Sample records for suspected disability including

  1. Factors Affecting Special Education Services for English Language Learners with Suspected Language Learning Disabilities (United States)

    Langdon, Henriette W.


    This article focuses on factors that impact identification of and services for English-language learners (ELLs) with suspected language-learning disabilities. These factors include (a) home and school environments, (b) the school's philosophy, (c) instructional strategies, and (d) other contextual variables that affect language use. In addition,…

  2. Diversity: Including People with Disabilities in Outdoor Adventure Programs. (United States)

    Sugerman, Deb


    Organizations that offer outdoor adventure activities can integrate programs to include individuals with disabilities. The paper describes how one organization includes diverse groups of people with and without disabilities in its outdoor activities, focusing on each member's strengths and encouraging cooperation. (SM)

  3. Including Students with Disabilities in a Foreign Language Class (United States)

    Duvall, Emily D.


    Student diversity and inclusion presents a unique set of challenges to foreign language teachers. In fact, it has long been recognized that children with learning disabilities, especially those whose difficulties are language-based, will be challenged by foreign language education. Including children with disabilities in a foreign language class…

  4. Including a learner with physical disabilities: stressful for teachers?

    Directory of Open Access Journals (Sweden)

    I. Eloff


    Full Text Available Learners with physical disabilities have been entering mainstream schools for some years now. Whereas early research on inclusive education necessitated a strong focus on the needs of the learners, there has also been a recent interest in the role of the teachers in inclusive education. By adopting constructivism as the paradigm for inquiry a study was undertaken to establish the stress factors for teachers who have to include a learner with a physical disability in their mainstream classes. The rationale for the study is threefold: i Learners with physical disabilities are entering mainstream schools increasingly, ii it is often assumed that inclusive education is too stressful for teachers to cope with, and iii related research has shown that increased contact with individuals with disabilities has a positive effect on attitudes towards individuals with disabilities. In accordance with the dialectical methodology of constructivism, the Teacher Stress and Coping Questionnaire and in-depth interviews were utilised to establish the stress factors and the extent of the stress factors that may be present. The aim of the constructivist inquiry process is to promote understanding and reconstruction. In this article the quantitative results indicate overall low or non-existent levels of stress in teachers who have to include a learner with a physical disability, and the results therefore contribute to our understanding of this situation. The qualitative results reconstruct the meanings that these teachers attach to the inclusion of a learner with a physical disability and reveal some albeit limited concerns about the communication processes between parents and teachers and a perceived lack of pre-service training.

  5. Including Students with Severe Disabilities in General Education Settings. (United States)

    Wisniewski, Lech; Alper, Sandra


    This paper presents five systematic phases for bringing about successful regular education inclusion of students with severe disabilities. Phases include develop networks within the community, assess school and community resources, review strategies for integration, install strategies that lead to integration, and develop a system of feedback and…


    Directory of Open Access Journals (Sweden)

    Soloviov S. O


    Full Text Available Background: Viruses play a leading role in human pathology development, causing a large number of infectious diseases in acute, persistent or chronic forms. Although the number of deaths caused by viral infections have decreased significantly today, they continue to be a significant factor in reducing of the population overall productivity. Viral diseases cause additional losses in community related to the duration of the course or disease or its chronization, increased use of health care, loss of working hours, premature death etc. Introduction of the new antiviral drugs into medical practice is accompanied by the emergence of questions to assess its effectiveness and including into existing clinical protocols. So the aim of this work is the development of methodology of choosing and justification of optimal treatment strategy for viral diseases that could be included into certain clinical protocols for managing patients with certain viral diseases. Methodology justification: The methodology based on the method of pharmacoeconomic analysis "cost of illness", takes into account the economic burden of viral diseases: direct costs for treating of disease, indirect costs related to the disease and intangible costs. Algorithm of treatment scheme choice depends on the cost of treatment for the patient without viral disease also as for patient with viral disease. It was proposed to use lower limit priori probability (critical prevalence of viral disease as decision rule in the choice of treatment scheme. Results: Examples of the proposed methodology use show that the choice of the optimal therapeutic scheme for patients with suspected viral disease depends on the current prevalence of this disease among patients with similar clinical symptoms of the disease and its cost, depending on the chosen strategy of therapy. The proposed methodology determines the critical level of viral infection prevalence, which comparing to the current prevalence level is

  7. Music-based Autism Diagnostics (MUSAD) - A newly developed diagnostic measure for adults with intellectual developmental disabilities suspected of autism. (United States)

    Bergmann, Thomas; Sappok, Tanja; Diefenbacher, Albert; Dames, Sibylle; Heinrich, Manuel; Ziegler, Matthias; Dziobek, Isabel


    The MUSAD was developed as a diagnostic observational instrument in an interactional music framework. It is based on the ICD-10/DSM-5 criteria for autism spectrum disorder (ASD) and was designed to assess adults on a lower level of functioning, including individuals with severe language impairments. This study aimed to evaluate the psychometric properties of the newly developed instrument. Calculations were based on a consecutive clinical sample of N=76 adults with intellectual and developmental disabilities (IDD) suspected of ASD. Objectivity, test-retest reliability, and construct validity were calculated and a confirmatory factor analysis was applied to verify a reduced and optimized test version. The structural model showed a good fit, while internal consistency of the subscales was excellent (ω>.92). Item difficulties ranged between .04≤pi≤.82 and item-total correlation from .21 to .85. Objectivity was assessed by comparing the scorings of two external raters based on a subsample of n=12; interrater agreement was .71 (ICC 2, 1). Reliability was calculated for four test repetitions: the average ICC (3, 1) was .69. Convergent ASD measures correlated significantly with the MUSAD, while the discriminant Modified Overt Aggression Scale (MOAS) showed no significant overlap. Confirmation of factorial structure and acceptable psychometric properties suggest that the MUSAD is a promising new instrument for diagnosing ASD in adults with IDD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Self-reported care needs of Dutch homeless people with and without a suspected intellectual disability: a 1.5-year follow-up study. (United States)

    Van Straaten, Barbara; Rodenburg, Gerda; Van der Laan, Jorien; Boersma, Sandra N; Wolf, Judith R L M; Van de Mheen, Dike


