome. RELEVANCE TO CLINICAL PRACTICE: The ever-changing bulge posed a threat to patients' control of the ostomy and required specific care from the stoma therapist. Needs-based access to counselling, advice and supplementary materials is important....

  5. [Evaluation of endoscopic live case demonstrations--the patient's and participant's perspective].

    Science.gov (United States)

    Pfeifer, U G; Neuhaus, H

    2015-10-01

    Benefits and ethics of live demonstrations of endoscopic interventions as part of educational meetings are controversial. Of particular importance is the acceptance and satisfaction of patients treated and the opinion of the participants of the courses. A validated questionnaire was sent to all patients who were treated in live demonstrations at the Düsseldorf International Endoscopy Symposium (DIES) in the years 2008-2014. In addition, all participants completed evaluation forms of the same events were evaluated in order to determine the benefits of live performances. The assessments were carried out with evaluations 1-6 (1=very good, 6=very poor). Of 174 patients, 76 written questionnaires were returned, of which 70 were evaluable (40.2%). The rate of satisfaction with the course of treatment and stay in the endoscopy department was 80.8%. The vast majority of patients (84.1%) did not feel that a wrong treatment option was chosen, and only a few (6.7%) questioned the expertise of the treating physician. 83% of respondents felt also at the nurses in good hands. For three-quarters of patients surveyed (74.3%), the quality of life has improved as a result of the measures in the live demonstrations. Of 10,004 participants of the symposia, 6770 evaluation forms were filled out. Mean scores of below 2 were rated for questions about the quality of patient care from a medical and ethical point of view as well as for questions about the learning effect through live demonstrations compared to canned videos. The vast majority of patients treated within live demonstrations as part of the DIES is satisfied with the course, treatment and patient care and outcomes. Congress participants assess the educational value of the live broadcasts as well as patient care in medical and ethical terms as good to very good. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Adherence to rehabilitative programmes by patients living with ...

    African Journals Online (AJOL)

    ... of it are not easily established. Contributing factors however were noted in this study. Information obtained from the study will assist health professionals to understand the patients' context and can inform rehabilitation programmes to support adherence. Keywords: Adherence, rehabilitation, stroke, physiotherapy, quality ...

  7. The Knowledge, Perception, and Attitude of Patients Living with ...

    African Journals Online (AJOL)

    ABSTRACT. Background: In the developing countries, most patients present with advanced disease or glaucoma blindness. This has been attributed to lack of awareness and poor knowledge as major contributing factors. The outcome of glaucoma management, however, depends largely on the understanding and ...

  8. The knowledge, perception, and attitude of patients living with ...

    African Journals Online (AJOL)

    Background: In the developing countries, most patients present with advanced disease or glaucoma blindness. This has been attributed to lack of awareness and poor knowledge as major contributing factors. The outcome of glaucoma management, however, depends largely on the understanding and perception of the ...

  9. Support through patient internet-communities: Lived experience of Russian in vitro fertilization patients

    Directory of Open Access Journals (Sweden)

    Olga G. Isupova

    2011-07-01

    Full Text Available The article is concerned with the life experiences of infertile women going through infertility treatment and their need for social and psychological support, which they try to find in their immediate social environment. The Internet has become one place where everyone can find “people like oneself.” The best support is received from these people who are in the same life situation and are able and willing to share their lived experiences with each other. Communication via the Internet and the formation of a virtual community of patients has both positive and negative aspects, all of which are examined in the article. On the one hand, it creates a psychologically favorable atmosphere and might potentially increase the success rate of IVF treatment. On the other, this leads to the seclusion of patients within the circle of “similar people” and sometimes to negative attitudes towards people outside the circle. The article is based on the author's “netnography” research of a virtual community of Russian In-Vitro Fertilization (IVF1 patients.

  10. Support through patient internet-communities: Lived experience of Russian in vitro fertilization patients.

    Science.gov (United States)

    Isupova, Olga G

    2011-01-01

    The article is concerned with the life experiences of infertile women going through infertility treatment and their need for social and psychological support, which they try to find in their immediate social environment. The Internet has become one place where everyone can find "people like oneself." The best support is received from these people who are in the same life situation and are able and willing to share their lived experiences with each other. Communication via the Internet and the formation of a virtual community of patients has both positive and negative aspects, all of which are examined in the article. On the one hand, it creates a psychologically favorable atmosphere and might potentially increase the success rate of IVF treatment. On the other, this leads to the seclusion of patients within the circle of "similar people" and sometimes to negative attitudes towards people outside the circle. The article is based on the author's "netnography" research of a virtual community of Russian In-Vitro Fertilization (IVF)(1) patients.

  11. Activities of daily living and lesion position among multiple sclerosis patients by Bayes network☆

    Science.gov (United States)

    Pan, Zhifang; Lu, Hongtao; Cheng, Qi

    2013-01-01

    Magnetic resonance imaging is a highly sensitive approach for diagnosis of multiple sclerosis, and T2-weighted images can reveal lesions in the cerebral white matter, gray matter, and spinal cord. However, the lesions have a poor correlation with measurable clinical disability. In this study, we performed a large-scale epidemiological survey of 238 patients with multiple sclerosis in eleven districts by network member hospitals in Shanghai, China within 1 year. The involved patients were scanned for position and size of lesions by MRI. Results showed that lesions in the cerebrum, spinal cord, or supratentorial position had an impact on the activities of daily living in multiple sclerosis patients, as assessed by the Bayes network. On the other hand, brainstem lesions were very unlikely to influence the activities of daily living, and were not associated with the position of lesion, patient's gender, and patient's living place. PMID:25206427

  12. Vocal effort and voice handicap among teachers.

    Science.gov (United States)

    Sampaio, Márcio Cardoso; dos Reis, Eduardo José Farias Borges; Carvalho, Fernando Martins; Porto, Lauro Antonio; Araújo, Tânia Maria

    2012-11-01

    The relationship between voice handicap and professional vocal effort was investigated among teachers in a cross-sectional study of census nature on 4496 teachers within the public elementary education network in Salvador, Bahia, Brazil. Voice handicap (the outcome of interest) was evaluated using the Voice Handicap Index 10. The main exposure, the lifetime vocal effort index, was obtained as the product of the number of years working as a teacher multiplied by the mean weekly working hours. The prevalence of voice handicap was 28.8% among teachers with high professional vocal effort and 21.3% among those with acceptable vocal effort, thus yielding a crude prevalence ratio (PR) of 1.36 (95% confidence interval [CI]=1.14-1.61). In the final logistic model, the prevalence of voice handicap was statistically associated with the professional vocal effort index (PR=1.47; 95% CI=1.19-1.82), adjusted according to sex, microphone availability in the classroom, excessive noise, pressure from the school management, heartburn, and rhinitis. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  13. Hand Hygiene Saves Lives: Patient Admission Video (Short Version)

    Centers for Disease Control (CDC) Podcasts

    2008-05-01

    This podcast is for hospital patients and visitors. It emphasizes two key points to help prevent infections: the importance of practicing hand hygiene while in the hospital, and that it's appropriate to ask or remind healthcare providers to practice hand hygiene.  Created: 5/1/2008 by National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID).   Date Released: 4/26/2010.

  14. Sexual Experiences of Chinese Patients Living With an Ostomy.

    Science.gov (United States)

    Zhu, Xiaomei; Chen, Yongyi; Tang, Xinhui; Chen, Yupan; Liu, Yangyu; Guo, Wei; Liu, Aizhong

    The purpose of this study was to examine the sexual experience of Chinese patients with ostomy and associated factors. A prospective descriptive study using self-report questionnaires. Seventy-five Chinese participants who underwent ostomy surgery in a large cancer specialist hospital in the Hunan province between 2008 and 2013. Data were collected face-to-face by the investigators in an outpatient setting from 75 participants who completed the Arizona Sexual Experience Inventory Scale (ASEX). The t test was used to compare variances between sexual function and dysfunction subgroups. A multiple linear regression model was used to analyze factors influencing sexual life after ostomy surgery. The mean ASEX score was 20.56 (5.378) years, which is higher than the standard for sexual dysfunction. The main subsection of sexual dysfunction included sexual arousal, orgasm ability, vaginal lubrication/penile erection, and sexual satisfaction. Significant differences in the ASEX score were observed in subgroups of age, gender, educational level, family relations, operation modes, stoma type, operation time, complications, supporters, self-care ability, and sexual life guidance. Multiple stepwise regression analysis indicated that family relations, operation modes, ostomy type, complications, and sexual life guidance affected sexual experience. The findings of this study demonstrate that patients with ostomy experience sexual dysfunction and many factors influence their quality of sexual life. WOC nurses and other healthcare providers should consider providing sexual health education for both the patient and spouse to improve the self-care capacity and quality of sexual life following ostomy surgery.

  15. Living with encapsulating peritoneal sclerosis (EPS): the patient's perspective.

    Science.gov (United States)

    Hurst, Helen; Summers, Angela; Beaver, Kinta; Caress, Ann-Louise

    2014-01-01

    Although relatively rare, encapsulating peritoneal sclerosis (EPS) is nonetheless a major concern within the renal community. Risk of developing EPS is associated with long-term peritoneal dialysis (PD). High mortality was previously reported, although surgery has since improved outcomes. Research into EPS focuses on imaging and early detection methods, genetics, biomarkers and preventive strategies. No previous studies have examined patients' experiences of EPS. The aim of the present study was to explore the experience of patients who have undergone surgery for EPS in one center in the North of England. A qualitative phenomenological approach, involving in-depth interviews, was adopted. Nine participants were recruited out of a total of 18 eligible. Most participants were interviewed twice over a 12-month period (October 2009 to October 2010). Interpretive data analysis was conducted, following the philosophical tradition of hermeneutics, to draw out themes from the data. Data collection and analysis took place concurrently and participants were sent a summary of their first interview to allow a period of reflection prior to the subsequent interview. EPS presented the most serious challenge participants had faced since developing chronic kidney disease (CKD). Three major themes were identified, each with subcategories. The key issues for patients were related to identification of early symptoms and lack of understanding. The patients' sense of 'not being heard' by health care professionals led to a loss of trust and enhanced their feelings of uncertainty. The enormity of the surgery, the suffering, and what they had to endure had an enormous impact, but an overriding aspect of this experience was also the loss they felt for their independence and for the PD therapy over which they had control. The findings of this study highlight a number of important issues relevant to clinical practice, including lack of information and understanding of EPS, particularly its

  16. Patients living in impoverished areas have more severe ischemic strokes.

    Science.gov (United States)

    Kleindorfer, Dawn; Lindsell, Christopher; Alwell, Kathleen A; Moomaw, Charles J; Woo, Daniel; Flaherty, Matthew L; Khatri, Pooja; Adeoye, Opeolu; Ferioli, Simona; Kissela, Brett M

    2012-08-01

    Initial stroke severity is one of the strongest predictors of eventual stroke outcome. However, predictors of initial stroke severity have not been well-described within a population. We hypothesized that poorer patients would have a higher initial stroke severity on presentation to medical attention. We identified all cases of hospital-ascertained ischemic stroke occurring in 2005 within a biracial population of 1.3 million. "Community" socioecomic status was determined for each patient based on the percentage below poverty in the census tract in which the patient resided. Linear regression was used to model the effect of socioeconomic status on stroke severity. Models were adjusted for race, gender, age, prestroke disability, and history of medical comorbidities. There were 1895 ischemic stroke events detected in 2005 included in this analysis; 22% were black, 52% were female, and the mean age was 71 years (range, 19-104). The median National Institutes of Health Stroke Scale was 3 (range, 0-40). The poorest community socioeconomic status was associated with a significantly increased initial National Institutes of Health Stroke Scale by 1.5 points (95% confidence interval, 0.5-2.6; P<0.001) compared with the richest category in the univariate analysis, which increased to 2.2 points after adjustment for demographics and comorbidities. We found that increasing community poverty was associated with worse stroke severity at presentation, independent of other known factors associated with stroke outcomes. Socioeconomic status may impact stroke severity via medication compliance, access to care, and cultural factors, or may be a proxy measure for undiagnosed disease states.

  17. Potential factors, including activities of daily living, influencing home discharge for patients with putaminal haemorrhage.

    Science.gov (United States)

    Maeshima, Shinichiro; Okamoto, Sayaka; Okazaki, Hideto; Mizuno, Shiho; Asano, Naoki; Maeda, Hirofumi; Masaki, Mitsuko; Matsuo, Hiroshi; Tsunoda, Tetsuya; Sonoda, Shigeru

    2016-02-01

    Convalescent rehabilitation wards assist stroke patients in acquiring skills for activities of daily living to increase the likelihood of home discharge. However, an improvement in activities of daily living does not necessarily imply that patients are discharged home. We investigated the characteristics of patients with putaminal haemorrhage who are discharged home following convalescence in rehabilitation wards. The sample comprised 89 patients (58 men and 31 women) with putaminal haemorrhage hospitalised in the convalescent rehabilitation ward of our hospital between August 2012 and July 2013. Their age ranged from 29 to 88 years (61.9 ± 11.9 years). The lesion occurred on the right side in 48 and on the left in 41 patients. The mean period from onset to hospitalisation in the convalescent rehabilitation ward was 30.8 ± 17.2 days, and the mean hospitalisation period was 70.7 ± 31.8 days. We examined age, sex, haematoma volume, duration from onset to hospitalisation, neurological symptoms, cognitive function, functional independence measure, number of cohabitating family members and whether the patient lived alone before stroke, and the relationship among these factors and discharge destination (home or facility/hospital) was assessed. The discharge destination was home for 71 and a facility or hospital for 18 patients. Differences were observed in age, haematoma volume, neurological symptoms, cognitive function, functional independence measure score on admission and discharge, number of cohabitating family members and whether the patient lived alone before stroke for patients discharged home. Patients who required long-term care and were discharged home were more likely to be living with family members who were present during daytime. Home discharge was possible if functional independence measure score was ≥70 at the time of discharge for motor items and ≥24 for cognitive items, even if a patient lived alone before stroke. Although the

  18. [Benefits of routine psychological counselling for patients living with HIV].

    Science.gov (United States)

    Toma, S; Sartori, M; Moayedoddin, B; Weber, K; Toutous Trellu, L; Canuto, A; Calmy, A

    2013-02-13

    Despite improvement of life expectancy of human immunodeficiency virus (HIV) infected people since the implementation of antiretroviral treatment, psychological suffering prevails and needs to be considered as part of the treatment to guarantee its efficiency. Mental disorders and social stigmatization substantially affect patients' quality of life and their adherence to treatment. The article details the benefits of a routine screening for mental disorders within this population, who is often reluctant to consult psychiatric services. The different treatments provided by the Geneva University Hospital (HUG) are introduced. A clinical case report illustrates the relevance of a multidisciplinary care program and the role of the liaison psychiatry in this field.

  19. Jordanian teachers' perceptions of voice handicap.

    Science.gov (United States)

    Marie, Basem S; Natour, Yaser S; Haj-Tas, Maisa A

    2014-07-01

    This study aimed to investigate if Jordanian school teachers perceive their voice as handicapped using the Voice Handicap Index (VHI)-Arab. The effect of teachers' age, gender, years of teaching, class taught, and education level on VHI was examined. A total of 289 teachers and a control group of 100 participants took part in the study. The teachers' group differed significantly from the control group in the physical, emotional, and functional subscales and the total score of the VHI-Arab. There was no significant difference among teachers in any of the three VHI subscales or total regarding gender, age, years of teaching experience, education level, and classes taught. Jordanian teachers have a strong perception of voice handicap. Thus, preventive and treatment vocal programs are strongly advised.

  20. Physical strain during activities of daily living of patients with coronary artery disease

    NARCIS (Netherlands)

    Nieuwenburg-van Tilborg, E. M.; Horstman, A. M.; Zwarts, B.; de Groot, S.

    The purpose of this study was to determine the physical strain of activities of daily living (ADL) in patients with coronary artery disease (CAD) compared with healthy controls. Seventeen patients with CAD and 15 controls performed a graded exercise bicycle test and 5 ADL tasks: walking with/without

  1. Evaluation of Instrumental Activities of Daily Living in Greek Patients with Advanced Cancer

    Science.gov (United States)

    Mystakidou, Kyriaki; Parpa, Efi; Tsilika, Eleni; Panagiotoua, Irene; Roumeliotou, Anna; Symeonidi, Matina; Galanos, Antonis; Kouvaris, Ioannis

    2013-01-01

    Translation of the instrumental activities of daily living (IADL) was carried out and its psychometric properties were assessed in a Greek sample of patients with advanced cancer. The scale was translated with the forward-backward procedure into the Greek language. It was initially administered to 136 advanced cancer patients. To assess…

  2. Craniofacial morphology of orthodontically untreated patients living in Saxony, Germany.

    Science.gov (United States)

    Reich, U; Dannhauer, K H

    1996-08-01

    The subject of this study is an analysis of the possible specific ethnic characteristics of the craniofacial morphology within the Saxon population. For this purpose we analyzed, in a cephalometric cross-sectional study, lateral cephalometric radiographs taken between 1992 and 1994 of 10,047 orthodontically untreated native Saxon patients. The cephalometric analysis used was a synthesis of several classic procedures as applied at Leipzig University. Among the sagittal parameters there was a relatively high prevalence of mandibular retrognathism and skeletal distal jaw relationship. The vertical parameters displayed a relatively good balance between vertical and horizontal growth patterns. With respect to sexual dimorphism, the differences in the angular parameters and in the indices of relationship were only moderate and so almost irrelevant in clinical terms. Among the age-related changes, the focus is on the increase in the degree of prognathism of both jaws and the anterior rotation of the mandible.

  3. Significant differences in struvite and cystine stone frequency seen among Chinese nephrolithiasis patients living in North America compared to those living in China.

    Science.gov (United States)

    Chi, Thomas; Usawachintachit, Manint; Filippou, Pauline; Bayne, David; Hu, Weiguo; Chang, Helena; Xia, Lei; Chen, Qi; Xue, Wei; He, Hui; Long, Qingzhi; Arsovska, Olga; Taylor, Eric; Paterson, Ryan; Sur, Roger L; Chew, Ben; Stoller, Marshall L; Li, Jianxing

    2016-06-01

    Interracial disparities in nephrolithiasis prevalence have been reported, but the interplay between genetics and the environment for urinary stone disease risk factors is poorly understood. To examine how environment may alter genetic predisposition for stone formation, we established the International Chinese Consortium on Nephrolithiasis (ICCON) as a multi-institutional collaboration to examine patterns of nephrolithiasis presentation between Chinese patients living in different countries. Chinese patients undergoing percutaneous nephrolithotomy (PCNL) at six participating institutions in China and North America over 4 years were reviewed retrospectively. Patient demographics and clinical data were compared between Chinese patients living in China and North America. A total of 806 patients were included, encompassing 721 Chinese patients living in China and 85 living in North America. Nephrolithiasis patients living in China were more likely to be male (67% vs. 56%, P=0.02), present at a younger age (48.6±15.0 vs. 55.0±13.0 years, P<0.01), and have a lower BMI (24.6±4.0 vs. 25.9±5.7, P=0.04) but were less likely to form struvite stones (5.5% vs. 14.1%, P<0.01). No cystine stone patients were seen in North American Chinese patients, whereas 1.8% of nephrolithiasis patients living in China presented with cystine stones. Similar rates of calcium-based and uric acid calculi as well as urinary pH were seen among both groups. Significant differences exist between Chinese nephrolithiasis patients living in China compared to those living in North America, highlighting the importance of environmental factors in addition to genetics in modulating risk for urinary stone disease.

  4. Handicapped Infants and Euthanasia: A Challenge to Our Advocacy.

    Science.gov (United States)

    Smith, J. David

    1985-01-01

    The issue of pediatric euthanasia for handicapped newborns is examined and contrasting viewpoints emphasizing the quality and the sanctity of life are considered. The author asserts that advocacy for handicapped children involves decisions regarding the euthanasia question. (CL)

  5. The Art therapy's methods use at work with handicapped children

    OpenAIRE

    Němcová, Jindřiška

    2011-01-01

    The thesis deals with using art therapy's methods and technique by multi-handicapped children. The first chapter characterizes multi-handicap, defines various disorders and their influence on the personality of a child. The second chapter introduces the therapy options which can be applied to multi-handicapped children, with a strong accent on artetherapy. In the third chapter there are various artetherapic methods and techniques which can be applied to multi-handicapped children. The fourth ...

  6. The use of "lives saved" measures in nurse staffing and patient safety research: statistical considerations.

    Science.gov (United States)

    Diya, Luwis; Van den Heede, Koen; Sermeus, Walter; Lesaffre, Emmanuel

    2011-01-01

    Lives saved predictions are used to quantify the impact of certain remedial measures in nurse staffing and patient safety research, giving an indication of the potential gain in patient safety. Data collected in nurse staffing and patient safety are often multilevel in structure, requiring statistical techniques to account for clustering in the data. The purpose of this study was to assess the impact of model specifications on lives saved estimates and inferences in a multilevel context. A simulation study was carried out to assess the impact of model assumptions on lives saved predictions. Scenarios considered were omitting an important covariate, taking different link functions, neglecting the correlations coming from the multilevel data structure, and neglecting a level in a multilevel model. Finally, using a cardiac surgery data set, predicted lives saved from the random intercept logistic model and the clustered discrete time logistic model were compared. Omitting an important covariate, neglecting the association between patients within the same hospital, and the complexity of the model affect the prediction of lives saved estimates and the inferences thereafter. On the other hand, a change in the link function led to the same predicted lives saved estimates and standard deviations. Finally, the lives saved estimates from the two-level random intercept model were similar to those of the clustered discrete time logistic model, but the standard deviations differed greatly. The results stress the importance of verifying model assumptions. It is recommended that researchers use sensitivity analyses to investigate the stability of lives saved results using different statistical models or different data sets.

  7. New Surge of Syphilis among Patients Living with Human Immunodeficiency Virus in Martinique in 2015.

    Science.gov (United States)

    Putot, Alain; Rozé, Benoît; Pierre-François, Sandrine; Pircher, Mathilde; Vilain, Rosalie; Miossec, Charline; Desbois, Nicole; Hochedez, Patrick; Guitteaud, Karine; Laudarin, Ingrid; Abel, Sylvie; Cabié, André

    2017-09-01

    A syphilis outbreak began in Martinique, French Antilles, in 2004, initially among men who had sex with men (MSM) and who were living with human immunodeficiency virus (HIV). The outbreak subsequently affected all groups at risk, leading to a first epidemic peak in 2008. After an initial decrease, the outbreak started growing again in 2014 among patients living with HIV with unprecedented incidence among MSM. Herein, we describe the change in medical and social parameters of the outbreak since 2005.

  8. [Relationships between Half-Lives of Dioxins and SNPs in AhR among Yusho Patients].

    Science.gov (United States)

    Matsumoto, Shinya; Akahane, Manabu; Kanagawa, Yoshiyuki; Kajiwara, Jumboku; Tsukimori, Kiyomi; Wake, Norio; Mitoma, Chikage; Uchi, Hiroshi; Furue, Masutaka; Imamura, Tomoaki

    2015-05-01

    Half-lives of blood levels of 2,3,4,7,8-Pentachlorodibenzofuran (PeCDF) are varied in Yusho patients. The objective was to evaluate a relationship between half-lives of PeCDF levels and types of SNP rs10249788 of aryl hydrocarbon receptor (AHR) gene in 93 Yusho patients. Based on physical symptoms, age, sex, body mass index and other factors, we set up suitable calculation formulas to fit the actual PeCDF levels thorough rates of change in PeCDF. We found that patients with C/T SNP had longer half lives than patients with C/C and T/T SNPs. Patients with T/T SNP are known to express higher amount of AHR mRNAs. However, detailed analysis could not be carried out in T/T group due to a limited number of patients (n = 11). Further research is warranted to determine the cause of the longer half-lives in C/T patients.

  9. What is the impact of giant cell arteritis on patients' lives? A UK qualitative study.

    Science.gov (United States)

    Liddle, Jennifer; Bartlam, Roisin; Mallen, Christian D; Mackie, Sarah L; Prior, James A; Helliwell, Toby; Richardson, Jane C

    2017-08-23

    Clinical management of giant cell arteritis (GCA) involves balancing the risks and burdens arising from the disease with those arising from treatment, but there is little research on the nature of those burdens. We aimed to explore the impact of giant cell arteritis (GCA) and its treatment on patients' lives. UK patients with GCA participated in semi-structured telephone interviews. Inductive thematic analysis was employed. 24 participants were recruited (age: 65-92 years, time since diagnosis: 2 months to >6 years). The overarching themes from analysis were: ongoing symptoms of the disease and its treatment; and 'life-changing' impacts. The overall impact of GCA on patients' lives arose from a changing combination of symptoms, side effects, adaptations to everyday life and impacts on sense of normality. Important factors contributing to loss of normality were glucocorticoid-related treatment burdens and fear about possible future loss of vision. The impact of GCA in patients' everyday lives can be substantial, multifaceted and ongoing despite apparent control of disease activity. The findings of this study will help doctors better understand patient priorities, legitimise patients' experiences of GCA and work with patients to set realistic treatment goals and plan adaptations to their everyday lives. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. An Age and Body Mass Handicap for the Marathon

    Science.gov (United States)

    Vanderburgh, Paul M.

    2015-01-01

    An age and body mass handicap has been previously developed and validated for the 5-kilometer (5K) run. The purpose of this study was to develop a similar handicap for the marathon but with a different age adjustment based on deviations from age group world best marathon times within each sex. The resulting handicap allowed finish time comparisons…

  11. 38 CFR 21.51 - Determining employment handicap.

    Science.gov (United States)

    2010-07-01

    ... handicap. 21.51 Section 21.51 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS.... Chapter 31 Initial and Extended Evaluation § 21.51 Determining employment handicap. For the purposes of § 21.50, an employment handicap will be found to exist only if a CP or VRC determines that the...

  12. 34 CFR 75.610 - Access by the handicapped.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Access by the handicapped. 75.610 Section 75.610... by a Grantee? Construction § 75.610 Access by the handicapped. A grantee shall comply with the Federal regulations on access by the handicapped that apply to construction and alteration of facilities...

  13. 36 CFR 910.34 - Accommodations for the physically handicapped.

    Science.gov (United States)

    2010-07-01

    ... physically handicapped. 910.34 Section 910.34 Parks, Forests, and Public Property PENNSYLVANIA AVENUE... § 910.34 Accommodations for the physically handicapped. (a) Every development shall incorporate features which will make the development accessible by the physically handicapped. The standards in the “American...

  14. 38 CFR 21.52 - Determining serious employment handicap.

    Science.gov (United States)

    2010-07-01

    ... employment handicap. 21.52 Section 21.52 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... 38 U.S.C. Chapter 31 Initial and Extended Evaluation § 21.52 Determining serious employment handicap. (a) Requirements for determining serious employment handicap. For each individual who is found to...

  15. Involving Handicapped Cub Scouts: Cubmaster's Guide. Cub Scout Leader Development.

    Science.gov (United States)

    Boy Scouts of America, New Brunswick, NJ.

    The Cub Scout Leader Development Guide is designed to train adult leaders to conduct discussions and set up activities that foster understanding and involvement of the handicapped in den and pack programs. Stressed are development of the handicapped individual's ability and potential as well as similarities between handicapped and nonhandicapped…

  16. Handicap og beskæftigelse i 2006

    DEFF Research Database (Denmark)

    Høgelund, Jan; Larsen, Brian; Kløft Schademan, Helle

    Denne rapport giver ny viden om beskæftigelsessituationen for personer med handicap. Den viser, at personer med handicap er lige så tilfredse med deres arbejde, som personer uden handicap, og at de oplever at de har de samme jobkrav og de samme muligheder for indflydelse og udvikling, og de har s...

  17. The lived experience of fibromyalgia in female patients, a phenomenological study

    OpenAIRE

    Wuytack Francesca; Miller Peter

    2011-01-01

    Abstract Background Fibromyalgia is a chronic syndrome with no cure. A thorough understanding of the illness experience is therefore key in the palliative care of patients with this condition. In search for supportive treatments fibromyalgia patients often attend a chiropractor or other manual therapist. Knowledge of the meaning and reality of living with this condition to the patient could be considered essential to any health care practitioner playing a role in the management. This study ai...

  18. Social participation in home-living patients with mild Alzheimer's disease

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Villemoes; Waldorff, Frans Boch; Waldemar, Gunhild

    2007-01-01

    The purpose of this study was to investigate social participation in home-living patients with mild Alzheimer's disease (AD) and to identify predictors for low social participation. The study was based on baseline data from 330 home-living patients with mild AD who participated in The Danish...... Alzheimer Intervention Study (DAISY). Proxy-obtained information from primary caregiver assessed patients' social participation. The result showed that low social participation was present in mild AD. Significant independent predictors of low social participation were impairment in activities of daily...... living (ADL) and neuropsychiatric symptoms. The findings from this study add to the literature that social impairment is present even in the mild stage of AD. The findings underscore the importance of assessing social participation in mild AD as soon as few ADL skills are lost....

  19. Correlation between Cognitive Functions and Activity of Daily Living among Post-Stroke Patients

    Directory of Open Access Journals (Sweden)

    Kurniawan Prakoso

    2016-09-01

    Full Text Available Background: Cognitive impairment is one of the most common post-stroke complications; however, neither patients nor health professionals are often aware of this complication. The impact of cognitive impairment on quality of life is reflected through basic activity daily living (bADL and instrumental activity daily living (IADL. Prior studies concerning the correlation between cognitive impairment and activity daily living has shown contradictive results. This study was conducted in order to analyze the correlation between the cognitive functions and activity daily living in post stroke patients at Dr. Hasan Sadikin General Hospital. Methods: This cross-sectional study was carried out to 23 post-stroke patients from September–November 2015. Samples were collected through consecutive sampling at Dr. Hasan Sadikin General Hospital. Mini Mental State Examination (MMSE was used to assess the cognitive functions and Lawton and Brody Scale to assess both bADL and IADL. Spearman correlation was selected to analyze the existing correlation between each cognitive domain and activity daily living. Results: Spearman statistical correlation showed an insignificant correlation between the cognitive functions and bADL (r2=0.181, p=0.408 and a significant correlation with IADL was obtained (r2=0.517, p=0.03. The only cognitive domain positively correlated with IADL was orientation to time and verbal recall. Conclusions: There is a correlation between cognitive functions and IADL among post-stroke patients at Dr. Hasan Sadikin General Hospital.

  20. Living with bipolar disorder: the impact on patients, spouses, and their marital relationship.

    Science.gov (United States)

    Granek, Leeat; Danan, Dor; Bersudsky, Yuly; Osher, Yamima

    2016-03-01

    Patients with bipolar disorder are characterized by an unusually high divorce rate. As such, the purpose of the present study was to uncover information relating specifically to the impact of bipolar disorder on patients and spouses individually, and on the marital relationship from the perspectives of both patients and spouses. Eleven patients with bipolar disorder and ten spouses were interviewed separately about the impact of bipolar disorder on their lives and on their marital relationship. Data were analyzed using the grounded theory method. The impact of bipolar disorder for spouses included self-sacrifice, caregiving burden, emotional impact, and a sense of personal evolution. The impact of bipolar disorder on patients included an emotional impact, responsibility for self-care, and struggling socially and developmentally. When comparing patient and spouse perspectives on the impact of the disorder, neither the patient nor the spouse was able to accurately assess the impact of the disorder on their partner's lives. The impact of bipolar disorder on the relationship included volatility in the relationship, strengthening the relationship, weakening the relationship, and family planning. The research indicated that patients and partners alike struggle with the tremendous impact of bipolar disorder on their lives and on their relationships. Given the high rates of divorce and volatility in these relationships, healthcare professionals can provide (or refer to) emotional and practical support both to patients and spouses on their own, and as a couple in their clinics. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Use of standardized patients to teach medical students about living organ donation.

    Science.gov (United States)

    Bramstedt, Katrina A; Moolla, Ariff; Rehfield, Patricia L

    2012-03-01

    Educators routinely use standardized patients to teach medical students a variety of clinical concepts. Standardized patients have also been used to teach students about medical ethics and deceased organ donation. Not reported before, however, is the use of standardized patients to educate medical students about the ethical issues in living organ donation. It seems important to fill this gap because in the United States, roughly 45% of organ donors are living donors, and these patients will visit physicians throughout their lifespan, not just with the occurrence of donation. This article reports an experience teaching concepts in living donation and transplant ethics to second-year osteopathic medicine students using a standardized patient and supplementary instructional materials (eg, film, panel discussion, reading list). Specifically, a transplant ethics module was created that included an actor portraying a living donor candidate who had a number of case variables pertaining to medical and psychosocial matters. Instructional themes included informed consent, altruism, patient selection criteria, organ vending, and post-donation support systems.

  2. Psychological distress longitudinally mediates the effect of vertigo symptoms on vertigo-related handicap.

    Science.gov (United States)

    Probst, Thomas; Dinkel, Andreas; Schmid-Mühlbauer, Gabriele; Radziej, Katharina; Limburg, Karina; Pieh, Christoph; Lahmann, Claas

    2017-02-01

    Vertigo symptoms can lead to more or less vertigo-related handicap. This longitudinal study investigated whether depression, anxiety, and/or somatization mediate the relationship between vertigo symptoms and vertigo-related handicap. N=111 patients with vertigo/dizziness provided complete data on the following measures: Vertigo symptoms at baseline, depression at 6-month follow-up, anxiety at 6-month follow-up, somatization at 6-month follow-up, and vertigo handicap at 12-month follow-up. Mediation analyses with bootstrapping were performed to investigate the mediating role of anxiety, depression, and somatization in the relationship between vertigo symptoms and vertigo-related handicap. When the mediating role of anxiety, depression, and somatization was evaluated separately from each other in single mediation models, the effect vertigo symptoms at baseline exerted on vertigo-related handicap at 12-month follow-up was significantly mediated by depression at 6-month follow-up (phandicap at 12-month follow-up (phandicap. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The subjective handicap of epilepsy. A new approach to measuring treatment outcome.

    Science.gov (United States)

    O'Donoghue, M F; Duncan, J S; Sander, J W

    1998-02-01

    It is now widely acknowledged that the impact of epilepsy on the individual extends beyond the occurrence of seizures, and that there is a need for outcome measures sensitive to these consequences. Until now these instruments have largely been developed within a 'quality of life' framework. The technical and conceptual difficulties that arise with measuring quality of life have led us to develop a more focused measurement model, the 'Subjective Handicap of Epilepsy' (SHE) scale, based on the World Health Organization's concept of handicap. The scale contains 32 items in six subscales: 'Work and activities' (eight items), 'Social and personal' (four items), 'Self-perception' (five items), 'Physical' (four items), 'Life-satisfaction' (four items) and a 'Change' scale (seven items); and it takes on average handicapping effects of increasing seizure frequency, employment status, the impact of epilepsy on career choice and the subject's own opinion as to the major determinant of their quality of life. The scales were also sensitive, retrospectively, to the benefits of successful epilepsy surgery in a cohort of 105 patients. Scales focusing specifically on handicap were more sensitive to group differences in seizure frequency in the clinic population, and to outcome after epilepsy surgery, than the 'Life-satisfaction' scale and the Epilepsy Surgery Inventory 55 (ESI-55) scales. This supports the contention that measuring 'subjective handicap' may be a more sensitive, and more useful, approach to assessing the impact of interventions on the long-term consequences of epilepsy than current methods.

  4. Temporal tuning of daily rhythms helps advanced cancer patients and cancer survivors feel better, live better, and live longer

    Directory of Open Access Journals (Sweden)

    Hrushesky W

    2016-01-01

    Full Text Available William Hrushesky,1–5 James F Grutsch,6 Dinah Faith Q Huff,1 Linda Tavolacci,7 Thomas Kazlausky7 1Oncology Analytics, Inc., Plantation, FL, USA; 2South Carolina College of Pharmacy, 3Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; 4Hollings Cancer Center, 5Department of Public Health Science, Medical University of South Carolina, Charleston, SC, USA; 6Department of Epidemiology and Biostatistics, University of Illinois School of Public Health, Chicago, IL, USA; 7Ambulatory Monitoring, Inc., Ardsley, NY, USA Abstract: There is now little doubt that disrupted day/night (circadian time structures are involved in the initiation and promotion of neoplastic disease. It has been established that the incidence of breast cancer, colorectal cancer, and prostate cancer is increased as a result of nocturnal exposure to light and circadian function disruption and that cancer patient survival is diminished. So the question is: what public health measures can be implemented to minimize these health hazards? In addition, untreated cancer patients experience the symptom cluster of brief, interrupted, and poor nighttime sleep; depressed mood/anxiety; daytime fatigue/lethargy; and anorexia/early satiety/diminished taste sensation – each of which is virtually pathognomonic of a disrupted circadian temporal organization. Direct measurements of patients' activities and their timing and intensity using actigraphy reveal that untreated cancer patients experience severe deterioration in the robustness (amplitude and day-to-day phase stability of their daily rest/activity rhythms – and one of the most personal and socially destructive results of such circadian disorientation is unplanned, unwanted, and avoidable temporal isolation from family, friends, and society. Thus, therapeutic manipulation of the circadian clock is a powerful tool for improving cancer patients' quality of life (QOL, making life more worth living and perhaps

  5. Information Prosthetics for the Handicapped. Final Report.

    Science.gov (United States)

    Papert, Seymour A.

    The paper describes the successful use of the LOGO System (an interactive graphics, computer based learning environment) with 12 severely physically handicapped adolescents with cerebral palsy. Five goals were set forth concerning the opportunity to work with microcomputers in interesting ways, the assessment of the students' spatial competence,…

  6. Predictors of Choral Directors' Voice Handicap

    Science.gov (United States)

    Schwartz, Sandra

    2013-01-01

    Vocal demands of teaching are considerable and these challenges are greater for choral directors who depend on the voice as a musical and instructive instrument. The purpose of this study was to (1) examine choral directors' vocal condition using a modified Voice Handicap Index (VHI), and (2) determine the extent to which the major variables…

  7. Evaluating Behavioural Observation Audiometry with Handicapped Children.

    Science.gov (United States)

    Flexer, Carol; Gans, Donald P.

    1982-01-01

    Three observers evaluated the responses to sound with 21 mild to severely handicapped children (7 months to 10 years old) on Behavioural Observation Audiometry, an alternative to conditioning paradigms in audiometric assessment. Results showed that inter-observer agreement was high and that responsitivity was not affected by stimulus presentation…

  8. Nutritional Assessment of Children with Handicapping Conditions.

    Science.gov (United States)

    Brown, Judith E.; And Others

    1979-01-01

    Discusses the methods and results of a nutritional assessment involving 64 noninstitutionalized children (ages 2-19 years) with various types of handicapping conditions. It is explained that, in general, children were smaller in weight and height than average and frequently consumed unbalanced diets. (Author/PHR)

  9. Injuries in Handicapped Alpine Ski Racers.

    Science.gov (United States)

    McCormick, David P.

    1985-01-01

    A study of 68 handicapped skiers showed a rate of two injuries per 1,000-skier days. Disabled skiers, while risking the same injuries as nondisabled skiers, also have problems related to their disabilities. A particular hazard for amputee skiers is the outrigger injury. Recommendations to reduce the injury rate are presented. (MT)

  10. Deaf Blind Children: Evaluating Their Multiple Handicaps.

    Science.gov (United States)

    Curtis, Scott, Ed.; And Others

    Prepared by specialists on the evaluation team at the Syracuse University Center for the Development of Blind Children, the book describes the procedures of the special diagnostic clinic within this unit. The diagnostic clinic was established to provide a unified approach to the evaluation and study of multiply handicapped children. Described in…

  11. Employer Duties to Accommodate Handicapped Employees.

    Science.gov (United States)

    Lehr, Richard I.

    1980-01-01

    Examines proposed legislation that would add handicapped individuals to Title VII of the Civil Rights Act of 1964. Discusses the appropriateness of this proposal, the coverage of the act, the accomodation requirements to be imposed on employers, and the advisability of having the Equal Employment Opportunity Commission administer the legislation.…

  12. Ureteric complications in live related donor renal transplantation - impact on graft and patient survival

    Directory of Open Access Journals (Sweden)

    A Srivastava

    2004-01-01

    Full Text Available Objective : The study was performed with an aim to determine the incidence of ureteric complications in live related donor renal transplantation, and to study the effect of ureteric complications on long term graft and patient survival. Patients And Methods: Records of 1200 consecutive live related renal transplants done from 1989-2002 were reviewed. Twenty-six ureteric complications were noted to occur and treatment modalities employed were documented. In the non complication group sufficient data for evaluation was available in 867 patients. Survival analysis were performed using Kaplan-Meier techniques. Results: The overall incidence of urological complications is 2.9%. Complications occurred at a mean interval of 31.9 days after renal transplantation. Ureteric complications occurred in 2% patients with stented and 7.7% patients with non stented anastomosis (p=0.001. Mean follow up following renal transplantation was 37.4 months. Survival analysis showed that ureteric complications did not increase the risk of graft fai lu re or patient death. Conclusions: Ureteric complications in live related donor renal transplantation occurred in 2.9 % patients and did not impair graft and patient survival.