    Cognitive impairment is a prevalent problem among the homeless and seems related to more psychosocial problems. However, little is known about the care needs of the subgroup of homeless people with an intellectual disability compared to those without an intellectual disability and how their care needs develop over time. This study explores self-reported care needs within a broad range of life domains among Dutch homeless people with and without a suspected intellectual disability to gain insight into the transition of self-reported care needs from baseline to follow-up in both subgroups. This longitudinal study is part of a cohort study among homeless people who had been accepted for an individual programme plan in four major Dutch cities. The initial cohort consisted of 513 participants who were interviewed in 2011. At 1.5-year follow-up, 336 participants (65.5%) were also interviewed and screened for intellectual disability. Of these participants, 31% (95% CI 26.2-36.1) had a suspected intellectual disability. For both groups, between baseline and follow-up, the number of 'unmet care needs' decreased significantly and the number of 'no care needs' increased significantly, while at follow-up, participants with a suspected intellectual disability reported 'no care needs' on significantly fewer life domains than those without a suspected intellectual disability (mean numbers 16.4 vs. 17.5). Between baseline and follow-up, 'met care needs' decreased significantly on housing for both groups, and increased on finances and dental care for participants with a suspected intellectual disability. At follow-up, participants with a suspected intellectual disability more often preferred housing support available by appointment than those without a suspected intellectual disability. These findings suggest that homeless people who had been accepted for an individual programme plan with a suspected intellectual disability have care needs for a longer period of time than those

  9. Instrument for locating students with suspected learning disabilities: a quantitative approach. (United States)

    Engel, R


    The instrument to locate students with learning disabilities was developed to create equality and uniformity, so that such difficulties could be spotted independently of socialization factors, teachers and parents to whom the student had been exposed. The instrument was developed on the basis of research that defines the reading rate of students with reading disabilities in words per minute, the minimum number of errors for locating writing disabilities, and the number of answers and lines a student uses to reconstruct the content of a passage adapted to his or her age level. The research carried out in order to construct the instrument is the first to attempt to quantify disability, and on this basis to construct an instrument to locate students with disabilities in reading, writing and visual recall. The procedure can be carried out for a whole class in a single lesson period. One indirect conclusion from the research is that disability indicators remain with the learning disabled regardless of time since diagnosis or remedial help. Other implications related to combining the quantity component in diagnoses of degrees of difference in the disability identified, and in extra examination time for the learning disabled. The instrument should solve the problem of locating students with difficulty reading, writing or in visual recall, due to disability. Students thus identified will be directed to individual diagnosis to find out whether their difficulties are primary or secondary (e.g. a new immigrant who still has trouble with Hebrew). A personal corrective programme can then be constructed.

  10. Could You Hold the Door for Me? Including Disability in Diversity. (United States)

    Olkin, Rhoda


    This paper presents background information for counselors on issues concerning disabilities. Part 1 discusses counselor training in graduate programs on disabilities and considers the training accessibility for graduate students with disabilities. Part 2 explains information about disabled students, including the terminology used, their…

  11. Including People with Intellectual Disabilities in Qualitative Research (United States)

    Hall, Sarah A.


    The voice of people with intellectual disabilities (ID) is needed in the literature to best understand their unique experiences and perspectives. Researchers face challenges in conducting interviews with people with ID who are limited in conceptual and verbal language skills. It can also be difficult to obtain participants with ID because of…

  12. Using Photovoice to Include People with Profound and Multiple Learning Disabilities in Inclusive Research (United States)

    Cluley, Victoria


    Background: It is now expected that projects addressing the lives of people with learning disabilities include people with learning disabilities in the research process. In the past, such research often excluded people with learning disabilities, favouring the opinions of family members, carers and professionals. The inclusion of the voices of…

  13. Validity of the social communication questionnaire in adults with intellectual disabilities and suspected autism spectrum disorder. (United States)

    Sappok, Tanja; Diefenbacher, Albert; Gaul, Isabell; Bölte, Sven


    This study examined the validity of the Social Communication Questionnaire (SCQ) to identify autism spectrum disorder (ASD) in 151 adults with intellectual disabilities (ID) in Germany. Sensitivities and specificities for ASD were 98/47% for the SCQ-current version and 92/22% for the SCQ-lifetime version. Sensitivities and specificities were increased to 89/66% and 78/48% by adjusting the recommended cut-points. The SCQ-current score correlated with the Scale for Pervasive Developmental Disorders in Mentally Retarded Persons and the Autism Diagnostic Observation Schedule, whereas the SCQ-lifetime score correlated with the Autism Diagnostic Interview-Revised. Our findings support the use of the SCQ-current version for ASD screening in adults with ID, although the SCQ-lifetime version should be used with caution in this population.

  14. The effectiveness of police custody assessments in identifying suspects with intellectual disabilities and attention deficit hyperactivity disorder. (United States)

    Young, Susan; Goodwin, Emily J; Sedgwick, Ottilie; Gudjonsson, Gisli H


    Intellectual Disabilities (ID) and Attention Deficit Hyperactivity Disorder (ADHD) are recognized psychological vulnerabilities in police interviews and court proceedings in England and Wales. The aims of this study were to investigate: (a) the prevalence of ID and/or ADHD among suspects detained at a large London metropolitan police station and their relationship with conduct disorder (CD), (b) the impact of their condition on police staff resources, (c) the effectiveness of current custody assessment tools in identifying psychological vulnerabilities, and (d) the use of 'Appropriate Adults' in interviews. A total of 200 individuals in a police custody suite were interviewed and screened for ID, ADHD (current symptoms) and CD. The screening rates for these three disorders were 6.7%, 23.5% and 76.3%, respectively. ADHD contributed significantly to increased requests being made of staff after controlling for CD and duration of time in custody. This is a novel finding. Reading and writing difficulties and mental health problems were often identified from the custody risk assessment tools, but they were not used effectively to inform on the need for the use of an Appropriate Adult. The frequency with which Appropriate Adults were provided to support detainees in police interviews (4.2%) remains almost identical to that found in a similar study conducted 20 years previously. The current findings suggest that in spite of reforms recently made in custodial settings, procedures may not have had the anticipated impact of improving safeguards for vulnerable suspects. Detainees with ID and ADHD require an Appropriate Adult during police interviews and other formal custody procedures, which they commonly do not currently receive. The findings of the current study suggest this may be due, in large part, to the ineffective use of risk-assessment tools and healthcare professionals, which represent missed opportunities to identify such vulnerabilities.