  13. STATE ANXIETY, SUBJECTIVE IMBALANCE AND HANDICAP IN VESTIBULAR SCHWANNOMA

    Directory of Open Access Journals (Sweden)

    Yougan Saman

    2016-07-01

    Full Text Available ABSTRACTEvidence is emerging of a significant clinical and neuro-anatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety and there is a relationship between increased state anxiety and worsening balance function. Aims1.To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit.2.To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. MethodsTwo separate cohorts Vestibular Schwannoma (VS patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials and caloric responses and questionnaire assessment (Vertigo handicap Questionnaire, Vertigo Symptom Scale, State Trait Anxiety InventoryFifteen post resection Vestibular schwannoma patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1. Forty-five patients with VS in-situ and with preserved vestibular function formed the cohort for Experiment 2 (Aim 2. Experiment 1: VS subjects (N=15 with a complete post-resection unilateral vestibular deafferentation completed a State anxiety questionnaire before caloric assessment and again afterwards with the point of maximal vertigo as the reference (Aim 1. Experiment 2: State anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of presenting with balance symptoms (Group 1 N=26 and without balance symptoms (Group 2 N=11 (Aim 2. The presence of balance symptoms was defined as having a positive score on the VSS-VER.ResultsIn experiment 1, a significant difference (p<0.01 was found when comparing

  14. Pattern of microbial translocation in patients living with HIV-1 from Vietnam, Ethiopia and Sweden

    Directory of Open Access Journals (Sweden)

    Samir Abdurahman

    2014-01-01

    Full Text Available Introduction: The role of microbial translocation (MT in HIV patients living with HIV from low- and middle-income countries (LMICs is not fully known. The aim of this study is to investigate and compare the patterns of MT in patients from Vietnam, Ethiopia and Sweden. Methods: Cross-sectional samples were obtained from treatment-naïve patients living with HIV-1 and healthy controls from Vietnam (n=83; n=46, Ethiopia (n=9492; n=50 and Sweden (n=51; n=19. Longitudinal samples were obtained from a subset of the Vietnamese (n=24 in whom antiretroviral therapy (ART and tuberculostatics were given. Plasma lipopolysaccharide (LPS, sCD14 and anti-flagellin IgG were determined by the endpoint chromogenic Limulus Amebocyte Assay and enzyme-linked immunosorbent assay. Results: All three biomarkers were significantly increased in patients living with HIV-1 from all countries as compared to controls. No differences were found between males and females. Vietnamese and Ethiopian patients had significantly higher levels of anti-flagellin IgG and LPS, as compared to Swedes. ART reduced these levels for the Vietnamese. Vietnamese patients given tuberculostatics at initiation of ART had significantly lower levels of anti-flagellin IgG and higher sCD14. The biomarkers were lower in Vietnamese who did not develop opportunistic infection. Conclusions: Higher MT is common in patients living with HIV compared to healthy individuals, and in patients from LMICs compared to patients from a high-income country. Treatment with tuberculostatics decreased MT while higher levels of MT are associated with a poorer clinical outcome.

  15. Handicap og beskæftigelse i 2014. Regionale forskelle

    DEFF Research Database (Denmark)

    Larsen, Malene Rode; Høgelund, Jan

    Denne rapport belyser tilknytningen til arbejdsmarkedet blandt personer med handicap i første kvartal 2014. Rapporten belyser blandt andet, om der er regionale forskelle i beskæftigelsen for personer med handicap, samt om beskæftigelsesudviklingen for personer med handicap har været den samme i de...... fire regioner. Desuden undersøges bl.a. kendskabet til beskæftigelsesrettede støtteordninger for personer med handicap samt holdningen blandt beskæftigede personer til at have en kollega med handicap i de fire regioner. Rapporten skal ses i sammenhæng med rapporten ”Handicap og beskæftigelse...... – udviklingen mellem 2002 og 2014”(SFI-rapport 15:06), som belyser beskæftigelsen blandt personer med handicap på landsplan....

  16. From handicap to disability: language use and cultural meaning in the United States.

    Science.gov (United States)

    Devlieger, P J

    1999-07-01

    The historical shift in discourse regarding disabled persons in the US is analysed by its core terms, handicap and disability. First, this shift in discourse is illustrated in the marketplace and in the context of the Americans with Disabilities Act. Then, discourse shifts are theoretically explicated through a semiotic and historical analysis. Last, the discouse shifts are theoretically explicated through a semiotic and historical analysis. Last, the discourses of handicap and disability are tested in their societal context, especially in the case of American youngsters who have directly experienced the shift in their own life course. Changes in terminology reflect a different logic of the understanding of disability as phenomenon. While 'handicap' reflects an era in which accessibility is central for understanding and practice, the concept of 'disability' shifted the attention to the individual's ability. The impact of such large discourse shifts is tangible in the lives of individuals with mental retardation in the experiences that shift from 'access' to 'ability'. Whereas in the handicap era, access is to be created, in the disability era this is replaced by ability. Professionals are reminded that the rehabilitation process takes on different meanings with shifting discourses.

  17. Improved neurologic prognosis for a patient with propionic acidemia who received early living donor liver transplantation.

    Science.gov (United States)

    Nagao, Masayoshi; Tanaka, Toju; Morii, Mayuko; Wakai, Shuji; Horikawa, Reiko; Kasahara, Mureo

    2013-01-01

    Despite medical therapy, patients with propionic academia (PA) still display a tendency to develop epilepsy. Patients with neonatal-onset PA who have received early living donor liver transplantation (LDLT) are limited in number, and the effect on neurologic prognosis, including epilepsy, is not clear. We report a patient with PA whose EEG findings improved dramatically after undergoing LDLT at age 7 months. The patient's neurologic development and brain MRI findings were quite satisfactory at age 2 years and 3 months. LDLT is effective not only in preventing metabolic decompensation, but also in improving neurologic function to ensure better quality of life. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. The relation of vocal fold lesions and voice quality to voice handicap and psychosomatic well-being.

    Science.gov (United States)

    Smits, R; Marres, H; de Jong, Felix

    2012-07-01

    Voice disorders have a multifactorial genesis and may be present in various ways. They can cause a significant communication handicap and impaired quality of life. To assess the effect of vocal fold lesions and voice quality on voice handicap and psychosomatic well-being. Female patients, aged 18-65 years, who were referred to the outpatient clinic with voice problems were subsequently assessed. Laryngostroboscopic examination and acoustic voice analysis were carried out, and the patients were asked to fill in the Voice Handicap Index (VHI) and Symptom Check List-90 questionnaires. Eighty-two patients were included. In 43 patients (52.4%), a vocal fold lesion was observed. The VHI and psychosomatic well-being did not differ significantly between patients with and without a vocal fold lesion. The patients with a vocal fold lesion showed lower scores on the Dysphonia Severity Index (DSI) compared with those without a vocal fold lesion. However, the DSI was not correlated with voice handicap and psychosomatic well-being, except for the VHI physical subscale. Objective measurement does not necessarily correlate with the subjective appraisal of the patient's voice handicap and psychosomatic well-being. Furthermore, the criterion of the presence of a vocal fold lesion as the base of indemnity that is applied by health insurance institutions should be questioned. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  19. Promoting Cardiovascular Health in Patients Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome.

    Science.gov (United States)

    Harris, Robin

    2018-03-01

    Patients living with human immunodeficiency virus/acquired immunodeficiency syndrome (PLWHA) are at increased risk of cardiovascular disease because of advances in human immunodeficiency virus/acquired immunodeficiency syndrome treatment and increased life expectancy. Cardiovascular health promotion in PLWHA includes strategies for risk factor reduction, disease prevention, early detection, and treatment of cardiovascular disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Lived experiences of Rwandan ICU nurses caring for patients with a ...

    African Journals Online (AJOL)

    Additional education about DNR orders as well as policies to guide its implementation could assist ICU nurses in their difficult work. S Afr J Crit ... body of knowledge. The purpose of the study was to explore the lived experiences of nurses caring for a patient with a DNR order in an ICU in Kigali, Rwanda. Methods. Using a ...

  1. Effectiveness of interventions influencing activities of daily living on visually impaired patients: a systematic review.

    NARCIS (Netherlands)

    Poot, E.; Mistiaen, P.; Hickox, S.; Wagner, C.

    2003-01-01

    Visually impaired patients have difficulty in performing the activities of daily living (ADL). For example, one study found that 21% of the participants had trouble with dressing or undressing, 25 % with mobility at home, and 31 % with eating and drinking. Another study showed that 27,5% experience

  2. A review of quality of care for patients living with diabetes at ...

    African Journals Online (AJOL)

    A review of quality of care for patients living with diabetes at Chitungwiza Central Hospital, Zimbabwe. ... to become a systematic part of diabetes service provision, with continuous encouragement of staff and strong leadership from hospital management, in order to prevent negative consequences of poor diabetes control.

  3. Living with a permanent intestinal stoma: changes tolo by patients with a stoma

    OpenAIRE

    Renata Furlani; Maria Filomena Ceolim

    2002-01-01

    This study relates to the first part of a study developed with persons with permanent intestinal stomas, assisted in specialized outpatient clinics in Campinas, SP (Brazil), aiming to identify the information provided to these patients about their stoma and their difficulties in living with this device. It was verified that patients received insufficient information concerning the stoma before the surgery, what could have contributed to postoperative fears and difficulties in adaptation to th...

  4. Extent of Burden and coping among family Caregivers living with schizophrenic patients in Nepal

    OpenAIRE

    kali kumari pun; Gouping He; Xiu Hua Wang

    2014-01-01

    Caring for schizophrenic patient is an enduring affect among family caregivers and gives substantial amount of burden. None any research has carried out to know the extent of burden among family caregivers of schizophrenia in Nepal. The aim of this study was to explore the extent of burden and identify coping strategies adopted by family caregivers living with schizophrenic patient. A descriptive cross sectional study was undertaken to assess the extent of burden and coping, using purposive s...

  5. Outcomes of transplants from patients with small renal tumours, live unrelated donors and dialysis wait-listed patients.

    Science.gov (United States)

    Brook, Nicholas R; Gibbons, Norma; Johnson, David W; Nicol, David L

    2010-05-01

    We report the outcomes of renal transplant patients (n = 43) who received grafts from donors (n = 41) with small (live unrelated transplants (LURTs) (n = 120) and to patient survival on the transplant waiting list for those who did not receive a kidney during this period (n = 153). Patient survival at 1, 3 and 5 years were 92%, 88% and 88% for recipients of tumourectomized kidneys (TKs), 99%, 97% and 97% for LURTs, and 98%, 92% and 74% for dialysis patients waiting for a deceased donor kidney (log rank score 10.4, P = 0.005). One patient experienced a local tumour recurrence at 9 years following transplantation. This patient declined intervention and is currently under active surveillance. Transplantation of tumourectomized kidneys from patients with small, localized, incidentally detected renal tumours results in similar outcomes to conventional LURTs and confers a significant survival advantage for patients who would otherwise be unable to receive a transplant.

  6. Passion for Life: Lived Experiences of Patients after Coronary Artery Bypass Graft

    Directory of Open Access Journals (Sweden)

    Nooredin Mohammadi

    2015-12-01

    Full Text Available Background: Coronary artery bypass graft surgery (CABG improves the quality of life, increases survival, and influences the patient's mental and emotional aspects. Little information is available on the lived experience of Iranian patients after this surgery. Understanding the lived experiences of patients will help health professionals with better provision of high quality care.Methods: This hermeneutic phenomenological study aimed to understand the lived experience of patients after CABG.  Van Manen's method was used to conduct the study. A semi-structured, face-to-face interview technique was employed to explore the experiences of the patients following surgery. Seven men and 4 women between 49 and 80 years old were interviewed. Results: Passion for life was the main theme extracted from the participants’ interviews. This theme comprised the three sub-themes of receiving attention from family, being hopeful, and being spiritually oriented.Conclusion:  The results showed that the participants experienced passion for life after their surgery. This finding reveals that patients tend to find a new perspective on life and their health after surgery.

  7. The importance of orthoses on activities of daily living in patients with unilateral lower limb amputations.

    Science.gov (United States)

    Onat, Sule Sahin; Ünsal-Delialioğlu, Sibel; Özel, Sumru

    2017-01-01

    The role of the selected prothesis on activities of daily living (ADL). To evaluate the impact of prothesis on ADL in patients with lower-limb amputations. The data of 500 patients with unilateral lower limb amputation were recorded. The activity level was defined based on the Medicare Functional Classification Level. Old and new prescribed prosthesis were recorded. Nottingham Extended Activities of daily living activities Daily Living Scale was used to evaluate ADL. Amputation levels were transfemoral (TF) in 268 (53.6%), transtibial (TT) in 178 (35.6%), knee disarticulation (KD) in 54 (10.8%). In patients with TF and KD amputation active vacuum system, pin modular system, hydraulic system and mechanical modular prosthesis were replaced with the swing stance phase microprocessor-controlled prostheses. In patients with TT amputation pin modular system, hydraulic system and mechanical modular prosthesis were converted to active vacuum system prostheses. Prescribed new prosthesis has caused a statistically significant increase in all amputation levels in ADL of patients (p≤ 0.05). We observed that there was significant improvement in ADL when conventional prostheses replaced with advanced technology prostheses in unilateral lower extremity amputation patients.

  8. Lived Experiences of "Illness Uncertainty" of Iranian Cancer Patients: A Phenomenological Hermeneutic Study.

    Science.gov (United States)

    Sajjadi, Moosa; Rassouli, Maryam; Abbaszadeh, Abbas; Brant, Jeannine; Majd, Hamid Alavi

    2016-01-01

    For cancer patients, uncertainty is a pervasive experience and a major psychological stressor that affects many aspects of their lives. Uncertainty is a multifaceted concept, and its understanding for patients depends on many factors, including factors associated with various sociocultural contexts. Unfortunately, little is known about the concept of uncertainty in Iranian society and culture. This study aimed to clarify the concept and explain lived experiences of illness uncertainty in Iranian cancer patients. In this hermeneutic phenomenological study, 8 cancer patients participated in semistructured in-depth interviews about their experiences of uncertainty in illness. Interviews continued until data saturation was reached. All interviews were recorded, transcribed, analyzed, and interpreted using 6 stages of the van Manen phenomenological approach. Seven main themes emerged from patients' experiences of illness uncertainty of cancer. Four themes contributed to uncertainty including "Complexity of Cancer," "Confusion About Cancer," "Contradictory Information," and "Unknown Future." Two themes facilitated coping with uncertainty including "Seeking Knowledge" and "Need for Spiritual Peace." One theme, "Knowledge Ambivalence," revealed the struggle between wanting to know and not wanting to know, especially if bad news was delivered. Uncertainty experience for cancer patients in different societies is largely similar. However, some experiences (eg, ambiguity in access to medical resources) seemed unique to Iranian patients. This study provided an outlook of cancer patients' experiences of illness uncertainty in Iran. Cancer patients' coping ability to deal with uncertainty can be improved.

  9. Total energy expenditure in underweight patients with severe chronic obstructive pulmonary disease living at home.

    Science.gov (United States)

    Slinde, F; Ellegård, L; Grönberg, A M; Larsson, S; Rossander-Hulthén, L

    2003-04-01

    The aim of the study was to assess total daily energy expenditure (TDE), as measured by doubly labelled water (DLW), and describe its components in home-living underweight patients with severe chronic obstructive pulmonary disease (COPD). Basal metabolic rate (BMR) was measured prior to the study. Ten patients received DLW, followed by urine analysis by isotope ratio mass spectrometry from 10 standardised occasions during 15 days. Dietary intake was registered by each patient the first 7 days of the study. The patients were also interviewed about their physical activity pattern. Measured BMR was higher than predicted in five of the 10 patients using equations from WHO. Using disease-specific equations, estimated BMR was higher for male, but not for female COPD patients. The best estimation of BMR resulted from prediction including fat-free mass. TDE varied considerably between 5200 and 11,100 kJ. Physical activity level (PAL) ranged from 1.15 to 1.80. Energy intake varied between 4500 and 9100 kJ. In underweight patients with severe COPD, TDE is highly variable, ranging from 110 to 200 kJ/kg body weight. This is the first study assessing and describing total energy expenditure in underweight patients with severe COPD living at home. Energy requirement in the patient group cannot solely be calculated from prediction equations. BMR should be measured and physical activity level assessed. Copyright 2003 Elsevier Science Ltd.

  10. Impact of living environment on 2-year mortality in elderly maintenance hemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Wen-Hung Huang

    Full Text Available BACKGROUND: Studies on risk factors of mortality in elderly patients with hemodialysis usually focus on comorbidities, nutrition, and inflammation. Discussion on the correlation between living environment and mortality of these patients is limited. METHODS: A total of 256 elderly hemodialysis patients participated in this 2-year prospective observational study. The subjects were divided into 2 subgroups based on whether they were living in Taipei Basin (n = 63 or not (n = 193. Demographic, hematological, nutritional, inflammatory, biochemical, and dialysis-related data were obtained for cross-sectional analysis. Causes of death and mortality rates were also analyzed for each subgroup. RESULTS: Patients in the basin group had a higher incidence of combined protein-energy wasting and inflammation than those in the around basin group. At the end of the 2-year follow-up, 68 patients had died. Univariate binary logistic regression analysis revealed that a very advanced age, basin group, serum albumin levels, serum creatinine levels, non-anuria, and the complications of stroke and CAD were associated with 2-year mortality. Meanwhile, log high-sensitivity C-reactive protein (hs-CRP levels were not associated with 2-year mortality. Multivariate Cox regression analysis revealed that basin group, serum albumin levels, and the complications of stroke and CAD were significant risk factors for 2-year mortality in these patients. CONCLUSION: The results of this study indicate that factors such as living in the Taipei Basin with higher air pollutant levels in elderly hemodialysis patients is associated with protein-energy wasting and inflammation, as well as 2-year mortality. These findings suggest that among this population, living environment is as important as comorbidities and nutrition. Furthermore, air pollution should be getting more attention especially in the overcrowding Basin topography.

  11. Patients' perspectives on how idiopathic pulmonary fibrosis affects the quality of their lives

    Directory of Open Access Journals (Sweden)

    Gould Michael K

    2005-10-01

    Full Text Available Abstract Background Idiopathic pulmonary fibrosis (IPF is a debilitating lung disease with a survival of only three to five years from the time of diagnosis. Due to a paucity of studies, large gaps remain in our understanding of how IPF affects the quality of patients' lives. In only one other study did investigators ask patients directly for their perspectives on this topic. Further, currently there is no disease-specific instrument to measure health-related quality of life (HRQL in patients with IPF. A carefully constructed measurement instrument, sensitive to underlying change, is needed for use in clinical trials and longitudinal studies of patients with IPF. Before developing such an instrument, researchers must improve their understanding of the relevant effects of IPF on patients' lives. On a broader scale, to provide the best care for people with IPF, clinicians must appreciate – from patients' perspectives – how this disease affects various aspects of their lives. Methods We used focus groups and individual in-depth interviews with 20 IPF patients to collect their perspectives on how IPF affects their lives (with a focus on the quality of their lives. We then analyzed these perspectives and organized them into a conceptual framework for describing HRQL in patients with IPF. Next, we examined how well certain existing measurement instruments – which have been administered to IPF patients in prior studies – covered the domains and topics our patients identified. Results In our framework, we identified 12 primary domains: symptoms, IPF therapy, sleep, exhaustion, forethought, employment and finances, dependence, family, sexual relations, social participation, mental and spiritual well-being, mortality. Each domain is composed of several topics, which describe how IPF affects patients' lives. When we compared the content of our conceptual framework with the existing instruments, we found the coverage of the existing instruments to

  12. Comparison of baseline data between chronic kidney disease patients starting hemodialysis who live near and far from the dialysis center

    OpenAIRE

    Paulo Roberto Santos; Cecília Costa Arcanjo; Sânkia Maria Lopes Aragão; Fernando Lopes Ponte Neto; Antônio Robson Gomes Ximenes; Janaína Teixeira Pereira Carneiro Tapeti; Hyngridd Soares Mendes; Luise Vasconcelos Vieira; Rita de Cássia Parente Prado; Marcela Lopes Lima; Wirvig Dionnas Cassemiro Adeodato; Ivo Antônio Mendes de Menezes; Mairla Maracaba Moreira; Estevam Nelson Moura de Oliveira; Thais Costa Ehrich

    2014-01-01

    Introduction: The treatment offered to chronic kidney disease (CKD) patients before starting hemodialysis (HD) impacts prognosis. Objective: We seek differences among incident HD patients according to the distance between home and the dialysis center. Methods: We included 179 CKD patients undergoing HD. Patients were stratified in two groups: "living near the dialysis center" (patients whose hometown was in cities up to 100 km from the dialysis center) or as "living far from the dialysis ...

  13. Analysis of acutely exacerbated chronic tinnitus by the Tinnitus Handicap Inventory.

    Science.gov (United States)

    Zeng, X; Li, P; Li, Z; Cen, J; Li, Y; Zhang, G

    2016-01-01

    To examine factors potentially contributing to acutely exacerbated chronic tinnitus initiation using the Tinnitus Handicap Inventory. Sixty acutely exacerbated chronic tinnitus out-patients were divided into two groups depending on whether hearing loss was aggravated or stable during tinnitus exacerbation. Total Tinnitus Handicap Inventory scores and scores for the three subscales (assessing functional limitations, emotional attitudes and catastrophic thoughts) were analysed. Total Tinnitus Handicap Inventory scores did not differ between groups. In patients with acutely exacerbated chronic tinnitus and aggravated hearing loss, functional subscale scores were significantly higher after acutely exacerbated chronic tinnitus than at baseline, but catastrophic and emotional subscale scores did not change. In patients with acutely exacerbated chronic tinnitus and stable hearing loss, emotional subscale scores were significantly higher after acutely exacerbated chronic tinnitus than at baseline, but catastrophic and functional subscale scores did not change. Elevated Tinnitus Handicap Inventory functional subscale scores might indicate further hearing loss, whereas elevated emotional subscale scores might be associated with negative life or work events.

  14. Voice handicap in essential tremor: a comparison with normal controls and Parkinson's disease.

    Science.gov (United States)

    Louis, Elan D; Gerbin, Marina

    2013-01-01

    Although voice tremor is one of the most commonly noted clinical features of essential tremor (ET), there are nearly no published data on the handicap associated with it. The Voice Handicap Index (VHI) was self-administered by participants enrolled in a research study at Columbia University Medical Center. The VHI quantifies patients' perceptions of handicap due to voice difficulties. Data from 98 ET cases were compared with data from 100 controls and 85 patients with another movement disorder (Parkinson's disease, PD). Voice tremor was present on examination in 25 (25.5%) ET cases; 12 had mild voice tremor (ETMild VT) and 13 had marked voice tremor (ETMarked VT). VHI scores were higher in ET cases than controls (p = 0.02). VHI scores among ETMarked VT were similar to those of PD cases; both were significantly higher than controls (phandicap associated with ET had multiple (i.e., physical, functional, and emotional) dimensions. Moreover, ET cases with marked voice tremor on examination had a level of self-reported voice handicap that was similar to that observed in patients with PD.

  15. Patients Living Alone Can Be Safely Discharged Directly Home After Total Joint Arthroplasty: A Prospective Cohort Study.

    Science.gov (United States)

    Fleischman, Andrew N; Austin, Matthew S; Purtill, James J; Parvizi, Javad; Hozack, William J

    2018-01-17

    Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period. Patients discharged directly home who were living alone for the first 2 weeks after the surgical procedure were identified as the investigational group and those discharged to home and living with others constituted the control group. The primary outcomes were 90-day complications and unplanned clinical events, including readmissions, emergency department or urgent care visits, and office visits. Functional outcomes, patient satisfaction, pain relief, and return to daily function were also assessed. During the study period, 874 patients (96%) were discharged directly home and only 36 patients (4%) were discharged to a rehabilitation facility. Of those discharged home, 769 patients were included in the final analysis, including 138 patients living alone and 631 patients living with others, and 105 patients were excluded as they opted not to participate. Patients living alone more commonly stayed an additional night in the hospital and utilized more home health services. There was no increase in complications or unplanned clinical events for patients living alone compared with those living with others. Further, no significant differences in functional outcomes or pain relief were detected, and satisfaction scores were equivalent after 90 days. Patients living alone had a safe and manageable recovery when discharged directly home after total joint arthroplasty. Extending the initial hospitalization and providing home health services on a selected

  16. Influence of complaints and singing style in singers voice handicap.

    Science.gov (United States)

    Moreti, Felipe; Ávila, Maria Emília Barros de; Rocha, Clara; Borrego, Maria Cristina de Menezes; Oliveira, Gisele; Behlau, Mara

    2012-01-01

    The aim of this research was to verify whether the difference of singing styles and the presence of vocal complaints influence the perception of voice handicap of singers. One hundred eighteen singing voice handicap self-assessment protocols were selected: 17 popular singers with vocal complaints, 42 popular singers without complaints, 17 classic singers with complaints, and 42 classic singers without complaints. The groups were similar regarding age, gender and voice types. Both protocols used--Modern Singing Handicap Index (MSHI) and Classical Singing Handicap Index (CSHI)--have specific questions to their respective singing styles, and consist of 30 items equally divided into three subscales: disability (functional domain), handicap (emotional domain) and impairment (organic domain), answered according to the frequency of occurrence. Each subscale has a maximum of 40 points, and the total score is 120 points. The higher the score, the higher the singing voice handicap perceived. For statistical analysis, we used the ANOVA test, with 5% of significance. Classical and popular singers referred higher impairment, followed by disability and handicap. However, the degree of this perception varied according to the singing style and the presence of vocal complaints. The classical singers with vocal complaints showed higher voice handicap than popular singers with vocal complaints, while the classic singers without complaints reported lower handicap than popular singers without complaints. This evidences that classical singers have higher perception of their own voice, and that vocal disturbances in this group may cause greater voice handicap when compared to popular singers.

  17. A confirmatory factor analytic validation of the Tinnitus Handicap Inventory.

    Science.gov (United States)

    Kleinstäuber, Maria; Frank, Ina; Weise, Cornelia

    2015-03-01

    Because the postulated three-factor structure of the internationally widely used Tinnitus Handicap Inventory (THI) has not been confirmed yet by a confirmatory factor analytic approach this was the central aim of the current study. From a clinical setting, N=373 patients with chronic tinnitus completed the THI and further questionnaires assessing tinnitus-related and psychological variables. In order to analyze the psychometric properties of the THI, confirmatory factor analysis (CFA) and correlational analyses were conducted. CFA provided a statistically significant support for a better fit of the data to the hypothesized three-factor structure (RMSEA=.049, WRMR=1.062, CFI=.965, TLI=.961) than to a general factor model (RMSEA=.062, WRMR=1.258, CFI=.942, TLI=.937). The calculation of Cronbach's alpha as indicator of internal consistency revealed satisfactory values (.80-.91) with the exception of the catastrophic subscale (.65). High positive correlations of the THI and its subscales with other measures of tinnitus distress, anxiety, and depression, high negative correlations with tinnitus acceptance, moderate positive correlations with anxiety sensitivity, sleeping difficulties, tinnitus loudness, and small correlations with the Big Five personality dimensions confirmed construct validity. Results show that the THI is a highly reliable and valid measure of tinnitus-related handicap. In contrast to results of previous exploratory analyses the current findings speak for a three-factor in contrast to a unifactorial structure. Future research is needed to replicate this result in different tinnitus populations. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Personer med fysiske handicap og psykiske lidelser

    DEFF Research Database (Denmark)

    Larsen, Malene Rode; Larsen, Mona

    2018-01-01

    Det er velkendt, at personer med fysiske handicap i større omfang er i beskæftigelse end personer med psykiske lidelser. Formålet med dette notat er at forøge den eksisterende viden om, hvorfor der er forskel på de to gruppers beskæftigelsesomfang. Vi undersøger, om forskelle mellem de to grupper......, hvad angår en række målbare personkarakteristika og deres sammenhæng med gruppernes beskæftigelsessandsynlighed, spiller en rolle i denne forbindelse. De undersøgte personkarakteristika er: a) personforhold som fx alder, etnisk oprindelse, uddannelse og sværhedsgrad af handicap, b) personlighedstræk...

  19. Screening for subclinical Leishmania infection in HIV-infected patients living in eastern Spain.

    Science.gov (United States)

    Ena, Javier; Pasquau, Francisco; del Mar López-Perezagua, María; Martinez-Peinado, Carmen; Arjona, Francisco

    2014-12-01

    We anticipated that patients with HIV infection living in endemic areas were at greater risk of infection which can reactivate due to immunosuppression; therefore, we analyzed the prevalence of latent Leishmania infantum infection in patients infected with HIV. A total of 179 patients with HIV infection were screened for the presence of anti-Leishmania antibodies using indirect immunofluorescent antibody test (IFAT) (Leishmania-spot IF; bioMérieux, Marcy l'Etoile, France). All patients were followed up for at least 1 year. The primary end-point was to confirm the presence of Leishmania infection. Significant titer of antibodies to Leishmania was detected in six (3%; 95% confidence interval: 0.5-5.5%) asymptomatic patients. Two of them had visceral leishmaniasis that was confirmed by parasite visualization in clinical samples, the presence of Leishmania promastigotes in Novy-MacNeal-Nicolle culture, polymerase chain reaction (PCR)-based methods, and/or urinary antigen test. Among 173 patients with indirect immunofluorescent antibody test below 1:40, one HIV-infected patient severely immunosuppressed, confirmed negative by IFAT, was diagnosed of visceral leishmaniasis. The use of indirect immunofluorescent antibody test for Leishmania screening is not justified in asymptomatic patients with HIV infection living in endemic areas due to the small rate of significant antibody titer and the low frequency of clinical disease.

  20. Teaching behaviorally handicapped preschool children to share.

    OpenAIRE

    Bryant, L E; Budd, K S

    1984-01-01

    We examined the effectiveness of Barton and Ascione 's (1979) package for training sharing in a classroom setting with six behaviorally handicapped preschool children, four of whom were also developmentally delayed. Individual responses in sharing and not sharing were examined. Training consisted of initial instructions, modeling, and behavioral rehearsal, followed by teacher prompts and praise regarding sharing directly in a classroom free play period. Introduction of training in a multiple-...

  1. Subjective experiences of occupational performance of activities of daily living in patients with mild stroke

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Postat, Annemette; Poulsen, Trine

    2014-01-01

    and risk of accidents. Conclusion: It is important to view the patients with mild stroke as heterogeneous, and consider post-stroke fatigue and emotional reactions when evaluating rehabilitation needs. Therefore, it is important to look further into structured tools, which examine how well the participant......Aim: To investigate the subjective experiences of occupational performance of activities of daily living (ADL) in patients with mild stroke. Methodology: Data was generated from January – December 2011 and consisted of 41 individual ADL-I interviews with patients in hospital and another 41...

  2. Comparison of Irrational Believes between Mothers of Severe or Profound Mentally Handicapped Children with Healthy Children Mothers

    Directory of Open Access Journals (Sweden)

    Behrouz Hivadi

    2007-10-01

    Full Text Available Objective: The purpose of present research was the comparison of mothers irrational believes with severe or profound mentally handicapped child and mothers with normal child from 6 to14 years old in Tehran city. Materials & Methods: This study was an analytical, cross – sectional and comparative (case – control research. From mothers with severe or profound mentally handicapped child who had refered to Tehran welfare services centers, 80 mothers were selected by regular randomized sampling from two rehabilitation centers and 80 mothers with normal child were selected for peering with the group of testimonial from schools areas of east, west, south, north and center of Tehran, through multi - stage cluster sampling in for variables of: age of mothers, educational levels, the location of living and the number of children. They answered to questionnaire of irrational believes of jons (IBT. Analysis of data was done by descriptive and infringing statistics methods (Independent T test, U Mann Whitney, Chi-square and fisher. Results: The findings showed that: there are significantly differences in total irrational believes and irrational believes of blame proneness, frustration reactive, anxious over concern, problem avoiding and dependency, perfectionism between two groups of mothers (P<0/05. There was no significant difference in irrational believes between mothers who had mental handicap daughter and mothers who had mental handicap son (P=0/314. There was no significantly difference between two groups of mothers in four believes of demand for approval (P=0/737, high-self expectation (P=0/126, emotional irresponsibility (P=0/727, helplessness for change (p=0/283. Conclusion: Irrational believes and many its sub scales. In mothers of severe or profound mental handicap children were more than mothers with normal child. But believes of demand for approval, high self expectation, emotional irresponsibility, helplessness for change in mothers with

  3. Avaliação do handicap auditivo do adulto com deficiência auditiva unilateral Assessment of the auditory handicap in adults with unilateral hearing loss

    Directory of Open Access Journals (Sweden)

    Patrícia Graciano Vicci de Araújo

    2010-06-01

    Full Text Available A deficiência auditiva (DA unilateral é caracterizada pela diminuição da audição em apenas uma orelha podendo acarretar dificuldade acadêmica, alterações de linguagem e dificuldade sócio-emocionais. OBJETIVO: Avaliar a autopercepção do handicap auditivo de sujeitos adultos, portadores de DA sensório-neural unilateral, não usuários de Aparelho de Amplificação Sonora Individual. MATERIAL E MÉTODO: Estudo Prospectivo com 52 sujeitos adultos, com média de 34.5 anos e de ambos os gêneros (26 do gênero feminino, 26 do masculino com deficiência auditiva: tipo neurossensorial unilateral, de graus variados; responderam a um questionário para a avaliação do handicap sendo utilizado o "Hearing Handicap Inventory for Adults" (HHIA. RESULTADOS: Foram pontuadas as subescalas dos aspectos emocionais e sociais/situacionais sendo encontrados 73,1% de presença do handicap entre os graus leve, moderado e significativo e em maior porcentagem (88,5% no gênero feminino. CONCLUSÕES: A aplicação do questionário mostrou-se um procedimento eficiente, pois a DA unilateral pode, não raramente, comprometer aspectos sociais e emocionais do sujeito adulto e o mesmo grau de DA podem reagir de forma diferente, indicando que a grande variabilidade na autopercepção do handicap auditivo está associada a aspectos não audiológicos.Hearing impairment (HI is characterized by unilateral hearing loss in one ear and can result in learning difficulties, language impairment and socio-emotional difficulties. To assess the perception of hearing handicap in adult subjects, patients with unilateral sensorineural HI, non-users of individual hearing aids. MATERIALS AND METHODS: Prospective study with 52 adult subjects with a mean of 34.5 years of age, from both genders (26 females, 26 males with hearing loss: sensorineural unilateral, in varying degrees, responded to a questionnaire for assessing hearing handicap, and for that we used the Hearing Handicap

  4. [Combined hepatitis A/B vaccination: evaluation of a vaccination schedule in facilities for handicapped people].

    Science.gov (United States)

    Wolters, B; Müller, T; Ross, R S; Kundt, R; Roggendorf, M; Roggendorf, H

    2014-02-01

    People with mental and physical disabilities have a higher risk of infection with hepatitis viruses. Studies conducted so far show contradictory results on the success of vaccination in this population. These people live and work under special conditions and sometimes have immune defects. We investigated the antibody response after combined vaccination against hepatitis A and B in facilities for handicapped people in the city of Essen/Germany. Antibodies were determined in people with disabilities (n=949) and also in social workers taking care of handicapped people (n=115). Protective antibodies against hepatitis A were detected in 98.9% in people with disabilities and social workers. The seroconversion rate against hepatitis B in handicapped people was 90.2% and was comparable to the seroconversion rate in social workers (91.3%). Re-vaccinations were offered to all people with anti-HBs titres below 100 IU/L (28% of handicapped and 23.5% of social workers). In the group of low responders in handicapped people about 50% developed anti-HBs concentration above 100 IU/L. Non-responders showed 30-40% seroconversion rate after re-vaccination. Based on this study we would recommend serological tests about 4-8 weeks after vaccination to confirm seroconversion. By this procedure people who need a booster vaccination will be recognized and non-responders should be offered another HBV vaccination. In about 20% of the non-responders included in this study HBs antigen was detected. © Georg Thieme Verlag KG Stuttgart · New York.

  5. The effect of live spontaneous harp music on patients in the intensive care unit.

    Science.gov (United States)

    Chiasson, Ann Marie; Linda Baldwin, Ann; McLaughlin, Carrol; Cook, Paula; Sethi, Gulshan

    2013-01-01

    This study was performed to investigate the effect of live, spontaneous harp music on individual patients in an intensive care unit (ICU), either pre- or postoperatively. The purpose was to determine whether this intervention would serve as a relaxation or healing modality, as evidenced by the effect on patient's pain, heart rate, respiratory rate, blood pressure, oxygen saturation, and heart rate variability. Each consenting patient was randomly assigned to receive either a live 10-minute concert of spontaneous music played by an expert harpist or a 10-minute rest period. Spontaneous harp music significantly decreased patient perception of pain by 27% but did not significantly affect heart rate, respiratory rate, oxygen saturation, blood pressure, or heart rate variability. Trends emerged, although being not statistically significant, that systolic blood pressure increased while heart rate variability decreased. These findings may invoke patient engagement, as opposed to relaxation, as the underlying mechanism of the decrease in the patients' pain and of the healing benefit that arises from the relationship between healer, healing modality, and patient.

  6. Voice Handicap in Essential Tremor: A Comparison with Normal Controls and Parkinson’s Disease

    Science.gov (United States)

    Louis, Elan D.; Gerbin, Marina

    2013-01-01

    Background Although voice tremor is one of the most commonly noted clinical features of essential tremor (ET), there are nearly no published data on the handicap associated with it. Methods The Voice Handicap Index (VHI) was self-administered by participants enrolled in a research study at Columbia University Medical Center. The VHI quantifies patients’ perceptions of handicap due to voice difficulties. Data from 98 ET cases were compared with data from 100 controls and 85 patients with another movement disorder (Parkinson’s disease, PD). Results Voice tremor was present on examination in 25 (25.5%) ET cases; 12 had mild voice tremor (ETMild VT) and 13 had marked voice tremor (ETMarked VT). VHI scores were higher in ET cases than controls (p = 0.02). VHI scores among ETMarked VT were similar to those of PD cases; both were significantly higher than controls (phandicap associated with ET had multiple (i.e., physical, functional, and emotional) dimensions. Moreover, ET cases with marked voice tremor on examination had a level of self-reported voice handicap that was similar to that observed in patients with PD. PMID:23450107

  7. Personality disorder in mental handicap.

    Science.gov (United States)

    Reid, A H; Ballinger, B R

    1987-11-01

    100 randomly selected mildly or moderately mentally retarded adults were assessed for personality disorder using the Standardized Assessment of Personality devised by Mann et al. (1981). By the terms of this instrument 56% of patients showed features of abnormal personality, and in 22% this abnormality was marked, suggesting the presence of personality disorder. Personality problems may be a more significant factor in assessing a mentally retarded person's acceptability in a community setting than has hitherto been realized.

  8. Patient participation in emergency care - a phenomenographic study based on patients' lived experience.

    Science.gov (United States)

    Frank, Catharina; Asp, Margareta; Dahlberg, Karin

    2009-01-01

    International guidelines promote patient participation in health care. When patients participate in their care they experience greater satisfaction. Studies have shown that patients in emergency departments express dissatisfaction with their care, and it was therefore important to study how patients understand and conceptualize their participation. The aim of this study was to describe patients' qualitatively different conceptions of patient participation in their care in an emergency department. Based on a lifeworld perspective, nine interviews were performed with patients in an emergency department. The phenomenographic analysis shows that participation by patients means contact with the emergency department staff in three categories of conceptions: being acknowledged; struggling to become involved; and having a clear space. The different conceptions of patient participation give us a deeper understanding of how patients may experience their care, and this result may provide a foundation for developing nursing practice and the quality of health care in line with international guidelines.

  9. OPINIONS OF HEALTHY ADOLESCENTS CONCERNING THEIR HANDICAP CLASSMATES

    Directory of Open Access Journals (Sweden)

    Dragica MACIC

    1999-11-01

    Full Text Available In this work is presented a part of the research project about the attitudes of non-chandicapped adolescents toward physical handicapped and chronically ill persons. The research sample was made of 689 pupils (4th class from secondary medical schools and secondary nonmedical schools in Belgrade. The informing for this handicap category, cognitive, affective and connative components of the attitudes of adolescents toward physically handicapped and chronically ill persons, have been examined by mixed questionnaire.The results of this work show adolescents inadequate informing for physical handicap. There are also, a negative direction concerning cognitive components of the attitude, and mostly positive direction concerning affective component (except they meet physical handicapped when dominate negative feelings. Component is reflecting the positive directions of attitude towards physical handicapped persons in a short-time relations, and negative direction is case of intensive and long-time relationships, like tenancy and marriage.

  10. Reliability and validity of the Lithuanian Tinnitus Handicap Inventory.

    Science.gov (United States)

    Ulozienė, Ingrida; Balnytė, Renata; Alzbutienė, Giedrė; Arechvo, Irina; Vaitkus, Antanas; Šileikaitė, Milda; Šaferis, Viktoras; Ulozas, Virgilijus

    2016-01-01

    The aim of this study was to determine the reliability and validity of the Lithuanian version of the Tinnitus Handicap Inventory (THI), a self-report measure of perceived tinnitus handicap. A cross-sectional psychometric validation study was performed in the University Hospital. A total of 248 subjects reporting chronic tinnitus as their primary complaint or secondary to hearing loss were encluded in the study and filled in the Lithuanian version of THI. For assessment of construct validity a subgroup of 55 participants completed the Lithuanian version of the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. Test-retest and internal consistency reliability as well as construct validity were calculated. The Lithuanian version of the THI and its subscales showed a robust internal consistency reliability (Cronbach's alpha=0.93) comparable to the original version. Statistically significant correlations were observed between the Lithuanian translation of the THI and the measures of self-perceived levels of anxiety and depression using HADS. Confirmatory factor analysis demonstrated that the three subscales of the THI Lithuanian version corresponded to three different factors, which strongly correlated between themselves. The results suggest that the Lithuanian version of THI maintains its original validity and may serve as reliable and valid measure of general tinnitus related distress that can be used in a clinical setting to quantify the impact of tinnitus on daily living. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  11. Patient Mood and Instrumental Activities of Daily Living in Alzheimer Disease: Relationship Between Patient and Caregiver Reports.