  15. Food Insecurity in U.S. Households That Include Children with Disabilities (United States)

    Sonik, Rajan; Parish, Susan L.; Ghosh, Subharati; Igdalsky, Leah


    The authors examined food insecurity in households including children with disabilities, analyzing data from the 2004 and 2008 panels of the Survey of Income and Program Participation, which included 24,729 households with children, 3,948 of which had children with disabilities. Logistic regression models were used to estimate the likelihood of…

  16. Visual Impairments, "Including Blindness." NICHCY Disability Fact Sheet #13 (United States)

    National Dissemination Center for Children with Disabilities, 2012


    Vision is one of the five senses. Being able to see gives tremendous access to learning about the world around--people's faces and the subtleties of expression, what different things look like and how big they are, and the physical environments, including approaching hazards. When a child has a visual impairment, it is cause for immediate…

  17. 20 CFR 410.410 - Total disability due to pneumoconiosis, including statutory presumption. (United States)


    ... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.410 Total disability due to pneumoconiosis, including statutory... their death. (For benefits to the eligible survivors of miners whose deaths are determined to have been...

  18. The extent to which students with disabilities are included in elite ...

    African Journals Online (AJOL)

    Inclusion is imperative to eliminate discrimination against people with disabilities. In educational context inclusion can be defined as including a number of key perspectives, policies and practices (such as reducing barriers) to learning and participation of students regardless of their ability or disability level. It seems ...

  19. Implementation of the Project "Including Disabled Senior Citizens in Creative Activities in 2013-2015" (United States)

    Ploch, Leszek


    This paper made an attempt to indicate the findings of the author's research from the experiences of the implementation of the project "Including disabled senior citizens in creative activities in 2013-2015". The issues of disabled senior citizens have been an object of interest over the recent years though it still has not had a proper…

  20. Including students with moderate and severe intellectual disabilities in school extracurricular and community recreation activities. (United States)

    Kleinert, Harold L; Miracle, Sally; Sheppard-Jones, Kathy


    We conducted an online statewide survey of teachers of students with moderate and severe intellectual disabilities to determine the extent to which their students were included in school extracurricular and community recreation activities. For the 252 teacher respondents who indicated that their primary caseload consisted of students with significant intellectual disabilities, we report the numbers of students participating in school and community activities and the primary type of support students required to participate in each activity. Finally, we identify implications for practitioners who want to increase the participation of students with significant disabilities in school and community activities.

  1. Music for All: Including young people with intellectual disability in a university environment. (United States)

    Rickson, Daphne; Warren, Penny


    We investigated a continuing education course in creative music making, initiated to promote the inclusion of young people with intellectual disability in a university setting. Despite organizers' attempts to foster diversity within the student cohort, enrolments were almost exclusively from students who had intellectual disability. Being in the university environment, and in a place of higher learning, seemed to be valued by some. However, students' main focus was on group musicking in a dedicated music room rather than interacting with the wider university community. Those who did not identify as disabled believed it was important to continue to address the barriers to wider inclusion. While acknowledging the risks around mediating the social interactions of young people with intellectual disability, we argue that future courses should include activities specifically designed to bring them to classes with typical students and to the wider activities of the university.

  2. An Initial Look at the Quality of Life of Malaysian Families That Include Children with Disabilities (United States)

    Clark, M.; Brown, R.; Karrapaya, R.


    Background: While there is a growing body of literature in the quality of life of families that include children with disabilities, the majority of research has been conducted in western countries. The present study provides an initial exploration of the quality of life of Malaysian families that include children with developmental/intellectual…

  3. Evaluating and Using Literature Including People with Disabilities in All Classrooms (United States)

    Oslick, Mary Ellen; Pearson, Mary


    To help students see their worlds differently and to expand those views beyond their own backyards, educators can expose them to quality multicultural children's literature. In this article, we focus on a subtopic within the genre of multicultural children's literature: literature including people with disabilities. We chose seven recent texts…

  4. Adolescent Judgments and Reasoning about the Failure to Include Peers with Social Disabilities (United States)

    Bottema-Beutel, Kristen; Li, Zhushan


    Adolescents with autism spectrum disorder often do not have access to crucial peer social activities. This study examines how typically developing adolescents evaluate decisions not to include a peer based on disability status, and the justifications they apply to these decisions. A clinical interview methodology was used to elicit judgments and…

  5. The phenotypic spectrum of ARHGEF9 includes intellectual disability, focal epilepsy and febrile seizures. (United States)

    Klein, Karl Martin; Pendziwiat, Manuela; Eilam, Anda; Gilad, Ronit; Blatt, Ilan; Rosenow, Felix; Kanaan, Moien; Helbig, Ingo; Afawi, Zaid


    Mutations or structural genomic alterations of the X-chromosomal gene ARHGEF9 have been described in male and female patients with intellectual disability. Hyperekplexia and epilepsy were observed to a variable degree, but incompletely described. Here, we expand the phenotypic spectrum of ARHGEF9 by describing a large Ethiopian-Jewish family with epilepsy and intellectual disability. The four affected male siblings, their unaffected parents and two unaffected female siblings were recruited and phenotyped. Parametric linkage analysis was performed using SNP microarrays. Variants from exome sequencing in two affected individuals were confirmed by Sanger sequencing. All affected male siblings had febrile seizures from age 2-3 years and intellectual disability. Three developed afebrile seizures between age 7-17 years. Three showed focal seizure semiology. None had hyperekplexia. A novel ARHGEF9 variant (c.967G>A, p.G323R, NM_015185.2) was hemizygous in all affected male siblings and heterozygous in the mother. This family reveals that the phenotypic spectrum of ARHGEF9 is broader than commonly assumed and includes febrile seizures and focal epilepsy with intellectual disability in the absence of hyperekplexia or other clinically distinguishing features. Our findings suggest that pathogenic variants in ARHGEF9 may be more common than previously assumed in patients with intellectual disability and mild epilepsy.