    Science.gov (United States)

    Votruba, Kristen L; Persad, Carol; Giordani, Bruno

    2015-09-01

    This retrospective study investigated the relationship between self-reports and caregiver perceptions of patients' depressive symptoms and the respective ability of these reports to predict instrumental activities of daily living (IADLs) beyond what is accounted for by cognitive abilities in 71 patients with mild Alzheimer disease. Patients completed the Geriatric Depression Scale-Short Form, and caregivers completed the Behavior Rating Scale for Dementia assessing their perception of patients' depressive symptoms. Caregivers also completed IADL items from the Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory. Cognitive measures included the Mini-Mental State Examination, Logical Memory from the Wechsler Memory Scale III, and Trail Making Test, Part B. The relationship between self-reported depressive symptoms and caregiver report of patients' depressive symptoms showed a trend toward significance (r = .22, P = .06). Measures of depressive symptoms significantly predicted 12.5% of the variance in IADLs performance, beyond that accounted for by patient demographics and cognitive functioning. Interestingly, patients' reports, rather than caregivers', were particularly useful in this prediction. © The Author(s) 2015.

  12. Techniques for Daily Living: Curriculum Guides.

    Science.gov (United States)

    Wooldridge, Lillian; And Others

    Presented are specific guides concerning techniques for daily living which were developed by the child care staff at the Illinois Braille and Sight Saving School. The guides are designed for cottage parents of the children, who may have both visual and other handicaps, and show what daily living skills are necessary and appropriate for the…

  13. Living situation, occupation and health-related quality of life in adult patients with classic galactosemia.

    Science.gov (United States)

    Hoffmann, Björn; Dragano, Nico; Schweitzer-Krantz, Susanne

    2012-11-01

    Galactose-1-phosphate uridyltransferase deficiency is well known as the underlying defect in classic galactosemia. However, little is known about the consequences of this defect beyond physical disease. To evaluate psychosocial, educational and occupational outcome as well as health-related quality of life (HRQOL) in adult German patients with galactosemia and to compare information with data from patients with phenylketonuria as well as the general German population. Members of the German patient support group for galactosemia received invitation, informed consent form and questionnaires by regular mail from the patient support group. Participation was voluntary. Forty-one out of 66 invited patients participated in this study. Nearly 2/3 of the patients were singles, and the majority of patients were still living with their parents. Frequently, patients had no school leaving certificate, and 30% of the patients had never started or never completed an apprenticeship. Getting along with galactosemia was rated as 'very good' or 'good' although following the diet was a burden. Social well-being and social functioning was lower compared to patients with PKU. Patients with galactosemia need a multi-professional team not only focusing on physical and/or biochemical aspects of disease but including also psycho-social dimensions of life.

  14. A Comparative Study on the Quality of Living for Therapeutic Cancer and Hospice Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Kook [Dept. of Radiological Technology, Kwangju Health College, Kwangju (Korea, Republic of); Rhee, Dong Soo; Rou, Jae Man; Kim, Jong Deok [Dept. of Therapeutic Radiology, Chonnam University Hospital, Kwangju (Korea, Republic of)

    2004-03-15

    This study carried a comparative analysis of quality of living perceived by cancer and hospice patients who received radiotherapy, and influential factors in order to provide basic data for nursing goals and establishment of strategy. The subjects of the study were 50 cancer patients who were more than twenty years old and was receiving radiotherapy in therapeutic radiology department of C university hospital, and fourteen hospice patients who were in J hospital in Gwangju. They were conveniently sampled according to the selection standard, and researchers personally interviewed them using questionnaire and patient scripts to obtain necessary data. The results were presented as follows: 1. When cancer and hospice patients were examined demographically, the number of 60 year-old patients were the most. The subjects whose marriage period was more than thirty-one years were the most. In medical expense, more than 70.0% of the patients bore their expenses themselves. 2. When disease-related characteristics of the cancer and pos piece patients were examined, more than 75% of the patients had experience of being in hospital, and more than experienced operation. However, for prevalence period, 57.5% of the cancer patients had less than six months, and 64.3% of the hospice patients had more than two years. 3. For physical symptoms of cancer patients, 77.5% had fatigue, 60.0% had loss of appetite, and 52.5% had loss of weight while for the hospice patients, 100% had loss of weight, and 92.9% had fatigue and loss of appetite. For the cancer patients, 0.0% had swelling, and 7.5% had bleeding, For the hospice patients, 7.1% had change in skin, and 14.3% had diarrhea. 4. Mean score of the cancer subjects were as follows: family support, social support, emotional and spiritual support, physical symptoms, and periods were 3.87, 2.88, 3.10, 2.80, and 2.94 respectively. Those of the hospice patients were 3.80, 1.96, 1.58, 2.64 and 3.24 respectively. 5. Mean score of family support

  15. Totally changed, yet still the same: patients' lived experiences 5 years beyond bariatric surgery.

    Science.gov (United States)

    Natvik, Eli; Gjengedal, Eva; Råheim, Målfrid

    2013-09-01

    Bariatric surgery provides sustainable weight loss and increased quality of life for most, but not all patients. To increase the knowledge of this complex patient group and their needs during follow-up, we aimed to describe the essential meaning of bariatric surgery patients' long-term experiences by using a phenomenological lifeworld approach. Eight patients were interviewed between 5 and 7 years after bariatric surgery. Life after bariatric surgery was described as living with tension, ambivalence, and reinforced attention toward one's own body. The tension was related to embodied change and altered relations to the social world. The patients express an ongoing demand for control of health-related habits and practices, and to not lose control over the body again. Surgical weight loss and improved physical function do not necessarily mean changed health-related habits and practices in the long term. Experiencing weight regain is connected with emotional stress, shame, and self-contempt.

  16. Cognitive structure of executive deficits in frontally lesioned head trauma patients performing activities of daily living.

    Science.gov (United States)

    Fortin, Sandra; Godbout, Lucie; Braun, Claude M J

    2003-04-01

    Executive functions in activities of daily living (ADL) were investigated in 10 patients with frontal lobe lesions after a mild to severe closed head injury (CHI). The CHI patients were compared to 12 normal controls with a neuropsychological test battery, a script recitation task and a realistic simulation of complex multitask ADL (planning and preparing a meal). Though the CHI patients were significantly slow on one test and subject to interference on an attention test with parametric testing, the groups did not differ on any neuropsychological test with non parametric testing. However, the CHI patients manifested marked anomalies in the meal preparation task. While small sequences of actions were easily produced, large action sets could not be correctly executed. An outstanding deficit in strategic planning and prospective memory appears to be an important underpinning of the impairment of ADL observed in CHI patients with frontal lobe lesions.

  17. The Relationship Between Academic Identity and Self-Handicapping

    OpenAIRE

    Carlisle, Brandon Lamare

    2015-01-01

    The purpose of the present dissertation was to examine whether, and how, behavioral academic self-handicapping and claimed academic self-handicapping differentially relate to the academic identity statuses (i.e., achieved, diffused, moratorium, and foreclosed). Self-handicapping has been defined as creating or claiming obstacles to performance in order to enhance the ability to externalize failure and internalize success. Academic identity status involves a student’s decision to attend colleg...

  18. Variability in glycosylated hemoglobin values in diabetic patients living in long-term care facilities.

    Science.gov (United States)

    Meyers, Roberta M; Broton, Jay C; Woo-Rippe, Kathleen W; Lindquist, Sara A; Cen, Ye-Ying

    2007-10-01

    The objectives of this study were to determine the prevalence of diabetes and mean A1C of patients in long-term care facilities (LTCFs); to determine differences in A1C values based on patient characteristics; and to examine the self-reported practices of providers regarding diabetes management goals. Twelve-month retrospective review of patient charts; survey of physicians and nurse practitioners providing care to these patients. Nursing facility practice of an urban teaching hospital. Participants included 168 diabetic patients living in 20 nursing facilities and 18 physician and nurse practitioners in one practice providing care to these patients. The prevalence of diabetes was 21.6% (168 of 778 patients). Mean A1C was 7.1% +/- 1.2%for 135 patients who had AIC values measured during the study interval. A1C varied by age, with patients younger than 65 having higher A1C values than patients older than 65. Higher A1C values were associated with insulin use, frequent glucose monitoring, and attending a diabetes clinic. Although a survey of providers identified modifying A1C target ranges for LTCF compared with ambulatory patients, they did not reach consensus on the actual target A1C. No association between provider perception of either patient health status or patient life expectancy and A1C values was found. Relatively low A1C values were obtainable in LTCF patients without diabetes specialty clinic use. Providers identified modifying target A1C values for LTCF patients, but achieved relatively low A1C values and did not agree on a target A1C value for LTCF patients.

  19. Characterization of Ictus in the Long-lived Patient: A Decade of Study

    Directory of Open Access Journals (Sweden)

    Yainelí Cutiño Maás

    2016-09-01

    Full Text Available Background: the increase of longevity, together non-transmissible diseases, support the prediction of the occurrence of ictus as cause of death. Objective: to characterize lomg-lived patients who have suffered from ictus. Methods: it is a descriptive study which included 456, 90 year old or more patients, with the diagnosis of ictus admitted at the Hospital Gustavo Aldereguía Lima, from January 2005 to December 2014. The variables included were: age, sex, kind of ictus, toxic habits, personal pathologic antecedents and condition at discharge. Results: 5,41 % of the total admissions due to ictus corresponded to long-lived patients. Female sex was more representative with 58,6 %. Ischemic etiology with 91,4 %. Arterial hypertension (76, 1 % and ischemic cardiopathy (43, 9 % were the most frequent risk factors. Hospital death rate was 35,7 %. Conclusion: there is a progressive increase of the presentation of ictus in long-lived with higher prevalence in the female sex and a high hospital death rate.

  20. Adaptation and coping in patients living with an LVAD: a metasynthesis

    Science.gov (United States)

    Abshire, Martha; Prichard, Roslyn; Cajita, Mia; DiGiacomo, Michelle; Himmelfarb, Cheryl Dennison

    2016-01-01

    Background Left Ventricular Assist Device (LVAD) patients have shown improvements in measures of quality of life and functional status compared to those who are medically managed. Qualitative research has not yet been meaningfully integrated. Aim To synthesize and convey information to inform components of LVAD education programs that support the coping and adaptation of patients living with an LVAD and to identify opportunities for future interventions. Methods Qualitative meta-synthesis using Lazarus and Folkmans’ Transactional Model of stress and coping Results Four distinct stages of adaptation were identified: Pre-LVAD, Implant Hospitalization, Early Home Adaptation and Late Home Adaptation. Each stage includes tasks related to physical, psychological and social domains. Further, two themes emerged: 1) Primary Appraisal: Every stage is a new challenge and 2) Secondary Appraisal: Routines are achievable, emotions are more difficult. Conclusions The emotional challenges LVAD patients face including fear and anxiety related to living with a life limiting illness and changed social roles need to be honestly addressed. Individuals living with LVAD can achieve a sense of independence and enjoy social interactions and activities that are important to them through addressing practical and emotional problems to facilitate effective coping. PMID:27342261

  1. Academic self-handicapping and their correlates in adolescence

    Directory of Open Access Journals (Sweden)

    Cocoradă, E.

    2011-01-01

    Full Text Available The self-handicapping has been examined as a self-protectivestrategy, used by adults and young, males and females, in different situations assessed as threatening for the positive self-esteem. The purpose of this study is to explore the relations between self-handicapping and some variables relevant in the academic field as learning motivation, academic results, selfesteem. Age and gender are the criteria of our analysis. The results suggestthe males and later adolescents (males and females self-handicap more that the females and the young adolescents. Self-esteem and some components of learning motivation are the variables that influence self-handicapping at significant levels.

  2. Prognostic evaluation of patients undergoing living-donor liver transplant by APACHE II and MELD scores.

    Science.gov (United States)

    Zhang, Zheng-Yun; Chen, Rui; Zhou, Zun-Qiang; Peng, Cheng-Hong; Zhou, Guang-Wen

    2015-02-01

    We hypothesized that the combination of APACHE II and Model for End-Stage Liver Disease systems would work satisfactorily in patients admitted to intensive care unit after living-donor liver transplant. Data were retrospectively collected from the database of our surgical team. The study included 38 patients (hepatitis B virus cirrhosis, 47.4%; hepatocellular carcinoma, 28.9%; other diseases, 23.7%). Laboratory values were obtained. Vital signs, Glasgow Coma scale scores, and urine output were abstracted. Variables included age, sex, acute physiology score, APACHE II score, APACHE II-predicted intensive care unit and hospital mortality, predicted length of intensive care unit, and hospital stay. Patients' actual length of intensive care unit and hospital stays, intensive care unit and hospital discharge status, and discharge location were recorded. Standardized mortality ratios were calculated. Discrimination and calibration of APACHE II were assessed. All patients were divided into 3 groups: Model for End-Stage Liver Disease score: >25, 18 to 25, and APACHE II scores of survivors and non-survivors were 13.03 and 23.67. Mean risk of death was 7.05% and 25.07%. APACHE II scores and risk of death between survivors and non-survivors was significantly different (P APACHE II score and Model for End-Stage Liver Disease score in the receiving operating characteristic curve was 20 and 25. Patients with APACHE II scores greater than 20 or Model for End-Stage Liver Disease scores greater than 25 had higher predicted hospital mortality after living-donor liver transplant. The modified APACHE II model provides an accurate prognosis of patients receiving a living-donor liver transplant. The combined application of Model for End-Stage Liver Disease score and APACHE II score can improve the predictive accuracy.

  3. The lived experience of fibromyalgia in female patients, a phenomenological study

    Directory of Open Access Journals (Sweden)

    Wuytack Francesca

    2011-09-01

    Full Text Available Abstract Background Fibromyalgia is a chronic syndrome with no cure. A thorough understanding of the illness experience is therefore key in the palliative care of patients with this condition. In search for supportive treatments fibromyalgia patients often attend a chiropractor or other manual therapist. Knowledge of the meaning and reality of living with this condition to the patient could be considered essential to any health care practitioner playing a role in the management. This study aimed to gain a better understanding of the subjective experience of fibromyalgia, focusing on the personal, occupational and social impact of the condition on patients' lives. This included exploring the patients' views about the future. Methods This study employed descriptive phenomenology and adopted Husserl's concept of transcendental subjectivity or "bracketing". This qualitative study involved semi-structured interviews and was undertaken to obtain rich data that reflected the essence of the participants' experience. Participants consisted of six female volunteers, diagnosed with fibromyalgia by the University Hospital Gent, Belgium. Data were analysed using a thematic framework. Results Fibromyalgia pervaded all aspects of life. Four main themes arose from data analysis, namely; the impact of fibromyalgia on patients' occupational and personal life, the impact on their future and aspects of social interaction. Nearly all participants had stopped working, giving rise to feelings of uselessness and loss of identity. Leisure activities were also greatly affected. Fibromyalgia was said to alter family bonds, some of which were reinforced, others were broken. The diagnosis was seen as a relief, marking an end to a period of uncertainty. Participants reported ambivalence in interaction. Despite some positive encounters, frustration arising from perceived incomprehension dominated. Consequently patients preferred not to share their experiences. Conclusions The

  4. A System Design for Studying Geriatric Patients with Dementia and Hypertension Based on Daily Living Information

    Science.gov (United States)

    Xu, Weifeng; Betz, Willian R.; Frezza, Stephen T.; Liu, Yunkai

    2011-08-01

    Geriatric patients with dementia and hypertension (DAH) suffer both physically and financially. The needs of these patients mainly include improving the quality of daily living and reducing the cost of long-term care. Traditional treatment approaches are strained to meet these needs. The goal of the paper is to design an innovative system to provide cost-effective quality treatments for geriatric patients with DAH by collecting and analyzing the multi-dimensional personal information, such as observations in daily living (ODL) from a non-clinical environment. The proposed ODLs in paper include activities, cleanliness, blood pressure, medication compliance and mood changes. To complete the system design, an incremental user-centered strategy is exploited to assemble needs of patients, caregivers, and clinicians. A service-oriented architecture (SOA) is employed to make full use of existing devices, software systems, and platforms. This health-related knowledge can be interpreted and utilized to help patients with DAH remain in their homes safely and improve their life quality while reducing medical expenditures.

  5. The Effect of Live Spontaneous Harp Music on Patients in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Ann Marie Chiasson

    2013-01-01

    Full Text Available This study was performed to investigate the effect of live, spontaneous harp music on individual patients in an intensive care unit (ICU, either pre- or postoperatively. The purpose was to determine whether this intervention would serve as a relaxation or healing modality, as evidenced by the effect on patient’s pain, heart rate, respiratory rate, blood pressure, oxygen saturation, and heart rate variability. Each consenting patient was randomly assigned to receive either a live 10-minute concert of spontaneous music played by an expert harpist or a 10-minute rest period. Spontaneous harp music significantly decreased patient perception of pain by 27% but did not significantly affect heart rate, respiratory rate, oxygen saturation, blood pressure, or heart rate variability. Trends emerged, although being not statistically significant, that systolic blood pressure increased while heart rate variability decreased. These findings may invoke patient engagement, as opposed to relaxation, as the underlying mechanism of the decrease in the patients’ pain and of the healing benefit that arises from the relationship between healer, healing modality, and patient.

  6. Factors Associated With Hyperphagic Behavior in Patients With Dementia Living at Home.

    Science.gov (United States)

    Chi, Lu-Wen; Lin, Shu-Chin; Chang, Shu-Hua; Wu, Hua-Shan

    2015-10-01

    To investigate the prevalence and patterns of and factors associated with hyperphagic behavior in Taiwanese patients with dementia living at home. A cross-sectional and correlational design was used. A total of 104 patients with dementia and their primary caregivers were recruited from the geriatric, neurology, and memory clinics of a regional hospital, a medical center and two day-care centers in central Taiwan. The data related to hyperphagic behavior, functional abilities, medical conditions, body weight, and demographic characteristics of patients as well as the demographic characteristics of their primary caregivers were collected between January and May 2013. Based on a strict criterion (a median score of 3 for the hyperphagic subscale), the prevalence of hyperphagia in patients with dementia was 53.8%. Specific hyperphagic patterns exhibited included increased food intake (49% of patients with dementia), hoarding (8.7%), oral exploration (6.8%), and pica (3.9%). Years of education of the patient, the use of antipsychotics in patients, and the age of primary caregivers explained 16.3% of the variance in hyperphagic behavior subscale scores (F = 6.47, p behavior in patients with dementia in home care or in clinic services provided by health professionals, specific attention should be paid to the usual eating behaviors of patients with lower levels of education or who are taking antipsychotic medication or those who have a female primary caregiver. © The Author(s) 2014.

  7. Quality of life in Greek family members living with leg ulcer patients.

    Science.gov (United States)

    Kouris, Anargyros; Christodoulou, Christos; Efstathiou, Vasiliki; Chatzimichail, Iakovoula; Zakopoulou, Nikoletta; Zouridaki, Eftychia

    2015-09-01

    Leg ulcers have been shown to have a significant impact on a patient's quality of life (QoL). Little is known, however, about the secondary impact of the disease on the QoL of the relatives and partners of patients with leg ulcers. The aim of this study was to explore the impact of chronic leg ulcers on the lives of both patients and their family members. Two hundred sixteen patients with leg ulcers and their family members were recruited. All patients entered were evaluated for QoL using the Dermatology Life Quality Index (DLQI) scale, and family members were similarly evaluated using the Family Dermatology Life Quality Index (FDLQI).The study included 56 female and 52 male patients, and 50 female and 58 male family members. The FDLQI score for the latter group was 14.37 ± 2.46 with over 96% of family members reporting a large effect on their QoL due to their relative's disease. The DLQI score in patients with leg ulcers was 13.18 ± 2.88. A significant positive and high correlation between DLQI and FDLQI scores (r = 0.71, p family was also affected by the patient's condition of chronic leg ulcers and clearly associated with that of the patients. © 2015 by the Wound Healing Society.

  8. Evaluation of a complex intervention to improve activities of daily living of disabled cancer patients

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; la Cour, Karen

    2014-01-01

    BACKGROUND: Many cancer patients have problems performing activities of daily living (ADL). A randomised controlled trial was designed to examine the effects of an ADL intervention in addition to standard treatment and care in a hospital setting. The objective of this article was to present...... the study and to analyse the feasibility of the recruitment process and the intervention. METHODS: Adult disabled cancer patients at Naestved Hospital in Denmark were enrolled between 1 March 2010 and 30 June 2011 and randomised into an ADL intervention or to a control group. The intervention was performed...... by occupational therapists. The feasibility of the recruitment was analysed with regard to success in achieving the estimated number of participants and identification of barriers, and feasibility of the intervention was based on calculations of patient attendance and patient acceptability. The primary outcome...

  9. Feeling Well and Having Good Numbers: Renal Patients' Encounter With Clinical Uncertainties and the Responsibility to "Live Well".

    Science.gov (United States)

    Kang, Helen; Stenfors-Hayes, Terese

    2016-10-01

    Individuals living with chronic kidney disease (CKD) must be mindful of their diet and exercise, take multiple medications, and deal with other compounding illnesses. We observed renal patients' encounters with health professionals at a renal clinic for tensions and gaps in patients' and health professionals' understandings of "living well" with CKD. We found that the renal patients at the clinic become emotionally invested in the fluctuations in the numbers on their blood work. Narrative practices of health professionals greatly affect how patients emotionally deal with the possibility of dialysis, transplant, death, or aging. Expectations to "live well" can become a moral burden to be a "good" patient. The gaps between the priorities of patients, their caregivers, and health professionals complicate the notion of "living well" with CKD. Trust, rapport and the practice of listening appear to have the greatest impact in addressing these gaps. © The Author(s) 2015.

  10. Dialysis and kidney transplantation among patients living in rural areas of the United States.

    Science.gov (United States)

    O'Hare, A M; Johansen, K L; Rodriguez, R A

    2006-01-01

    Although one-fifth of the United States population is rural, little is known about the characteristics and outcomes of rural dialysis patients. We measured the association of rural residence with patient characteristics, survival, and time to transplant among 552,279 patients who initiated dialysis between January 1, 1995 and December 31, 2002 and survived more than 90 days. We also examined the characteristics of 4363 Medicare-certified dialysis facilities by degree of rurality. Compared with urban patients, rural dialysis patients were older, less racially diverse with a higher prevalence of most co-morbid conditions. Hemodialysis was the dominant modality in both urban and rural areas, although the use of peritoneal dialysis was more frequent in rural areas. Survival and time to transplant differed by racial-ethnic group. Most notably, despite slightly better survival associated with rural vs urban residence among black populations, black populations living in rural areas were less likely to be transplanted than their urban counterparts (and than any other group examined). Compared with urban facilities, rural facilities are smaller, less likely to be for profit or owned by a large chain. Nonetheless, rural facilities perform at least as well as urban facilities based on standard performance measures. Despite more frequent use of peritoneal dialysis among rural patients, rural facilities were markedly less likely to offer peritoneal dialysis or home hemodialysis training than urban facilities. Rural black patients (most of whom live in the south) should be targeted in policies to reduce racial disparities in access to transplant. Further studies are needed to determine whether rural dialysis patients have adequate access to home-based therapies.

  11. Handicap som risikofaktor? Et udviklingspsykopatologisk perspektiv på børn med handicap

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup; Bøttcher, Louise

    2010-01-01

    Børn med handicap er generelt i større risiko for at udvikle psykopatologi. Men risikoen for fejludvikling er ikke enkelt forbundet med graden af handicappet. F.eks. oplever børn med hørehandicap næsten fire gange så hyppigt psykosociale vanskeligheder sammenlignet med hørende børn, men det er ikke...... psykopatologi etableres. I artiklen vil vi præsentere en almen model til forståelse af mennesker med handicap og deres udviklingsmuligheder – en handicappsykologisk udviklingsmodel ud fra et dialektisk kultur-historisk perspektiv (Vygotsky, (1924-31) 1993). Ved hjælp af empiriske studier vil vi eksemplificere...... forskellige typiske udviklingsmæssige problemer, der ofte opstår blandt børn med forskellige typer af handicap. At studere børn med handicap og deres psykiske udvikling kan være et vigtigt forskningsmæssigt vindue til at forstå udviklingspsykopatologi generelt....

  12. Comparison of baseline data between chronic kidney disease patients starting hemodialysis who live near and far from the dialysis center.

    Science.gov (United States)

    Santos, Paulo Roberto; Arcanjo, Cecília Costa; Aragão, Sânkia Maria Lopes; Ponte Neto, Fernando Lopes; Ximenes, Antônio Robson Gomes; Tapeti, Janaína Teixeira Pereira Carneiro; Mendes, Hyngridd Soares; Vieira, Luise Vasconcelos; Prado, Rita de Cássia Parente; Lima, Marcela Lopes; Adeodato, Wirvig Dionnas Cassemiro; de Menezes, Ivo Antônio Mendes; Moreira, Mairla Maracaba; de Oliveira, Estevam Nelson Moura; Ehrich, Thais Costa

    2014-01-01

    The treatment offered to chronic kidney disease (CKD) patients before starting hemodialysis (HD) impacts prognosis. We seek differences among incident HD patients according to the distance between home and the dialysis center. We included 179 CKD patients undergoing HD. Patients were stratified in two groups: "living near the dialysis center" (patients whose hometown was in cities up to 100 km from the dialysis center) or as "living far from the dialysis center" (patients whose hometown was more than 100 km from the dialysis center). Socioeconomic status, laboratory results, awareness of CKD before starting HD, consultation with nephrologist before the first HD session, and type of vascular access when starting HD were compared between the two groups. Comparisons of continuous and categorical variables were performed using Student's t-test and the Chi-square test, respectively. Ninety (50.3%) patients were classified as "living near the dialysis center" and 89 (49.7%) as "living far from the dialysis center". Patients living near the dialysis center were more likely to know about their condition of CKD than those living far from the dialysis center, respectively 46.6% versus 28.0% (p = 0.015). Although without statistical significance, patients living near the dialysis center had more frequent previous consultation with nephrologists (55.5% versus 42.6%; p = 0.116) and first HD by fistula (30.0% versus 19.1%; p = 0.128) than those living far from the dialysis center. There are potential advantages of CKD awareness, referral to nephrologists and starting HD through fistula among patients living near the dialysis center.

  13. Comparison of baseline data between chronic kidney disease patients starting hemodialysis who live near and far from the dialysis center

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    Paulo Roberto Santos

    2014-09-01

    Full Text Available Introduction: The treatment offered to chronic kidney disease (CKD patients before starting hemodialysis (HD impacts prognosis. Objective: We seek differences among incident HD patients according to the distance between home and the dialysis center. Methods: We included 179 CKD patients undergoing HD. Patients were stratified in two groups: "living near the dialysis center" (patients whose hometown was in cities up to 100 km from the dialysis center or as "living far from the dialysis center" (patients whose hometown was more than 100 km from the dialysis center. Socioeconomic status, laboratory results, awareness of CKD before starting HD, consultation with nephrologist before the first HD session, and type of vascular access when starting HD were compared between the two groups. Comparisons of continuous and categorical variables were performed using Student's t-test and the Chi-square test, respectively. Results: Ninety (50.3% patients were classified as "living near the dialysis center" and 89 (49.7% as "living far from the dialysis center". Patients living near the dialysis center were more likely to know about their condition of CKD than those living far from the dialysis center, respectively 46.6% versus 28.0% (p = 0.015. Although without statistical significance, patients living near the dialysis center had more frequent previous consultation with nephrologists (55.5% versus 42.6%; p = 0.116 and first HD by fistula (30.0% versus 19.1%; p = 0.128 than those living far from the dialysis center. Conclusion: There are potential advantages of CKD awareness, referral to nephrologists and starting HD through fistula among patients living near the dialysis center.

  14. YHD in Struggle for Independent Living for Disabled

    Directory of Open Access Journals (Sweden)

    Elena Pečarič

    2013-09-01

    Full Text Available The YHD group (Youth Handicapped Deprivileged was shaped from the need of young disabled students who wanted to taste freedom and independence. Through revolt, persistence and thirst for answers, the informal movement Youth Handicapped Deprivileged was established. It was later transformed into YHD – Association for Theory and Culture of Handicap. YHD found a home in ACC Metelkova and has stayed there for 20 years. The theory of handicap and revolt against medical comprehension of disability are the principal guidelines to which the Associations’ projects and actions adhere. Other associations for disabled people are centered around medical diagnoses of its members, whereas YDH aims to bring about positive changes concerning the position of handicapped people in the society. For YHD, disability is a social status and not a characteristic of the body or a mental condition, difficulty or »special need«. YHD rejects a pre-written script for the lives of the disabled.

  15. Noise-induced hearing impairment and handicap

    Science.gov (United States)

    1984-01-01

    A permanent, noise-induced hearing loss has doubly harmful effect on speech communications. First, the elevation in the threshold of hearing means that many speech sounds are too weak to be heard, and second, very intense speech sounds may appear to be distorted. The whole question of the impact of noise-induced hearing loss upon the impairments and handicaps experienced by people with such hearing losses was somewhat controversial partly because of the economic aspects of related practical noise control and workmen's compensation.

  16. Emirati Teachers' Perceptions of Voice Handicap.

    Science.gov (United States)

    Natour, Yaser S; Sartawi, Abdealaziz M; Al Muhairy, Ousha; Efthymiou, Effie; Marie, Basem S

    2016-05-01

    The purpose of the study was to explore Emirati teachers' perceptions of voice handicap and to analyze their acoustic characteristics to determine whether acoustic measures of teachers' voice would verify their perceptions of voice handicap. Sixty-six Emirati school teachers (33 men and 33 women), with different years of teaching experience and age, and 100 control participants (50 men and 50 women) underwent vocal assessment that included the Voice Handicap Index (VHI-Arab) and acoustic measures (F0, jitter%, shimmer%, signal to noise ratio [SNR]). Significant differences between the teachers' group scores and the control group scores on the following subscales of VHI-Arab: physical (P = 0.006), emotional (P = 0.004), and total score of the test (P = 0.002). No significant differences were found among teachers in the three VHI subscales, and the total score regarding gender (functional P = 0.307; physical P = 0.341; emotional P = 0.126; and total P = 0.184), age (functional P = 0.972; physical P = 0.525; emotional P = 0.772; and total P = 0.848), and years of teaching experience (functional P = 0.319; physical P = 0.619; emotional P = 0.926; and total P = 0.638). The significant differences between the teacher's group and the control group in three acoustic measures: F0 (P = 0.000), shimmer% (P = 0.000), and SNR (P = 0.000) were further investigated. Significant differences were found among female and male teachers in F0 (P = 0.00) and SNR (P = 0.007). As for teachers' age, significant differences were found in SNR (P = 0.028). Teachers' years of experience did not show significant differences in any of the acoustic measures. Teachers have a higher perception of voice handicap. However, they were able to produce better voice quality than control participants were, as expressed in better SNRs. This might have been caused either by manipulation of vocal properties or abusive overloading the vocal system to produce a

  17. Patients' experiences of living with and receiving treatment for fibromyalgia syndrome: a qualitative study

    Directory of Open Access Journals (Sweden)

    Carville Serene F

    2009-10-01

    Full Text Available Abstract Background Fibromyalgia syndrome (FMS presents a challenge for patients and health care staff across many medical specialities. The aetiology is multi-dimensional, involving somatic, psychological and social factors. Patients' views were obtained to understand their experience of living with this long-term condition, using qualitative interviews. Methods 12 patients were recruited and stratified by age, gender and ethnicity from one rheumatology outpatient clinic, and a departmental held database of patients diagnosed with FMS. Results Patients' accounts of their experience of FMS resonated well with two central concepts: social identity and illness intrusiveness. These suggested three themes for the analytical framework: life before and after diagnosis (e.g. lack of information about FMS, invisibility of FMS; change in health identity (e.g. mental distress, impact on social life and perceived quality of care (e.g. lack of contact with nurses, attitudes of specialists. The information provided from one male participant did not differ from the female patients, but black and ethnic community patients expressed a degree of suspicion towards the medication prescribed, and the attitudes displayed by some doctors, a finding that has not been previously reported amongst this patient group. Patients expected more consultation time and effective treatment than they received. Subjective experiences and objective physical and emotional changes were non-overlapping. Patients' accounts revealed that their physical, mental and social health was compromised, at times overwhelming and affected their identity. Conclusion FMS is a condition that intrudes upon many aspects of patients' lives and is little understood. At the same time, it is a syndrome that evokes uneasiness in health care staff (as current diagnostic criteria are not well supported by objective markers of physiological or biochemical nature, and indeed because of doubt about the existence

  18. The effect of live music on decreasing anxiety in patients undergoing chemotherapy treatment.

    Science.gov (United States)

    Ferrer, Alejandra J

    2007-01-01

    The purpose of this study was to investigate the effects of familiar live music on the anxiety levels of patients undergoing chemotherapy treatment. Randomly selected patients were assigned to experimental (n = 25) and control (n = 25) conditions. Pre and posttests consisted of questionnaires and the recording of the patient's heart rate and blood pressures. Subjects in the experimental group received 20 minutes of familiar live music during their chemotherapy treatment. Subjects in the control group received standard chemotherapy. It was assumed that those patients receiving music intervention would: (a) lower their anxiety levels; (b) experience a decrease in heart rate and blood pressure; (c) improve their levels of negative reactions including fatigue, worry, and fear; and (d) improve their levels of positive reactions including comfort and relaxation. Results of the study showed statistically significant improvement for the experimental group on the measures of anxiety, fear, fatigue, relaxation, and diastolic blood pressure. No significant differences between groups were found for heart rate and systolic blood pressure. Descriptive values indicated that, on average, the experimental group was influenced positively by the music intervention, and participants improved their quality of life while undergoing chemotherapy treatment.

  19. The lived experience of patients regarding patients' rights practice at hospitals in Amhara Region, northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Berhane A

    2016-05-01

    Full Text Available Adugnaw Berhane,1 Fikre Enquselassie2 1College of Health Sciences, Debre Berhan University, Debre Berhan, 2School of Public Health, Addis Ababa University, Addis Ababa, EthiopiaBackground: There are a number of different international guidelines promoting the practice of observing patients’ rights in the health care service. Patients experience greater satisfaction in the health care service when their rights are protected. The purpose of this study was to examine patients’ experiences regarding their rights in hospital settings in northern Ethiopia.Patients and methods: Data were collected using semistructured interviews of 22 patients, who have had experience of health care service in the hospital setting. The patients were selected from the outpatient and inpatient departments of referral and district hospitals in northern Ethiopia. The interview data were tape-recorded, transcribed, translated, reviewed, and analyzed using a phenomenographic approach. Categories of descriptions were constructed based on the patients’ conceptions and ways of understanding the phenomenon of patients’ rights practice.Results: The findings revealed four main qualitatively different ways of understanding patients’ rights practice from the patients’ perspective. These main categories of description were patient-centered practice, being secured, respecting patients’ dignity, and getting referral.Conclusion: The different conceptions of patient rights give us a deeper understanding of how patients may experience patients’ rights practice. The result provides a foundation for developing health care practice that equips the patient with a positive experience, thus contributing in drafting patients’ bill of rights in the local context.Keywords: patient rights, phenomenography, hospital health care, patient experience

  20. Localized intraoperative virtual endoscopy (LIVE) for surgical guidance in 16 skull base patients.

    Science.gov (United States)

    Haerle, Stephan K; Daly, Michael J; Chan, Harley; Vescan, Allan; Witterick, Ian; Gentili, Fred; Zadeh, Gelareh; Kucharczyk, Walter; Irish, Jonathan C

    2015-01-01

    Previous preclinical studies of localized intraoperative virtual endoscopy-image-guided surgery (LIVE-IGS) for skull base surgery suggest a potential clinical benefit. The first aim was to evaluate the registration accuracy of virtual endoscopy based on high-resolution magnetic resonance imaging under clinical conditions. The second aim was to implement and assess real-time proximity alerts for critical structures during skull base drilling. Patients consecutively referred for sinus and skull base surgery were enrolled in this prospective case series. Five patients were used to check registration accuracy and feasibility with the subsequent 11 patients being treated under LIVE-IGS conditions with presentation to the operating surgeon (phase 2). Sixteen skull base patients were endoscopically operated on by using image-based navigation while LIVE-IGS was tested in a clinical setting. Workload was quantitatively assessed using the validated National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire. Real-time localization of the surgical drill was accurate to ~1 to 2 mm in all cases. The use of 3-mm proximity alert zones around the carotid arteries and optic nerve found regular clinical use, as the median minimum distance between the tracked drill and these structures was 1 mm (0.2-3.1 mm) and 0.6 mm (0.2-2.5 mm), respectively. No statistical differences were found in the NASA-TLX indicators for this experienced surgical cohort. Real-time proximity alerts with virtual endoscopic guidance was sufficiently accurate under clinical conditions. Further clinical evaluation is required to evaluate the potential surgical benefits, particularly for less experienced surgeons or for teaching purposes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  1. Unilateral deafness after acoustic neuroma surgery: subjective hearing handicap and the effect of the bone-anchored hearing aid.

    Science.gov (United States)

    Andersen, Henrik Terkel; Schrøder, Stine Attrup; Bonding, Per

    2006-09-01

    To evaluate the subjective hearing handicap in patients with unilateral deafness after acoustic neuroma surgery and the effect of the Bone-anchored Hearing Aid (BAHA) on test band. Fifty-nine consecutive patients with unilateral deafness after translabyrintine removal of an acoustic neuroma, treated in Denmark in 2001 and 2002, were included. The patients were asked to complete a questionnaire, which addressed the subjective handicap of unilateral deafness; 90% responded. These patients were invited to test the BAHA on test band, and the subjective and objective effects were recorded. Eighty percent of the patients thought that they had a subjective hearing handicap of some significance. However, only 50% accepted the invitation to test the BAHA. The overall subjective effect was positive, and a significant improvement in speech discrimination in noise with the BAHA was demonstrated. After the test, however, only about 50%, that is, 25% of all patients wished implantation for BAHA treatment. This study shows that unilateral deafness after acoustic neuroma surgery is thought as a handicap in most of the patients and confirms that treatment with the BAHA has positive subjective effects and improves speech discrimination in noise. However, only 25% of the patients wished implantation for BAHA treatment. The implications of these findings are discussed. Data from centers that perform simultaneous acoustic neuroma surgery and implantation for BAHA are necessary for firm conclusions.

  2. Motion analysis of patients after knee arthroplasty during activities of daily living--a systematic review.

    Science.gov (United States)

    Komnik, I; Weiss, S; Fantini Pagani, C H; Potthast, W

    2015-02-01

    Motion analysis with optoelectronic systems is a frequently used method to analyze the patient's gait as well as further relevant activities of daily living before and after knee arthroplasty. The aim of this systematic review was to identify the investigated activities of daily living and to show an extensive presentation of gait analysis studies with patients after knee arthroplasty surgery. The articles were searched in electronic databases: MEDPILOT, EMBASE. To identify articles that potentially met the inclusion criteria the titles and abstracts were screened. The level of evidence was analyzed for the included articles. Overall 3989 abstracts were reviewed and 87 full text articles were included. Ten activities of daily living were identified. Level walking was the most frequently investigated activity (78.2%). In 94.6% the sagittal plane kinematics were analyzed and 5.3% presented the results in all three planes. Knee adduction moments were determined in 33.3% of the included articles. At least two joints were investigated in 40.2%, including the impaired knee and further body parts (ankle, hip, pelvis, trunk). Unicondylar knee arthroplasty was addressed in 14.1%. Besides level walking, it is necessary to examine physical more demanding activities of daily living to detect potential kinematic and kinetic abnormalities. Further research should imply the evaluation of sagittal, frontal and transverse plane joint and muscle function based on accurate inverse-dynamic techniques. More motion analysis studies are necessary that address unicondylar knee arthroplasty in comparison to total knee arthroplasty and healthy controls. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Singing voice handicap mapped by different self-assessment instruments.

    Science.gov (United States)

    Paoliello, Karla; Oliveira, Gisele; Behlau, Mara

    2013-01-01

    To map voice handicap of popular singers with a general voice and two singing voice self-assessment questionnaires. Fifty singers, 25 male and 25 female, 23 with vocal complaint and 27 without vocal complaint answered randomly the questionnaires. For the comparison of data, the following statistical tests were performed: Mann-Whitney, Friedman, Wilcoxon, Spearman and Correlation. Data showed that the VHI yielded a smaller handicap when compared to the other two questionnaires (VHI x S-VHI - p=0.001; VHI x MSVH - p=0.004). The S-VHI and MSVH produced similar results (p=0.723). Singers with vocal complaint had a VHI total score of 17.5. The other two instruments showed more deviated scores (S-VHI - 24.9; MSVH - 25.2). There was no relationship between gender and singing style with the handicap perceived. A weak negative correlation between the perceived handicap and the time of singing experience was found (-37.7 to -13.10%), that is, the smaller the time of singing experience, the greater the handicap is. The questionnaires developed for the assessment of singing voice, S-VHI and MSVH, showed to be more specific and correspondent to each other for the evaluation of vocal handicap in singers. Findings showed that the more the time of singer's singing experience, the smaller the handicap is. Gender and singing styles did not influence the perception of the handicap.