  6. Policies for including disabled people in education. obstacles and facilitating factors for their implementation: Bucaramanga, 2010

    Directory of Open Access Journals (Sweden)

    Claudia P. Serrano R


    Full Text Available Objective: to explore the factors enabling or hindering the implementation of inclusive education policies for the disabled population of Bucaramanga. Methodology: a descriptive study, involving representatives from governmental agencies (EG, members of the faculty boards of educational institutions (DIE and guardians of disabled individuals (APSD. Physical, social, and political obstacles and facilitating factors that could potentially determine the implementation of these policies were analyzed. Data was collected through interviews. Results: there was a total of 2, 32, and 34 participants from the EG, DIE, and APSD groups respectively. Identified obstacles included: lack of strategies to support educational institutions, poor or limited teacher training, high tuition fees, and negative attitude towards disability. The facilitating factors included: availability of places, inclusion of this issue in the political agenda, and desire of the disabled individuals’ families to provide them with education. Discussion: These findings provide useful information for further research on this issue and show how action has been taken, as well as how urgent it is to establish a direct relationship between academia and the public sector to propose strategies for assessing and modifying these policies.

  7. Examining the Outcomes of Including Students with Disabilities in a Bullying/Victimization Intervention (United States)

    Graybill, Emily C.; Vinoski, Erin; Black, Mary; Varjas, Kris; Henrich, Christopher; Meyers, Joel


    Students with disabilities are bullied at rates disproportionate to their typically developing peers, yet we know little about effective interventions to reduce the rates of victimization among students with disabilities across all disability categories. This study examined the effectiveness of the inclusive Bullying/Victimization Intervention…

  8. A Case Study of Tack Tiles[R] Literacy Instruction for a Student with Multiple Disabilities Including Congenital Blindness (United States)

    Klenk, Jessicia A.; Pufpaff, Lisa A.


    Research on literacy instruction for students with multiple disabilities is limited. Empirical research on braille instruction for students with multiple disabilities that include congenital blindness is virtually nonexistent. This case study offers initial insight into possible methods of early braille literacy instruction for a student with…

  9. Hybridising Sport Education and Teaching for Personal and Social Responsibility to Include Students with Disabilities (United States)

    Menendez, Jose Ignacio; Fernandez-Rio, Javier


    The present study aimed to explore the impact of the combination of two pedagogical models, Sport Education and Teaching for Personal and Social Responsibility, for learners with disabilities experiencing a contactless kickboxing learning unit. Twelve secondary education students agreed to participate. Five had disabilities (intellectual and…

  10. Including People with Disabilities into the Workplace in the Balearic Islands (United States)

    Ramon, Rosa Rossello; Gelabert, Sebastia Verger


    If education is an inalienable right for children and young people with disabilities, securing employment plays a key role in their inclusion into adult life. A broad study was conducted to analyse the transition between the end of compulsory education and the beginning of employment in young people with disabilities in the Autonomous Community of…

  11. Intellectual disability (United States)

    ... high bilirubin levels in babies) Nutritional (such as malnutrition) Toxic ( intrauterine exposure to ... a family, you may suspect your child has an intellectual disability when your child has ...

  12. Beyond the Business Case: Different Models of Including People with Disabilities at Work

    Directory of Open Access Journals (Sweden)

    Justin Lee


    Full Text Available When not done properly, policies or interventions that claim to be 'inclusive' can be patronizing or even oppressive. Through interviews and focus groups with employers, service providers and the disability community in Singapore, we helped to articulate what counts as ideal or sensible inclusion of people with disabilities at work. Against those that might seek to mainstream disability wherever it exists, our findings suggest that enclaved spaces for work serve an important function despite charges of being exclusionary. Some enclaves operate as 'work villages' that provide a protected, familiar space to accommodate unique needs while others serve as 'diversity incubators' that provide scalable lessons for more mainstream contexts. Within the Singapore context, policymakers largely operate within a 'business case' paradigm that focuses on incentivizing employers and an 'industrial model' of vocational assessment and job placement. While this has a role to play, we demonstrate the importance of attending to the neglected 'moral case' for hiring people with disabilities.

  13. The impact of disability on the lives of children; cross-sectional data including 8,900 children with disabilities and 898,834 children without disabilities across 30 countries.

    Directory of Open Access Journals (Sweden)

    Hannah Kuper

    Full Text Available BACKGROUND: Children with disabilities are widely believed to be less likely to attend school or access health care, and more vulnerable to poverty. There is currently little large-scale or internationally comparable evidence to support these claims. The aim of this study was to investigate the impact of disability on the lives of children sponsored by Plan International across 30 countries. METHODS AND FINDINGS: We conducted a cross-sectional survey including 907,734 children aged 0-17 participating in the Plan International Sponsorship Programme across 30 countries in 2012. Parents/guardians were interviewed using standardised questionnaires including information on: age, sex, health, education, poverty, and water and sanitation facilities. Disability was assessed through a single question and information was collected on type of impairment. The dataset included 8,900 children with reported disabilities across 30 countries. The prevalence of disability ranged from 0.4%-3.0% and was higher in boys than girls in 22 of the 30 countries assessed - generally in the range of 1.3-1.4 fold higher. Children with disabilities were much less likely to attend formal education in comparison to children without disabilities in each of the 30 countries, with age-sex adjusted odds ratios exceeding 10 for nearly half of the countries. This relationship varied by impairment type. Among those attending school, children with disabilities were at a lower level of schooling for their age compared to children without disabilities. Children with disabilities were more likely to report experiencing a serious illness in the last 12 months, except in Niger. There was no clear relationship between disability and poverty. CONCLUSIONS: Children with disabilities are at risk of not fulfilling their educational potential and are more vulnerable to serious illness. This exclusion is likely to have a long-term deleterious impact on their lives unless services are adapted to