  4. Ethical Issues in Withholding Care from Severely Handicapped Infants.

    Science.gov (United States)

    Cohen, Libby

    1981-01-01

    Ethical issues are examined that involve withholding medical treatment from severely handicapped infants. Although current laws do not sanction euthanasia, severely handicapped infants are often assisted in dying. Discussion includes society's apparent acceptance of this practice and several solutions to the problems. (Author)

  5. Academic Self-Handicapping and Achievement: A Meta-Analysis

    Science.gov (United States)

    Schwinger, Malte; Wirthwein, Linda; Lemmer, Gunnar; Steinmayr, Ricarda

    2014-01-01

    Self-handicapping represents a frequently used strategy for regulating the threat to self-esteem elicited by the fear of failing in academic achievement settings. Several studies have documented negative associations between self-handicapping and different educational outcomes, inter alia academic achievement. However, studies on the relation…

  6. Handicapped Children in Schools: Administrators and the Courts. Revised.

    Science.gov (United States)

    O'Reilly, Robert C.; Sayler, Mary R.

    School principals perform a crucial role in discharging a school system's legal obligations toward the handicapped. Since principals are unable to supply money damages, they are rarely primary targets of lawsuits involving handicapped children, but their role in representing Individualized Education Programs (IEPs) to parents is critical. Thus,…

  7. Orientation and Mobility for Multiply Handicapped Blind Children.

    Science.gov (United States)

    Wood, Thomas A.

    A research project was conducted to investigate sensory, concept, and locomotion skills in severely multiply handicapped children. The project involved the development of evaluation and teaching materials to be utilized by classroom teachers and paraprofessionals with multi-handicapped children with severe visual deficits. The programed…

  8. "Euthanasia" of Persons with Severe Handicaps: Refuting the Rationalizations.

    Science.gov (United States)

    Lusthaus, Evelyn

    1985-01-01

    The article examines two common rationalizations for euthanasia of persons with severe handicaps and presents arguments to refute them. The article calls for parents, professionals, and friends of persons with severe handicaps to be vocal in refuting euthanasia and its rationales. (Author/CL)

  9. Handicapism: The case of the hearing impaired in inclusive ...

    African Journals Online (AJOL)

    The paper is a careful review of related literature and detail examination of other researchers' work in the area of handicapism, and the researcher also made some proposals in relation to planning and policy in matters that concern handicapped or disabled students relative to inclusive education now made available to ...

  10. Handicapping Raters for Fairer Clinical Grading: A Practical Application.

    Science.gov (United States)

    Cason, Gerald J.; And Others

    To minimize the effects of systematic differences in raters' standards of clinical competence, a handicapping system was applied to the ratings made by fourteen preceptors of 128 junior year medical students in a 6-week psychiatry clerkship at the University of Arkansas for Medical Sciences. The handicap of a preceptor was the difference between…

  11. A Selected Bibliography for and about Parents of the Handicapped.

    Science.gov (United States)

    Cohen, Shirley

    The bibliography contains approximately 90 citations of publications for and about parents of handicapped children. Citations are listed alphabetically by author within the following categories: "On Being the Parent of a Handicapped Child--Writings by Parents", "Information, Teaching Suggestions, and Training Guides for…

  12. Involving Handicapped Cub Scouts: Instructor's Guide. Cub Scout Leader Development.

    Science.gov (United States)

    Boy Scouts of America, New Brunswick, NJ.

    The Instructor's Guide is intended for use in training adult leaders to foster understanding and involvement of the handicapped in Cub Scout activities. Suggestions are offered for organizing two leadership training sessions which include defining types of handicaps leaders may encounter, conducting buzz group discussions on similarities between…

  13. Personal Integration Resources of Mentally Handicapped Teenagers into Society

    Science.gov (United States)

    Konovalova, Natalia

    2016-01-01

    The paper deals with the issues concerning the study of mentally handicapped teenagers' integrative potential within modernisation of contemporary Russian education. The research is concentrated on the study of personal and social determinants influencing the readiness of mentally handicapped students to be integrated into the environment.…

  14. Sexuality and the Developmentally Handicapped: Health Education Strategies.

    Science.gov (United States)

    Martin, Mary-Lou; Fochuk, Cheryl

    1987-01-01

    The Health Education and Learning for The Handicapped (HEALTH) program provides sex education to developmentally handicapped persons through group discussion, role-playing, films, and other visual aids. The one-hour group sessions, given over 12-14 weeks with 6-12 participants, discuss body parts, acceptable social behavior, assertiveness, birth…

  15. Frequency of Divorce Among Parents of Handicapped Children.

    Science.gov (United States)

    Shufeit, Lawrence J.; Wurster, Stanley R.

    Seventy-six parents of handicapped children were surveyed to compare the frequency of divorce in the sample population to that of the U.S. population. A research review revealed that the first-born child causes extensive to severe crises in the parents' marital relationship; that the presence of a child with a handicapping condition causes a…

  16. The psychometric properties of the Tinnitus Handicap Questionnaire in a Dutch-speaking population.

    Science.gov (United States)

    Vanneste, S; To, W T; De Ridder, D

    2011-02-01

    The aim of the study is to translate and validate the tinnitus handicap questionnaire (THQ) for a Dutch-speaking population. The factor structure of the questionnaire, the reliability and the validity is determined. Furthermore, a statistical comparison with the original English version of the tinnitus handicap questionnaire is performed. We assessed 101 patients at the Tinnitus Research Initiative clinic of Antwerp University Hospital. Twenty-seven Dutch items from the tinnitus handicap questionnaire by Kuk et al. [(1990), Ear Hear11:434-45.] were obtained by the process of translation and back translation. The factor structure, internal consistency, was evaluated using Cronbach's alpha coefficient and item correlations were used to confirm reliability. The construct validity was confirmed with a visual analogue scale for loudness and distress, awareness, annoyance, the Tinnitus Questionnaire (TQ), the mini-Tinnitus Questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory (BDI) and the Profile of Mood State (POMS), ensuring that this new instrument measures the tinnitus handicap. This study demonstrates that the Dutch version of the tinnitus handicap questionnaire is a reliable (Cronbach's alpha coefficient α = 0.93) and valid measure of self-perceived tinnitus-related distress [with visual analogue scale for loudness (r = 0.39) and distress (r =0.45), awareness (r = 0.39), annoyance (r = 0.57), the Tinnitus Questionnaire (r = 0.82), the mini-Tinnitus Questionnaire (r = 0.79), the Hospital Anxiety and Depression Scale (r = 0.62) and the Beck Depression Inventory (r = 0.32)]. The psychometric properties are in line with previous findings on the English version with regard to reliability and validity. However, the items in the subscales differ from the English version. While the English version has three subscales, our version has only two subscales. Yet, the English version reports that for the three factors, there is a low

  17. Cultural interrelationships and the lived experience of Pakistani breast cancer patients.

    Science.gov (United States)

    Banning, Maggi; Hassan, M; Faisal, S; Hafeez, H

    2010-09-01

    There is a paucity of British and international literature on the psychological, sociological and cultural correlates of breast health in ethnic minority women. This two centre qualitative study was part of a larger study that aimed to examine the influence of culture on the lived experience of Pakistani Muslim breast cancer patients. Thirty six patients attending hospital out-patient breast cancer clinics in Lahore, Pakistan and London, UK were recruited to the study. Women were predominantly married, 20-76 years of age with an average of three children. Semi-structured interviews were undertaken. Interview data were analysed using thematic analysis. Five themes emerged: Discovery and reaction to the disease; disclosure to family; developing emotions; emerging reality; long term uncertainty. Data infer that irrespective of city of residence, the cultural attributes of women, breast health awareness and reactions to the diagnosis and treatment are similar. To raise awareness, more focused health education interventions are needed.

  18. Ability to perform Actvities of Daily Living among patients with bipolar disorder in remission

    DEFF Research Database (Denmark)

    Decker, Lone; Träger, Conny; Miskowiak, Kamilla

    2017-01-01

    in the community. While participants reported decreased ADL ability, especially within instrumental ADL, they had a tendency towards evaluating themselves as more competent than what was observed. No relationships between measures of observed and self-reported ADL ability were found. Conclusion: Overall, patients......ABSTRACT Aims: Patients with bipolar disorder often experience disability in terms of cognitive impairments and activity limitations even in remission. However, knowledge is sparse concerning the ability to perform Activities of Daily Living (ADL) during remission. The aim of this study was to (1......) investigate the observed and self-reported ability to perform ADL tasks and (2) examine the association between observed and self-reported ability to perform ADL in patients with bipolar disorder in remission. Methods: The observed ADL ability was assessed with the Assessment of Motor and Process Skills...

  19. Lived experience of the intensive care unit for patients who experienced delirium.

    Science.gov (United States)

    Whitehorne, Karen; Gaudine, Alice; Meadus, Robert; Solberg, Shirley

    2015-11-01

    Delirium is a common occurrence for patients in the intensive care unit and can have a profound and lasting impact on them. Few studies describe the experience of intensive care patients who have had delirium. To understand the lived experience of intensive care for critically ill patients who experienced delirium. The study participants consisted of 7 men and 3 women, 46 to 70 years old, who had delirium according to the Confusion Assessment Method for the Intensive Care Unit. The van Manen method of hermeneutic phenomenology was used, and data collection entailed audio recorded semistructured interviews. Four themes were detected: "I can't remember," "Wanting to make a connection," "Trying to get it straight," and "Fear and safety concerns." Nurses working in intensive care units need to assess patients for delirium, assess the mental status of patients who have delirium, and help patients and patients' families learn about and deal with the psychological effects of the intensive care unit experience. ©2015 American Association of Critical-Care Nurses.

  20. Living Arrangements Modify the Relationship Between Depressive Symptoms and Self-care in Patients With Heart Failure.

    Science.gov (United States)

    Lee, Kyoung Suk; Lennie, Terry A; Yoon, Ju Young; Wu, Jia-Rong; Moser, Debra K

    Depressive symptoms hinder heart failure patients' engagement in self-care. As social support helps improve self-care and decrease depressive symptoms, it is possible that social support buffers the negative impact of depressive symptoms on self-care. The purpose of this study is to examine the effect of living arrangements as an indicator of social support on the relationship between depressive symptoms and self-care in heart failure patients. Stable heart failure patients (N = 206) completed the Patient Health Questionnaire-9 to measure depressive symptoms. Self-care (maintenance, management, and confidence) was measured with the Self-Care of Heart Failure Index. Path analyses were used to examine associations among depressive symptoms and the self-care constructs by living arrangements. Depressive symptoms had a direct effect on self-care maintenance and management (standardized β = -0.362 and -0.351, respectively), but not on self-care confidence in patients living alone. Depressive symptoms had no direct or indirect effect on any of the 3 self-care constructs in patients living with someone. Depressive symptoms had negative effects on self-care in patients living alone, but were not related to self-care in patients living with someone. Our results suggest that negative effects of depressive symptoms on self-care are buffered by social support.

  1. Patient safety culture lives in departments and wards: Multilevel partitioning of variance in patient safety culture

    Directory of Open Access Journals (Sweden)

    Hofoss Dag

    2010-03-01

    Full Text Available Abstract Background Aim of study was to document 1 that patient safety culture scores vary considerably by hospital department and ward, and 2 that much of the variation is across the lowest level organizational units: the wards. Setting of study: 500-bed Norwegian university hospital, September-December 2006. Methods Data collected from 1400 staff by (the Norwegian version of the generic version of the Safety Attitudes Questionnaire (SAQ Short Form 2006. Multilevel analysis by MLwiN version 1.10. Results Considerable parts of the score variations were at the ward and department levels. More organization level variation was seen at the ward level than at the department level. Conclusions Patient safety culture improvement efforts should not be limited to all-hospital interventions or interventions aimed at entire departments, but include involvement at the ward level, selectively aimed at low-scoring wards. Patient safety culture should be studied as closely to the patient as possible. There may be such a thing as "hospital safety culture" and the variance across hospital departments indicates the existence of department safety cultures. However, neglecting the study of patient safety culture at the ward level will mask important local variations. Safety culture research and improvement should not stop at the lowest formal level of the hospital (wards, out-patient clinics, ERs, but proceed to collect and analyze data on the micro-units within them.

  2. Handicap, beskæftigelse og uddannelse i 2016

    DEFF Research Database (Denmark)

    Larsen, Malene Rode; Larsen, Mona

    for det første om og, i givet fald, hvordan personer med handicap adskiller sig fra personer uden handicap, når det gælder beskæftigelse, modtagelse af overførselsindkomst, uddannelse, læse- og skrivevanskeligheder, arbejdsudbud og jobsøgning samt tidspunkt for tilbagetrækning fra arbejdsmarkedet. For det...... ikkebeskæftigedes beskæftigelsespotentiale for personer med handicap. Endelig belyser rapporten beskæftigedes holdninger til at arbejde med personer med handicap.......Denne rapport afdækker, hvor stor en del af den danske befolkning i alderen 16 til 64 år, der har et handicap eller et længerevarende helbredsproblem. I forlængelse heraf undersøger rapporten en lang række forhold relateret til denne gruppes tilknytning til arbejdsmarkedet. Rapporten belyser...

  3. Quality of life for patients living with ostomies: influence of contact with an ostomy nurse.

    Science.gov (United States)

    Aronovitch, Sharon A; Sharp, Robbie; Harduar-Morano, Laurel

    2010-01-01

    This study was conducted to determine whether or not contact with a WOC nurse improves quality of life for ostomy patients. Home health care agencies, hospitals, and a durable medical equipment company in northern Florida were contacted to participate in the study. The role of the participating facilities was to address the provided envelopes and mail the patient survey packet (introductory letter, Ostomy Quality of Life Questionnaire [OQLQ], and demographic survey) directly to the patient. The mean age or respondents was 62 years, and the mean time of living with an ostomy was 10 years. Ninety-six percent of the sample participants did not attend support groups, yet nearly 50% reported receiving education following discharge home. Analysis of OQLQ scores revealed statistically significant differences based on who the respondent lived with, the number of comorbidities, how the respondent received supplies, and the type of appliance worn. There was no significant difference between respondents who saw an ostomy nurse and those who did not among the various sections of the OQLQ, even though 83% indicated seeing an ostomy nurse. Body image was a concern to respondents. The data demonstrated that most participants maintained satisfactory quality of life despite the presence of an ostomy. Individuals who were working part-time had a better health-related quality of life than those who worked full-time. More than 50% of our study sample participants reported satisfaction with the healthcare services they received, regardless of whether services were provided by a WOC or a nonspecialist nurse.

  4. Successful living donor kidney transplantation in a patient with prothrombin gene mutation: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Edward Shen

    2014-01-01

    Full Text Available We present a patient with known prothrombin gene mutation and a history of prior vascular events, who underwent living donor kidney transplantation. Given the presumed elevated risk of complication from known prothrombin mutation, clinical management was directed towards optimizing living donor allograft function.

  5. Medication adherence and beliefs about medication in elderly patients living alone with chronic diseases.

    Science.gov (United States)

    Park, Hwa Yeon; Seo, Sin Ae; Yoo, Hyeyoung; Lee, Kiheon

    2018-01-01

    The aim of this study was to assess medication adherence and its related factors among elderly people living alone with chronic diseases using a conceptual framework with the Belief about Medicines Questionnaire and the Adherence to Refills and Medication Scale-Korean version. This was a cross-sectional study conducted in 3,326 elderly people living alone, who were enrolled in Seongnam Center for Home Health Care in South Korea. They completed validated questionnaires assessing their adherence and beliefs about medication in general. In attitudinal analysis using Belief about Medicines Questionnaire, 37.0% of patients were accepting of medication (high necessity with low concerns), 49.7% were ambivalent (high necessity with high concerns), 1.9% were skeptical (low necessity with high concerns), and 11.4% were indifferent (low necessity and low concerns). In multivariable analysis, we found that adherence was related to patients' beliefs about medication; compared with patients who were accepting of medication, those in the other three attitudinal groups had significantly lower adherence (indifferent, p =0.003; skeptical, p =0.001; ambivalent, p adherence was associated with heavy burden of drug costs (β=0.109; 95% CI 0.03, 0.19), presence of drug side effects (β=0.431; 95% CI 0.11, 0.75), dissatisfaction with medication (β=-0.626; 95% CI -0.77, -0.48), perceiving health status as poor (β=-0.151; 95% CI -0.27, -0.03), and receiving medical aid (β=0.655; 95% CI 0.42, 0.89). Gender, age group, and number of prescribed medication were not associated with medication adherence. To improve medication adherence of elderly living alone, it is essential to identify barriers to adherence, including their concerns and attitudes toward medications. These factors associated with adherence should be considered in further intervention studies.

  6. The lived experiences of spiritual suffering and the healing process among Taiwanese patients with terminal cancer.

    Science.gov (United States)

    Chio, Chung-Ching; Shih, Fu-Jin; Chiou, Jeng-Fong; Lin, Hsiao-Wei; Hsiao, Fei-Hsiu; Chen, Yu-Ting

    2008-03-01

    The purposes of this study were to explore the lived experiences of spiritual suffering and the change mechanism in healing processes among Taiwanese patients with terminal cancer. The approach to this study was phenomenological-hermeneutic. Twenty-one patients with terminal cancer were invited to participate in a semi-structured interview that dealt with their experiences of spiritual suffering and the healing process. This study was conducted in the inpatient unit of the oncology department in two general hospitals. The interviews were recorded, transcribed and later analysed using the approach of narrative analysis. According to the results of case narration, the causes of spiritual suffering included cancer, known as a life-threatening illness, physical pain, treatment complications, uncertain illness progression, disability problems and lack of support. Patients turned to internal resources (including regarding the suffering as a life challenge, volunteering to help other cancer patients and searching for life wisdoms) and external resources (including peer support groups and family support) as they endured spiritual suffering. Taiwanese patients turned to Eastern and Western philosophies of Taoism, Confucianism, Buddhism and Christianity as methods to interpret their spiritual suffering. Patients' positive views of misfortune because of cancer and sufficient social supports were the key elements of the healing process to alleviate spiritual suffering. Nurses who learn to participate in suffering assessment are better able to understand spiritual needs of cancer patients. Cancer patients' views on the change mechanism in healing processes could provide essential information for nurses in developing an effective intervention programme. If nurses consider cultural factors that shape patients' experiences of spiritual suffering and the healing process, they could learn how to meet the needs of patients better from different cultural backgrounds.

  7. Ethics and aging: focus on living will for patients with dementia

    Directory of Open Access Journals (Sweden)

    Alberto Sardella

    2017-07-01

    Full Text Available Today dementia certainly represents a public health priority with a huge global impact on wordwide population. However, clinical and social issues related to dementia have long been marginalized. The actual high prevalence of dementias requires also to face issues from a bioethical perspective, regarding how to deal with demented patient’s disposition. There are currently no specific guidelines on the national territory regarding whether to draw up a living will by a patient with dementia, neither about the informative role of physicians during the progressive story of the disease.

  8. Translation, validity, and reliability of a persian version of the iowa tinnitus handicap questionnaire.

    Science.gov (United States)

    Arian Nahad, Homa; Rouzbahani, Masomeh; Jarollahi, Farnoush; Jalaie, Shohreh; Pourbakht, Akram; Mokrian, Helnaz; Mahdi, Parvane; Amali, Amin; Nodin Zadeh, Abdolmajid

    2014-04-01

    Tinnitus is a common otologic symptom that can seriously affect a patient's quality of life. The purpose of the present study was to translate and validate the Iowa Tinnitus Handicap Questionnaire (THQ) into the Persian language, and to make it applicable as a tool for determining the effects of tinnitus on a patient's life. The main version of the THQ was translated into the Persian language. The agreed Persian version was administered to 150 tinnitus patients. The validity of the Persian THQ was evaluated and internal reliability was confirmed using Cronbach's α-coefficient. Finally, the effect of independent variables such as age, mean patient threshold, gender, and duration of tinnitus were considered in order to determine the psychometric properties of tinnitus. After an exact translation process, the Persian THQ was found to exhibit face validity. In terms of content validity, content validity index in total questionnaire was 0.93. Further, in structural validity measurements, intermediate correlation with annoyance from tinnitus (r=0.49), low correlation with duration of tinnitus (r=0.34) and high correlation with the Tinnitus Handicap Inventory (THI) questionnaire (r=0.84) were demonstrated. Additionally, a negligible effect of gender and age was noted on degree of tinnitus handicap (P= 0.754, P= 0.573, respectively). In the internal reliability assessment for Factors 1, 2, 3, and the whole questionnaire, Cronbach`s α-coefficient was 0.95, 0.92, 0.25 and 0.88, respectively. The Persian version of the Iowa THQ demonstrates high validity and reliability and can be used for the determination of tinnitus handicap and for following-up in the intervention process in Persian tinnitus patients.

  9. Brazilian Dental Students' Attitudes About Provision of Care for Patients Living in Poverty.

    Science.gov (United States)

    Dos Santos, Beatriz Ferraz; Madathil, Sreenath; Zuanon, Angela Cristina Cilense; Bedos, Christophe; Nicolau, Belinda

    2017-11-01

    The aims of this study were to investigate dental students' attitudes toward people living in poverty and the extent to which their perceptions were associated with their willingness to treat those patients in their future practice. All 910 dental students enrolled in three Brazilian public universities in 2010 were invited to take part in a cross-sectional survey. A total of 766 students (83.7% response rate) completed the self-administered questionnaire on their perceptions of and attitudes about poverty and their intention to provide dental care to poor people. The responding students showed slightly positive attitudes about people living in poverty; however, a high percentage (35%) reported thinking they were different from the rest of the population. Nevertheless, most of these students expressed willingness to provide care to underserved populations in their future practice; this willingness was found to be associated with their beliefs about poverty (OR 1.65; 95% CI=1.41-1.94). Overall, the study found that these dental students had altruistic views toward people living in poverty. However, they seemed to lack a deep understanding of poverty that may prevent them from acting on their good intentions.

  10. Pet ownership may attenuate loneliness among older adult primary care patients who live alone.

    Science.gov (United States)

    Stanley, Ian H; Conwell, Yeates; Bowen, Connie; Van Orden, Kimberly A

    2014-01-01

    Older adults who report feelings of loneliness are at increased risk for a range of negative physical and mental health outcomes, including early mortality. Identifying potential sources of social connectedness, such as pet ownership, could add to the understanding of how to promote health and well-being in older adults. The aim of this study is to describe the association of pet ownership and loneliness. The current study utilizes cross-sectional survey data from a sample (N = 830) of older adult primary care patients (age ≥ 60 years). Pet owners were 36% less likely than non-pet owners to report loneliness, in a model controlling for age, living status (i.e., alone vs. not alone), happy mood, and seasonal residency (adjOR = 0.64, 95% CI = 0.41-0.98, p pet ownership and living status (b = -1.60, p pet was associated with the greatest odds of reporting feelings of loneliness. The findings suggest that pet ownership may confer benefits for well-being, including attenuating feelings of loneliness and its related sequelae, among older adults who live alone.

  11. Vocal handicap and quality of life after treatment of advanced squamous carcinoma of the larynx and/or hypopharynx.

    Science.gov (United States)

    Azevedo, Elma Heitmann Mares; Montoni, Neyller; Gonçalves Filho, João; Kowalski, Luiz Paulo; Carrara-de Angelis, Elisabete

    2012-03-01

    To evaluate and correlate voice-specific quality of life (QOL) and health-related QOL (HR-QOL) after treatment for advanced cancer of the larynx and/or hypopharynx. Cross-sectional study. Patients submitted to partial laryngectomy (PL), salvage PL (sPL), concomitant radiotherapy and chemotherapy (RT+Chemo), total laryngectomy (TL), salvage TL (sTL), total pharyngolaryngectomy (TP) and salvage total pharyngolaryngectomy (sTP). The following questionnaires were used: (1) Voice Handicap Index (VHI) and (2) University of Washington Quality of Life Questionnaire (UW-QOL; version 4). Eighty-four patients participated in the study. All the patients PL (10), sPL (1), and RT+Chemo (24) communicated by laryngeal voice. Of the 49 patients submitted to total removal of the larynx, 30 communicated with alaryngeal phonation, the major part being tracheoesophageal prosthesis (17). The worst subscale of VHI for the total patient group was functional (mean=13.15), and the value of the total score was 31. Patients submitted to PL, RT+Chemo, and TL presented slight handicap (medians of 27, 14, and 21.5, respectively). Patients treated with sTL, TP, and sTP presented moderate handicap (medians of 45, 37.5, and 31.5, respectively). HR-QOL was considered between good and excellent for 78.6% of the patients, and poor for 21.4%. The correlation between voice-specific QOL and HR-QOL was significant (P=0.0001). Patients treated for advanced cancer of the larynx/hypopharynx present slight to moderate voice handicap and good/excellent HR-QOL. Stricter analysis of both the VHI and UW-QOL data suggests that more attention be given to the vocal handicap of the individual patient. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  12. Effects of live saxophone music on physiological parameters, pain, mood and itching levels in patients undergoing haemodialysis.

    Science.gov (United States)

    Burrai, Francesco; Micheluzzi, Valentina; Zito, Maria Pia; Pietro, Giurdanella; Sisti, Davide

    2014-12-01

    Few studies have focused on the effect of music in patients undergoing haemodialysis. To determine the effects of live saxophone music on various physiological parameters and pain, mood and itching levels. A randomised controlled study with 114 patients undergoing haemodialysis with a control group (n = 57) and an experimental group (n = 57) who received 30 minutes of live saxophone music therapy. Systolic and diastolic blood pressure, pulse rate, glycaemia, oxygen saturation, pain, mood and itching levels were measured before and after the live music performance, resulting in baseline and post-test values for the patients in the experimental group. The experimental group showed a statistically significant reduction in pain level, and an improvement in mood and itching levels and in the oxygen saturation. Live saxophone music could be introduced to improve clinical and quality-of-life measures in patients undergoing haemodialysis. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  13. Children's experiences of war: handicapped children in England during the Second World War.

    Science.gov (United States)

    Wheatcroft, Sue

    2008-01-01

    The experiences of children during the Second World War have attracted considerable attention, both scholarly and popular. Not all children however, have received equal attention. Handicapped children are conspicuous by their absence from all types of literature, both on evacuation and on children's experiences of the Second World War. This article restores these children to the story of wartime England and assesses their experiences. It examines the plans that were made for their evacuation and how they were carried out, and compares their lives, both individually and institutionally (i.e. in the various types of 'special' school) with those who, for various reasons, were not evacuated. It also compares their experiences, to a lesser degree, with those of their non-handicapped counterparts. The article argues that for many handicapped children it was a positive experience but one which depended on specific aspects, such as the attitudes of the authorities and of the general public, and perhaps more importantly, the attitudes and quality of the teaching and nursing staff, who were responsible for the children on a daily basis.

  14. Adaptation and coping in patients living with an LVAD: A metasynthesis.

    Science.gov (United States)

    Abshire, Martha; Prichard, Roslyn; Cajita, Mia; DiGiacomo, Michelle; Dennison Himmelfarb, Cheryl

    2016-01-01

    To synthesize information supporting coping and adaptation of LVAD patients and to identify opportunities for future interventions. Left Ventricular Assist Device (LVAD) patients demonstrate improvements in quality of life and functional status, but qualitative research has not been meaningfully integrated. Qualitative meta-synthesis using Lazarus and Folkmans' Transactional Model of stress and coping. Four distinct stages of adaptation were identified: Pre-LVAD, Implant Hospitalization, Early Home Adaptation and Late Home Adaptation. Each stage includes tasks in physical, psychological and social domains. Two themes emerged: 1) Primary Appraisal: Every stage is a new challenge and 2) Secondary Appraisal: Routines are achievable, emotions are more difficult. Emotional challenges including fear and anxiety related to life-limiting illness and changed social roles need to be honestly addressed. Individuals living with LVAD achieve a sense of independence, enjoy social interactions and meaningful activities through addressing practical and emotional problems to facilitate coping. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Behavioral and physiological responses to male handicap in chick-rearing black-legged kittiwakes

    Science.gov (United States)

    Leclaire, S.; Bourret, V.; Wagner, R.H.; Hatch, Shyla A.; Helfenstein, F.; Chastel, O.; Danchin, E.

    2011-01-01

    Parental investment entails a trade-off between the benefits of effort in current offspring and the costs to future reproduction. Long-lived species are predicted to be reluctant to increase parental effort to avoid affecting their survival. We tested this hypothesis in black-legged kittiwakes Rissa tridactyla by clipping flight feathers of experimental males at the beginning of the chick-rearing period. We analyzed the consequences of this handicap on feeding and attendance behavior, body condition, integument coloration, and circulating levels of corticosterone and prolactin in handicapped males and their mates in comparison to unmanipulated controls. Chicks in both groups were compared in terms of aggressive behavior, growth, and mortality. Handicapped males lost more mass, had less bright integuments, and attended the nest less often than controls. Nevertheless, they fed their chicks at the same rate and had similar corticosterone and prolactin levels. Compared with control females, females mated with handicapped males showed a lower provisioning rate and higher nest attendance in the first days after manipulation. Their lower feeding rate probably triggered the increased sibling aggression and mortality observed in experimental broods. Our findings suggest that experimental females adaptively adjusted their effort to their mate's perceived quality or that their provisioning was constrained by their higher nest attendance. Overall, our results suggest that kittiwake males can decrease their condition for the sake of their chicks, which seems to contradict the hypothesis that kittiwakes should be reluctant to increase parental effort to avoid affecting their survival. ?? 2011 The Author. Published by Oxford University Press on behalf of the International Society for Behavioral Ecology. All rights reserved.

  16. Anxiety of Parents of Mentally Handicapped Children and Affects of Informing on Anxiety Level

    Directory of Open Access Journals (Sweden)

    Arzu Kocak Uyaroglu

    2009-10-01

    Full Text Available AIM: This study was aimed to determine effect of education on anxiety level in the parents with mentally handicapped children. METHOD: The quasi-experimental field study was performed on parents of 91 mentally handicapped children who are between 6-15 ages and live in the center of Karaman. State and Trait Anxiety Scale was applied before and after informing. RESULTS: Average age of mothers was 36.5±7.2, average state anxiety point was 47.2±13.4 and average trait anxiety point was 51.9±10.1; their father’s average age was 40.2±8.6, average state anxiety point was 35.9±6.5 and average trait anxiety point was 41.3±6.2. Anxiety points of mothers are higher. Mothers who are graduated from primary school, younger than 35 age, have a boy or child younger than 12 age, have social assurance, do not take institutional service, have low family income, and whose first or last child is mentally handicapped, whose husband do not help with caring child have significant decrease in anxiety points after informing. In the fathers, only a decrease in the trait anxiety level was significant. CONCLUSION: Education decreases the parents’ anxiety level. Institutional services have to contain all of the mentally handicapped children and should be educated the parents by nurses periodically to decrease their anxiety. [TAF Prev Med Bull 2009; 8(5.000: 405-412

  17. Study of daily quality of life in patients living with HIV in Bushehr province

    Directory of Open Access Journals (Sweden)

    Katayoun Vahdat

    2012-06-01

    Full Text Available Background: Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL has emerged as a significant medical outcome measure, and its enhancement has an important goal. This review highlights the relevance and complexity of physical, psychological, and social factors as determinants of health-related quality of life in HIV-infected person in Bushehr province. Methods: This cross-sectional study was conducted using a convenience sampling method on 54 patients living with HIV or suffering from AIDS on 2009. The method of data collection was summarized questionnaire of World Health Organization (WHO-QOL-Brief. The main measured outcome in this study was quality of life and some related demographic and clinical variables. Results: The majority of the patients were males (46/54 and unemployed (37.25 participants were married. The mean±SD age of the patients was 38.1+‌‌_7.47 years. Employment, marital status, level of education, and clinical stage of the disease, had a significant effect on the quality of life of the patients. In multivariate analysis, the most important predictor of the quality of life was job. Conclusion: The most important factors, association with decreased quality of life of the Patients in this study, were being separated or divorced, unemployment and being at severe stage of the disease. The relationship of these measures to treatment outcomes can and should be examined in clinical settings in resource-limited countries.

  18. Activities of daily living questionnaire from patients' perspectives in Parkinson's disease: a cross-sectional study.

    Science.gov (United States)

    Lee, Su-Yun; Kim, Sung Kwan; Cheon, Sang-Myung; Seo, Jung-Wook; Kim, Min Ah; Kim, Jae Woo

    2016-05-21

    The aim of this study was to develop an assessment tool for activities of daily living (ADL) from the perspective of patients with Parkinson's disease (PD) and examine the validity and reliability of the assessment. A preliminary 45-item questionnaire was developed through intensive interviews with 54 patients with PD and administered to another group of 248 patients with PD. Based on clinical and statistical analyses, 20 ADL-items were selected. The final 20-item questionnaire was examined in the other group of 59 patients with PD. The new ADL questionnaire showed high internal consistency (Cronbach's α, 0.962-0.966) and acceptable test-retest reliability (0.632-0.984). Concurrent validity was shown as a significant positive correlation between the new ADL questionnaire and other ADL or clinical instruments. The Hoehn and Yahr stage showed the highest degree of correlation with the new ADL questionnaire, followed by the other ADL scales (Schwab and England ADL and the ADL subscore of the Unified Parkinson's Disease Rating Scale). Additionally, a regression analysis was conducted with the disease-specific quality of life questionnaire, and the new ADL questionnaire was the most powerful predictor of quality of life among the clinical instruments. The new ADL questionnaire is a valid tool for assessing ADL from the perspectives of patients with PD.

  19. Valuation of transfusion-free living in MDS: results of health utility interviews with patients

    Directory of Open Access Journals (Sweden)

    Lübbert Michael

    2009-09-01

    Full Text Available Abstract Background This study measured how myelodysplastic syndrome (MDS patients value transfusion independence (TI, reduced transfusions (RT and transfusion-dependence (TD using health utility assessment methodology. Methods 47 MDS patients were interviewed, US (n = 8, France (n = 9, Germany (n = 9 and the UK (n = 21, to elicit the utility value of TI, RT and TD. Health states were developed based on literature; patient forum discussions; and were validated by a hematologist. Face-to-face interviews used the feeling thermometer Visual Analogue Scale (VAS and the Time Trade-Off (TTO method to value the health states on a 0 (dead to 1 (perfect health scale. Socio-demographic, clinical, and quality-of-life (EQ-5D characteristics were surveyed to describe the patient sample. Results and Discussion The mean age was 67 years (range: 29-83; 45% male, 70% retired; 40% had secondary/high school education, or higher (32%, and 79% lived with family, a partner or spouse, or friends. The mean time from MDS diagnosis was 5 years (range:1-23. Most patients (87% received previous transfusions and 49% had received a transfusion in the last 3 months. Mean EQ-5D index score was 0.78; patients reported at least some problem with mobility (45%, usual activities (40%, pain/discomfort (47%, and anxiety/depression (34%. Few patients had difficulty understanding the VAS (n = 3 and TTO (n = 4 exercises. Utility scores for TI were higher than for RT (0.84 vs. 0.77; p Conclusion Patients value TI, suggesting an important role for new treatments aiming to achieve greater TI in MDS. These results can be used in preference-based health economic evaluation of new MDS treatments, such as in future cost-utility studies.

  20. Living with Malignant Wound in Cancer Patients and Adolescents with Non- Cancer Diagnosis: a Meta-Synthesis of Qualitative Studies

    Directory of Open Access Journals (Sweden)

    Ali Reza Mansourzadeh

    2016-09-01

    Full Text Available Background Malignant wound causes a devastating physical and psychological condition in cancer patients. This study presents a review which can provide better insights into the life of cancer patients living with malignant wound. The aim of this meta-synthesis was to analyze and synthesize findings from qualitative studies of the lived experiences of patients with malignant wound. Materials and Methods This meta-synthesis followed the Sandelowski and Barroso’s guideline and was designed to synthesize findings from previous qualitative studies. Variety of biomedical archives were searched, including PubMed, Web of Science, PsycINFO, Cochrane library, and ProQuest and Persian data bases such as Magiran, SID, Iran.doc, IranMedex, and  recently published articles and books on the lived experience of persons living with malignant wound were reviewed. In this article, the literature searches covering from January,1, 1990 to march,15, 2016 resulted in eight relevant studies which fulfilled the inclusion criteria for the review. Results Findings from all these studies were categorized into three main themes: "distortion of lived body", "symptomatic suffering", and "compatible living with wound". Our findings showed that the meanings of patients’ experiences living with malignant wound are important for the construction of multidisciplinary palliative care in these individuals. Conclusion: Gaining insights from analysis of qualitative studies is integral issue for developing new palliative care services for patients with malignant wound.

  1. Objective voice parameters and self-perceived handicap in dysphonia.

    Science.gov (United States)

    Hummel, Christina; Scharf, Manuela; Schuetzenberger, Anne; Graessel, Elmar; Rosanowski, Frank

    2010-01-01

    This study focuses on the relation between objective voice quality and the self-perception of a voice handicap. The study group consisted of 86 German-speaking patients (51 women, 35 men) suffering from benign dysphonia. The test persons completed the German version of the Voice-Related Quality of Life (V-RQOL) Questionnaire without prior information about their diagnosis and underwent voice analysis with the Dysphonia Severity Index (DSI) being the parameter of this study. No correlation between V-RQOL and DSI could be found (p>0.05). On the V-RQOL, women scored worse than men, but not at a significant level. Patients with dysphonia of organic origin scored significantly worse than patients with functional dysphonia (p=0.026). On the DSI, men's values were significantly lower than women's (p=0.001). Organic dysphonia caused significantly lower DSI values than functional dysphonia (p=0.011). Objective voice quality and the individual perception of voice quality by the patient are independent parameters. Both need to be assessed in clinical practice. Copyright © 2010 S. Karger AG, Basel.

  2. Mixité sociale : les handicapés dans la société britannique 

    Directory of Open Access Journals (Sweden)

    Marie-Hélène Adveille

    2007-11-01

    . Previously seen as mere objects of charity, disabled people acquired the right to be considered as individuals benefitting from the same rights as ordinary people, thanks to the action of numerous associations. However, despite changes in the perception of the disabled by able-bodied people, people with handicaps are still confronted with a wide range of problems in their daily lives. There has been progress in aid for the physically handicapped such as access to public buildings and public transport. The difficulties visually-impaired and deaf people experience have been taken into account with the introduction for example of warning sounds and the acceptance of dogs for the blind. However access to fundemental rights for the mentally handicapped (intellectually or psychologically impaired remains undeveloped. This study will concentrate on the integration and inclusion policies for people with mental handicaps. Firstly, the legislation enacted with a view to increasing their insertion in British society will be examined. Secondly, the way in which children are integrated into the school sytem is surveyed. Finally, the arguments surrounding the importance of successful integratio for the adult and society at large will be raised.

  3. Clinical assessment of prognostic factors for long-term pain and handicap after whiplash injury: a 1-year prospective study

    DEFF Research Database (Denmark)

    Kasch, H; Qerama, E; Kongsted, Alice

    2008-01-01

    BACKGROUND AND PURPOSE: Physical mechanisms are the possible factors involved in the development and maintenance of long-term handicaps after acute whiplash injury. This study prospectively examined the role of active neck mobility, cervical and extra-cervical pains, as well as non......-painful complaints after a whiplash injury as predictors for subsequent handicap. METHODS: Consecutive acute whiplash patients (n = 688) were interviewed and examined by a study nurse after the median of 5 days after injury, and divided into a high- or a low-risk group by an algorithm based on pain intensity, number...

  4. Litteraturstudie af handicap og beskæftigelse

    DEFF Research Database (Denmark)

    Larsen, Malene Rode; Høgelund, Jan

    Handicap har store konsekvenser. For den enkelte kan handicap begrænse livskvaliteten. For samfundet indebærer handicap et reduceret udbud af arbejdskraft og øgede offentlige udgifter. Der er således stor potentiel samfundsmæssig gevinst forbundet med en øget beskæftigelse for personer med handicap....... Denne rapport giver en oversigt over områder, hvor der er eller mangler systematisk forskningsbaseret viden om handicap og beskæftigelse. Desuden gennemgår rapporten resultaterne af en del af den internationale og skandinaviske forskning om beskæftigelsesindsatsers effekt for personer med handicap....... Forskerne finder hele 58 systematiske forskningsoversigter om handicap og beskæftigelse. Men den nærmere analyse af en del af litteraturen viser, at der ikke er mange undersøgelser, der reelt kan sige noget om effekten af indsatserne. Rapporten giver et grundlag for systematisk at arbejde med vidensbasering...

  5. Handicap og beskæftigelse i 2012. Regionale forskelle

    DEFF Research Database (Denmark)

    Møller Kjeldsen, Marie; Høgelund, Jan

    Denne rapport undersøger beskæftigelsen for personer med handicap i landets fire beskæftigelsesregioner, Hovedstaden og Sjælland, Syddanmark, Midtjylland og Nordjylland. Rapporten belyser regionale forskelle på en række områder inden for beskæftigelse, herunder beskæftigelsesomfanget og beskæftig......Denne rapport undersøger beskæftigelsen for personer med handicap i landets fire beskæftigelsesregioner, Hovedstaden og Sjælland, Syddanmark, Midtjylland og Nordjylland. Rapporten belyser regionale forskelle på en række områder inden for beskæftigelse, herunder beskæftigelsesomfanget og...... beskæftigelsens udvikling samt beskæftigelse på særlige vilkår og kendskab til beskæftigelsesrettede støtteordninger for personer med handicap. Den har desuden et særligt fokus på beskæftigedes holdninger til personer med handicap generelt og til synshandicap, mobilitetshandicap og en psykisk lidelse specifikt....... Undersøgelsen viser bl.a., at der ikke er signifikante forskelle mellem regionerne i beskæftigelsesandelen hverken for personer med eller uden handicap. I én region er beskæftigelsen for personer med handicap dog faldet fra 2010 til 2012, mens beskæftigelsen for personer uden handicap er steget i en anden...

  6. Behaviour problems in severely mentally handicapped children.

    Science.gov (United States)

    Quine, L

    1986-11-01

    A population study was undertaken in two health districts of children with severe mental handicap. Prevalence figures for behaviour problems are presented. A stratified random sample of 200 families was drawn from the population. Detailed structured interviews were carried out with the children's parents. The children were divided into two groups, comprising those with behaviour problems and those with no problems. There was a significant association between behaviour disorder and incontinence, lack of self-help skills, poor reading, writing and counting skills, and poor communication skills. Environmental correlates were few. There were no differences between groups in family size, birth order, age of parents, marital discord, social class or income. However, behaviour problems were more common in one-parent families. An association was found between maternal stress and problem behaviour. The possible mechanisms underlying this association are discussed.

  7. Kuwaiti Teachers' Perceptions of Voice Handicap.

    Science.gov (United States)

    Albustan, Sana A; Marie, Basem S; Natour, Yaser S; Darawsheh, Wesam B

    2017-05-30

    The study aimed to investigate the effects of age, gender, level of education, experience, and class level taught on the perception of voice handicap by Kuwaiti teachers using the Arabic version of the Voice Handicap Index (VHI-Arab). The mean VHI scores of Kuwaiti teachers were compared with those of Jordanian and Emirati teachers. The study had a cross-sectional survey design. A total of 460 individuals (100 controls and 360 teachers) participated in this study and completed the paper copy of the VHI-Arab. We recruited 360 teachers, 180 males and 180 females (age range: 20-50 years), from 60 schools in 6 Kuwaiti districts. Teachers' VHI scores were compared with 100 nonteaching voice users (50 males and 50 females, with an age range of 18-42 years). Female teachers scored significantly higher than male teachers in all subscales (ie, physical: P = 0.02; emotional: P = 0.007; total: P = 0.017), except for the functional subscale (P = 0.147). Elementary school teachers scored significantly higher than teachers of other levels (middle and high school) in all VHI subscales (physical: P = 0.047; emotional: P = 0.01; total: P = 0.039), except for the functional subscale (P = 0.47). The mean score of Jordanian teachers was higher than that of Kuwaiti and Emirati teachers in all VHI subscales. Teachers with a more favorable teaching environment scored better on the VHI. Gender differences were found in all the Arabic nationalities studied. Female teachers of the elementary level, in particular, should be the focus of attention of efforts to prevent voice damage. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  8. Instrumental activities of daily living are impaired in Parkinson's disease patients with mild cognitive impairment.

    Science.gov (United States)

    Pirogovsky, Eva; Schiehser, Dawn M; Obtera, Kristalyn M; Burke, Mathes M; Lessig, Stephanie L; Song, David D; Litvan, Irene; Filoteo, J Vincent

    2014-03-01

    Although it is well known that Parkinson's disease (PD) with dementia results in functional decline, little is known about the impact of mild cognitive impairment in PD (PD-MCI) on day-to-day functioning. Forty-one individuals with PD-MCI, 56 PD patients with normal cognition (PD-NC), and 47 healthy older adults were administered two performance-based measures of instrumental activities of daily living (IADLs) that evaluated medication and financial management. Informants of the PD patients were also administered an IADL questionnaire. There were no significant differences between PD-NC and healthy older adults on the performance-based measures of medication and financial management. However, PD-MCI patients demonstrated significantly lower scores on the performance-based measures of medication and financial management compared with healthy older adults. PD-MCI patients were also impaired compared with PD-NC patients on performance-based medication management, but no difference between these groups was observed for ability to manage finances. Performance-based financial and medication management did not correlate with scores on neuropsychological measures in PD-MCI patients. PD-MCI and PD-NC patients showed comparable scores on the informant-based IADL questionnaire. Performance-based measures of IADLs, particularly medication management ability, are sensitive to subtle functional declines in PD-MCI. Although impairment in performance-based measures is associated with cognitive status in PD, IADLs may be a separate domain of functioning from cognitive functioning in PD-MCI as these measures did not correlate with performance on the neuropsychological measures. Overall, performance-based assessment of IADLs may add to the clinical evaluation of PD-MCI. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  9. Living with incurable oesophageal cancer. A phenomenological hermeneutical interpretation of patient stories.

    Science.gov (United States)

    Missel, Malene; Birkelund, Regner

    2011-09-01

    The study explores how patients diagnosed with incurable oesophageal cancer experience living with the illness, and provides insight into and an understanding of the patients' situation, reality and phenomena in their life world. The method takes a phenomenological-hermeneutic approach, inspired by the French philosopher Paul Ricoeur's narrative theory on mimesis as the structure and process of the method, and Ricoeur's theory of interpretation for the analysis of patient stories. The stories materialise from narrative interviews, and the phenomena of the patients' life world results in an analysis of these stories. Through the analysis of the narrative interviews, phenomena of the patients' life world appear which are described in themes such as debut of the illness, denial, the person's own suspicion, existential turning point, despair, hope, the body, affirmation of irrevocable illness, acknowledgement of dying, life phenomena, relations and feeling of independence. The understanding of the patients' experiences is augmented and improved through a discussion of the themes in a philosophical perspective, drawing upon theoretical and philosophical viewpoints of Kierkegaard, Løgstrup, Merleau-Ponty, Ricoeur, Benner & Wrubel, and on empirical research. Based on the phenomena in the ill person's life world brought about by analysis, it seems that incurably ill oesophageal cancer patients find themselves in a complex life situation, in which they need more than an objective estimate and fulfilment of need from hospital service. Our study illustrates some perspectives on the life situation of the incurably ill, which will contribute to the improved development of supportive care in nursing. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Determinants and trajectory of phobic anxiety in patients living with an implantable cardioverter defibrillator.

    Science.gov (United States)

    Cho, En-Young Nicole; von Känel, Roland; Marten-Mittag, Birgit; Ronel, Joram; Kolb, Christof; Baumert, Jens; Ladwig, Karl-Heinz

    2012-05-01

    The implantable cardioverter defibrillator (ICD) is the gold standard therapy to prevent life-threatening arrhythmias. Phobic anxiety predicts ventricular arrhythmia in coronary heart disease patients, but little is known about phobic anxiety in ICD patients. This study aimed to identify determinants and the course of phobic anxiety in ICD patients. 140 outpatients living with an ICD (mean age 56±14 years, 66% men). Phobic anxiety was assessed with the Symptom Checklist-90 Revised at a mean of 27±21 months (range 3-109) post-ICD placement (baseline) and after an average follow-up of 41±18 months (range 10-82). Multivariate linear regression models considered sociodemographic factors, clinical variables and psychological scales as potential determinants of phobic anxiety scores. ICD patients reported more than 10-fold higher levels of phobic anxiety than a previous representative population survey (2.6±3.4 vs 0.2±0.4). Greater age (p=0.003), previous shock experience (p=0.007), depressed mood (pphobic anxiety scores at baseline. Multimorbidity (p=0.030) and higher baseline phobic anxiety (pphobic anxiety at follow-up. Younger age (p=0.029) and an elevated number of non-cardiac diseases (p=0.019) were both associated with an increase in phobic anxiety scores from baseline to follow-up. More patients had high phobic anxiety levels (score >4) at follow-up compared with baseline (31% vs 24%; p=0.048). Phobic anxiety was comparably high and persisted over time in ICD patients. Modifiable determinants of phobic anxiety were identified, which may inform tailored interventions to improve ICD patients' distress and perhaps also prognosis.

  11. Hearing handicap in adults with unilateral deafness and bilateral hearing loss.

    Science.gov (United States)

    Iwasaki, Satoshi; Sano, Hajime; Nishio, Shinya; Takumi, Yutaka; Okamoto, Makito; Usami, Shin-ichi; Ogawa, Kaoru

    2013-06-01

    To assess the perception of hearing handicap in adult patients with unilateral sudden sensorineural hearing loss (SNHL) compared with those with bilateral SNHL or unilateral congenital SNHL. Retrospective chart review. Multicenter department of otolaryngology referrals. Seventy-one subjects in the unilateral severe-profound (>70 dB) sudden SNHL group (Group 1), 17 subjects in the unilateral prelingual or congenital SNHL group (Group 2), and 121 subjects in the bilateral SNHL group (Group 3). Questionnaire. Hearing Handicap Inventory for Adults (HHIA) and visual analogue scale (VAS) measurements of hearing handicap. Average levels of hearing loss were 92 dB in Group 1, 109 dB in Group 2, and 67 dB in Group 3. The relative percentage scores of HHIA and VAS compared with Group 3 were 72.6% and 81.0% in Group 1 and 25.4% and 50.3% in Group 2, respectively. A mild correlation between the HHIA subscale or VAS scores and degree of hearing loss could be found in Group 3. No significant correlation was found between the HHIA subscale or VAS scores and duration of hearing loss in Group 1 or Group 3. Higher scores were obtained in male subjects than in female subjects. Patients in Group 1 who were troubled by tinnitus scored significantly higher in the HHIA. In multiple logistic regression analysis, presence of tinnitus, older age, higher average hearing loss level, and group (bilateral SNHL>unilateral sudden SNHL>unilateral precongenital SNHL) revealed a significant positive association with high score (>42) of HHIA (odds ratio, 3.171, 1.021, 1.031, and 6.690, respectively). The results of HHIA and VAS suggest that not only patients with bilateral SNHL but also those with unilateral sudden SNHL, particularly those who have tinnitus, experience a hearing handicap.

  12. Living with and Caring for Patients with Alzheimer’s Disease in Nursing Homes

    Directory of Open Access Journals (Sweden)

    Shahrzad Yektatalab

    2013-08-01

    Full Text Available Introduction: Many of the patients with Alzheimer disease are taken care of in nursing homes. However the literature on the experiences of Iranian formal caregivers of older adults with Alzheimer disease is scarce. This qualitative study explored the caring experiences of formal caregivers in nursing homes that can improve the quality of care and patient’s quality of life. Methods: This qualitative study used the principles of descriptive content analysis to analyze these data. Our participants included 11 female and 3 male caregivers aged 25 to 38 years who were selected for interviewing based on a purposive sampling method. The data were analyzed with a content analysis method. Results: Nearly 900 initial codes were extracted and categorized into 6 main themes including "managing difficult behaviors", "dependence on familial care", "continuum of different feelings", "care for a child", "living with the patients" and "not understanding the patients", which was further analyzed in the two subcategories "caring without enough information" and " a dead man moving". Conclusion: The care provided by our informants was mainly influenced by attitudes, culture and religious beliefs of caregivers about family attachment and ample driven reward of helping and caring frail or old people in Islam. These cultural and religious beliefs could facilitate provision of care and confrontation with patients’ child-like behaviors. It is suggested that employment of trained staff and plans for their continued education can improve the quality of care and the quality of the patient's life.

  13. CD4 T lymphocyte counts in patients undergoing splenectomy during living donor liver transplantation.

    Science.gov (United States)

    Natsuda, Koji; Eguchi, Susumu; Takatsuki, Mistuhisa; Soyama, Akihiko; Hidaka, Masaaki; Hara, Takanobu; Kugiyama, Tota; Baimakhanov, Zhassulan; Ono, Shinichiro; Kitasato, Amane; Fujita, Fumihiko; Kanetaka, Kengo; Kuroki, Tamotsu

    2016-02-01

    The role of splenectomy in increasing the CD4-positive T lymphocyte counts (hereafter: CD4 counts) and the CD4 to CD8 ratio have not yet been fully investigated, especially in the case of HIV-positive patients undergoing liver transplantation (LT). The change in the total lymphocyte counts of 32 patients who underwent one-stage splenectomy with living donor (LD) LT with (n=13) or without rituximab (RTX, n=19) therapy were examined to validate our cohort of ABO-incompatible LDLT with RTX. Subsequently, perioperative changes in CD4 counts and the CD 4 to CD8 ratio were measured in 13 patients who underwent ABO-incompatible LDLT/RTX with splenectomy. (1) The administration of RTX did not significantly affect the total lymphocyte counts of patients after LDLT/splenectomy in any of the observation periods. (2) The CD4 counts were significantly higher at 2years after LDLT in comparison to the perioperative CD4 counts but not within the 3-month period (p=0.039). The CD4/CD8 ratio gradually decreased after LDLT/splenectomy under RTX treatment. An immediate increase in the CD4 counts therefore cannot be expected after LDLT with splenectomy. The total lymphocyte and CD4 counts were rather stable in the peritransplant period even in ABO incompatible LDLT with RTX. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Activities of daily living for patients with chronic heart failure: a partnership care model evaluation.

    Science.gov (United States)

    Mohammadi, Eesa; Khoshab, Hadi; Kazemnejad, Anoshirvan

    2016-05-01

    The study determined the effect of a partnership care model (PCM) on the activities of daily living (ADL) of patients with chronic heart failure (CHF). Management programs for patients with CHF are needed to optimize care. This randomized clinical trial was designed in 2011 in four wards at two Iranian hospital centers with the participation of 104 patients with CHF who had hospitalization histories. The Lawton questionnaire was used to measure the dependent variable (ADL) at baseline after 3 months. The mean difference (pre- and post-intervention) of the scores for the control (MD=0.06; SD=1.5) and experimental (MD=-2.3; SD=1.4) groups were calculated. T-test results showed that there was a significant difference in the means (p<0.05) between groups. The effect size (2.18) and standardized effect size (54.5) were also calculated. The findings suggest that centered ADL intervention based on a PCM improved the ADL of patients substantially more than other interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Ethical issues in the geriatric patient with advanced cancer 'living to the end'.

    Science.gov (United States)

    Daher, M

    2013-10-01

    Cancer incidence will increase as the population ages; there will be a 50% increase in new cancer cases over the next 20 years, and the biggest rates of increase will occur in the developing world. Owing to technical advances in the care of critical illness, as it is the case in elderly people with advanced cancer, physicians, patients and families are often confronted with ambiguous circumstances in which medical advances may inadvertently prolong suffering and the dying process rather than bring healing and recovery. In this review of the ethical issues confronting physicians who care for patients with advanced life-limiting illnesses like cancer, a philosophical debate continues in the medical community regarding the rightness or wrongness of certain actions (e.g. physician-assisted death, euthanasia), while at the same time there is a strong desire to find a common ground for moral discourse that could guide medical decision-making in this difficult period in the lives of our patients. We will discuss how a good palliative care can be an alternative to these ethical dilemmas. Although some issues (e.g. the role of physician-assisted death in addressing suffering) remain very controversial, there is much common ground based on the application of the four major principles of medical ethics, no malfeasance, beneficence, autonomy and justice. Thus, the physician's primary commitment must always be the patient's welfare and best interests, whether the physician is treating illness or helping patients to cope with illness, disability and death. A key skill here is the communication of bad news and to negotiate a treatment plan that is acceptable to the patient, the family and the healthcare team. Attention to psychosocial issues demands involvement of the patients and their families as partners. Physicians should be sensitive to the range of psychosocial distress and social disruption common to dying patients and their families. Spiritual issues often come to the

  16. Increased respiratory symptoms in COPD patients living in the vicinity of livestock farms.

    Science.gov (United States)

    Borlée, Floor; Yzermans, C Joris; van Dijk, Christel E; Heederik, Dick; Smit, Lidwien A M

    2015-12-01

    Several studies have investigated the effect of livestock farm emissions on the respiratory health of local residents, but results are inconsistent. This study aims to explore associations between the presence of livestock farms and respiratory health in an area of high-density livestock farming in the Netherlands. We focused especially on associations between farm exposures and respiratory symptoms within subgroups of potentially susceptible patients with a pre-existing lung disease.In total, 14 875 adults (response rate 53.4%) completed a questionnaire concerning respiratory health, smoking habits and personal characteristics. Different indicators of livestock farm exposures relative to the home address were computed using a geographic information system.Prevalence of chronic obstructive pulmonary disease (COPD) and asthma was lower among residents living within 100 m of a farm (OR 0.47, 95% CI 0.24-0.91 and OR 0.65, 95% CI 0.45-0.93, respectively). However, >11 farms in 1000 m compared to fewer than four farms in 1000 m (fourth quartile versus first quartile) was associated with wheezing among COPD patients (OR 1.71, 95% CI 1.01-2.89). Using general practitioners' electronic medical records, we demonstrated that selection bias did not affect the observed associations.Our data suggest a protective effect of livestock farm emissions on the respiratory health of residents. Nonetheless, COPD patients living near livestock farms reported more respiratory symptoms, suggesting an increased risk of exacerbations. Copyright ©ERS 2015.

  17. La plateforme technique "Le Bâtim'Handicap"

    OpenAIRE

    Jamin, Frédéric; Campagne, Claude

    2014-01-01

    National audience; Cet article présente la plateforme technique dédiée à la problématique du handicap (physique, sensoriel et cognitif) dans le cadre bâti. Implanté à l'IUT de Nîmes, cet outil nous permet de proposer des mises en situation de handicap concrètes dans le cadre de la formation d'étudiants et de professionnels de la construction ou de sensibilisation du grand public. Nous abordons également l'intérêt de l'installation domotique, outil incontournable pour pallier les handicaps et ...

  18. Validation of the Lithuanian Version of the Speech Handicap Index.

    Science.gov (United States)

    Pribuisiene, Ruta; Liutkevicius, Vykintas; Pribuisis, Kipras; Uloza, Virgilijus

    2017-05-29

    The objective is to study the cultural adaptation and validation of the Speech Handicap Index (SHI) questionnaire to the Lithuanian language. Cultural adaptation and validation of the translated Lithuanian version of the SHI (SHI-LT) was performed as described by the Scientific Advisory Committee of the Medical Outcomes Trust. The SHI-LT was completed by 46 patients after total laryngectomy and by 60 healthy subjects of the control group. Validity and reliability of the SHI-LT were evaluated. The SHI-LT showed a statistically significant high internal consistency and test-retest reliability (Cronbach's α = 0.96-0.98). Good validity of SHI-LT was reflected by statistically significant (P  0.05). Receiver operating characteristic test indicated that SHI-LT scores exceeding 17.0 points (cutoff value) distinguish patients from healthy controls, with a sensitivity of 97.8% and specificity of 95.0%. SHI-LT is considered to be a valid and reliable speech assessment tool for Lithuanian-speaking patients after laryngectomy. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. Adaptation of the Arabic Version of the Tinnitus Handicap Inventory.

    Science.gov (United States)

    Barake, Rana; Rizk, Samer Abou; Ziade, Georges; Zaytoun, George; Bassim, Marc

    2016-03-01

    To translate the Tinnitus Handicap Inventory (THI) into literary Arabic to come up with a unified Arabic version and to determine its validity and reliability in assessing the quality of life of Arabic-speaking patients with tinnitus. Clinical measurement study. Tertiary care center. The original English THI was translated into literary Arabic by a forward- and back-translation process according to the published guidelines for cross-cultural adaptation of health-related quality-of-life measures and applied to 100 patients with chronic tinnitus. Internal consistency reliability was then assessed by calculating Cronbach's alpha coefficient. Pearson correlation coefficients were also calculated for the different scales and the different baseline characteristics. Results showed high internal consistency and reliability coefficients (total THI: 0.93, functional subscale: 0.86, emotional subscale: 0.86, catastrophic subscale: 0.66) comparable to those of the original English THI. The Arabic version of the THI is a valid and reliable tool for the assessment of the impact of tinnitus on the quality of life of Arabic-speaking patients with the complaint of chronic tinnitus. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  20. The view from Walter's window: social environment and the communicative competence of adults with a mental handicap.

    Science.gov (United States)

    van der Gaag, A D

    1989-06-01

    This paper reports on a study of the communicative competence of adults with a mental handicap living in hospital and community settings. One hundred and twenty subjects, half from hospital settings and half from community settings, were assessed on the Communication Assessment profile (CASP). Significant differences were found between the hospital and community groups on pragmatic competence. The communication environment was shown to be an important determinant of pragmatic skills. The implications of this finding are discussed.

  1. Handicap 5 years after stroke in the North East Melbourne Stroke Incidence Study.

    Science.gov (United States)

    Gall, Seana L; Dewey, Helen M; Sturm, Jonathan W; Macdonell, Richard A L; Thrift, Amanda G

    2009-01-01

    Handicap is rarely comprehensively examined after stroke. We examined handicap among 5-year stroke survivors from an 'ideal' stroke incidence study. Survivors were assessed with the London Handicap Scale [LHS, score range: 0 (greatest handicap) to 100 (least handicap)]. Multivariable regression was used to examine demographic, risk and stroke-related factors associated with handicap. 351 of 441 (80%) survivors were assessed. Those assessed were more often Australian born than those not assessed (p handicap was present for physical independence and occupation/leisure items. Handicap was associated with older age, manual occupations, smoking, initial stroke severity, recurrent stroke and mood disorders. Reducing recurrent stroke, through better risk factor management, is likely to reduce handicap. The association between handicap and mood disorders, which are potentially modifiable, warrants further investigation. Copyright (c) 2008 S. Karger AG, Basel.

  2. An application of Freud's castration concept on the perception of physical handicap

    Directory of Open Access Journals (Sweden)

    Tatjana Sedlar

    2002-09-01

    Full Text Available To the prevailing paradigm of our understanding of a physical handicap new paradigms have been recently added, which, as well, rarely discuss the physical handicap sex specifically. The article deals with a relationship between physically handicapped women and their surroundings through psychoanalytical perspective with the main focus on one of the basic psychoanalytical concepts–castration complex. Due to the anatomical difference between female and male sexual organs and due to the sex related solution of castration complex, following types of view on a physically handicapped body are presented: a female view on her own handicapped body, a female view on a female handicapped body, a male view on a female handicapped body, and a view on a handicapped body as a sexual object. The conclusion of the author is that the conflict between the physically handicapped and their surrounding, because of castration complex and inability to eliminate a handicap, is eternal.

  3. Exploratory factor analysis of the Dizziness Handicap Inventory (German version)

    Science.gov (United States)

    2010-01-01

    Background The Dizziness Handicap Inventory (DHI) is a validated, self-report questionnaire which is widely used as an outcome measure. Previous studies supported the multidimensionality of the DHI, but not the original subscale structure. The objectives of this survey were to explore the dimensions of the Dizziness Handicap Inventory - German version, and to investigate the associations of the retained factors with items assessing functional disability and the Hospital Anxiety and Depression Scale (HADS). Secondly we aimed to explore the retained factors according to the International Classification of Functioning, Disability and Health (ICF). Methods Patients were recruited from a tertiary centre for vertigo, dizziness or balance disorders. They filled in two questionnaires: (1) The DHI assesses precipitating physical factors associated with dizziness/unsteadiness and functional/emotional consequences of symptoms. (2) The HADS assesses non-somatic symptoms of anxiety and depression. In addition, patients answered the third question of the University of California Los Angeles-Dizziness Questionnaire which covers the impact of dizziness and unsteadiness on everyday activities. Principal component analysis (PCA) was performed to explore the dimensions of the DHI. Associations were estimated by Spearman correlation coefficients. Results One hundred ninety-four patients with dizziness or unsteadiness associated with a vestibular disorder, mean age (standard deviation) of 50.6 (13.6) years, participated. Based on eigenvalues greater one respectively the scree plot we analysed diverse factor solutions. The 3-factor solution seems to be reliable, clinically relevant and can partly be explained with the ICF. It explains 49.2% of the variance. Factor 1 comprises the effect of dizziness and unsteadiness on emotion and participation, factor 2 informs about specific activities or effort provoking dizziness and unsteadiness, and factor 3 focuses on self-perceived walking

  4. Minimal Important Difference in Voice Handicap Index-10.

    Science.gov (United States)

    Misono, Stephanie; Yueh, Bevan; Stockness, Ali N; House, Meaghan E; Marmor, Schelomo

    2017-09-28

    The minimal important difference (MID) on patient-reported outcome measures can indicate how much of a change on that scale is meaningful. To use an anchor-based approach to estimate MID in the Voice Handicap Index-10 (VHI-10) total score. In this cohort study, a volunteer sample of adult patients visiting the voice clinic at the University of Minnesota from April 7, 2013, through July 3, 2016, completed the VHI-10 (range, 0-40, with higher scores indicating greater voice-related handicap) at baseline and 2 weeks later in conjunction with a global rating of change. An anchor-based approach was used to identify an MID. The association between the global change score and change in VHI-10 score was analyzed using Pearson rank correlation. A distribution-based method was used to corroborate the findings. Global rating of change on the VHI-10. Of the 273 participants, 183 (67.0%) were women and 90 (33.0%) were men (mean [SD] age, 54.3 [15.6] years); 259 (94.9%) were white. Participants had a variety of voice disorders, most commonly muscle tension dysphonia, irritable larynx, benign vocal fold lesions, and motion abnormalities. Among patients reporting no change on the global change score, the mean (SD) change in VHI-10 score was 1 (5). Among those reporting a small change, the mean (SD) change in VHI-10 was also 1 (5). Among those reporting a moderate change in voice symptoms, the mean (SD) change in VHI-10 score was 6 (8). Among those with a large change, the mean (SD) change in VHI-10 score was 9 (13). The correlation between the global change score and the change in VHI-10 score was 0.32 (95% CI, 0.12-0.49). Distribution-based analyses identified effect sizes comparable to those of the anchor-based categories. These findings suggest that a difference of 6 on the VHI-10 may represent an MID. This difference was associated with a moderate change on the global rating scale, and the small-change and no-change categories were indistinguishable. Given the lack of

  5. Exploratory factor analysis of the Dizziness Handicap Inventory (German version

    Directory of Open Access Journals (Sweden)

    de Bruin Eling D

    2010-03-01

    Full Text Available Abstract Background The Dizziness Handicap Inventory (DHI is a validated, self-report questionnaire which is widely used as an outcome measure. Previous studies supported the multidimensionality of the DHI, but not the original subscale structure. The objectives of this survey were to explore the dimensions of the Dizziness Handicap Inventory - German version, and to investigate the associations of the retained factors with items assessing functional disability and the Hospital Anxiety and Depression Scale (HADS. Secondly we aimed to explore the retained factors according to the International Classification of Functioning, Disability and Health (ICF. Methods Patients were recruited from a tertiary centre for vertigo, dizziness or balance disorders. They filled in two questionnaires: (1 The DHI assesses precipitating physical factors associated with dizziness/unsteadiness and functional/emotional consequences of symptoms. (2 The HADS assesses non-somatic symptoms of anxiety and depression. In addition, patients answered the third question of the University of California Los Angeles-Dizziness Questionnaire which covers the impact of dizziness and unsteadiness on everyday activities. Principal component analysis (PCA was performed to explore the dimensions of the DHI. Associations were estimated by Spearman correlation coefficients. Results One hundred ninety-four patients with dizziness or unsteadiness associated with a vestibular disorder, mean age (standard deviation of 50.6 (13.6 years, participated. Based on eigenvalues greater one respectively the scree plot we analysed diverse factor solutions. The 3-factor solution seems to be reliable, clinically relevant and can partly be explained with the ICF. It explains 49.2% of the variance. Factor 1 comprises the effect of dizziness and unsteadiness on emotion and participation, factor 2 informs about specific activities or effort provoking dizziness and unsteadiness, and factor 3 focuses on self

  6. A patient's experience in dementia care: Using the "lived experience" to improve care.

    Science.gov (United States)

    Frank, Christopher; Forbes, Rev Faye

    2017-01-01

    To give FPs an understanding of the "lived experience" of dementia via the words of a person with dementia (PWD)- Faye Forbes, a 64-year-old Anglican priest with Alzheimer disease who provides her perspectives on living with dementia-and to use these thoughts to improve care and outcomes. Ovid MEDLINE was searched from January 2005 to February 2015 using subject headings for dementia, caregiver, perspectives, and quality of health care. Articles geared toward FPs were selected. Relevant review articles and original research articles were used when appropriate and if they were applicable to PWDs and their caregivers. There are several frameworks that organize the main experiences described by patients and caregivers. We used a review of the qualitative literature to provide the framework to summarize Faye's experience under the following headings: seeking a diagnosis, accessing supports and services, information needs, disease management, and communication and attitudes. Physicians should consider these themes when developing a management plan for PWDs. Trying to understand the experiences and perspectives of PWDs and their caregivers is important in providing optimal care. Copyright© the College of Family Physicians of Canada.

  7. The effects of balance of low vision patients on activities of daily living.

    Science.gov (United States)

    Jeon, Byoung-Jin; Cha, Tae-Hyun

    2013-06-01

    [Purpose] This research investigated the relationship between balance measured by a TETRAX and activities of daily living (ADL) assessed by NEI-VFQ 25. The results should provide basic data for rehabilitation therapy for low-vision patients. [Methods] We used the NEI-VFQ-25 vision-related Activities of Daily Living evaluation, MMSE-K, and TETRAX to evaluate 30 low-vision outpatients at K hospital in Daejeon, South Korea from July 5 to July 23, 2012. We performed linear regression analysis using a statistical significance level of 0.05. [Results] Balance in the normal eyes open (NO) posture correlated with the normal eyes closed posture and age, but showed no correlation with NEI-VFQ 25. The ADL level correlated with monocular vision, female gender, cognition, and NO posture. These variables explained 54.4% of the aspects of their ADL. [Conclusion] This research proves that low vision adversely affects balance ability, and is influenced by type of vision, gender, and cognitive assessment.

  8. Lessons in living and dying from my first patient: an autoethnography.

    Science.gov (United States)

    Warne, Katie E; Hoppes, Steve

    2009-10-01

    This study examines the challenges and rewards of a fieldwork student's first encounter with death in a clinical setting and describes occupational interventions that affirm the life of a client preparing for death. To explore meanings, challenges, and lessons of end-of-life care for an occupational therapy fieldwork student. A qualitative format, autoethnography, was used to develop a narrative that reveals the lived experience of a fieldwork student. FINDINGS. Findings include a description of what a fieldwork student was and was not able to accomplish in end-of-life care. The paper describes using self-care activities to normalize and cede control of end-of-life care to the client and developing a vision of how to help clients find closure. The study carries implications for students and therapists working in end-of-life care. Therapists and educators can draw from this study to better understand and support new therapists when patients die.

  9. Walking speed affects instrumental activities of daily living in patients with hip osteoarthritis.

    Science.gov (United States)

    Tanaka, Shigeharu; Matsumoto, Shinsuke; Kawashima, Takaki; Mitani, Shigeru; Miura, Yasushi

    2017-01-01

    The symptoms of hip osteoarthritis (OA) influence instrumental activities of daily living (IADL). Evidence form previous studies suggest that body functions and walking speed are important etiological factors for IADL. However, no studies have investigated which factors that have the greatest influence on IADL. The aims of this study were (1) to analyze factors related to IADL in patients with hip OA, including 10 m walking speed (10 mWS), and (2) to establish cut-off values for factors that predict maintenance of IADL. Forty-eight patients participated in this study. IADL was treated as dependent variable. Range of motion (ROM), muscle strength of the hips and knees, and 10 mWS were measured as independent variables. Other potential confounding factors were also measured. Data were analyzed using hierarchical multiple regression and Receiver Operating Characteristic curve analysis. The hip flexion ROM on the affected side and 10 mWS were selected as significant variables in this study. The cut-off values obtained were 92.5 degrees for the hip flexion ROM on the affected side and 42.3 m/min for 10 mWS. The suggested target associated with maintaining IADL in patients with hip OA is the cut-off value of 42.3 m/min for 10 mWS found in this study.

  10. Effect of early rehabilitation on activities of daily living in patients with aspiration pneumonia.

    Science.gov (United States)

    Yagi, Maiko; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Fujimoto, Masashi; Koyama, Teruyuki; Fujitani, Junko

    2016-11-01

    To assess the effect of early rehabilitation on improving activities of daily living (ADL) in elderly patients with aspiration pneumonia. Using the Japanese Diagnosis Procedure Combination inpatient database, we retrospectively analyzed consecutive patients with aspiration pneumonia at admission who received early rehabilitation (n = 48 201) or did not receive any rehabilitation (n = 64 357) from July 2010 to March 2013. Early rehabilitation was defined as any type of physical rehabilitation initiated within 7 days after admission. The proportions of improved ADL scores from admission to discharge were compared between the early rehabilitation group and the non-rehabilitation group using a multivariable logistic regression analysis and instrumental variable analysis. The proportion of improved ADL scores was higher in the early rehabilitation group than in the non-rehabilitation group (25.4% vs 33.9%; P < 0.001). The multivariable logistic regression analysis showed that the early rehabilitation group exhibited significant improvement in ADL (odds ratio 1.57; 95% confidence interval 1.50-1.64; P < 0.001). The instrumental variable analysis showed that early rehabilitation was associated with increased proportion of improved ADL (risk difference 8.2%; 95% confidence interval 6.9-9.5%; P < 0.001). The present results suggest that early rehabilitation might improve ADL during hospitalization in patients with aspiration pneumonia. Geriatr Gerontol Int 2016; 16: 1181-1187. © 2015 Japan Geriatrics Society.

  11. A cross-sectional study of prescribing patterns in chronic psychiatric patients living in sheltered housing facilities

    NARCIS (Netherlands)

    Schorr, S. G.; Loonen, A. J. M.; Brouwers, J. R. B. J.; Taxis, K.

    Objective: To analyze prescribing patterns of chronic psychiatric patients living in sheltered housing facilities, to identify the extent of polypharmacy and to estimate associated risks in this patient group. Methods: In a retrospective cross-sectional study the prescription data of 323 chronic

  12. Helping nurses care for self, family, and patients through the nurses living fit intervention.

    Science.gov (United States)

    Speroni, Karen Gabel; Williams, Deborah Ann; Seibert, Dorothy June; Gibbons, Mary G; Earley, Cynthia

    2013-01-01

    More than half of United States nurses are estimated to be overweight or obese. Interventions are needed that help nurses live healthier lifestyles. With most registered nurses being female and with an average age of 45.5 years in the category most likely to be obese, it is not promising that US nurses will become healthier over time without intervention. The Nurses Living Fit (NLF) program, an exercise- and nutrition-based intervention innovated by nurses, was developed to decrease body mass index in nurse participants and to help nurse's care for themselves and their families and patients. A total of 217 nurses self-selected to the NLF intervention (n = 108) or contrast (no intervention; n = 109) groups. The NLF program included exercise (12 once-weekly sessions, 1 hour each), yoga (4 once-monthly sessions, 1 hour each), nutrition education (4 once-monthly sessions, 1 hour each taught by registered dietitians), diary completion (completed daily for 4 weeks specifying time spent on exercise/yoga, types and amount of food consumed, amount of water consumed, and hours slept), and healthy lifestyle principles education. Evaluation of the NLF program components was also completed. The NLF participants had significant decreases in body mass index (NLF = -0.5 kg/m; contrast = -0.2 kg/m) and waist circumference (NLF = -0.9 in; contrast = -0.2 in). Overall, program component evaluation demonstrated that participants wanted more personalized exercise, more nutrition education, and year-round program provision. As a result of the NLF program, nurses specified they exercised more and improved nutrition. Evidence-based intervention or programs are needed to educate nurses on healthy lifestyles. Nurse leaders need to promote healthy workplace environments, which can be done in part through the facilitation of exercise- and nutrition-based programs, such as NLF, to help nurses better care for themselves and their families and patients.

  13. Diagnosis as the First Critical Point in the Treatment Trajectory: An Exploration of Operable Lung Cancer Patients' Lived Experiences.

    Science.gov (United States)

    Missel, Malene; Pedersen, Jesper H; Hendriksen, Carsten; Tewes, Marianne; Adamsen, Lis

    2015-01-01

    Significant advances have been made in the surgical treatment of lung cancer while patient experiences with diagnosis, treatment, and rehabilitation remain only sparsely researched. The objective of this study was to investigate how the diagnosis affects the daily lives of patients with operable lung cancer in order to identify their needs for care interventions from the point of diagnosis to hospitalization. We investigated patients' lived experiences from a longitudinal perspective at 4 critical time points during the treatment trajectory; we present here the findings from the first time point, diagnosis. Data were collected through interviews conducted 7 to 10 days following diagnosis of lung cancer. Data from 19 patients are included, and the analysis is based on Ricoeur's interpretation theory. The study framework is inspired by Schutz's phenomenological sociology. The findings are presented as themes that summarize and express the ways in which a diagnosis affects patients' daily lives: the cancer diagnosis comes as a shock, it changes everyday awareness; it presents the patient with an unfamiliar body, disturbs social relationships, forces the patient to face a new life situation, and demands one-on-one supportive care. Diagnosis is the first critical point for patients with operable lung cancer and disrupts their daily life. Patients need psychosocial support during the period from diagnosis to surgical intervention and patient-tailored one-on-one information. This article contributes to the knowledge base of support needs of lung cancer patients. Interventions aimed at supportive care during the period between diagnosis and surgical intervention should be researched.

  14. The elderly mentally handicapped in hospital: a clinical study.

    Science.gov (United States)

    Day, K A

    1987-06-01

    In a study of 99 long-stay hospital residents aged 65 years and over, two thirds were functioning in the moderately to mildly handicapped range, two thirds were under the age of 75 years and there was an overall female to male ratio of 2:1. As in the general population, mobility problems, a tendency to falls and fractures, cardiorespiratory disease, deteriorating eyesight, and hearing and urinary incontinence were commonly found; all increased in frequency with age. A fifth exhibited psychiatric disorder: the commonest conditions, as expected, were the psychoses and dementia. It is suggested that retirement provision for the elderly mentally handicapped should be made within the mental handicap services and that the small group with significant geriatric problems would be most appropriately cared for within the generic geriatric services. A plea is made for evaluative studies before large scale implementation of resettlement programmes for the elderly mentally handicapped in hospital.

  15. Intramurals for Handicapped Students at Kent State University.

    Science.gov (United States)

    Vannoy, Winona

    1981-01-01

    As an outgrowth of a student project, a recreational swimming program for handicapped students at Kent State University proved to be such a success that intramural basketball competitions were organized for students confined to wheelchairs. (JN)

  16. Hidden Abilities Discovered Among Multiply Handicapped Blind Children

    Science.gov (United States)

    Klineman, Janet

    1975-01-01

    The effectiveness of an objective, systematic assessment and individualized programing approach for discovering new channels of learning is illustrated with case study evaluations of multiply handicapped visually impaired children with complex learning and behavioral problems. (SB)

  17. Self-handicapping and managers' duty of care

    National Research Council Canada - National Science Library

    Hoffman, David A

    2007-01-01

      This essay focuses on the relationship between managers' duty of care and self-handicapping, or constructing obstacles to performance with the goal of influencing subsequent explanations about outcomes...

  18. Does Unilateral Hearing Loss Lead To Learning Handicap?

    Directory of Open Access Journals (Sweden)

    Gita Movalleli

    2000-05-01

    Full Text Available Hearing loss, even when limited to 1 ear, has been indicated as a handicap to communication and learning. Although this does not seem true based on my clinical impressions, there are no objective data available to evaluate, or even infer, what type of hearing loss can become a true handicap to overall academic achievement. Presented herein are findings that imply, although do not prove, the potential academic handicap of unilateral hearing loss. This study prospectively analyzed the audiologic and otologic screening tests in a university over a 9-year period. The University of Tokyo is one of the leading universities in Japan; the students examined undoubtedly had academic ability well above average, for the entrance examination is one of the most difficult to pass in Japan. The potential handicap to academic achievement caused by hearing impairment was evaluated by comparing the prevalence of hearing impairment among the study population.

  19. Concerns about Instructional Materials for Severely Handicapped Students.

    Science.gov (United States)

    Schoonhoven, Arlene

    1982-01-01

    The status of instructional materials developed for severely handicapped students is discussed. The author suggests that in light of decreased funding, teachers should reconsider all options for material development. (CL)

  20. [Sports for handicapped persons between the text and its implementation].

    Science.gov (United States)

    Negra Mahjoub, Samia; Djait, Salwa; Mahjoub, Rached; Turki, Ilhem

    2003-05-01

    The sports activities must occupy a paramount place in the schooling of the handicapped pupils. Indeed in addition to the development of the physical capacities, the sports activity has a positive impact on the development of the capacities of the communication and thus the integration of the pupil handicapped in his educational, family and social circle and on progress of psychomotor acquisitions. The national plan of education and the law N94-10 of August 3, 1994 relating to the sports activity in educational and university circle took part in the development and the promotion of the sports activities in the educational structures. This measurement, applied in the centers of specialized education, did not deny concerned the handicapped pupils provided education for in the colleges and normal colleges. What are the causes? Does there exist a remedy? How to introduce the sport for handicapped into the normal establishments?

  1. Handicaps for the large scale commercial application of micropropagation.

    NARCIS (Netherlands)

    Pierik, R.L.M.