  14. The comparative capacity of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and MMPI-2 Restructured Form (MMPI-2-RF) validity scales to detect suspected malingering in a disability claimant sample. (United States)

    Chmielewski, Michael; Zhu, Jiani; Burchett, Danielle; Bury, Alison S; Bagby, R Michael


    The current study expands on past research examining the comparative capacity of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001) and MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) overreporting validity scales to detect suspected malingering, as assessed by the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), in a sample of public insurance disability claimants (N = 742) who were considered to have potential incentives to malinger. Results provide support for the capacity of both the MMPI-2 and the MMPI-2-RF overreporting validity scales to predict suspected malingering of psychopathology. The MMPI-2-RF overreporting validity scales proved to be modestly better predictors of suspected psychopathology malingering-compared with the MMPI-2 overreporting scales-in dimensional predictive models and categorical classification accuracy analyses. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Spooky Suspects (United States)

    Pacifici, Lara


    This activity presents an option for covering biology content while engaging students in an investigation that highlights the spirit of Halloween. Students are engaged in the story line and have fun trying to solve the mystery kidnapping by using science skills to examine the evidence and eliminate some ghoulish suspects. (Contains 1 figure.)

  16. Forgotten, excluded or included? Students with disabilities: A case study at the University of Mauritius

    Directory of Open Access Journals (Sweden)

    Sameerchand Pudaruth


    Full Text Available Background: Students with disabilities in the tertiary education sector are more than a just a phenomenon, they are a reality. In general, little attention is devoted to their needs despite the fact that they need more care and attention.Objectives: This paper, through a case study at the University of Mauritius, sought to answer some pertinent questions regarding students with disabilities. Does the University of Mauritius have sufficient facilities to support these students? Are students aware of existing facilities? What additional structures need to be put in place so that students with any form of disability are neither victimised, nor their education undermined? Are there any local laws about students with disabilities in higher education?Method: To answer these questions and others, an online questionnaire was sent to 500 students and the responses were then analysed and discussed. The response rate was 24.4% which showed that students were not reticent to participate in this study.Results: Our survey revealed that most students were not aware of existing facilities and were often neglected in terms of supporting structures and resources. ICT facilities were found to be the best support that is provided at the University of Mauritius. The right legal framework for tertiary education was also missing.Conclusion: Ideally, students with disabilities should have access to special facilities to facilitate their learning experiences at tertiary institutions. Awareness about existing facilities must also be raised in order to offer equal opportunities to them and to enable a seamless inclusion.

  17. Forgotten, excluded or included? Students with disabilities: A case study at the University of Mauritius. (United States)

    Pudaruth, Sameerchand; Gunputh, Rajendra P; Singh, Upasana G


    Students with disabilities in the tertiary education sector are more than a just a phenomenon, they are a reality. In general, little attention is devoted to their needs despite the fact that they need more care and attention. This paper, through a case study at the University of Mauritius, sought to answer some pertinent questions regarding students with disabilities. Does the University of Mauritius have sufficient facilities to support these students? Are students aware of existing facilities? What additional structures need to be put in place so that students with any form of disability are neither victimised, nor their education undermined? Are there any local laws about students with disabilities in higher education? To answer these questions and others, an online questionnaire was sent to 500 students and the responses were then analysed and discussed. The response rate was 24.4% which showed that students were not reticent to participate in this study. Our survey revealed that most students were not aware of existing facilities and were often neglected in terms of supporting structures and resources. ICT facilities were found to be the best support that is provided at the University of Mauritius. The right legal framework for tertiary education was also missing. Ideally, students with disabilities should have access to special facilities to facilitate their learning experiences at tertiary institutions. Awareness about existing facilities must also be raised in order to offer equal opportunities to them and to enable a seamless inclusion.

  18. Including Students with Disabilities in Education for All: Lessons from Ethiopia (United States)

    Franck, Brittany; Joshi, Devin K.


    This article addresses the inclusion of students with disabilities into the Education for All and Sustainable Development Goals agenda through a case study of Ethiopia, a country aiming to promote inclusive education amidst rapidly rising school enrolments. The article begins with a review of debates concerning inclusive education in the Global…

  19. Effects of Leisure Education Programme Including Sportive Activities on Perceived Freedom in Leisure of Adolescents with Intellectual Disabilities (United States)

    Ertuzun, Ezgi


    The objective of this experimental study is to determine the effect of leisure education programme including sportive activities on the perceived freedom in leisure of adolescents with mild intellectual disabilities. The research was designed with an experimental group (n = 37) and a control group (n = 34), and was conducted among a total of 71…

  20. Including deaf and hard-of-hearing students with co-occurring disabilities in the accommodations discussion. (United States)

    Leppo, Rachel H T; Cawthon, Stephanie W; Bond, Mark P


    Students who are deaf or hard of hearing (SDHH) are a low-incidence group of students; however, SDHH also have a high incidence of additional disabilities (SDHH+). Many SDHH and SDHH+ require accommodations for equal access to classroom instruction and assessment, particularly in mainstreamed educational settings where spoken English is the primary language. Accommodations for SDHH, overall, have increased under federal legislation including the Individuals with Disabilities Education Improvement Act and the No Child Left Behind Act. Unfortunately, specific practice recommendations for SDHH+ and their unique needs are often lacking in the research literature. This article presents findings regarding accommodations use by SDHH and SDHH+ from the National Longitudinal Transition Study 2. Initial logistic regression analysis found no differences in accommodations use of SDHH and SDHH+. However, logistic regression analysis that compared specific additional disability groups with the larger overall SDHH group did find differences in accommodations use for two SDHH+ groups: students who had a learning disability and students with attention deficit hyperactivity disorder. This article includes a discussion of the implications of these findings for both research and practice.