    1988-01-01

    In the last 10 years micropropagation has shown a spectacular development. However, at present the widespread use of micropropagation is handicapped by the following facts: Frequently mutations occur, particularly when applying the adventitious bud technique and callus systems. Basic knowledge

  2. Connecting impairment, disability, and handicap in immune mediated polyneuropathies

    NARCIS (Netherlands)

    I.S.J. Merkies (Ingemar); P.I.M. Schmitz (Paul); F.G.A. van der Meché (Frans); J.P. Samijn (Johnny); P.A. van Doorn (Pieter)

    2003-01-01

    textabstractBACKGROUND: In the World Health Organisation (WHO) International Classification of Impairments, Disabilities, and Handicaps (ICIDH), it is suggested that various levels of outcome are associated with one another. However, the ICIDH has been criticised on the grounds

  3. Horticulture for Secondary Level Handicapped Adolescents: The Cherokee County Model.

    Science.gov (United States)

    Frith, Greg H.; And Others

    1981-01-01

    The Cherokee County (Alabama) horticulture training program provides 40 mildly mentally retarded adolescents with vocational training in a marketable skills. The broad spectrum of vocational skills makes horticulture ideal for the handicapped. (DB)

  4. Relationship of Cognitive Functions with Daily Living Activities, Depression, Anxiety and Clinical Variables in Hospitalized Elderly Patients.

    Science.gov (United States)

    Demir Akça, Ayşe Semra; Saraçli, Özge; Emre, Ufuk; Atasoy, Nuray; Güdül, Serdar; Özen Barut, Banu; Şenormanci, Ömer; Büyükuysal, M Çağatay; Atik, Levent; Atasoy, H Tuğrul

    2014-09-01

    Cognitive impairment in elderly patients, which may be a sign of dementia, depression, anxiety or medical diseases, has been determined as a risk factor for functional loss. In this study, we aimed to investigate the frequency of cognitive impairment and to investigate the relationship of cognitive status with sociodemographic variables, daily living activities, anxiety and depression in elderly inpatients. The sample of this cross-sectional and descriptive study consists of 243 patients aged 65 years and older who were hospitalized in Bülent Ecevit University Hospital. A sociodemographic questionnaire,, the Mini-Mental State Examination (MMSE), Activities of Daily Living Scale, Lawton-Brody Instrumental Daily Activities Scale, Geriatric Depression Scale (GDS) and the Beck Anxiety Inventory were used for data collection. One hundred and six (43.6%) patients were female and 137 (56.4%) were male. The patients were divided into two groups according to the Mini-Mental State Examination (MMSE) 23/24 cut-off score. The cognitive decline was statistically significantly more frequent in patients who were older, female, less educated, low socioeconomic status, and living in rural areas. There were more problems in the basic and instrumental activities of daily living and nutrition in patients with cognitive decline. Anxiety and depression scores were higher in this group. In our study, although the frequency of cognitive decline and depression according to GDS were 56% and 48%, respectively; we found that only 10.5% of patients applied to the psychiatrist, and 9.3% of patients received psychiatric treatment. Cognitive decline may cause deterioration in the daily living activities, nutrition and capacity for independent functioning. Older age, female, low education, low socioeconomic status and living in rural area are important risk factors for cognitive impairment. Cognitive decline in older age may be associated with depression and anxiety. We assume that when cognitive

  5. Violent behavior of patients living in psychiatric residential facilities: a comparison of male patients with different violence histories.

    Science.gov (United States)

    Candini, Valentina; Buizza, Chiara; Ferrari, Clarissa; Boero, Maria Elena; Giobbio, Gian Marco; Goldschmidt, Nicoletta; Greppo, Stefania; Iozzino, Laura; Maggi, Paolo; Melegari, Anna; Pasqualetti, Patrizio; Rossi, Giuseppe; de Girolamo, Giovanni

    2015-01-01

    People with severe mental disorders and a history of violence are often seen as a difficult-to-manage segment of the population. In addition, this group is usually characterized by a high risk of crime recidivism, and poor compliance with community and aftercare programs. To investigate a sample of male patients living in Residential Facilities (RFs) with a history of violent behavior against people and to compare their characteristics with those of never-violent residents; to analyze the associations between aggressive behaviors in the last two years and a history of previous violence; and, to assess the predictors of aggressive behaviors. This study is part of a prospective observational cohort study which involved 23 RFs in Northern Italy. A comprehensive set of sociodemographic, clinical, and treatment-related information was gathered, and standardized assessments were administered to each participant. Also a detailed assessment of aggressive behaviors in the past two years was carried out. The study involved 268 males: 81 violent and 187 never-violent. Compared to never-violent patients, violent patients were younger, with a higher proportion of personality disorders, and have displayed an increased number of aggressive behaviors in the last two years. The presence of a history of violent behavior in the past significantly increases the probability of committing aggressive acts in the future. Copyright © 2015. Published by Elsevier Ltd.

  6. Chorionic bump in pregnant patients and associated live birth rate: a systematic review and meta-analysis.

    Science.gov (United States)

    Arleo, Elizabeth Kagan; Dunning, Allison; Troiano, Robert N

    2015-04-01

    A chorionic bump on first-trimester sonography has been considered a risk factor for nonviability in pregnant patients with this rare finding, although the strength of this association has recently been questioned. We performed a systematic review and meta-analysis to summarize the association between a chorionic bump and nonviability. A comprehensive literature search was performed. We included all studies except case reports. A meta-analysis was performed using a random-effects model. After screening 5 studies, 2 studies with a total of 67 patients met inclusion criteria. These were combined with a study (n = 52) from our institution. Overall, the live birth rate was 62% (74 of 119). Fifty-one chorionic bump pregnancies were otherwise normal (ie, pregnancies in which a gestational sac, a yolk sac, and an embryo with a heartbeat was seen at some point), and in this subset, the live birth rate was 83% (42 of 51). There was no significant relationship found between vaginal bleeding and live birth (P = .857); there was no significant difference in bump volume between live birth and no live birth (P = .198); and for the subset analysis of pooled odds ratios for the relationship between live birth and history of infertility, there was no significant relationship found (P = .186). A chorionic bump remains a risk factor for nonviability in pregnancy; however, if the pregnancy is otherwise normal, then most result in live birth. © 2015 by the American Institute of Ultrasound in Medicine.

  7. Improving preemptive transplant education to increase living donation rates: reaching patients earlier in their disease adjustment process.

    Science.gov (United States)

    Hays, Rebecca; Waterman, Amy D

    2008-12-01

    Patients who receive a preemptive kidney transplant before starting dialysis avoid the medical complications related to dialysis and have the highest graft success and lowest mortality rates. Because only 2.5% of incident patients receive kidney transplants preemptively, improved psychosocial education may assist more patients in accessing preemptive transplant. This article outlines (1) unique psychosocial issues affecting patients with chronic kidney disease stage 4 (glomerular filtration rates > 20 mL/min per 1.73 m2) and (2) how an educational program about preemptive living donor transplant should be designed and administered to increase access to this treatment option. Early referral patients may be overwhelmed in coping with and learning about their disease and, therefore, not ready to make a treatment decision, or they may be highly motivated to obtain a transplant to avoid dialysis and return to a normal life. An education program that defines the quality-of-life and health benefits possible with early transplant is outlined. The program is focused on minimizing the disruption of starting 2 treatment techniques and maximizing early transplant health, graft survival, employability, and retention of insurance coverage. Once the benefits of preemptive living donor transplant are outlined, educators can focus on demystifying the living donor evaluation process and assisting interested patients in planning how to find a living donor. To reach all patients, especially racial minorities, education about preemptive transplant should be available in primary-care physicians' and community nephrologists' offices, at dialysis centers, and through other kidney organizations.

  8. Handicap og beskæftigelse. Regionale forskelle

    DEFF Research Database (Denmark)

    Larsen, Brian; Mølgaard Miiller, Max; Høgelund, Jan

    Denne rapport belyser beskæftigelsessituationen for personer med handicap i et regionalt perspektiv. Formålet er at bidrage med viden om den udfordring, landets fire beskæftigelsesregioner står over for i forbindelse med indsatsen over for personer med handicap. På baggrund af en...... interviewundersøgelse af ca. 9.000 personer viser rapporten, at personer med handicap tilsyneladende er bedst integreret på arbejdsmarkedet i Nordjylland. Blandt andet udgør personer med handicap en lidt større del af de beskæftigede i Nordjylland end i resten af landet, og lønmodtagere i Nordjylland er oftere positivt...... indstillet til at få en kollega med handicap, end lønmodtagere i de tre andre regioner. Desuden er kendskabet til beskæftigelsesfremmende støtteordninger større blandt personer med handicap i Nordjylland og Syddanmark end på Sjælland og i Midtjylland....

  9. Classical singing handicap index (CSHI) in erudite singers.

    Science.gov (United States)

    Avila, Maria Emília Barros de; Oliveira, Gisele; Behlau, Mara

    2010-01-01

    self-assessment of the impact of vocal deviation in the quality of life of erudite singers. to verify whether the presence of vocal complaints in erudite singers produces quality of life handicap in the use of singing voice and whether this handicap is related to gender, age, vocal classification or time of singing. fifty-nine professional erudite choir singers answered the questionnaire including general questions such as identification, vocal classification, gender, time of study and dedication to classical singing. The choir singers were categorized into two groups, according to the presence of vocal complaints. They all answered the protocol Classical Singing Handicap Index (CSHI), which analyzes the impact of abnormal voice on singing voice in three subscales: Disability, Handicap and Impairment. subscales Impairment (6.39) and Disability (5.39) presented higher scores than subscale Handicap (3.34) for all singers. Moreover, there was statistically significant correlation between presence of vocal complaint and higher score of CSHI (p > 0.001 to all subscales). In the group with complaints, women had higher score in subscale Disability than men. In the group without complaints, older subjects and those who had sung longer presented lower CSHI scores. singers with vocal complaints and/or symptoms had higher handicap index in singing, expressed in subscales Impairment and Disability, without relationship with vocal classification.

  10. Self-Handicapping and Its Impact on Mental Health

    Directory of Open Access Journals (Sweden)

    Yeter Sinem Uzar Ozcetin

    2016-06-01

    Full Text Available Self handicapping is characterized by experiencing anxiety at succeeding a mission although the person has the capacity to fulfill the assignment or duty. It describes one's showing tendency to link own failures to problems in own performance instead of own abilities to protect oneself from the possibility of failure. When individuals care about performance much but doubt about success, they display self-handicapping strategies to protect their self. Self-handicappers try to protect their self by internalizing successes and externalizing failures. This strategies help them feel well in both successes and failures. Self-handicapping becomes a trait of personality in time and the individual begins to use it continuously as a negative coping mechanism to protect his/her self and to avoid failures. These actions eliminates the capability of rational thinking and prevents solution of the problems as a result of irrational interpretations. Self-handicapping causes the decrease of life satisfaction and motivation, and causes the increase of maladaptation, negative mood, somatic symptoms and alcohol-drug abuse. As a conclusion, self-handicapping hinders performance and this negative performance influences adaptation and psychological well-being. The most essential approach to prevent occurrence of self-handicapping behaviours is empowerment of the self. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 145-154

  11. Choosing to live with home dialysis-patients' experiences and potential for telemedicine support: a qualitative study

    OpenAIRE

    Rygh Ellen; Arild Eli; Johnsen Elin; Rumpsfeld Markus

    2012-01-01

    Abstract Background This study examines the patients' need for information and guidance in the selection of dialysis modality, and in establishing and practicing home dialysis. The study focuses on patients' experiences living with home dialysis, how they master the treatment, and their views on how to optimize communication with health services and the potential of telemedicine. Methods We used an inductive research strategy and conducted semi-structured interviews with eleven patients estab...

  12. Translation and Psychometric Properties of Persian Version of Independent Living Scale in Patients with Schizophrenia

    Directory of Open Access Journals (Sweden)

    Khalafbeigi

    2016-12-01

    Full Text Available Background Independent living skills are major targets for rehabilitation in patients with schizophrenia. So, assessment of their performance is required to obtain valuable information for planning intervention. The independent living scale (ILS is a useful assessment tool for this population. Objectives The aims of this study were to translate the three of five subscales of ILS (“memory/orientation”, “health and safety” and “social adjustment” into Persian language and evaluate their validity. The remaining two subscales of ILS (“money management”, “home management and transportation” have already been translated to Persian language by other researchers in Iran. In addition, the reliability of whole Persian version of ILS subscales was evaluated to be used for patients with Schizophrenia. Methods The three subscales of ILS were translated from English into Persian according to the international quality of life assessment (IQOLA approach. The translation of the three subscales: memory/orientation, health and safety and social adjustment, were analyzed by experts to develop the final version of each subscale. After translation, face and content validity of scale were performed. In face validity evaluation, the scale was investigated by 6 occupational therapists in terms of simplicity, mastery, relationship and clarity or transparency for each of the items. To assess the validity of content, scale was examined by 15 occupational therapists and content validity ratio (CVR and content validity index (CVI of each item were calculated. To assess the reliability of the subscales, test-retest reliability techniques (intraclass correlation coefficient (ICC and standard error of measure (SEM were utilized. Results The simplicity, relevance, clarity and necessity of the translated items were acceptable, according to the CVI and CVR scores. Face validity was also acceptable with respect to agreement rate (> 80%. Test-retest reliability

  13. Intellectual function, activities of daily living and computerized tomography of the brain in geriatric demented patients

    Energy Technology Data Exchange (ETDEWEB)

    Omura, Fumiaki; Ogura, Chikara; Kishimoto, Akira; Okubo, Masayo; Imamoto, Atsushi (Tottori Univ., Yonago (Japan). School of Medicine); Tsuchie, Harutaka; Sugihara, Kanichiro; Fujii, Shozo

    1984-09-01

    Thirty eight patients of geriatric dementia (mean age 74.9 years) were examined by computerized tomography (CT) and their intellectual functions and activities of daily living (ADL) were evaluated. CT was evaluated by both visual assessment method and direct measuring method. Intellectual function was evaluated by Jikei University dementia rating scale. ADL was evaluated by both Hasegawa's rating scale and Sengoku's rating scale. Results were as follows: significant influence by age was observed in intellectual functions and ADL of subjects above 75 years old. There were good correlations between the higher intellectual function, the better grooming and hygiene, and less needs of nursing care. The severe brain atrophy evaluated by the visual assessment method was correlated with the depressed level of intellectual function. When brain atrophy is mild despite high degree of dementia, reexamination should be made to explore somatic diseases inducing depression of mental activity. It also should be noted that sex and age difference is important in studying geriatric patients.

  14. Development and validation of the Dutch version of the London Handicap Scale.

    Science.gov (United States)

    Groothuis-Oudshoorn, Catharina G M; Chorus, Astrid M J; Verrips, G H W; Detmar, Symone B

    2015-01-01

    The London Handicap Scale (LHS) was found to be a valid and reliable scale for measuring participation restrictions in adults. This paper describes the development and assesses the construct-related validity of a Dutch version of the London Handicap Scale (DLHS). The DLHS was tested in 798 adults (mean age: 50.7 years, SD=14.5, range 16 to 85) and validated with the 'Impact on Participation and Autonomy' (IPA) questionnaire, the Dutch version of the EQ-5D and questions concerning comorbidity and use of medical devices. The study population consisted of patients with rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), epilepsy, laryngectomy and multiple sclerosis. Feasibility was satisfactory. Large correlations (ρ > 0.6) for the DLHS sum score were found with the IPA subscales 'autonomy outdoors', 'perceiving problems', 'family role', autonomy indoors', 'work and education' and with the EQ-5D. The DLHS sum score differs significantly between subgroups based on the number of chronic diseases, number of medical devices and self-reported burden of disease or handicap (p< 0.001). Based on this evaluation the questionnaire seems feasible and valid for assessing differences in level of participation between subgroups of chronically ill or disabled persons in the Netherlands.

  15. Knowledge and affective traits of physiotherapy students to provide care for patients living with AIDS.

    Directory of Open Access Journals (Sweden)

    Oyeyemi Y. Adetoyeje

    2010-02-01

    Full Text Available Purpose: This  study  aimed  to  assess  Nigerian physiotherapy students’ knowledge and their affective traits in caring for patients living with AIDS (PWA.Methods: Nigerian students (N=104 in four training programs were surveyed using a 43-item questionnaire that elicited information on the  students’  demographics  characteristics,  knowledge  levels  on AIDS transmission, universal precaution and pathophysiology, their feeling  of  preparedness,  comfort,  ethical  disposition  for  PWA  and their  willingness  to  evaluate  and  provide  care  to  PWA  in  different clinical scenarios.Results: Overall  the  students  showed  unsatisfactory  know ledge  of universal  precaution  and  AIDS  pathophysiology  and  did  not  feel comfortable or prepared to care for PWA. The students did not also show  satisfactory  ethical  disposition  and  may  be  unwilling  to  care for PWA. The students’ knowledge levels on AIDS transmission and willingness were influenced by religious affiliation while feeling of comfort and ethical disposition were influenced by gender and knowing someone living with AIDS. They were more unwilling to provide whirlpool wound care procedures and chest physiotherapy compared to providing gait training, therapeutic exercise and activities of daily living training for PWA.Conclusion: The study identified the need to improve the curriculum on AIDS and recommends clinical clerkship and a methodical and sequential exposure of students to cases during clinical rotations.

  16. Managing Cancer And Living Meaningfully (CALM): randomised feasibility trial in patients with advanced cancer.

    Science.gov (United States)

    Lo, Chris; Hales, Sarah; Chiu, Aubrey; Panday, Tania; Malfitano, Carmine; Jung, Judy; Rydall, Anne; Li, Madeline; Nissim, Rinat; Zimmermann, Camilla; Rodin, Gary

    2016-01-19

    Managing Cancer And Living Meaningfully (CALM) is a brief individual psychotherapy for patients with advanced cancer. In an intervention-only phase 2a trial, CALM showed promising results, leading to the present 2b pilot, which introduces procedures for randomisation and improved rigour in preparation for a phase 3 randomised controlled trial (RCT). To test trial methodology and assess feasibility of a confirmatory RCT. A parallel-arm RCT (intervention vs usual care) with 3 and 6-month follow-ups. Assessment of feasibility included rates of consent, randomisation, attrition, intervention non-compliance and usual care contamination. depressive symptoms (Patient Health Questionnaire-9; PHQ-9). major depressive disorder (MDD), generalised anxiety, death anxiety, spiritual well-being, attachment anxiety and avoidance, self-esteem, experiential avoidance, quality of life and post-traumatic growth. Bayesian conjugate analysis was used in this low-powered setting. 60 adult patients with advanced cancer from the Princess Margaret Cancer Centre. Rate of consent was 32%, randomisation 78%, attrition 25%, non-compliance 37% and contamination 17%. There was support for potential treatment effects on: PHQ-9, OR=1.48, 95% Credible Interval (CRI.95) (0.65, 3.38); MDD, OR=1.56, CRI.95 (0.50, 4.84); attachment anxiety, OR=1.72, CRI.95 (0.73, 4.03); and attachment avoidance, OR=1.58, CRI.95 (0.67, 3.71). There was no support for effects on the seven remaining secondary outcomes. A phase 3 CALM RCT is feasible and should aim to detect effect sizes of d=0.40, with greater attention to issues of compliance and contamination. NCT02353546. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Hungarian adaptation of the Tinnitus Handicap Inventory: reliability and validity.

    Science.gov (United States)

    Bencsik, Beata; Tamás, László; Trimmel, Krisztina; Stauder, Adrienne

    2015-09-01

    The objective of this study was to determine the reliability and validity of the Hungarian version of the original Tinnitus Handicap Inventory (THI). In the study design the original THI (THI-US) was translated into Hungarian by three independent investigators. The final Hungarian version (THI-HUN) was constructed on the basis of these Hungarian interpretations and then administered to 72 patients suffering from chronic tinnitus. Construct validity was assessed using short version of Beck's Depression Inventory (BDI), Perceived Stress Scale (PSS4 version), Visual Analogue Scale (VAS) (loudness, annoyance and pitch of tinnitus), pure tone audiometry and tinnitometry. The 72 participants were 43 women and 29 men. Their mean age was 49.86 years with a mean tinnitus duration of 4.16 years. In the results THI-HUN and its subscales showed good internal consistency reliabilities (α = 0.95-0.74), with significant correlation between THI-HUN total score and subscales and the BDI, PSS4 and VAS annoyance. There was a high or moderate correlation between THI-HUN total score and VAS loudness, tinnitus duration, hearing loss and subjective perception of tinnitus loudness. The VAS pitch of tinnitus, the subjective perception of tinnitus pitch, age, gender and level of education did not show any correlation with THI-HUN total score. The test-retest reliability was high (r = 0.97). We conclude that a valid and reliable THI-HUN questionnaire was constructed.

  18. Information and Communication Technologies for the Activities of Daily Living in Older Patients with Dementia: A Systematic Review.

    Science.gov (United States)

    D'Onofrio, Grazia; Sancarlo, Daniele; Ricciardi, Francesco; Panza, Francesco; Seripa, Davide; Cavallo, Filippo; Giuliani, Francesco; Greco, Antonio

    2017-01-01

    Significant innovations have been introduced in recent years in the application of information and communication technologies (ICTs) to support healthcare for patients with dementia. In the present systematic review, our goal is to keep track of ICT concepts and approaches to support the range of activities of daily living for people with dementia and to provide a snapshot of the effect that technology is having on patients' self-reliance. We reviewed the literature and identified systematic reviews of cohort studies and other authoritative reports. Our selection criteria included: (1) activities of daily living, (2) ICT, and (3) dementia. We identified 56 studies published between 2000 and 2015, of which 26 met inclusion criteria. The present systematic review revealed many ICT systems that could purportedly support the range of activities of daily living for patients with dementia. The results showed five research bodies: 1) technologies used by patients with dementia, 2) technologies used by caregivers, 3) monitoring systems, 4) ambient assistive living with ICTs, and 5) tracking and wayfinding. There is a potential for ICTs to support dementia care at home and to improve quality of life for caregivers, reducing healthcare costs and premature institutional care for these patients.

  19. Kidney transplantation of 32 patients from HLA-incompatible live donors: Efficacy and outcome after desensitization

    Directory of Open Access Journals (Sweden)

    Constantino Fernández

    2017-11-01

    Full Text Available Desensitization is a procedure undergone by the recipient of a kidney transplant from a donor who is cross-match positive. The aim of this study was to present the outcomes from our hospital of kidney transplant recipients from HLA-incompatible live donors after desensitization.We studied 32 patients aged 46 ± 14 years with a mean fluorescence intensity (MFI versus class I HLA of 7979 ± 4089 and 6825 ± 4182 MFI versus class II and relative intensity scale (RIS of 8.9 ± 7.6. The complement-dependent cytotoxicity (CDC cross-matching test was positive in 18 patients, flow cytometry was positive in 7 patients and donor-specific antibodies (DEA were detected in 7. The protocol used was rituximab, plasmapheresis/immunoadsorption, immunoglobulins, tacrolimus, mycophenolic acid derivatives and prednisone.After 8 ± 3 sessions of plasmapheresis/immunoadsorption, 23 patients were transplanted (71.9% and desensitization was ineffective in 9. There were baseline differences in MFI class I (p < 0.001, RIS (p = 0.008, and CDC cross-matching, DSA and flow cytometry (p = 0.05. MFI class I and RIS were predictors of inefficiency in ROC curves. After follow-up of 43 ± 30 months, 13 patients (56% presented postoperative bleeding, 3 (13% delayed graft function, 4 (17.4% acute rejection, 6 (26% CMV viremia and 1 (4% BK viremia. Five-year patient survival was 90%, with 86% allograft survival. Five-year creatinine was 1.5 ± 0.4 and proteinuria was 0.5 ± 0.7. Conclusions: Kidney transplantation from HLA-incompatible live donors after desensitization was possible in 71.9% of patients. MFI class I and RIS predict the inefficiency of desensitization. Five-year allograft survival (86% was acceptable with a low incidence of acute rejection (17.4%, although with a greater trend toward postoperative bleeding. Resumen: La desensibilización es un método empleado en trasplante renal para tratar de trasplantar a pacientes que presentan una prueba

  20. What can be learned from patient stories about living with the chronicity of heart illness? A narrative inquiry.

    Science.gov (United States)

    Schwind, Jasna Krmpotić; Fredericks, Suzanne; Metersky, Kateryna; Porzuczek, Victoria Gaudite

    2016-01-01

    Patients' illness stories are valuable information that supports person-centred care across the illness trajectory. To learn how older South Asian immigrant women experience living with heart illness long after discharge from hospital. We used narrative inquiry, a personal experience method that explores and interprets lived and told stories through the three dimensions of experience. Four participants, over the age of sixty, living with heart illness for over ten years, were invited to engage in narrative interview and Narrative Reflective Process. Giving patients voice, allows caregivers insight into the human experience of illness beyond hospitalization. Considering the increased migration of people around the globe, this knowledge is significant in provision of person-centred care. Person-centred care does not end with the hospitalization and outpatient clinics. Inter-disciplinary teams need to reconsider the trajectory of chronic illnesses and the care required throughout, especially for marginalized populations.

  1. Electing Full Code in Hospice: Patient Characteristics and Live Discharge Rates.

    Science.gov (United States)

    Ankuda, Claire K; Fonger, Evan; O'Neil, Thomas

    2017-09-05

    It is unknown how many hospice enrollees elect to be full code and if this is associated with higher hospice live discharge rates. To measure the rates of hospice enrollees electing full code, the characteristics predicting full code status, and the association of full code status with various hospice live discharge patterns. Retrospective cohort study of electronic medical record data. A total of 25,636 decedents enrolled in two Michigan hospices between 2009 and 2014. Code status was defined as full code versus do-not-resuscitate (DNR) orders. Covariates include demographics, location (home, hospice facility, nursing home, and hospital), primary diagnosis, and length of stay. Hospice live discharge was defined as short (0-14 days), medium (15-179 days), and long (>179 days). A total of 12.9% of hospice enrollees elected full code status. This was significantly (p live discharge compared with those with DNR orders (95% confidence interval [CI] 1.44-2.16) and 2.47 times the odds of short live discharge (95% CI 1.69-3.62) with no significant difference in long live discharge. The association of full code orders with hospice live discharge was stronger for nonwhite enrollees, with a live discharge rate of 23.8% versus 11.6% for African Americans with full code versus DNR orders. Those electing full code status on admission to hospice are at high risk of live hospice discharge after short enrollments, particularly nonwhite enrollees.

  2. Dealing with existential anxiety in exercise-based cardiac rehabilitation: a phenomenological-hermeneutic study of patients' lived experiences.

    Science.gov (United States)

    Simonÿ, Charlotte P; Pedersen, Birthe D; Dreyer, Pia; Birkelund, Regner

    2015-09-01

    To investigate patients' lived experiences of exercise-based cardiac rehabilitation. Exercise-based cardiac rehabilitation is used to enable patients with cardiac problems to move forward to lead satisfying lives. However, knowledge of patients' concerns while they follow the current programmes is sparse. This study, which included nine men and two women with unstable angina pectoris and non-ST-elevation myocardial infarction, used a phenomenological-hermeneutic approach. The patients were followed by field observations during exercise-based cardiac rehabilitation. Focus group interviews were conducted at the programme end, and individual interviews were performed one to two months later. The interpretation comprised three methodological steps: naïve reading, structural analysis, and comprehensive interpretation and discussion. Although both physically and psychologically challenged, the patients were encouraged to maintain an active lifestyle. Three themes were identified: anxiety regarding exercise, whereby the patients are initially insecure about how to behave with their diseased hearts; encouragement from training together, whereby the patients support each other in exercising; and growing confidence in the heart, whereby the patients enjoy being physically active. In exercise-based cardiac rehabilitation, patients' insecurity with respect to their heart disease is revealed as an existential anxiety. Through peer support and a positive physical perception, the patients gain renewed self-efficacy, helping them to continue their lives in an active and satisfying way. Knowing that patients are confronted with an existential anxiety during exercise-based cardiac rehabilitation is important because it requires specific care. Recognising this anxiety also highlights how participating in the programme can be very demanding, which can help us understand aspects of adherence problems. Of greatest importance is that exercise-based cardiac rehabilitation enables

  3. Symptoms, disability and handicap in unilateral peripheral vestibular disorders. Effects of early presentation and initiation of balance exercises.

    Science.gov (United States)

    Bamiou, D E; Davies, R A; McKee, M; Luxon, L M

    2000-01-01

    The aim of this study was to obtain a profile of disability and handicap in patients with unilateral peripheral vestibular disorders presenting to a specialist tertiary care unit. Two validated questionnaires were sent to patients who had a unilateral peripheral vestibular disorder as defined by strict criteria. Some patients still suffered moderate handicap and disability 5 years after the initial symptoms related to a unilateral vestibular disorder, although the duration of symptoms (onset to questionnaire completion) did not correlate with severity of disability and handicap, as judged by questionnaire scores. However, patients presenting to the unit within 6 months of onset of vertigo commenced balance exercises significantly earlier and had significantly lower disability scores than patients presenting later. A high proportion of non-compliance with, and delay in initiation of, vestibular rehabilitation exercises was noted in the total patient sample, while compliance with, and early initiation of, Cooksey Cawthorne exercises were significantly correlated with low disability and questionnaire scores. These findings suggest that early referral to a specialist balance unit for patients with persistent dizziness is associated with better outcome.

  4. Effects of kinesiology taping on the upper-extremity function and activities of daily living in patients with hemiplegia.

    Science.gov (United States)

    Kim, Eung-Beom; Kim, Young-Dong

    2015-05-01

    [Purpose] This study determined the effects of kinesiology taping on the upper-extremity function and activities of daily living of patients with hemiplegia. [Subjects] The experimental group and control group comprised 15 hemiplegia patients each. [Methods] This study was performed from June 4 to December 22, 2012, involving 30 hemiplegia patients. The experimental and controls groups performed task practices for 30 minutes, 3 times per week for 28 weeks with and without taping, respectively. [Results] After treatment, there were significant differences in every outcome measures within each group except for the Brunnstrom recovery stage of the hand. However, there was a significant difference in functional independence movements between the groups. [Conclusion] Task practice has the same effectiveness regardless of the taping of the upper extremities. Nevertheless, taping is helpful for improving both the functions and activities of daily living in patients with hemiplegia.

  5. Effect of Reminding Patients to Complete Fecal Immunochemical Testing: A Comparative Effectiveness Study of Automated and Live Approaches.

    Science.gov (United States)

    Coronado, Gloria D; Rivelli, Jennifer S; Fuoco, Morgan J; Vollmer, William M; Petrik, Amanda F; Keast, Erin; Barker, Sara; Topalanchik, Emily; Jimenez, Ricardo

    2017-10-10

    The Community Preventive Services Task Force recommends multi-component interventions, including patient reminders, to improve uptake of colorectal cancer screening. We sought to compare the effectiveness of different forms of reminders for a direct-mail fecal immunochemical test (FIT) program. Patient-randomized controlled trial. 2772 adults aged 50-75, not up to date with colorectal cancer screening recommendations, with a clinic visit in the previous year at any of four participating health center clinics. Participants were mailed an introductory letter and FIT. Those who did not complete their FIT within 3 weeks were randomized to receive (1) a reminder letter, (2) two automated phone calls, (3) two text messages, (4) a live phone call, (5) a reminder letter and a live phone call, (6) two automated phone calls and a live phone call, or (7) two text messages and a live phone call. Patients with a patient portal account were sent two email reminders, but were not randomized. FIT return rates for each group, 6 months following randomization. A total of 255 (10%) participants returned their FIT within 3 weeks of the mailing. Among randomized participants (n = 2010), an additional 25.5% returned their FITs after reminders were delivered (estimated overall return rate = 32.7%). In intention-to-treat analysis, compared to the group allocated to receive a reminder letter, return rates were higher for the group assigned to receive the live phone call (OR = 1.51 [1.03-2.21]) and lower for the group assigned to receive text messages (OR = 0.66 [0.43-0.99]). Reminder effectiveness differed by language preference. Our data suggest that FIT reminders that included a live call were more effective than reminders that relied solely on written communication (a text message or letter). ClinicalTrials.gov/ctc2/show/NCT01742065 .

  6. Development of a questionnaire measuring instrumental activities of daily living (IADL) in patients with brain tumors: a pilot study

    NARCIS (Netherlands)

    Oort, Q.; Dirven, L.; Meijer, W.; Sikkes, S. A. M.; Uitdehaag, B. M. J.; Reijneveld, J. C.; Taphoorn, M. J. B.

    2017-01-01

    Both dementia and brain tumor patients exhibit cognitive decline during the course of their disease. They might therefore experience similar problems with cognitively complex daily activities (i.e., instrumental activities of daily living (IADL)). The study's objective is to evaluate if the

  7. Single-living is associated with increased risk of long-term mortality among employed patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, Finn Erland; Mard, Shan

    2010-01-01

    OBJECTIVE: There is conflicting evidence about the impact of social support on adverse outcome after acute myocardial infarction (MI). We examined the relation between single-living and long-term all-cause mortality after MI. DESIGN: A prospective cohort study of 242 employed patients with MI fol...

  8. Patient with Macular Disease, Good Visual Acuity, and Central Visual Field Disruption and Significant Difficulties with Activities of Daily Living

    Science.gov (United States)

    Fletcher, Donald C.; Schuchard, Ronald A.; Walker, Joseph P.; Raskauskas, Paul A.

    2008-01-01

    It is generally appreciated that patients with macular disease frequently experience reduced visual acuity. It is not as widely appreciated that they often have significant central visual field disruption, which, by itself, can cause significant problems with activities of daily living, such as reading and driving, even when they maintain good…

  9. Handicap og beskæftigelse i 2010. Regionale forskelle

    DEFF Research Database (Denmark)

    Brink Thomsen, Lars; Høgelund, Jan

    Med oprettelsen af beskæftigelsesregionerne i 2006 blev det væsentligt at undersøge beskæftigelsessituationen for personer med handicap i de enkelte regioner. Denne rapport belyser regionale forskelle i beskæftigelsesniveau og -udvikling samt beskæftigelse på særlige vilkår og kendskab til...... beskæftigelsesrettede støtteordninger for personer med handicap. Den har desuden et særligt fokus på beskæftigelsessituationen på landsplan for personer med psykiske lidelser og personer med handicap og læsevanskeligheder. Undersøgelsen viser, at der er flest personer med et selvvurderet handicap eller længerevarende...... helbredsproblem i Region Syddanmark. Beskæftigelsesandelen er stort set ens i alle regioner, og den er steget mest i Midt- og Nordjylland. For personer med psykiske lidelser er beskæftigelsen forbedret på landsplan. Endelig er personer med både handicap og læse/skrive-vanskeligheder i væsentligt mindre grad i...

  10. Handicap og beskæftigelse i 2008 - regionale forskelle

    DEFF Research Database (Denmark)

    Larsen, Brian; Høgelund, Jan

    2009-01-01

    Dette arbejdspapir handler om personer med handicap og deres tilknytning til arbejdsmarkedet i 1. kvartal 2008. Arbejdspapiret belyser bl.a., om der er forskel mellem de fire beskæftigelsesregioner mht. beskæftigelsessituationen for personer med handicap, beskæftigedes holdninger til at arbejde...... sammen med handicappede, og handicappedes viden om beskæf-tigelsesrettede støtteordninger. Arbejdspapiret opbygning og fremstilling ligger i forlængelse af rapporten ”Handicap og beskæftigelse. Regionale forskelle” (Larsen m.fl., 2007). Arbejdspapirets resultater kan imidlertid ikke direkte sammenlignes...... med resultaterne i Larsen m.fl. (2007), bl.a. fordi personer med handicap ikke er afgrænset på samme måde i de to publikationer. Arbejdspapiret er en del af en større undersøgelse, som bl.a. og-så belyser udviklingen i beskæftigelsen for personer med handicap mellem 2002 og 2008 (Larsen og Høgelund...

  11. [The importance of family coherence for mentally handicapped children].

    Science.gov (United States)

    Niederhofer, Helmut

    2006-06-01

    A lack of perseverance, attention and poor modulated behaviour are important criterions of handicapped children (Dilling et al. 1993). Therefore, instructions have to be repeated quite often, sometimes even by different family members. For this reason, good family coherence might reduce symptoms significantly (Döpfner and Lehmkuhl 1995). The handicapped child might cause less disagreement in families with good coherence, which improves family;s features (Saile et al. 1995). Families of 15 handicapped children were included for evaluation and compared with a matched, healthy control group. Parents were asked to complete a form assessing the family;s features ("Familienklima-Testsystem", Schneewind et al. 1985), "Erziehungspraktiken", (Schneewind et al. 1985). Group comparison was made by the Mann-Whitney-U-Test. Our results strongly suggest, that good coherence seems to have positive effects on family;s features, especially by handicapped children. So we think, that on the one hand good coherence might reduce symptomatology and that on the other hand family's features have protective effects on handicapped children.

  12. Inter-relationship of intelligence-quotient and self-concept with dental caries amongst socially handicapped orphan children.

    Science.gov (United States)

    Virk, Pks; Jain, R L; Pathak, A; Sharma, U; Rajput, J S

    2012-01-01

    India has been the focus of many health surveys among normal, physically, and mentally handicapped children. However, the data, concerning oral health conditions of socially handicapped children living in orphanages, are scanty. To study the effect of parental inadequacy, environmental deprivation, and emotional disturbances on dental caries through intelligence quotient (IQ) and self-concept in orphan children and also to co-relate dental caries with different levels of IQ and self-concept. The study was carried out amongst socially handicapped children living in orphanages. 100 children in the age group of 10-14 years from orphanages were selected. Malin's Intelligence Scale for Indian Children (MISIC) was used to assess the intelligence quotient; self-concept questionnaire to assess self-concept of the child and recording of dental caries status of children was done as per WHO Index (1997). To assess the relationship of dental caries with IQ, student's unpaired t-test was used and; to find the relationship between self-concept and dental caries, Karl-Pearson's coefficient of co-relation was applied. the children in orphanages had a lower IQ and high caries experience but had an above average self-concept. There was also no co-relation between dental caries and self-concept. Orphan children, being socially handicapped, are at an increased risk for dental caries due to a lower IQ level, parental deprivation, and institutionalization. Moreover, lack of co-relation between dental caries and self-concept could be explained by the fact that dental caries is a lifelong process whereas different dimensions of self-concept are in a state of constant flux.

  13. [Elderly people, precariousness, social handicap and length of stay: pilot study at the Lariboisière-Fernand Widal Hospital Group in Paris].

    Science.gov (United States)

    Bréchat, Nathalie; Besnier, Magali; Vogel, Thomas; Berthel, Marc; Castiel, Didier; Labalette, Céline; Lonsdorfer, Jean; Mathieu-Grenouilleau, Marie-Christine; Rymer, Roland; Bréchat, Pierre-Henri

    2010-04-01

    To administer a social handicap questionnaire associated with French DRGs (PMSI) to determine the social handicaps of a population hospitalized in a public health establishment and to measure the cost implications for the establishment due to increased length of stay (DMS). A prospective pilot study has been carried out in the Lariboisière-Fernand Widal Hospital Group in Paris targeting users 50 or more years old hospitalized for short stays in medicine, surgery and obstetrics. Data of the PMSI and answers to the questionnaire for hospitalisations longer than 24 hours have been exploited. Two hundred twenty-two stays from 8 to 23 November 2005 have been analyzed: 140 pertained to patients aged 50-69 years (27.8%) and 82 to patients aged 70 or more years (16.3%). Three-fourths of the persons aged 50-69 and 70 or over presented a social handicap: 45% showed a strong handicap and a third an average handicap. The three indicators "renter/owner", "interior comfort" and "family relations" were the major determinants of social handicap for those aged 70 or more, 50-69 and 50 or more years. For the patients 70 years and over and those 50-69 years, with an average handicap, the indicator was "income" with the domain "patrimony." For strong handicaps, it was the indicator "scolarisation" for the 70 or more years and the indicator "income" for the 50-69 years old. When all classes and populations were pooled, the DMS was significantly lower than that of the ENC (phandicap remained hospitalized on average more than 2.5 days: 2.2 days for the 70 and over and 3.1 days for the 50-69 years group. In terms of hospital days that produces an increase of 18%, corresponding to a supplementary expenditure attributable to social handicap of approximately 5.9 million euros. This pilot study with a questionnaire disability social PMSI proposing specific aid, but also reducing the DMS, provides several promising information but also indicates the limits of our approach. Among these, we

  14. Indoor mite allergens in patients with respiratory allergy living in Porto, Portugal.

    Science.gov (United States)

    Plácido, J L; Cuesta, C; Delgado, L; da Silva, J P; Miranda, M; Ventas, P; Vaz, M

    1996-09-01

    We investigated the levels of mite allergens (Der p 1, Der f 1, Der 2, and Lep d 1) in dust samples from the homes of 59 patients with asthma, 36 sensitized to house-dust mites (HDM) and 23 to grass pollen (controls), living in Porto, northern Portugal. The relationship between exposure and sensitization to HDM and the influence of housing conditions on mite-allergen levels were also evaluated. Der p 1 (median 9.2 micrograms/g) and Der 2 (4.6 micrograms/g) were the main allergens, while Der f 1 and Lep d 1 levels were always 2 micrograms/g and their homes contained significantly higher levels of Der p 1 (median 12.5 vs 6.4 micrograms/g; P = 0.008) and Der 2 (6.2 vs 3.0 micrograms/g; P = 0.004) when compared to the control group. A significant correlation was observed between the exposure to Der p 1 and the wheal area at skin testing with the Dermatophagoides pteronyssinus (Dp) extract (P = 0.01) as well as with serum specific IgE levels to Dp (P = 0.03). Patients with higher levels of serum specific IgE (> or = 17.5 HRU/ml) were also more frequently exposed to Der p 1 levels > or = 10 micrograms/g (P = 0.002). Old homes, presence of carpets, and signs of dampness were conditions associated with significantly higher levels of mite allergens. In conclusion, we found high levels of Der p 1 and Der 2 particularly in the homes of HDM-sensitized patients and we confirm the relationship between exposure and sensitization to HDM, assessed by both in vivo and in vitro methods. In additional to a favorable outdoor climate, we found in our region housing conditions propitious to mite growth, suggesting that specific geographic characteristics must also be taken into account for the correct planning of mite-avoidance measures.