  1. Using assistive technology adaptations to include students with learning disabilities in cooperative learning activities. (United States)

    Bryant, D P; Bryant, B R


    Cooperative learning (CL) is a common instructional arrangement that is used by classroom teachers to foster academic achievement and social acceptance of students with and without learning disabilities. Cooperative learning is appealing to classroom teachers because it can provide an opportunity for more instruction and feedback by peers than can be provided by teachers to individual students who require extra assistance. Recent studies suggest that students with LD may need adaptations during cooperative learning activities. The use of assistive technology adaptations may be necessary to help some students with LD compensate for their specific learning difficulties so that they can engage more readily in cooperative learning activities. A process for integrating technology adaptations into cooperative learning activities is discussed in terms of three components: selecting adaptations, monitoring the use of the adaptations during cooperative learning activities, and evaluating the adaptations' effectiveness. The article concludes with comments regarding barriers to and support systems for technology integration, technology and effective instructional practices, and the need to consider technology adaptations for students who have learning disabilities.

  2. Microdeletions including FMR1 in three female patients with intellectual disability - further delineation of the phenotype and expression studies

    DEFF Research Database (Denmark)

    Zink, A M; Wohlleber, E; Engels, H


    Fragile X syndrome (FXS) is one of the most common causes of intellectual disability/developmental delay (ID/DD), especially in males. It is caused most often by CGG trinucleotide repeat expansions, and less frequently by point mutations and partial or full deletions of the FMR1 gene. The wide...... clinical spectrum of affected females partly depends on their X-inactivation status. Only few female ID/DD patients with microdeletions including FMR1 have been reported. We describe 3 female patients with 3.5-, 4.2- and 9.2-Mb de novo microdeletions in Xq27.3-q28 containing FMR1. X-inactivation was random...

  3. Yearly Data for Asian & Pacific Islander Language Preferences of Social Security Disability Insurance Claimants (FY 2016, including 53rd week) (United States)

    Social Security Administration — This dataset provides annual volumes for API language preferences at the national level of individuals filing claims for Disability insurance benefits for federal...

  4. Pediatric glaucoma suspects

    Directory of Open Access Journals (Sweden)

    Kooner K


    Full Text Available Karanjit Kooner,1 Matthew Harrison,1 Zohra Prasla,1 Mohannad Albdour,1 Beverley Adams-Huet21Department of Ophthalmology, 2Department of Clinical Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX, USAPurpose: To report demographic and ocular features of pediatric glaucoma suspects in an ethnically diverse population of North Central Texas.Design: Retrospective cross-sectional chart review.Participants: Subjects included 75 (136 eyes pediatric glaucoma suspects. Patients with one or more of the following risk factors were included: cup-to disc (C/D ratio of ≥0.6; intraocular pressure (IOP ≥21 mmHg; family history of glaucoma; congenital glaucoma in the opposite eye; history of blunt trauma to either eye; and presence of either Sturge–Weber or Axenfeld–Rieger syndrome, or oculodermal melanocytosis.Methods: Data were extracted from electronic patient medical records. Patient records with incomplete data were excluded. The main outcome measures were race, sex, age, IOP, C/D, family history of glaucoma; and glaucoma treatment.Results: Subjects included 28 (37.3% Hispanics, 20 (26.6% African Americans, 20 (26.6% Caucasians, and seven (9.3% Asians. Forty (53.3% of the patients were male. Suspicious optic disc was seen in 57 (76%; elevated IOP in 25 (33.3%; presence of family history in 13 (17.3%, and Sturge–Weber syndrome in nine (12% patients. The average C/D ratio was 0.58±0.2. The C/D ratios of African American (0.65±0.2, Hispanic (0.63±0.2, and Asian (0.62±0.15 patients were significantly greater than those of Caucasians (0.43±0.18; P=0.0004, 0.0003, and 0.0139, respectively. Caucasian patients were the youngest (7.9±4.8 years. Eleven cases (14.7% required medication.Conclusion: Thirty-three point seven percent of patients seen in the glaucoma clinic were glaucoma suspects. The most common risk factors for suspected glaucoma were suspicious optic discs, elevated IOP, and family history

  5. Yearly Data for Spoken Language Preferences of Social Security Disability Insurance Claimants (FY 2016, including 53rd week) (United States)

    Social Security Administration — This dataset provides annual volume of the Social Security Disability initial claims at the national level from federal fiscal year 2016 shown two ways—we base one...

  6. Quarterly Data for Asian & Pacific Islander Languages, Social Security Disability Insurance Initial Claims (FY 2016, including 53rd week) (United States)

    Social Security Administration — This dataset provides quarterly volumes of the Social Security Disability initial claims at the national level from federal fiscal year 2016 with quarter 4 shown two...

  7. Quarterly Data for Spoken Language Preferences of Social Security Disability Insurance Claimants (FY 2016, including 53rd week) (United States)

    Social Security Administration — This dataset provides quarterly volumes of the Social Security Disability initial claims at the national level for federal fiscal year 2016 with quarter 4 shown two...

  8. The impact of including children with intellectual disability in general education classrooms on the academic achievement of their low-, average-, and high-achieving peers. (United States)

    Sermier Dessemontet, Rachel; Bless, Gérard


    This study aimed at assessing the impact of including children with intellectual disability (ID) in general education classrooms with support on the academic achievement of their low-, average-, and high-achieving peers without disability. A quasi-experimental study was conducted with an experimental group of 202 pupils from classrooms with an included child with mild or moderate ID, and a control group of 202 pupils from classrooms with no included children with special educational needs (matched pairs sample). The progress of these 2 groups in their academic achievement was compared over a period of 1 school year. No significant difference was found in the progress of the low-, average-, or high-achieving pupils from classrooms with or without inclusion. The results suggest that including children with ID in primary general education classrooms with support does not have a negative impact on the progress of pupils without disability.

  9. Including Disabled Children in Learning: Challenges in Developing Countries. CREATE Pathways to Access. Research Monograph No. 36 (United States)

    Croft, Alison


    This is an exploratory study suggesting ways of analysing challenges for developing countries in the move to greater inclusion of disabled children and young people in learning. The paper focuses on pedagogical challenges to realising more inclusive education. Pedagogy encompasses not only the practice of teaching and learning, but also the ideas…

  10. iStimulation: Apple iPad Use with Children Who Are Visually Impaired, Including Those with Multiple Disabilities (United States)

    Campaña, Laura V.; Ouimet, Donald A.


    Since its creation in the early 1980s, Light Box, a product developed by the American Printing House for the Blind (APH) that is designed for working on functional vision tasks with children who have visual impairments or multiple disabilities, has been an effective tool to help teach children with visual impairments to locate and track items…

  11. The Effects of a Family Support Program Including Respite Care on Parenting Stress and Family Quality of Life Perceived by Primary Caregivers of Children with Disabilities in Korea (United States)

    Sung, Minjung; Park, Jiyeon


    In this study, a family support program was carried out for primary caregivers of children with disabilities. The program included respite care, recreation programs, counseling, and social support coordination based on individual needs of each family. In order to verify the intervention effects, parenting stress and family quality of life were…

  12. The Blind Advantage: How Going Blind Made Me a Stronger Principal and How Including Children with Disabilities Made Our School Better for Everyone (United States)

    Henderson, Bill


    'The Blind Advantage" provides insight into the challenges, possibilities, and practicalities of including students with disabilities--and into the mind and heart of an inspired and determined leader. "You should get out of education." That was the advice first-year teacher Bill Henderson received when he discovered he was gradually…

  13. De novo 14q24.2q24.3 microdeletion including IFT43 is associated with intellectual disability, skeletal anomalies, cardiac anomalies, and myopia

    NARCIS (Netherlands)

    Stokman, M.F.; Oud, M.M.; Binsbergen, E. van; Slaats, G.G.; Nicolaou, N.; Renkema, K.Y.; Nijman, IJ; Roepman, R.; Giles, R.H.; Arts, H.H.; Knoers, N.V.A.M.; Haelst, M.M. van


    We report an 11-year-old girl with mild intellectual disability, skeletal anomalies, congenital heart defect, myopia, and facial dysmorphisms including an extra incisor, cup-shaped ears, and a preauricular skin tag. Array comparative genomic hybridization analysis identified a de novo 4.5-Mb

  14. Using patient reported outcome measures in health services: A qualitative study on including people with low literacy skills and learning disabilities

    Directory of Open Access Journals (Sweden)

    Jahagirdar Deepa


    Full Text Available Abstract Background Patient reported outcome measures (PROMs are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated stakeholder views on the accessibility and use of PROMs to develop suggestions for more inclusive practice. Methods Taking PROMs recommended for chronic obstructive pulmonary disease (COPD as an example, we conducted 8 interviews with people with low literacy skills and/or learning disabilities, and 4 focus groups with 20 health professionals and people with COPD. Discussions covered the format and delivery of PROMs using the EQ-5D and St George Respiratory Questionnaire as prompts. Thematic framework analysis focused on three main themes: Accessibility, Ease of Use, and Contextual factors. Results Accessibility included issues concerning the questionnaire format, and suggestions for improvement included larger font sizes and more white space. Ease of Use included discussion about PROMs’ administration. While health professionals suggested PROMs could be completed in waiting rooms, patients preferred settings with more privacy and where they could access help from people they know. Contextual Factors included other challenges and wider issues associated with completing PROMs. While health professionals highlighted difficulties created by the system in managing patients with low literacy/learning disabilities, patient participants stressed that understanding the purpose of PROMs was important to reduce intimidation. Conclusions Adjusting PROMs’ format, giving an explicit choice of where patients can complete them, and clearly conveying PROMs’ purpose and benefit to patients may help to prevent inequality when using PROMs in health services.

  15. Learning Disabilities and ADHD (United States)

    ... disabilities Learning disabilities and ADHD Learning disabilities and ADHD Learning disabilities affect how you understand, remember, and ... learning skills, including memory tips from LD Online. Attention deficit hyperactivity disorder (ADHD) top ADHD is a medical condition that ...

  16. Yearly Data for Asian & Pacific Islander Language Preferences of Supplemental Security Income Blind and Disabled Applicants (FY 2016, including 53rd week) (United States)

    Social Security Administration — This dataset provides annual volumes for API language preferences at the national level of individuals filing claims for SSI Blind and Disabled benefits for federal...

  17. Technology and the Glaucoma Suspect

    National Research Council Canada - National Science Library

    Blumberg, Dana M; De Moraes, Carlos Gustavo; Liebmann, Jeffrey M; Garg, Reena; Chen, Cynthia; Theventhiran, Alex; Hood, Donald C


    ...), stereoscopic disc photographs, and automated perimetry as assessed by a group of glaucoma specialists in differentiating individuals with early glaucoma from suspects. Forty-six eyes (46 patients...

  18. Short and long-term outcomes in children with suspected acute encephalopathy. (United States)

    Nishiyama, Masahiro; Nagase, Hiroaki; Tanaka, Tsukasa; Fujita, Kyoko; Kusumoto, Mayumi; Kajihara, Shinsuke; Yamaguchi, Yoshimichi; Maruyama, Azusa; Takeda, Hiroki; Uetani, Yoshiyuki; Tomioka, Kazumi; Toyoshima, Daisaku; Taniguchi-Ikeda, Mariko; Morioka, Ichiro; Takada, Satoshi; Iijima, Kazumoto


    The time-dependent changes that occur in children after acute encephalopathy are not clearly understood. Therefore, we assessed changes in brain function after suspected acute encephalopathy over time. We created a database of children admitted to the pediatric intensive care unit at Kobe Children's Hospital because of convulsions or impaired consciousness with fever between 2002 and 2013. Clinical courses and outcomes were reviewed and patients who met the following criteria were included in the study: (1) 6months to 15years of age, (2) no neurological abnormality before onset, (3) treated for suspected acute encephalopathy, and (4) followed after 1 (0-2) month and 12 (10-17) months of onset. Outcomes were assessed using the Pediatric Cerebral Performance Category (PCPC) scale, with a score of 1 representing normal performance; 2, mild disability; 3, moderate disability; 4, severe disability; 5, vegetative state; and 6, brain death. A total of 78 children (32 male) with a median (range) age at onset of 20 (6-172) months were enrolled. Fifty-one cases scored 1 on the PCPC, 13 scored 2, three scored 3, five scored 4, one scored 5, and five cases scored 6 at discharge. Whereas seven of the 13 cases that scored a 2 on the PCPC recovered normal brain function after 12months, none of the nine cases that scored a 3-5 on the PCPC recovered normal function. Our findings suggest moderate to severe disability caused by acute encephalopathy had lasting consequences on brain function, whereas mild disability might result in improved function. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  19. Effectiveness of Combining Tangible Symbols with the Picture Exchange Communication System to Teach Requesting Skills to Children with Multiple Disabilities Including Visual Impairment (United States)