  15. Single-living is associated with increased risk of long-term mortality among employed patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Finn Erl

    2010-05-01

    Full Text Available Finn Erland Nielsen, Shan MardDepartment of Cardiology S, Herlev University Hospital, DenmarkObjective: There is conflicting evidence about the impact of social support on adverse outcome after acute myocardial infarction (MI. We examined the relation between single-living and long-term all-cause mortality after MI.Design: A prospective cohort study of 242 employed patients with MI followed up to 16 years after MI.Results: A total of 106 (43.8% patients died during the follow-up. Single-living nearly doubled the risk of death; after adjusting for potential confounding factors, single-living was an independent predictor of death, with a hazard ratio of 2.55 (95% confidence interval: 1.52–4.30. Other predictors of death were diabetes mellitus, atrial fibrillation, age, and ejection fraction less than 35%.Conclusion: Single-living is a prognostic determinant of long-term all-cause mortality after MI.Keywords: acute myocardial infarction, social support, single-living, prognosis.

  16. Efficacy of yoga therapy on subjective well-being and basic living skills of patients having chronic schizophrenia

    Directory of Open Access Journals (Sweden)

    Babu Paikkatt

    2012-01-01

    Full Text Available Background: Scientific studies demonstrate efficacy of yogic treatment methods in stress and anxiety related disorders, psychosomatic disorders and physical illness. Very few studies have been conducted on schizophrenic patients. Aims: This study was conducted to determine the efficacy of yoga therapy on subjective well-being, basic living skills, self-care, interpersonal, communicational and routine functions of schizophrenic patients. Materials and Methods: Thirty chronic schizophrenic hospitalized patients were selected from Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi and were randomly assigned to the experimental group (yoga therapy along with Pharmacotherapy, n=15, and to control group (Pharmacotherapy alone, n=15. Baseline assessment was done using Post Graduate Institute general well-being measure (GWBM, Checklist for basic living skills and Indian disability evaluation and assessment scale (IDEAS. The experimental group attended yoga therapy every day for about 1΍ h including motivational and feedback session. After 1 month post-assessment was done for both the groups. Statistical Analysis: Pearson Chi-square test was used for comparing the results. Results: At the end of 1 month experimental group showed better rating in comparison to control group in PGI GWBM, basic living skills and IDEAS. Conclusion: Yoga could improve patients′ subjective well-being, their daily basic living functioning, personal hygiene, self-care, interpersonal activities and communication, and prompted more involvement in routine work.

  17. Evaluation of Hearing Handicap in Adults with Auditory Neuropathy Spectrum Disorder.

    Science.gov (United States)

    Prabhu, Prashanth

    2017-08-01

    The present study attempted to evaluate hearing handicap in adults with auditory neuropathy spectrum disorder (ANSD). The study also attempted to determine if gender, pure tone average, speech identification scores (SIS), and reported duration of hearing loss could predict the hearing handicap in adults with ANSD. Hearing Handicap Inventory for Adults and Hearing Handicap Questionnaire were administered to 50 adults with ANSD. Using both the scales, there was a significant hearing handicap in both the social and emotional domains in adults with ANSD. SIS was a good predictor of hearing handicap compared to other variables. The poor SIS can affect communication skills leading to higher degree of social handicap. The ignorance regarding the exact cause for their hearing problems and lack of appropriate management strategies could lead to emotional problems in individuals with ANSD. However, further studies are essential for determining hearing handicap with the use of hearing aids and cochlear implants.

  18. Minimizing Teacher Stress. Structuring Positive Interactions for Handicapped and Nonhandicapped Children in Physical Education.

    Science.gov (United States)

    Colvin, Nola R.; And Others

    1982-01-01

    Components of an integrated physical education program, which consists of handicapped and nonhandicapped students, include: (1) activities that promote interaction among all students; (2) strategies that place handicapped and nonhandicapped students together; and (3) reinforcement of cooperative behavior. (CJ)

  19. Live sibling skin allografts for severe burns in a paediatric patient: A viable option in developing countries

    Directory of Open Access Journals (Sweden)

    Basil Leodoro

    2014-11-01

    Full Text Available Severe burns in the paediatric population are associated with high mortality and morbidity in any developing countries. Children with more than 40% total body surface area burns in Fiji will succumb from complications and as a direct result of inadequate treatment and lack of resources. The surgical treatment of any severely burnt patient is not only laborious but very costly to the Fiji health system and depletes existing resources with few options for skin coverage. This is the first case report of live sibling skin allograft for severe paediatric burns and one of only few patients to have survived more than 50% burns in Fiji. We describe the technique and the role of using live sibling skin allograft as an option to improve survival in patients with severe burns in a developing country.

  20. How a Model of Communication Can Assist Nurses to Foster Hope When Communicating with Patients Living with a Terminal Prognosis

    Directory of Open Access Journals (Sweden)

    Rebecca Petley

    2017-10-01

    Full Text Available Nurses play a central role in joint decision-making and person-centred care, whereby care is focused on the needs of an individual patient. A key part of person-centred care is the way nurses engage with patients because good communication can impact on a person’s spiritual wellbeing, particularly in relation to their ability to have hope. The way nurses communicate can be even more pertinent for people living with a terminal prognosis as the issues discussed can in themselves significantly influence a person’s spiritual wellbeing. This paper combines contemporary research on how health professionals can foster hope in patients living with a terminal prognosis with The Awareness Context Theory described by Glaser and Strauss in 1965. A model of communication is then used to demonstrate how the research on hope and The Awareness Context Theory can be applied to practice.

  1. Tuberculosis patients in an Indian mega-city: Where do they live and where are they diagnosed?

    Directory of Open Access Journals (Sweden)

    Ramnath Subbaraman

    Full Text Available Tuberculosis (TB is a major source of mortality in urban India, with many structural challenges to optimal care delivery. In the government TB program in Chennai, India's fourth most populous city, there is a 49% gap between the official number of smear-positive TB patients diagnosed and the official number registered in TB treatment within the city in 2014. We hypothesize that this "urban registration gap" is partly due to rural patients temporarily visiting the city for diagnostic evaluation.We collected data for one month (May 2015 from 22 government designated microscopy centers (DMCs in Chennai where 90% of smear-positive TB patients are diagnosed and coded patient addresses by location. We also analyzed the distribution of chest symptomatics (i.e., patients screened for TB because of pulmonary symptoms and diagnosed smear-positive TB patients for all of Chennai's 54 DMCs in 2014.At 22 DMCs in May 2015, 565 of 3,543 (15.9% chest symptomatics and 71 of 412 (17.2% diagnosed smear-positive patients had an address outside of Chennai. At the city's four high patient volume DMCs, 54 of 270 (20.0% smear-positive patients lived out-of-city. At one of these high-volume DMCs, 31 of 59 (52.5% smear-positive patients lived out-of-city. Out of 6,135 smear-positive patients diagnosed in Chennai in 2014, 3,498 (57% were diagnosed at the four high-volume DMCs. The 32 DMCs with the lowest patient volume diagnosed 10% of all smear-positive patients.TB case detection in Chennai is centralized, with four high-volume DMCs making most diagnoses. One-sixth of patients are from outside the city, most of whom get evaluated at these high-volume DMCs. This calls for better coordination between high-volume city DMCs and rural TB units where many patients may take TB treatment. Patient mobility only partly explains Chennai's urban registration gap, suggesting that pretreatment loss to follow-up of patients who live within the city may also be a major problem.

  2. Lifestyle, attitudes and needs of uncured XDR-TB patients living in the communities of South Africa: a qualitative study.

    Science.gov (United States)

    Senthilingam, Meera; Pietersen, Elize; McNerney, Ruth; Te Riele, Julian; Sedres, Pat; Wilson, Ruth; Dheda, Keertan

    2015-09-01

    Patient-level data are required to inform strategies interrupting transmission and default in patients with extensively drug-resistant TB (XDR-TB) to improve models of care and identify potential routes of transmission. We therefore explored the experiences, lifestyle, attitudes and needs of patients with uncured XDR-TB, who failed or interrupted therapy, living without treatment in the community. We conducted in-depth interviews with 12 community-based patients from South Africa. Family members were interviewed when patients were unavailable. Interviews were analysed using inductive thematic analysis. The thematic experiences identified from the interviews were as follows: (i) living with but not being cured of XDR-TB, (ii) altered lifestyle in the community, (iii) experiences with community health care, (iv) local community members, and (v) wants and needs. Patients identified mistrust in health care, futility of treatment regimens, a need for a purpose in life and subsistence as major concerns. Restriction of living in the community for patients whose treatment had failed resulted in self-imposed isolation. Defaulters focused more on the never-ending drug regimen and bad experiences with health care contributing to non-adherence. Family members emphasised an under-recognised experience of unforeseen burden, obligation, worry and discomfort. Lack of knowledge and lack of concern about transmission was evident. Current models of care are not adequately meeting the needs of patients with uncured XDR-TB and relatives. These data inform the need for community-based palliative care, vocational facilities to improve economic opportunities, home-based infection control and improved psychosocial support to increase patient adherence, reduce transmission, provide income and relieve the burden on family members. © 2015 John Wiley & Sons Ltd.

  3. Sygemeldte og førtidspensionister med handicap

    DEFF Research Database (Denmark)

    Tørslev, Mette Kirstine; Weibel, Kristina; Høgelund, Jan

    2010-01-01

    Dette arbejdspapir belyser udvalgte jobcentermedarbejderes erfaringer med og perspektiver på beskæftigelsesindsatsen for sygedagpengemodtagere og førtidspensionister med handicap. Undersøgelsen er gennemført i tre jobcentre, hvor der er foretaget interview med sagsbehandlere, virksomhedskonsulenter...... sygedagpengemodtagere og førtidspensionister med handicap igangsat af Vidensnetværket, som er forankret i Danske Handicaporganisationer. Arbejdspapiret er udarbejdet af forskningsassistent, cand.mag. (antropologi) Mette Kristine Tørslev, forskningsassistent, cand.scient.soc. Kristina Weibel og seniorforsker, cand...

  4. The handicap principle and the argument of subversion from within

    DEFF Research Database (Denmark)

    Baron, Christian

    2013-01-01

    This paper examines the very disparate positions that various actors have taken towards the argument of subversion from within (a classical argument against the evolution of altruism by group selection) in a set of related debates on group selection, altruism and the handicap principle. Using...... connected to important epistemological differences related in part (but not solely) to their disciplinary background. Apart from conflicting evolutionary views concerning the theoretical feasibility of the handicap effect, these antagonists both differed in the confidence they ascribed to mathematical...

  5. Voice-controlled Internet Browsing for Motor-handicapped Users

    DEFF Research Database (Denmark)

    Brøndsted, Tom; Aaskoven, Erik

    2006-01-01

    The public-funded project "Indtal" ("Speak-it") has succeeded in developing a Danish voice-controlled utility for internet browsing targeting motor-handicapped users having difficulties using a standard keyboard and/or a standard mouse. The system has been designed and implemented in collaboration...... with an advisory board of motor-handicapped (potential) end-users and underlies a number of a priori defined design criteria: learnability and memorability rather than naturalness, minimal need for maintenance after release, support for "all" web standards (not just HTML conforming to certain "recommendations...

  6. The role of nature in cancer patients' lives: a systematic review and qualitative meta-synthesis

    National Research Council Canada - National Science Library

    Sarah Blaschke

    2017-01-01

    Background A systematic review and meta-synthesis was conducted to identify, compare and synthesize the published qualitative literature contributing to our understanding of the role of nature in cancer patients’ lives...

  7. Influence of Self-generated Anchors on the Voice Handicap Index-10 (VHI-10).

    Science.gov (United States)

    Canals-Fortuny, Elisabet; Vila-Rovira, Josep

    2017-03-01

    The aim of this research is to study whether the presentation of the Voice Handicap Index-10 questionnaire administered at the beginning of the treatment impinged on the results of the responses from the end of the treatment. The questionnaire was administered at the beginning of the treatment to a total of 308 patients. After the treatment, a group of 235 patients answered the questionnaire again without any reference to their responses on the initial administration. The other group of participants, consisting of 73 subjects, completed the questionnaire with the answer sheet of their initial self-assessment in sight. The data obtained show that patients who responded to the anchored answer test show less dispersion and a smaller coefficient of variation (0.90) than those who responded to the nonanchored answer test (coefficient of variation = 1.66). The method of administration of the Voice Handicap Index-10 at the end of a treatment influences the dispersion of the results. We recommend that the patient be anchored to the initial answer sheet while responding to the final self-assessment. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  8. Chronic leg ulcers disrupt patients' lives: A study of leg ulcer-related life changes and quality of life.

    Science.gov (United States)

    Cunha, Nélia; Campos, Sara; Cabete, Joana

    2017-09-01

    Chronic leg ulcers have a profound impact on patients' physical, functional, and psychological status, which may result in several life changes and a significant decline in quality of life (QoL). We aimed to study what changed in patients' lives after developing a chronic leg ulcer, including QoL, patients' comprehension of the disease and related feelings. A cross-sectional study, using an anonymous questionnaire and the Dermatology Life Quality Index (DLQI) was performed. Chronic leg ulcers were life changing events, causing abandonment of work in almost 80% of the patients and important limitations in daily activities and autonomy. Familial relationships changed in more than half of the patients. Almost 15% hid or would like to hide their disease from others, especially patients with a shorter duration of disease. QoL was very or extremely affected in 18.2% of the participants completing the DLQI.

  9. The effects of live therapeutic music on patient's affect and perceptions of care: a randomized field study.

    Science.gov (United States)

    Mogos, Mulubrhan F; Angard, Nancy; Goldstein, Lloyd; Beckstead, Jason W

    2013-11-01

    This article examines the effects of live therapeutic music (LTM) on patients in a hospital setting. LTM was hypothesized to directly increase patients' positive affect and to indirectly influence their perceptions of the care they received. One hundred patients participated in a two group (fifty per group), quasi-experimental design in which they completed a very brief questionnaire assessing their affect and perceptions of care. Half of the participants were exposed to LTM at the bedside. The other half served as a comparison group. A structural equation model was used to test the hypothesized effects of LTM. The model explained 63% of the variance in patient's affect and 10% of the variance in perceptions of care. Patients respond to LTM with increased positive affect and by assigning higher ratings to the care they receive. LTM could be used as a viable means to improve patient outcomes and satisfaction. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. The effect of activities of daily living on the self-care agency of patients in a cardiovascular surgery clinic.

    Science.gov (United States)

    Karakurt, Papatya; Kasimoğlu, Necla; Bahçeli, Aybike; Atalikoğlu Başkan, Sebahat; Ağdemir, Burcu

    2017-06-01

    Cardiovascular diseases are the leading cause of death globally, and nurses have a crucial role in informing cardiovascular disease patients about their diseases. The aim of the present study was to identify the effect of activities of daily living on the self-care agency of patients in a cardiovascular surgery clinic. This descriptive study was conducted between June 2014 and January 2015 with 180 patients hospitalized in the cardiovascular surgery clinic of a university hospital in the province of Erzincan in the Eastern region of Turkey. The data of the study were gathered using a descriptive form designed by the authors, Katz index of activities of daily living scale (ADLS), Lawton-Brody instrumental activities of daily living scale (IADLS), and self-care agency scale (SCAS). The data were processed using computer software and assessed using percentages, means, t test for independent groups, one-way analysis of variance, and correlation analysis tests. It was found that 50.6% of the patients were ≥65 years, 66.1% were male, 46.1% perceived their health status as moderate, and 35.6% had previously had heart attacks. The patients' mean ADLS score was 16.39 ± 2.30, their mean IADLS score was 19.23 ± 4.16, and their mean SCAS score was 92.11 ± 18.81. The patients' education level and perceived health were found to affect their mean SCAS scores. In addition, there was a positive correlation between the patients' ADLS and IADLS scores and their SCAS score. It was also noted that patients were more independent on the ADL and IADL, and that their self-care agency was higher. Copyright © 2016 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

  11. 41 CFR 50-201.1102 - Tolerance for apprentices, student-learners, and handicapped workers.

    Science.gov (United States)

    2010-07-01

    ..., student-learners, and handicapped workers. 50-201.1102 Section 50-201.1102 Public Contracts and Property... REGULATIONS § 50-201.1102 Tolerance for apprentices, student-learners, and handicapped workers. (a... standards and procedures as are prescribed for the employment of apprentices, student-learners, handicapped...

  12. 24 CFR 235.331 - Increased maximum mortgage amount for physically handicapped persons.

    Science.gov (United States)

    2010-04-01

    ... for physically handicapped persons. 235.331 Section 235.331 Housing and Urban Development Regulations... maximum mortgage amount for physically handicapped persons. If the mortgage relates to a dwelling unit to be occupied by a handicapped person as defined in § 235.5(c)(2), the otherwise applicable dollar...

  13. 41 CFR 50-202.3 - Learners, student learners, apprentices, and handicapped workers.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Learners, student learners, apprentices, and handicapped workers. 50-202.3 Section 50-202.3 Public Contracts and Property... handicapped workers. Learners, student learners, apprentices, and handicapped workers may be employed at less...

  14. 48 CFR 552.238-70 - Identification of Electronic Office Equipment Providing Accessibility for the Handicapped.

    Science.gov (United States)

    2010-10-01

    ... Electronic Office Equipment Providing Accessibility for the Handicapped. 552.238-70 Section 552.238-70... Equipment Providing Accessibility for the Handicapped. As prescribed in 538.273(a)(1), insert the following clause: Identification of Electronic Office Equipment Providing Accessibility for the Handicapped (SEP...

  15. 36 CFR 701.6 - Loans of library materials for blind and other physically handicapped persons.

    Science.gov (United States)

    2010-07-01

    ... for blind and other physically handicapped persons. 701.6 Section 701.6 Parks, Forests, and Public... physically handicapped persons. (a) Program. In connection with the Library's program of service under the... Physically Handicapped provides books in raised characters (braille), on sound reproduction recordings, or in...

  16. 38 CFR 17.152 - Devices to assist in overcoming the handicap of deafness.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Devices to assist in overcoming the handicap of deafness. 17.152 Section 17.152 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... in overcoming the handicap of deafness. Devices for assisting in overcoming the handicap of deafness...

  17. 13 CFR 113.3-3 - Structural accommodations for handicapped clients.

    Science.gov (United States)

    2010-01-01

    ... handicapped clients. 113.3-3 Section 113.3-3 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... ADMINISTRATOR General Provisions § 113.3-3 Structural accommodations for handicapped clients. (a) Existing... by handicapped clients. Where structural changes are necessary to make the recipient's goods or...

  18. 45 CFR Appendix C to Part 84 - Guidelines Relating to Health Care for Handicapped Infants

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Guidelines Relating to Health Care for Handicapped... ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Pt. 84, App. C Appendix C to Part 84—Guidelines Relating to Health Care for Handicapped Infants (a...

  19. 24 CFR 100.202 - General prohibitions against discrimination because of handicap.

    Science.gov (United States)

    2010-04-01

    ... discrimination because of handicap. 100.202 Section 100.202 Housing and Urban Development Regulations Relating to... Against Discrimination Because of Handicap § 100.202 General prohibitions against discrimination because of handicap. (a) It shall be unlawful to discriminate in the sale or rental, or to otherwise make...

  20. 29 CFR 516.30 - Learners, apprentices, messengers, students, or handicapped workers employed under special...

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Learners, apprentices, messengers, students, or handicapped... handicapped workers employed under special certificates as provided in section 14 of the Act. (a) With respect... education, or handicapped workers employed at special minimum hourly rates under Special Certificates...

  1. Kangaroo Kapers or How to Jump into Library Services for the Handicapped.

    Science.gov (United States)

    Ruark, Ardis; Melby, Carole

    This guide to educational and library resources for handicapped individuals cites agencies, organizations, and bibliographies of children's and adult/professional books in separate sections for the aurally, visually, and mentally handicapped, and in a general section for other handicapping conditions. Guidelines for volunteers include suggested…

  2. Longitudinal study of the activities of daily living and quality of life in Japanese patients with fibrodysplasia ossificans progressiva.

    Science.gov (United States)

    Nakahara, Yasuo; Kitoh, Hiroshi; Nakashima, Yasuharu; Toguchida, Junya; Haga, Nobuhiko

    2017-11-16

    Fibrodysplasia ossificans progressiva is a rare congenital disorder that causes systemic heterotopic ossification, leading to systemic ankyloses and mobility losses. This study aimed to ascertain the natural history of fibrodysplasia ossificans progressiva. In addition to the medical history questionnaire, patients aged 16 years and older were asked to complete activities of daily living and quality of life surveys using the Barthel Index, MOS 36-Item Short-Form Health Survey, and Health Assessment Questionnaire. The surveys were conducted over a 4-years period. Of the 15 participating patients, 13 reported swelling during the study period. The Barthel Index and Health Assessment Questionnaire surveys indicated a tendency for questionnaire items related to arm function to reflect early decreases in the activities of daily living. Decreases in activities of daily living functioning were closely related to decreases in the quality of life in physical function domains. Activities of daily living and quality of life were maintained at a similar level to baseline values over the study period (Barthel Index: p = 0.42, MOS 36-Item Short-Form Health Survey: p = 0.43, Health Assessment Questionnaire: p = 0.87). We obtained longitudinal information relating to natural history on fibrodysplasia ossificans progressiva patients. Implications for rehabilitation Fibrodysplasia ossificans progressiva is a rare congenital disease that causes heterotopic ossification of muscle tissue throughout the body, leading to systemic ankyloses and mobility losses. When the Barthel Index was high and the activities of daily living were relatively stable, the items on the Health Assessment Questionnaire that are related to arm function began to show impairment. Early focus on upper extremity function that includes the use of assistive devices during the period when a patient is still able to perform many activities of daily living is important. Although decreases in activities of

  3. Effects of the Live Attenuated Measles-Mumps-Rubella Booster Vaccination on Disease Activity in Patients With Juvenile Idiopathic Arthritis A Randomized Trial : a randomized trial

    NARCIS (Netherlands)

    Heijstek, Marloes W; Kamphuis, Sylvia; Armbrust, Wineke; Swart, Joost; Gorter, Simone; de Vries, Lara D; Smits, Gaby P; van Gageldonk, Pieter G; Berbers, Guy A M; Wulffraat, Nico M

    2013-01-01

    Importance The immunogenicity and the effects of live attenuated measles-mumpsrubella (MMR) vaccination on disease activity in patients with juvenile idiopathic arthritis (JIA) are matters of concern, especially in patients treated with immunocompromising therapies. Objectives To assess whether MMR

  4. Correlation of Superior Canal Dehiscence Surface Area With Vestibular Evoked Myogenic Potentials, Audiometric Thresholds, and Dizziness Handicap.

    Science.gov (United States)

    Hunter, Jacob B; O'Connell, Brendan P; Wang, Jianing; Chakravorti, Srijata; Makowiec, Katie; Carlson, Matthew L; Dawant, Benoit; McCaslin, Devin L; Noble, Jack H; Wanna, George B

    2016-09-01

    To correlate objective measures of vestibular and audiometric function as well as subjective measures of dizziness handicap with the surface area of the superior canal dehiscence (SCD). Retrospective chart review and radiological analysis. Single tertiary academic referral center. Preoperative computed tomography imaging, patient survey, audiometric thresholds, and vestibular evoked myogenic potential (VEMP) testing in patients with confirmed SCD. Image analysis techniques were developed to measure the surface area of each SCD in computed tomography imaging. Preoperative ocular and cervical VEMPs, air and bone conduction thresholds, air-bone gap, dizziness handicap inventory scores, and surface area of the SCD. Fifty-three patients (mean age 52.7 yr) with 84 SCD were analyzed. The median surface area of dehiscence was 1.44 mm (0.068-8.23 mm). Ocular VEMP amplitudes (r = 0.61, p handicap and surface area was identified. Among patients with confirmed SCD, ocular and cervical VEMP amplitudes, cervical VEMP thresholds, and air conduction thresholds at 250 Hz are significantly correlated with the surface area of the dehiscence.

  5. Predictive properties of the video head impulse test: measures of caloric symmetry and self-report dizziness handicap.

    Science.gov (United States)

    McCaslin, Devin L; Jacobson, Gary P; Bennett, Marc L; Gruenwald, Jill M; Green, Andrea P

    2014-01-01

    The purpose of this investigation was to determine whether a predictable relationship existed between self-reported dizziness handicap and video Head Impulse Test (vHIT) results in a large sample of patients reporting to a dizziness clinic. Secondary objectives included describing the characteristics of the vHIT ipsilesional and contralesional vestibulo-ocular reflex slow-phase velocity in patients with varying levels of canal paresis. Finally, the authors calculated the sensitivity and specificity of the vHIT for detecting horizontal semicircular canal impairment using the caloric test as the "gold standard." Participants were 115 adults presenting to a tertiary medical care center with symptoms of dizziness. Participants were administered a measure of self-report dizziness handicap (i.e., Dizziness Handicap Inventory) and underwent caloric testing and vHIT at the same appointment. Results showed that (1) there were no significant group differences (i.e., vHIT normal versus vHIT abnormal) in the Dizziness Handicap Inventory total score, (2) both ipsilesional and contralateral velocity gain decreased with increases in caloric paresis, and (3) a caloric asymmetry of 39.5% was determined to be the cutoff that maximized discrimination of vHIT outcome. The level of self-reported dizziness handicap is not predicted by the outcome of the vHIT, which is consistent with the majority of published reports describing the poor relationship between quantitative tests of vestibular function and dizziness handicap. Further, the study findings have demonstrated that vHIT and caloric data are not redundant, and each test provides unique information regarding the functional integrity of the horizontal semicircular canal at different points on the frequency spectrum. The vHIT does offer some advantages over caloric testing, but at the expense of sensitivity. The vHIT can be completed in less time, is not noxious to the patient, and requires very little laboratory space. However, the

  6. Validation and Adaptation of the Singing Voice Handicap Index for Egyptian Singing Voice.

    Science.gov (United States)

    Abou-Elsaad, Tamer; Baz, Hemmat; Afsah, Omayma; Abo-Elsoud, Hend

    2017-01-01

    Measuring the severity of a voice disorder is difficult. This can be achieved by both subjective and objective measures. The Voice Handicap Index is the most known and used self-rating tool for voice disorders. The Classical Singing Handicap Index (CSHI) is a self-administered questionnaire measuring the impact of vocal deviation on the quality of life of singers. The objective of this study was to develop an Arabic version of the CSHI and to test its validity and reliability in Egyptian singers with different singing styles with normal voice and with voice disorders. The interpreted version was administered to 70 Egyptian singers including artistic singers (classical and popular) and specialized singers (Quran reciters and priests) who were divided into 40 asymptomatic singers (control group) and 30 singers with voice disorders. Participants' responses were statistically analyzed to assess the validity and reliability, and to compare the patient group with the control group. Quran reciters, patients with no previous professional training, and patients with vocal fold lesions demonstrated the highest scores. The Arabic version of CSHI is found to be a reliable, valid, and sensitive self-assessment tool that can be used in the clinical practice for the evaluation of the impact of voice disorders on singing voice. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. Working with a chronic disorder--the development of the Work and Handicap Questionnaire.

    Science.gov (United States)

    Andries, Frank; Kremer, Anja M; Hoogendoorn, Wilhelmina E; Wevers, Cees W J; van Putten, Dick J

    2004-03-01

    The Work and Handicap Questionnaire (WHQ) was developed to improve the vocational perspectives of patients with a chronic disorder. The WHQ differs from similar instruments in its explicit linkage between disabilities in daily life and job demands. This is an important feature, which allows for the development of specific strategies to counter work problems of people with a chronic disorder. The WHQ makes an inventory of possibly harmful working conditions and of possible strategies to counter health-related work problems by means of the work adjustments. Results of the application of the WHQ are shown for three patient groups (neuromuscular disorders, multiple sclerosis and asthma) and a group of colleagues with no chronic disorder. Results show similarities and differences between labour conditions and labour experiences between the three patient groups. It also shows differences and similarities between those working with a chronic disorder and those without such a disorder. Acceptance of the consequences of a chronic disorder for the job performance and a focus on health-related work problems would prolong career opportunities for workers with a chronic disorder. The use of the Work and Handicap Questionnaire will hopefully further these aims in determining health-related work problems and offer solutions by means of adequate work adjustment.

  8. Routine health maintenance in patients living with multiple myeloma: survivorship care plan of the International Myeloma Foundation Nurse Leadership Board.

    Science.gov (United States)

    Bilotti, Elizabeth; Gleason, Charise L; McNeill, Ann

    2011-08-01

    Patients diagnosed with multiple myeloma are living longer because of new therapeutic options. Helping patients with multiple myeloma maintain a good state of health from the time of diagnosis and throughout their therapy leads to better quality of life. However, patients with multiple myeloma are at risk for illnesses experienced by the general population and at additional risk for illnesses related to multiple myeloma and its treatment. Therefore, the International Myeloma Foundation Nurse Leadership Board (NLB) has developed practice recommendations to meet the particular needs of adult patients with multiple myeloma using evidence-based recommendations for screening and disease prevention, as well as nursing experience. The NLB recommendations are designed to address and overcome barriers to health maintenance by educating and empowering nurses and their patients.

  9. Living With Prophylactic ICD Therapy and the Risk of Sudden Cardiac Death: How Patients Negotiate Solutions and Problems.

    Science.gov (United States)

    Grew, Julie Christina

    2017-12-01

    Prophylactic implantable cardioverter defibrillator (ICD) therapy treats potentially lethal cardiac arrhythmias in patients who have not previously experienced such but are at considerable risk due to underlying heart disease. Most patients are unaware of their risk of sudden cardiac death (SCD) until the ICD is introduced to them. Thus, the problem of risk of death and the solution of ICD therapy are presented simultaneously. Based on ethnographic fieldwork in Danish hospitals, this article illustrates how clinicians narrate prophylactic ICD therapy as a benign therapy preventing risk of death and providing the good life. However, risk of SCD is not the most pressing problem for the patients. The article argues that the solution of ICD therapy ignores patients' experience of living with severe heart disease and introduces the risk of shock therapy. For patients, a good life does not equal absence of risk of death but a life without heart disease.

  10. Can a conditioning programme improve Handicap Index in ...

    African Journals Online (AJOL)

    The implementation of off-links conditioning programmes for amateur golfers to enhance performance is often neglected. This study was conducted to determine the effects of a conditioning programme on body composition, flexibility, muscular strength, muscular endurance, cardiorespiratory fitness and handicap index as ...

  11. Signal modulation as a mechanism for handicap disposal

    Science.gov (United States)

    Gavassa, Sat; Silva, Ana C.; Gonzalez, Emmanuel; Stoddard, Philip K.

    2012-01-01

    Signal honesty may be compromised when heightened competition provides incentive for signal exaggeration. Some degree of honesty might be maintained by intrinsic handicap costs on signalling or through imposition of extrinsic costs, such as social punishment of low quality cheaters. Thus, theory predicts a delicate balance between signal enhancement and signal reliability that varies with degree of social competition, handicap cost, and social cost. We investigated whether male sexual signals of the electric fish Brachyhypopomus gauderio would become less reliable predictors of body length when competition provides incentives for males to boost electric signal amplitude. As expected, social competition under natural field conditions and in controlled lab experiments drove males to enhance their signals. However, signal enhancement improved the reliability of the information conveyed by the signal, as revealed in the tightening of the relationship between signal amplitude and body length. Signal augmentation in male B. gauderio was independent of body length, and thus appeared not to be curtailed through punishment of low quality (small) individuals. Rather, all individuals boosted their signals under high competition, but those whose signals were farthest from the predicted value under low competition boosted signal amplitude the most. By elimination, intrinsic handicap cost of signal production, rather than extrinsic social cost, appears to be the basis for the unexpected reinforcement of electric signal honesty under social competition. Signal modulation may provide its greatest advantage to the signaller as a mechanism for handicap disposal under low competition rather than as a mechanism for exaggeration of quality under high competition. PMID:22665940

  12. The London handicap scale: validation of a Yoruba (Nigerian ...

    African Journals Online (AJOL)

    Objective To evaluate the validity of a Yoruba translated version of the London Handicap Scale (LHS). The LHS is a valid and reliable measure of participation that has been validated in different cultures, but not among Yoruba speaking people of West Africa. Methods A validation study which involved 20 post-stroke ...

  13. Intestinal parasitic infections among mentally handicapped individuals in Alexandria, Egypt.

    Science.gov (United States)

    Shehata, Amany I; Hassanein, Faika

    2015-01-01

    This cross-sectional study was carried to determine the prevalence of intestinal parasitic infections among mentally handicapped individuals in Alexandria, Egypt, in the period from December 2012 till November 2013. The study was conducted on 200 institutionalized and non-institutionalized mentally handicapped individuals. Fresh stool samples were subjected to different stains including; trichrome for detecting intestinal protozoa, modified acid fast stain for intestinal coccidia and quick hot gram chromotrope stain for Microsporidia. Also they were processed by Kato-Katz and formol ethyl acetate techniques for intestinal helminths. Additionally, blood samples were collected for measuring hemoglobin levels. Out of 200 mentally handicapped individuals, 87 (43.5%) were infected. The infection rates were 44.6% and 42.6% for non-institutionalized and institutionalized people, respectively. Regarding gender, 46.7% and 38.5% were reported for the males and females respectively. The most common parasites detected were: Cryptosporidium sp. (23.5%), microsporidia (15%), Giardia lamblia (8.5%), Dientamoeba fragilis (8%), Cyclospora cyatanensis (7.5%), Blastocystis hominis (6.5%), Entamoeba histolytica (5.5%) and Entamoeba coli (2.5%). Rates for Isospora belli and Enterobius vermicularis were estimated to be 1.5% for each, while lower rate was reported for Iodamoeba butschlii (1.0%). Prevalence of infections among mentally handicapped individuals are indications for several risk factors, including improper sanitary hygiene and illiteracy about personal hygiene. Therefore, frequent investigations, health care and medical intervention are needed.

  14. [The handicapped children in Rome: current studies and perspectives].

    Science.gov (United States)

    Gourevitch, Danielle

    2006-01-01

    Reading literary, medical and juridical texts, the author tries to understand what was the meaning of the handicap or monstrum in Roman times. She insists on the evolution of the concept and scrutinizes the case of emperor Claudius. For a real understanding of the problems, a cross-examination of texts, images and bones is necessary, she concludes.

  15. Education for the Handicapped: What Is the Appropriate Federal Role?

    Science.gov (United States)

    IFG Policy Notes, 1981

    1981-01-01

    This series of short articles discusses two separate educational policy issues: the federal role in education for the handicapped and tuition tax credits. Concerning the first issue, the document discusses the background of P.L. 94-142 and its first 5 years, concluding that, although accomplishments are impressive, there are still difficulties in…

  16. Orthopaedically Handicapped Students in Public and Private High Schools.

    Science.gov (United States)

    Gregory, James F.; And Others

    1987-01-01

    Orthopedically handicapped (OH, N=353) twelfth graders were compared to a control group. Blacks were under-represented in the OH cohort, and OH students had a higher incidence of other impairments. Academically the OH teenagers performed competitively with classmates, though they experienced difficulties in self-esteem, locus of contrtol, and…

  17. Videophone to improve communication between intellectual handicapped and their relatives

    NARCIS (Netherlands)

    Deverson, Melinda M.C.E.; Spil, Antonius A.M.; van Gemert-Pijnen, Julia E.W.C.

    2012-01-01

    The aim of this study is to evaluate the use of a videophone by people with an intellectual handicap and their relatives at a healthcare organisation in the Netherlands. A triangulation of methods is used. The first method was a questionnaire (pre-study) were 195 clients and 439 client

  18. Employers' Attitudes toward Employing People with Mental Handicap.

    Science.gov (United States)

    Tse, John W. L.

    1993-01-01

    A survey of 66 Hong Kong companies and factories identified factors affecting employers' decisions to hire workers with mental handicaps. The five most important factors were emotional problems and personalities of workers, workers' ability to perform the job, availability of low-level jobs, productivity of workers, and possible special…

  19. Developmental Trampoline Activities for Individuals with Multiple Handicapping Conditions.

    Science.gov (United States)

    Thomas, Bill

    1979-01-01

    The use of trampoline activities with multiple handicapped students is discussed. Management considerations in safety are noted, and developmental trampoline skills are listed beginning with bouncing for stimulation. Progression to limited independence and finally independent jumping is described. The position statement of the American Alliance…

  20. The Focus of Attention Is on the Handicapped College Student

    Science.gov (United States)

    Zaitsev, D. V.

    2010-01-01

    As a social institution, higher education constitutes one of the most important factors that enable an individual's mobility. In the past few years, both specialists and the broader public have been addressing the problem of how people with health limitations and handicaps can acquire an education. In part this is because society and the state…

  1. Sequenced Instructional Programs in Physical Education for the Handicapped.

    Science.gov (United States)

    Carr, Dorothy B.; And Others

    The curriculum guidelines for a comprehensive physical education program consist of developmentally sequenced skills and instructional activities appropriate for handicapped children from early preschool age (18 months) through high school. Suggested activities and materials are arranged in color-coded sections on motor and movement skills,…

  2. Demographic and audiological factors as predictors of hearing handicap

    Directory of Open Access Journals (Sweden)

    Leposavić Ljubica

    2006-01-01

    Full Text Available INTRODUCTION Currently available evidence reveals comparatively few studies of psychological effects of hearing impairments, in spite of the fact that clinicians have for a long time been aware of a connection between the acquired hearing impairment and mental disorders. They are focused on the investigation of dysfunction in general. Thus, three domains of the auditory imbalance may be distinguished: disorder, disability and handicap. 'Handicap', according to the definition of the World Health Organization, is a hindrance in an individual that results from an impairment or disability and represents psychological response of the individual to the impairment. OBJECTIVE Validation of acquired hearing impairment as a risk factor of psychical disorders as well as an analysis of relation of some demographic factors (sex, age, education and audiological factors (degree and duration of the impairment with the frequency of hearing handicap. METHOD MMPI-201 has been applied in 60 subjects affected with otosclerosis, potential candidates for stapedectomy, before and after the surgery. RESULTS Individuals with acquired hearing impairment manifest more frequent disorders of psychical functioning in comparison with general population, while demographic and audiometric parameters did not correlate with acquired hearing handicap. CONCLUSION It may be assumed that the very recognition of demographic and audio-logical factors can not help much in the understanding of the psychological stress associated with hearing impairment.

  3. Some Personality Characteristics of Self-Handicapping Behavior.

    Science.gov (United States)

    Levey, Cathy A.

    Based on a modification of Berglas and Jones' (1978) design, conditions of contingent and noncontingent success and failure were manipulated to determine when and why individuals choose to adopt self-handicapping strategies. Male undergraduates (N=76) were informed that they were participating in a study investigating the effects of music on…

  4. Degraded Imagery/Art Technique for the Handicapped.

    Science.gov (United States)

    Agard, Richard

    Developed for handicapped artists, Degraded Imagery is a technique whereby images can be extracted and refined from a photograph or a collage of photographs. The advantage of this process is that it requires a lower degree of fine motor skills to produce a quality image from a photograph than it does to create a quality image on a blank piece of…

  5. Increasing Preservice Curriculum Accountability to Rural Handicapped Populations.

    Science.gov (United States)

    Helge, Doris

    Addressing acute problems in delivery of services to rural handicapped students, the document emphasizes the need for relevant preservice training for special education teachers who will work in rural areas. A list of specific elements for inclusion in a rural-focused curriculum philosophy includes: training students possessing appropriate skills…

  6. Places and Spaces: Facility Planning for Handicapped Children and Adults.

    Science.gov (United States)

    Aiello, Barbara, Ed.

    Intended for special educators and architectural designers, the book provides specifications and lists of resource materials on facility design for handicapped children and adults. In an overview, R. Vosbeck discusses the need for cooperation between architects and educators and relates his experiences in planning facilities for exceptional…

  7. Influenza Vaccination for the Pediatric Patient: A Focus on the New Intranasal, Cold-Adapted, Live Attenuated Vaccine

    OpenAIRE

    Ellis, Jennifer M.; Reilly, Joan C.; Salazar, Juan C.

    2004-01-01

    FluMist is the first live attenuated, cold-adapted intranasal influenza vaccine (LAIV) approved for the prevention of influenza A and B. Clinical trials have shown that annual vaccination with LAIV is effective for the prevention of influenza. LAIV appears well tolerated in healthy patients 5–49 years of age. The most common adverse events are abdominal pain, chills, cough, diarrhea, headache, irritability, lethargy, muscle aches, otitis media, rhinitis, sinusitis, sore throat, and vomiting. ...

  8. A comparison on HBsAg and HBsAb prevalence in patients with Down syndrome and other mentally retarded patients living in retarded children institutes in Tehran

    Directory of Open Access Journals (Sweden)

    Sahebjamei M. Associate Professor

    2003-06-01

    Full Text Available Statement of Problem: The Prevalence of HBsAg, among patients with Down Syndrome (DS has been"nreported higher than normal population. Living in institutes, comparing to home, leads to higher"nprobability of HBsAg prevalence."nAim: The purpose of the present study was to determine HBsAg prevalence in patients with DS and"ncompare it with other mentally retarded patients with similar conditions, and also with healthy population"nin Iran."nMaterials and Methods: One hundred patients, with average age of 12 years, living in five institutes in"nTehran, were chosen. Children with DS and other mentally retarded children were considered as the first"nand second groups, respectively (50 members in each group. Blood samples were taken and tested"n(ELLSA to determine HBsAg and HBsAb titre. For statistical analysis, Chi- Square test was used."nResults: HBsAg was positive in 8% and 4% of DS and MR groups, respectively. HBsAb was seen in"n25% of DS, comparing to 32% of MR. The prevalence of HBsAg in retarded patients living in institutes"nwas higher than normal population of Iran (less than 3%, which was not statistically significant."nConclusion: Consideration of sterilization principles and infection control upon dental operations, in"nthese centers, are necessary. It is also suggested that these children, as a high- risk population, should be"nvaccinated against hepatitis B.

  9. Breakdown in informational continuity of care during hospitalization of older home-living patients: A case study

    Directory of Open Access Journals (Sweden)

    Rose Mari Olsen

    2014-05-01

    Full Text Available Introduction: The successful transfer of an older patient between health care organizations requires open communication between them that details relevant and necessary information about the patient's health status and individual needs. The objective of this study was to identify and describe the process and content of the patient information exchange between nurses in home care and hospital during hospitalization of older home-living patients.Methods: A multiple case study design was used. Using observations, qualitative interviews and document reviews, the total patient information exchange during each patient's episode of hospitalization (n = 9, from day of admission to return home, was captured.Results: Information exchange mainly occurred at discharge, including a discharge note sent from hospital to home care, and telephone reports from hospital nurse to home care nurse, and meetings between hospital nurse and patient coordinator from the municipal purchaser unit. No information was provided from the home care nurses to the hospital nurses at admission. Incompleteness in the content of both written and verbal information was found. Information regarding physical care was more frequently reported than other caring dimensions. Descriptions of the patients’ subjective experiences were almost absent and occurred only in the verbal communication.Conclusions: The gap in the information flow, as well as incompleteness in the content of written and verbal information exchanged, constitutes a challenge to the continuity of care for hospitalized home-living patients. In order to ensure appropriate nursing follow-up care, we emphasize the need for nurses to improve the information flow, as well as to use a more comprehensive approach to older patients, and that this must be reflected in the verbal and written information exchange.

  10. Breakdown in informational continuity of care during hospitalization of older home-living patients: A case study

    Directory of Open Access Journals (Sweden)

    Rose Mari Olsen

    2014-05-01

    Full Text Available Introduction: The successful transfer of an older patient between health care organizations requires open communication between them that details relevant and necessary information about the patient's health status and individual needs. The objective of this study was to identify and describe the process and content of the patient information exchange between nurses in home care and hospital during hospitalization of older home-living patients.Methods: A multiple case study design was used. Using observations, qualitative interviews and document reviews, the total patient information exchange during each patient's episode of hospitalization (n = 9, from day of admission to return home, was captured. Results: Information exchange mainly occurred at discharge, including a discharge note sent from hospital to home care, and telephone reports from hospital nurse to home care nurse, and meetings between hospital nurse and patient coordinator from the municipal purchaser unit. No information was provided from the home care nurses to the hospital nurses at admission. Incompleteness in the content of both written and verbal information was found. Information regarding physical care was more frequently reported than other caring dimensions. Descriptions of the patients’ subjective experiences were almost absent and occurred only in the verbal communication. Conclusions: The gap in the information flow, as well as incompleteness in the content of written and verbal information exchanged, constitutes a challenge to the continuity of care for hospitalized home-living patients. In order to ensure appropriate nursing follow-up care, we emphasize the need for nurses to improve the information flow, as well as to use a more comprehensive approach to older patients, and that this must be reflected in the verbal and written information exchange.

  11. Successful IVF-ICSI with live baby in an azoospermic patient with ...

    African Journals Online (AJOL)

    The recommended treatment was testicular biopsy with cryopreservation of the sperm and subsequent Intra cytoplasmic Sperm Injection (ICSI). This treatment option was undertaken with successful implantation and live baby delivery. The case study presents the diagnostic modalities and management of male infertility with ...

  12. Australian practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease.

    Science.gov (United States)

    Cass, Sarah; Ball, Lauren; Leveritt, Michael

    2014-01-01

    Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term 'basic' varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

  13. Assessment of right ventricular geometry and mechanics in chronic obstructive pulmonary disease patients living at high altitude.

    Science.gov (United States)

    Güvenç, Tolga Sinan; Kul, Seref; Doğan, Coşkun; Yıldırım, Binnaz Zeynep; Karabağ, Yavuz; Cetin, Rengin; Kaya, Yüksel; Karadağ, Pelin; Değirmencioğlu, Aleks; Balcı, Bahattin

    2014-10-01

    Degree of increase in pulmonary artery pressure (PAP) and adaptive responses in right ventricular morphology and mechanics play an important role in the prognosis of chronic obstructive pulmonary disease (COPD) patients. Three dimensional echocardiography and deformation imaging are recent advancements in echocardiography that allow more through assessment of right ventricle. We aimed to investigate right ventricular geometry and mechanics in a stable COPD population living at moderately high altitude. A total of 26 stable COPD patients with variable disease severity were included to this study. Pulmonary function tests, six minutes walking test (6MWT) and two- and three-dimensional echocardiography were performed for evaluation and data collection. Both systolic (43.06 ± 11.79 mmHg) and mean (33.38 ± 9.75 mmHg) PAPs were significantly higher in COPD patients compared to controls (p Right ventricular volumes were similar between groups, although right ventricular free wall thickness was significantly increased in COPD group. The number of subjects with a sub-normal (right ventricular ejection fraction was significantly higher in COPD group (45.8 vs. 17.4 %, p right ventricular strain was significantly lower (-21.05 ± 3.80 vs. -24.14 ± 5.37; p right ventricular contractility were found in COPD patients living at moderately high altitude, although right ventricular volumes were normal. Similar findings can be expected in other COPD patients with high PAP, since these findings probably represents the effect of increased PAP on right ventricular mechanics.

  14. Early diagnosis saves lives: focus on patients with chronic kidney disease

    OpenAIRE

    Ecder, Tevfik

    2013-01-01

    Chronic kidney disease is a global public health problem. Patients with chronic kidney disease have an increased risk of developing end-stage kidney disease and its complications. Early identification and management of patients with chronic kidney disease is important in order to decrease the morbidity and mortality. Early detection of chronic kidney disease is possible with screening programs targeting high-risk patients, such as patients with diabetes mellitus, hypertension, elderly patient...

  15. Self-Assessed Hearing Handicap in Older Adults with Poorer-than-Predicted Speech Recognition in Noise

    Science.gov (United States)

    Eckert, Mark A.; Matthews, Lois J.; Dubno, Judy R.

    2017-01-01

    Purpose: Even older adults with relatively mild hearing loss report hearing handicap, suggesting that hearing handicap is not completely explained by reduced speech audibility. Method: We examined the extent to which self-assessed ratings of hearing handicap using the Hearing Handicap Inventory for the Elderly (HHIE; Ventry & Weinstein, 1982)…

  16. Patient-Provider Engagement and Chronic Pain in Drug-Using, Primarily African American Persons Living with HIV/AIDS.

    Science.gov (United States)

    Mitchell, Mary M; Nguyen, Trang Q; Maragh-Bass, Allysha C; Isenberg, Sarina R; Beach, Mary Catherine; Knowlton, Amy R

    2017-06-01

    Among disadvantaged persons living with HIV/AIDS (PLHIV), patient-provider engagement, which has been defined as patient-provider relationships that promote the use of health care services and are characterized by active listening and supportive decision making, has been associated with antiretroviral therapy (ART) maintenance and viral suppression. However, chronic pain, depression, and substance use, all of which are prevalent in this population, can reduce the quality of patient-provider engagement. We hypothesized a model in which chronic pain, depression, and substance use would be associated with poorer patient-provider engagement, which would be positively associated with adherence, with the latter associated positively with viral suppression. We analyzed data from the BEACON study, which included surveys from 383 PLHIV who were primarily African American, on ART, and had histories of drug use. Due to six missing cases on the chronic pain variable, we used data from 377 respondents in a structural equation model. Chronic pain and depressive symptoms were significantly associated with poorer patient-provider engagement, while substance use was associated with better engagement. Patient-provider engagement in turn was associated with better ART adherence, which was associated with higher viral suppression. Results suggest the role of chronic pain in poor patient-physician engagement in this population, which has potential implications for quality of HIV patient care and health outcomes. Findings suggest the need for attention to patient-provider engagement in PLHIV.

  17. The effect of stretch-and-flow voice therapy on measures of vocal function and handicap.

    Science.gov (United States)

    Watts, Christopher R; Diviney, Shelby S; Hamilton, Amy; Toles, Laura; Childs, Lesley; Mau, Ted

    2015-03-01

    To investigate the efficacy of stretch-and-flow voice therapy as a primary physiological treatment for patients with hyperfunctional voice disorders. Prospective case series. Participants with a diagnosis of primary muscle tension dysphonia or phonotraumatic lesions due to hyperfunctional vocal behaviors were included. Participants received stretch-and-flow voice therapy structured once weekly for 6 weeks. Outcome variables consisted of two physiologic measures (s/z ratio and maximum phonation time), an acoustic measure (cepstral peak prominence [CPP]), and a measure of vocal handicap (voice handicap index [VHI]). All measures were obtained at baseline before treatment and within 2 weeks posttreatment. The s/z ratio, maximum phonation time, sentence CPP, and VHI showed statistically significant (P < 0.05) improvement through therapy. Effect sizes reflecting the magnitude of change were large for s/z ratio and VHI (d = 1.25 and 1.96 respectively), and moderate for maximum phonation time and sentence CPP (d = 0.79 and 0.74, respectively). This study provides supporting evidence for preliminary efficacy of stretch-and-flow voice therapy in a small sample of patients. The treatment effect was large or moderate for multiple outcome measures. The data provide justification for larger, controlled clinical trials on the application of stretch-and-flow voice therapy in the treatment of hyperfunctional voice disorders. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Adaptation and validation of the Singing Voice Handicap Index into Polish.

    Science.gov (United States)

    Sielska-Badurek, E M; Sobol, M; Cioch, A; Osuch-Wójcikiewicz, E; Rzepakowska, A M; Niemczyk, K

    2017-10-01

    To translate and adapt the original Singing Voice Handicap Index (SVHI) for the Polish population and to evaluate the psychometric properties of the Polish SVHI version, such as internal consistency, reliability and construct validity in different groups of dysphonic singers. Prospective case-control study. Patients treated at a single institute. Sixty singers with voice disorders and 57 healthy singers completed the SVHI and the Voice Handicap Index (VHI). Thirty singers completed the SVHI twice within a 2- to 4-week interval. Internal consistency, test-retest reliability, discriminant validity, criterion-related validity RESULTS: A strong Cronbach's alpha coefficient (0.96) indicates that the SVHI items are measuring the same construct. Evaluating the test-retest reliability, the r-Spearman correlation coefficient was r = 0.797 for the total score of SVHI, which shows a good level of reproducibility. There were significant differences between the control group (CG) and patients with benign vocal fold lesions (P < 0.001), CG and singers with muscle tension dysphonia (P < 0.001), CG and coexistence of muscle tension dysphonia and chronic laryngitis (P < 0.001). There was a positive statistically significant correlation between SVHI and VHI (r = 0.753, P = 0.000*). The Polish version of SVHI serves as a valid health status instrument, as well as discriminating between singers with voice disorders and singers without voice problems. The SVHI is easy to perform in clinical practice. © 2017 John Wiley & Sons Ltd.

  19. Dizziness Handicap Inventory Score Is Highly Correlated With Markers of Gait Disturbance.

    Science.gov (United States)

    Zanotto, Damiano; Mamuyac, Erin M; Chambers, Adam R; Nemer, John S; Stafford, John A; Agrawal, Sunil K; Lalwani, Anil K

    2017-12-01

    To evaluate the association between Dizziness Handicap Inventory-Screening version (DHI-S) score and spatiotemporal gait parameters using SoleSound, a newly developed, inexpensive, portable footwear-based gait analysis system. Cross-sectional. One hundred eighteen patients recruited from otology clinic. Subjects completed the DHI-S survey and four uninterrupted walking laps wearing SoleSound instrumented footwear on a hard, flat surface for 100 m. For each subject, mean and coefficient of variation (CV) of stride length, cadence, walking speed, foot-ground clearance, double-support time, swing period, and stance-to-swing were computed by considering 40 strides of steady-state walking within each lap. Linear regression models were employed to study correlations between these variables and DHI-S scores after adjusting for age, sex, and race/ethnicity. Patients with higher DHI-S score took shorter steps and less steps per minute (-0.017 m and -1.1 steps/min per every four-point increase in DHI-S score, p handicap, as assessed with DHI-S, is associated with deterioration in measurable gait parameters independent of age.

  20. Lived experiences of everyday life during curative radiotherapy in patients with non-small cell lung cancer: A phenomenological study

    DEFF Research Database (Denmark)

    Petri, Suzanne; Berthelsen, Connie Bøttcher

    2015-01-01

    AIM: To explore and describe the essential meaning of lived experiences of the phenomenon: Everyday life during curative radiotherapy in patients with non-small-cell lung cancer (NSCLC). BACKGROUND: Radiotherapy treatment in patients with NSCLC is associated with severe side effects such as fatigue...... phenomenological framework. FINDINGS: The essential meaning structure of the phenomenon studied was described as "Hope for recovery serving as a compass in a changed everyday life," which was a guide for the patients through the radiotherapy treatment to support their efforts in coping with side effects......: A sample of three patients treated with curative radiotherapy for NSCLC was interviewed 3 weeks after the end of radiotherapy treatment about their experiences of everyday life during their treatment. Data were collected in 2014 and interviews and analysis were conducted within the descriptive...

  1. Prolonged Ischemic Time, Delayed Graft Function, and Graft and Patient Outcomes in Live Donor Kidney Transplant Recipients.

    Science.gov (United States)

    Krishnan, A R; Wong, G; Chapman, J R; Coates, P T; Russ, G R; Pleass, H; Russell, C; He, B; Lim, W H

    2016-09-01

    The association between prolonged cold ischemic time (CIT) and graft and patient outcomes in live donor kidney transplant recipients remains unclear. The aims of this study were to examine the association of CIT with delayed graft function and graft loss in live donor kidney transplant recipients and those who participated in the Australian Paired Kidney Exchange program using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) registry. Of 3717 live donor transplant recipients between 1997 and 2012 who were followed for a median of 6.6 years (25 977 person-years), 224 (25%) experienced CIT >4-8 h. Donor age was an effect modifier between CIT and graft outcomes. In recipients who received kidneys from older donors aged >50 years, every hour of increase in CIT was associated with adjusted odds of 1.28 (95% confidence interval [CI] 1.07-1.53, p = 0.007) for delayed graft function, whereas CIT >4-8 h was associated with adjusted hazards of 1.93 (95% CI 1.21-3.09, p = 0.006) and 1.91 (95% CI 1.05-3.49, p = 0.035) for overall and death-censored graft loss, respectively, compared with CIT of 1-2 h. Attempts to reduce CIT in live donor kidney transplants involving older donor kidneys may lead to improvement of graft outcomes. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. Effects of live sax music on various physiological parameters, pain level, and mood level in cancer patients: a randomized controlled trial.

    Science.gov (United States)

    Burrai, Francesco; Micheluzzi, Valentina; Bugani, Valentina

    2014-01-01

    Few randomized controlled trial studies have focused on the effect of music in cancer patients, and there are no randomized controlled trials on the effects of live music with saxophone in cancer patients. To determine the effects of live saxophone music on various physiological parameters, pain level, and mood level. A randomized controlled trial study. 52 cancer patients were randomized to a control group (n = 26), an experimental group (n = 26) whose members received 30 minutes of live music therapy with saxophone. Systolic and diastolic blood pressure, pulse rate, glycemia, oxygen saturation, pain level, and mood level were measured before and after the live music performance. There was a statistical difference between the groups for oxygen saturation (0.003) and mood level (0.001). Live music performed with a saxophone could be introduced in oncology care to improve the oxygen saturation and mood in cancer patients.

  3. Choosing to live with home dialysis-patients' experiences and potential for telemedicine support: a qualitative study

    Directory of Open Access Journals (Sweden)

    Rygh Ellen

    2012-03-01

    Full Text Available Abstract Background This study examines the patients' need for information and guidance in the selection of dialysis modality, and in establishing and practicing home dialysis. The study focuses on patients' experiences living with home dialysis, how they master the treatment, and their views on how to optimize communication with health services and the potential of telemedicine. Methods We used an inductive research strategy and conducted semi-structured interviews with eleven patients established in home dialysis. Our focus was the patients' experiences with home dialysis, and our theoretical reference was patients' empowerment through telemedicine solutions. Three informants had home haemodialysis (HHD; eight had peritoneal dialysis (PD, of which three had automated peritoneal dialysis (APD; and five had continuous ambulatory peritoneal dialysis (CAPD. The material comprises all PD-patients in the catchment area capable of being interviewed, and all known HHD-users in Norway at that time. Results All of the interviewees were satisfied with their choice of home dialysis, and many experienced a normalization of daily life, less dominated by disease. They exhibited considerable self-management skills and did not perceive themselves as ill, but still required very close contact with the hospital staff for communication and follow-up. When choosing a dialysis modality, other patients' experiences were often more influential than advice from specialists. Information concerning the possibility of having HHD, including knowledge of how to access it, was not easily available. Especially those with dialysis machines, both APD and HHD, saw a potential for telemedicine solutions. Conclusions As home dialysis may contribute to a normalization of life less dominated by disease, the treatment should be organized so that the potential for home dialysis can be fully exploited. Pre-dialysis information should be unbiased and include access to other patients

  4. Choosing to live with home dialysis-patients' experiences and potential for telemedicine support: a qualitative study.

    Science.gov (United States)

    Rygh, Ellen; Arild, Eli; Johnsen, Elin; Rumpsfeld, Markus

    2012-03-19

    This study examines the patients' need for information and guidance in the selection of dialysis modality, and in establishing and practicing home dialysis. The study focuses on patients' experiences living with home dialysis, how they master the treatment, and their views on how to optimize communication with health services and the potential of telemedicine. We used an inductive research strategy and conducted semi-structured interviews with eleven patients established in home dialysis. Our focus was the patients' experiences with home dialysis, and our theoretical reference was patients' empowerment through telemedicine solutions. Three informants had home haemodialysis (HHD); eight had peritoneal dialysis (PD), of which three had automated peritoneal dialysis (APD); and five had continuous ambulatory peritoneal dialysis (CAPD). The material comprises all PD-patients in the catchment area capable of being interviewed, and all known HHD-users in Norway at that time. All of the interviewees were satisfied with their choice of home dialysis, and many experienced a normalization of daily life, less dominated by disease. They exhibited considerable self-management skills and did not perceive themselves as ill, but still required very close contact with the hospital staff for communication and follow-up. When choosing a dialysis modality, other patients' experiences were often more influential than advice from specialists. Information concerning the possibility of having HHD, including knowledge of how to access it, was not easily available. Especially those with dialysis machines, both APD and HHD, saw a potential for telemedicine solutions. As home dialysis may contribute to a normalization of life less dominated by disease, the treatment should be organized so that the potential for home dialysis can be fully exploited. Pre-dialysis information should be unbiased and include access to other patients' experiences. Telemedicine may potentially facilitate a

  5. 42 CFR 482.90 - Condition of participation: Patient and living donor selection.

    Science.gov (United States)

    2010-10-01

    ... FOR HOSPITALS Requirements for Specialty Hospitals Transplant Center Process Requirements § 482.90... transplant patient, or a dialysis facility, as requested by a patient or a dialysis facility. (b) Standard...

  6. Age-related prevalence and characteristics of Aggregatibacter actinomycetemcomitans in periodontitis patients living in Sweden

    DEFF Research Database (Denmark)

    Claesson, Rolf; Höglund-Åberg, Carola; Haubek, Dorte

    2017-01-01

    Background: The presence of Aggregatibacter actinomycetemcomitans in patients with periodontitis has been extensively studied for decades. Objective: To study the prevalence of A. actinomycetemcomitans in younger and older periodontitis patients and to genetically characterize isolates...

  7. The "patient patient": the trauma of waiting and the power of resistance for people living with cancer.

    Science.gov (United States)

    Mulcahy, Caitlin M; Parry, Diana C; Glover, Troy D

    2010-08-01

    In Canada's health care system today, cancer patients are expected to endure long, often painful wait times. In this study we explored whether Gilda's Club (an organization that supports people affected by cancer) might increase opportunities to resist the role of the "patient patient," consequently providing a better understanding of how cancer patients cope with the long wait times in Canada's time-crunched health care system. The research presented here provides examples of the painful waiting experience for cancer patients. Yet, this research also provides examples of patients refusing to be patient. We argue that organizations like Gilda's Club can provide a space that facilitates resistance and allows patients to become more informed and more participatory in decision-making processes. We conclude that these findings reflect a gap in cancer care in Canada that might be addressed through integrating organizations like Gilda's Club into standard medical practice for cancer patients.

  8. Predictors of six month change in the voice handicap index in a treatment seeking population

    Science.gov (United States)

    Moore, Jaime; Greenberg, Caprice

    2016-01-01

    Objective To evaluate predictors of longitudinal change in patient-perceived voice impact as determined by the Voice Handicap Index (VHI). Study Design Prospective, survey study. Methods Patients consented to the UW Voice and Swallow Clinics Outcomes Database with voice, breathing and/or cough concerns with a baseline clinic visit from November 2012 to January 2014 were eligible for the study. VHI was sent to patients six months post-clinic visit to determine change in voice handicap from baseline. General health was screened using the SF-12v2 survey, using physical component (PCS) and mental component summary (MCS) scores. Predictor variables included – treatment (medical and/or behavioral), dysphonia sub-diagnosis, GRBAS rating, age, sex, socioeconomic factors, smoking history, and comorbidity score. Results Two-hundred thirty-seven patients met study criteria and were followed longitudinally. Eighty-two patients returned six month surveys. VHI was significantly correlated with MCS scores. Patients with a higher grade in baseline GRBAS score were more likely to receive voice intervention (p = .04). Six-month improvement in VHI score was associated with both higher initial VHI score and higher education level in both univariate (p < .01, p = .04) and multivariate analyses (p < .01, p = .02). Voice treatment (medical and/or behavioral) was not a significant factor for improvement in VHI. Conclusions Our results suggest it is important to consider baseline self-perceived voice impact measures and education level in setting expectations for voice treatment. Future studies examining the relationship between treatment patterns and voice-related patient outcomes are warranted. PMID:26952321

  9. The functionality of masticatory apparatus and the sense of depression in patients over 55 years of age living in a family environment and social care centres.

    Science.gov (United States)

    Barczak, Katarzyna; Szmidt, Monika; Buczkowska-Radlińska, Jadwiga

    2016-10-31

    The aim of this study was to determine the relationship between the masticatory apparatus functionality and a sense of depression in patients over 55 years of age living in a family environment and the Social Care Centres (SCC). Shortened version of the Geriatric Depression Scale (GDS) was used to assess the wellbeing of patients and their state/sense of depression. The clinical evaluation of masticatory function was performed during one appointment in the natural light. The clinical criterion for the retention of masticatory function, adopted by the World Health Organization was a contact between at least 20 opposing teeth, natural or artificial. Among patients with a low number of GDS points (0-5), statistically significantly higher proportion of people living in family houses (69.4%) maintained functionality of masticatory apparatus than of people living in SCC (23.5%). In contrast, among patients with a higher number of GDS points (6-15), statistically significantly higher proportion of patients living in SCC (70.8%) did not maintain functionality of masticatory apparatus than of those living in family houses (41.7%). Patients with a sense of depression living in Social Care Centres were more likely to report lack of functionality of masticatory apparatus than patients with a sense of depression living in family houses. The presence of a growing sense of depression significantly affected a lower rate of preserved functionality of masticatory apparatus or vice versa.

  10. Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients.

    Science.gov (United States)

    Goldman, R H; Racowsky, C; Farland, L V; Munné, S; Ribustello, L; Fox, J H

    2017-04-01

    Can a counseling tool be developed for women desiring elective oocyte cryopreservation to predict the likelihood of live birth based on age and number of oocytes frozen? Using data from ICSI cycles of a population of women with uncompromised ovarian reserve, an evidence-based counseling tool was created to guide women and their physicians regarding the number of oocytes needed to freeze for future family-building goals. Elective oocyte cryopreservation is increasing in popularity as more women delay family building. By undertaking elective oocyte freezing at a younger age, women hope to optimize their likelihood of successful live birth(s) using their thawed oocytes at a future date. Questions often arise in clinical practice regarding the number of cryopreserved oocytes sufficient to achieve live birth(s) and whether or not additional stimulation cycles are likely to result in a meaningful increase in the likelihood of live birth. As relatively few women who have electively cryopreserved oocytes have returned to use them, available data for counseling patients wishing to undergo fertility preservation are limited. A model was developed to determine the proportion of mature oocytes that fertilize and then form blastocysts as a function of age, using women with presumably normal ovarian reserve based on standard testing who underwent ICSI cycles in our program from January, 2011 through March, 2015 (n = 520). These included couples diagnosed exclusively with male-factor and/or tubal-factor infertility, as well as cycles utilizing egg donation. Age-specific probabilities of euploidy were estimated from 14 500 PGS embryo results from an external testing laboratory. Assuming survival of thawed oocytes at 95% for women counseling tool was developed to predict the likelihood of live birth, based on individual patient age and number of mature oocytes. This study provides an evidence-based model to predict the probability of a woman having at least one, two or three live

  11. The Effect of Reminiscence Therapy on Cognition, Depression, and Activities of Daily Living for Patients With Alzheimer Disease.

    Science.gov (United States)

    Duru Aşiret, Güler; Kapucu, Sevgisun

    2016-01-01

    The purpose of this study was, conducted with experimental design, to investigate the effect of reminiscence therapy on cognition, depression, activities of daily living of institutionalized mild and moderate Alzheimer patients. The study was conducted with a total of 62 patients (31 intervention group and 31 control group) in four home care in Ankara, Turkey. Study was done between the July 1, 2013 and December 20, 2014. Reminiscence therapy sessions were held with groups consists of 4-5 patients, once a week with 30-35 minute duration for 12 weeks. Standardized Mini Mental Test was used in sample selection. Patients were listed through their mini mental test scores, and randomized as odd numbers to control group and even numbers to intervention group. Data were collected with forms developed by researcher 'Data Sheet' and 'Activities of Daily Living Follow-up Form' as well as scales 'Standardized Mini Mental Test' and 'Geriatric Depression Scale'. Chi-square, Mann Whitney-U test, variance analyses in repeated measures and Bonferroni tests were used for analysis. The increase in mean Standardized Mini Mental Test score and the decrease in mean Geriatric Depression Scale score of the individuals in the intervention group compared to the control group at the end of the reminiscence therapy was statistically significant (P < 0.05). At the end of reminiscence therapy sessions, increase in cognition and decrease in depression were found statistically significant in intervention group. © The Author(s) 2015.

  12. The Association of Education, Employment and Living with a Partner with the Treatment among Patients with Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Gabriela Štefková

    2015-01-01

    Full Text Available The aim of this study was to explore possible associations between social and socioeconomic status and ongoing treatment among patients with head and neck cancer. Material and methods: Data from 159 examined patients treated with head and neck cancer during the period from 2011 to 2012 were explored. A logistic regression analysis was used to assess association of social status (living with somebody vs. living alone, socioeconomic status (employed vs. unemployed and education (primary/secondary/university with treatment. Results: The results from logistic regression showed significant association of employment status and education with both interruption in radiochemotherapy and searching for additional help after surgery. Interruption of radiochemotherapy was almost 3 times more likely in a group of unemployed compared to the employed patients. Lack of searching for help after surgery was almost 4 times more likely in a group of unemployed compared to the employed and 5 times more likely in the group with the lowest education compared with the group with the highest education. Conclusions: The study suggests that special attention needs to be paid, not only during but also after treatment, to the patients from low socioeconomic groups.

  13. [Trial of information sharing for home-based patient care using Cybozu Live , a cloud-based groupware].

    Science.gov (United States)

    Asahina, Kan

    2011-12-01

    Home-based patient care involves several different care services of specialties, so that it is crucial to share patient information effectively among the caregivers. To overcome the problems with conventional means for storing and sharing information, we introduced Cybozu Live , a cloud-based groupware provided for free of charge. As a result, the amount of information shared increased while telephone and facsimile transactions dramatically decreased. A questionnaire survey revealed that the caregivers generally appreciated the use of this groupware; they felt that more information was needed for tasks while the load of using telephone and facsimile is minimal. We found the followings through our experiences: 1 ) Simply sharing information can largely contribute to supporting patients and their families; 2 ) Awareness of patients, families and caregivers is more important in the homecare information sharing than are numerical data; 3 ) Effective information sharing creates a sense of togetherness of the team beyond mere co-operation among the staff; 4 ) Effective information sharing provides learning opportunities for caregivers; and 5 ) An appropriate tool such as Cybozu Live is needed for effective information sharing.

  14. Robot-assisted surgery in cervical cancer patients reduces the time to normal activities of daily living.

    Science.gov (United States)

    Asciutto, Katrin C; Kalapotharakos, Grigorios; Löfgren, Mats; Högberg, Thomas; Borgfeldt, Christer

    2015-03-01

    To evaluate current surgical cervical cancer treatment in Sweden 2008-12. Analysis of data in the Swedish National Quality Register for Gynecological Surgery (GynOP). A total of 249 cervical cancer patients undergoing surgery. Analysis of prospectively gathered preoperative and postoperative data including patient-reported information. Mean operating time, blood loss/transfusion, length of hospital stay, return to activities of daily living. The patients undergoing laparoscopic robot-assisted surgery (n = 64) or laparotomy (n = 185) did not differ in age, body mass index, American Society of Anesthesiologists score, International Federation of Gynecology and Obstetrics (FIGO) stage or mean operating time. Blood loss was higher in the laparotomy group (p activities of daily living was longer in the laparotomy than the robot group (13.4 days vs. 9.7 days, p = 0.04). Laparoscopic robotic-assisted surgery is preferable to laparotomy for cervical cancer patients because it entails a significantly shorter hospital stay, less blood loss, fewer intraoperative complications and shorter time to normal daily activities. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia

    Directory of Open Access Journals (Sweden)

    Andersen Kjeld

    2004-09-01

    Full Text Available Abstract Background Dementia is a chronic illness associated with a progressive loss of cognitive and intellectual abilities, such as memory, judgment and abstract thinking. The objective of this study was to assess the health utilities of patients with dementia in Europe and identify the key factors influencing their Health-Related Quality of Life (HRQol. Methods This study used cross-sectional data from the Odense study; a Danish cohort of patients aged 65–84 living in Odense, Denmark. A total of 244 patients with mild to severe dementia were interviewed together with a caregiver about their health status and activities of daily living (ADL. Alzheimer's disease was diagnosed according to the NINCDS-ADRDA criteria for probable dementia. Vascular dementia and other types of dementia were diagnosed according to the DSM-IIIR criteria. Severity of dementia was defined by score intervals on the Mini Mental State Examination score: mild (MMSE 20–30, moderate (MMSE 10–19, and severe (MMSE 0–9. Based on the ADL information, the patients' dependency level was defined as either dependent or independent. Questions from the Odense Study were mapped into each of the five dimensions of the EQ-5D in order to assess patients' HRQol. Danish EQ-5D social tariffs were used to value patients' HRQol. A regression analysis of EQ-5D values was conducted with backward selection on gender, age, severity, ADL level and setting in order to determine the main factor influencing HRQoL. Results The EQ-5D weight in patients independent upon others in ADL was 0.641 (95% CI: [0.612–0.669], and in those dependent upon others was 0.343 (95% CI: [0.251–0.436]. Conclusion Dependency upon others to perform ADL was the main factor affecting HRQoL.

  16. Impact of a temporary stoma on patients' everyday lives: feelings of uncertainty while waiting for closure of the stoma.

    Science.gov (United States)

    Danielsen, Anne K; Soerensen, Erik E; Burcharth, Kirsten; Rosenberg, Jacob

    2013-05-01

    To examine patients' experiences of impact of a temporary stoma on their everyday life. Furthermore, we wanted to generate new knowledge and comprehension of learning how to live with a temporary stoma. There are many aspects, largely unexplored, that may influence patients' adaptation to life with a stoma. Amongst these, being in a temporary state is relatively unexplored and may have a restrictive impact on patients' adaptation. Focus group interviews conducted with seven patients with temporary stoma were set up with a hermeneutic phenomenological perspective. Data were processed using qualitative content analysis. The creation of a temporary stoma led to feelings of uncertainty related to being in an undecided situation. Stoma creation led to feelings of stigma and worries about disclosure. Patients proposed group-based patient education with lay educators with a stoma to make sure that information about the stoma was based on real-life experiences. Creation of a temporary stoma was linked to uncontrollable feelings of uncertainty. Professionals should assist patients with focus on coping strategies, as they are associated with positive re-evaluation of the situation. Introducing a coherent and structured learning environment involving both lay educators with a stoma and group-based learning would be useful. Nurses and other health professionals should support patients in problem-focused coping strategies. These strategies may be supported when patients have a high sense of coherence. Furthermore, patients' disclosure of the stoma as a way to master feelings of stigma should be facilitated. Stoma education is central for patients, and group-based learning that involves lay educators with a stoma is seen as a way to empower patients with temporary stomas. © 2013 Blackwell Publishing Ltd.

  17. Long-Term Results of Stent Placement in Patients with Outflow Block After Living-Donor-Liver Transplantation

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    Fujimori, Masashi, E-mail: fujimorim@clin.medic.mie-u.ac.jp [Mie University School of Medicine, Department of Radiology (Japan); Yamakado, Koichiro, E-mail: yamakado47@gmail.com; Takaki, Haruyuki, E-mail: takaki-h@clin.medic.mie-u.ac.jp [Hyogo College of Medicine, Department of Radiology (Japan); Nakatsuka, Atsuhiro, E-mail: nakatuka@clin.medic.mie-u.ac.jp; Uraki, Junji, E-mail: junji@clin.medic.mie-u.ac.jp; Yamanaka, Takashi, E-mail: t-yama@clin.medic.mie-u.ac.jp; Hasegawa, Takaaki, E-mail: hasegawat@clin.medic.mie-u.ac.jp; Sugino, Yuichi, E-mail: ysugino23@clin.medic.mie-u.ac.jp; Nakajima, Ken, E-mail: k-nakajima@clin.medic.mie-u.ac.jp; Matsushita, Naritaka, E-mail: n-matsushita@clin.medic.mie-u.ac.jp [Mie University School of Medicine, Department of Radiology (Japan); Mizuno, Shugo, E-mail: mizunos@clin.medic.mie-u.ac.jp [Mie University School of Medicine, Hepatobiliary Pancreatic and Transplant Surgery (Japan); Sakuma, Hajime, E-mail: sakuma.mie@gmail.com [Mie University School of Medicine, Department of Radiology (Japan); Isaji, Shuji, E-mail: isaji-s@clin.medic.mie-u.ac.jp [Mie University School of Medicine, Hepatobiliary Pancreatic and Transplant Surgery (Japan)

    2016-04-15

    PurposeTo evaluate long-term results of stent placement retrospectively in patients with outflow block after living-donor-liver transplantation (LDLT).Materials and MethodsFor this institutional review board approved retrospective study conducted during 2002–2012, stents were placed in outflow veins in 15 patients (11.3 %, 15/133) (12 men; 3 female) in whom outflow block developed after LDLT. Their mean age was 52.3 years ± 15.3 (SD) (range, 4–69 years). Venous stenosis with a pressure gradient ≥5 mmHg (outflow block) was observed in the inferior vena cava in seven patients, hepatic vein in seven patients, and both in one patient. Technical success, change in a pressure gradient and clinical manifestations, and complications were evaluated. Overall survival of 15 patients undergoing outflow block stenting was compared with that of 116 patients without outflow block after LDLT.ResultsStents were placed across the outflow block veins without complications, lowering the pressure gradient ≤ 3 mmHg in all patients (100 %, 15/15). Clinical manifestations improved in 11 patients (73.3 %, 11/15), and all were discharged from the hospital. However, they did not improve in the other 4 patients (26.7 %, 4/15) who died in the hospital 1.0–3.7 months after stenting (mean, 2.0 ± 1.2 months). No significant difference in 5-year survival rates was found between patients with and without outflow block after LDLT (61.1 vs. 72.2 %, p = .405).ConclusionStenting is a feasible, safe, and useful therapeutic option to resolve outflow block following LDLT, providing equal survival to that of patients without outflow block.

  18. Impact of Sativex(®) on quality of life and activities of daily living in patients with multiple sclerosis spasticity.

    Science.gov (United States)

    Arroyo, Rafael; Vila, Carlos; Dechant, Kerry L

    2014-07-01

    In individuals with multiple sclerosis (MS) spasticity, associated symptoms such as spasms, pain, mobility restrictions and sleep disturbances can interfere with the ability to perform activities of daily living and reduce quality of life (QoL). Recent cross-sectional studies from Europe have confirmed that advancing severity of MS spasticity correlates directly with worsening QoL. The treatment effect of Sativex(®) (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain) on QoL has been evaluated in randomized controlled trials, observational studies conducted under everyday clinical practice conditions and a survey in long-term users. Symptomatic relief of MS spasticity in responders to Sativex was associated with quantifiable improvements in QoL and activities of daily living that were maintained over time. Benefits were perceived by both patients and caregivers.

  19. A Website Intervention to Increase Knowledge About Living Kidney Donation and Transplantation Among Hispanic/Latino Dialysis Patients.

    Science.gov (United States)

    Gordon, Elisa J; Feinglass, Joe; Carney, Paula; Vera, Karina; Olivero, Maria; Black, Anne; O'Connor, Kate Grubbs; Baumgart, Jessica MacLean; Caicedo, Juan Carlos

    2016-03-01

    Hispanic dialysis patients often encounter barriers to learning about living kidney donation and transplantation. Effective culturally targeted interventions to increase knowledge are lacking. We developed a culturally targeted educational website to enhance informed treatment decision making for end-stage kidney disease. A pretest/posttest intervention study was conducted among adult Hispanic patients undergoing dialysis at 5 dialysis centers in Chicago, Illinois. Surveys included a 31-item, multiple-choice pretest/posttest of knowledge about kidney transplantation and living donation, attitudes about the website, Internet use, and demographics. The intervention entailed viewing 3 of 6 website sections for a total of 30 minutes. The pretest/posttest was administered immediately before and after the intervention. Participants completed a second posttest via telephone 3 weeks thereafter to assess knowledge retention, attitudes, and use of the website. Sixty-three patients participated (96% participation rate). Website exposure was associated with a mean 17.1% same day knowledge score increase between pretest and posttest (P < .001). At 3 weeks, participants' knowledge scores remained 11.7% above pretest (P < .001). The greatest knowledge gain from pretest to 3-week follow-up occurred in the Treatment Options (P < .0001) and Cultural Beliefs and Myths (P < .0001) website sections. Most participants (95%) "agreed" or "strongly agreed" that they would recommend the website to other Hispanics. Web-based education for patients undergoing dialysis can effectively increase Hispanics' knowledge about transplantation and living kidney donation. Study limitations include small sample size and single geographic region study. Dialysis facilities could enable website access as a method of satisfying policy requirements to provide education about kidney transplantation. © 2016, NATCO.

  20. Detection of Live Circulating Tumor Cells by a Class of Near-Infrared Heptamethine Carbocyanine Dyes in Patients with Localized and Metastatic Prostate Cancer

    Science.gov (United States)

    Hu, Peizhen; Chu, Chia-Yi; Zhang, Lei; Bui, Matthew H. T.; Ng, Christopher S.; Josephson, David Y.; Knudsen, Beatrice; Tighiouart, Mourad; Kim, Hyung L.; Zhau, Haiyen E.; Chung, Leland W. K.; Wang, Ruoxiang; Posadas, Edwin M.

    2014-01-01

    Tumor cells are inherently heterogeneous and often exhibit diminished adhesion, resulting in the shedding of tumor cells into the circulation to form circulating tumor cells (CTCs). A fraction of these are live CTCs with potential of metastatic colonization whereas others are at various stages of apoptosis making them likely to be less relevant to understanding the disease. Isolation and characterization of live CTCs may augment information yielded by standard enumeration to help physicians to more accurately establish diagnosis, choose therapy, monitor response, and provide prognosis. We previously reported on a group of near-infrared (NIR) heptamethine carbocyanine dyes that are specifically and actively transported into live cancer cells. In this study, this viable tumor cell-specific behavior was utilized to detect live CTCs in prostate cancer patients. Peripheral blood mononuclear cells (PBMCs) from 40 patients with localized prostate cancer together with 5 patients with metastatic disease were stained with IR-783, the prototype heptamethine cyanine dye. Stained cells were subjected to flow cytometric analysis to identify live (NIR+) CTCs from the pool of total CTCs, which were identified by EpCAM staining. In patients with localized tumor, live CTC counts corresponded with total CTC numbers. Higher live CTC counts were seen in patients with larger tumors and those with more aggressive pathologic features including positive margins and/or lymph node invasion. Even higher CTC numbers (live and total) were detected in patients with metastatic disease. Live CTC counts declined when patients were receiving effective treatments, and conversely the counts tended to rise at the time of disease progression. Our study demonstrates the feasibility of applying of this staining technique to identify live CTCs, creating an opportunity for further molecular interrogation of a more biologically relevant CTC population. PMID:24551200