    Ali, Emad; MacFarland, Stephanie Z.; Umbreit, John


    The Picture Exchange Communication System (PECS) is an augmentative and alternative communication (AAC) program used to teach functional requesting and commenting skills to people with disabilities (Bondy & Frost, 1993; Frost & Bondy, 2002). In this study, tangible symbols were added to PECS in teaching requesting to four students (ages 7-14) with…

  20. The Effectiveness of Combining Tangible Symbols with the Picture Exchange Communication System to Teach Requesting Skills to Children with Multiple Disabilities Including Visual Impairment (United States)

    Ali, Emad


    The Picture Exchange Communication System (PECS) is an augmentative and alternative communication program (Frost & Bondy, 2002). Although PECS has been effectively used to teach functional requesting skills for children with autism, mental retardation, visual impairment, and physical disabilities (e.g., Anderson, Moore, & Bourne, 2007; Chambers &…

  1. Learning Disabilities (United States)

    Sittiprapaporn, Wichian, Ed.


    Learning disability is a classification that includes several disorders in which a person has difficulty learning in a typical manner. Depending on the type and severity of the disability, interventions may be used to help the individual learn strategies that will foster future success. Some interventions can be quite simplistic, while others are…

  2. Suspected levamisole intoxication in calves. (United States)

    Müller, K R; Dwyer, C


    A group of 32 Friesian and four Hereford calves, 3-4 months old with body weights between 100-120 kg, were purchased from a weaner sale. On arrival at the property the Hereford calves were treated with a combination anthelmintic containing 2 g/L abamectin and 80 g/L levamisole hydrochloride. Shortly afterwards they developed tremors and frothing from the mouth, and two died overnight. The Friesian calves were treated with the same anthelmintic on the following day, when some showed hypersalivation and frothing from the mouth. Examination of the three most severely affected Friesian calves revealed severe nicotinic-type symptoms including hypersalivation, frothing from the mouth, muscle tremors, recumbency, rapid respiration, hyperaesthesia, and central nervous system depression. Other calves showed mild to moderate signs of intoxication including restlessness, tail switching, salivation, tremors, frequent defaecation, mild colic and jaw chomping. Two calves died shortly afterwards. An adverse drug event investigation revealed that the formulation and quality of the anthelmintic was within the correct specification, and that the drench gun was functioning correctly. Suspected levamisole intoxication due to a combination of possible overdosing, dehydration, and stress caused by transportation and prolonged yarding. Susceptibility to levamisole toxicity in New Zealand calves can be increased if factors like dehydration or stress are present. Levamisole has a narrow margin of safety, and overdosing in calves can easily occur if the dose rate is not based on their actual weight or health status.

  3. Rethinking Disability. (United States)

    Cieza, Alarcos; Sabariego, Carla; Bickenbach, Jerome; Chatterji, Somnath


    Disability as a health outcome deserves more attention than it has so far received. With people living longer and the epidemiological transition from infectious to noncommunicable diseases as the major cause of health burden, we need to focus attention on disability - the non-fatal impact of heath conditions - over and above our concern for causes of mortality.With the first Global Burden of Disease study, WHO provided a metric that enabled the comparison of the impact of diseases, drawing on a model of disability that focused on decrements of health. This model has since been elaborated in the International Classification of Functioning, Disability and Health as being either a feature of the individual or arising out of the interaction between the individual's health condition and contextual factors. The basis of WHO's ongoing work is a set of principles: that disability is a universal human experience; that disability is not determined solely by the underlying health condition or predicated merely on the presence of specific health conditions; and finally, that disability lies on a continuum from no to complete disability. To determine whether interventions at individual or population levels are effective, an approach to disability measurement that allows for an appropriate and fair comparison across health conditions is needed. WHO has designed the Model Disability Survey (MDS) to collect information relevant to understand the lived experience of disability, including the person's capacity to perform tasks actions in daily life, their actual performance, the barriers and facilitators in the environment they experience, and their health conditions. As disability gains prominence within the development agenda in the United Nations Sustainable Development Goals, and the implementation of the United Nations Convention on the Rights of Persons with Disabilities, the MDS will provide the data to monitor the progress of countries on meeting their obligations

  4. Learning disabilities. (United States)

    Lyon, G R


    Approximately 5% of all public school students are identified as having a learning disability (LD). LD is not a single disorder, but includes disabilities in any of seven areas related to reading, language, and mathematics. These separate types of learning disabilities frequently co-occur with one another and with social skill deficits and emotional or behavioral disorders. Most of the available information concerning learning disabilities relates to reading disabilities, and the majority of children with learning disabilities have their primary deficits in basic reading skills. An important part of the definition of LD is its exclusions: learning disabilities cannot be attributed primarily to mental retardation, emotional disturbance, cultural difference, or disadvantage. Thus, the concept of LD focuses on the notion of a discrepancy between a child's academic achievement and his or her apparent capacity to learn. Recent research indicates, however, that disability in basic reading skills is primarily caused by deficits in phonological awareness, which is independent of any achievement-capacity discrepancy. Deficits in phonological awareness can be identified in late kindergarten and first grade using inexpensive, straightforward testing protocol. Interventions have varying effectiveness, depending largely on the severity of the individual child's disability. The prevalence of learning disability identification has increased dramatically in the past 20 years. The "real" prevalence of LD is subject to much dispute because of the lack of an agreed-upon definition of LD with objective identification criteria. Some researchers have argued that the currently recognized 5% prevalence rate is inflated; others argue that LD is still underidentified. In fact, it appears that there are both sound and unsound reasons for the increase in identification rates. Sound reasons for the increase include better research, a broader definition of disability in reading, focusing on

  5. Prognostic importance of quantitative echocardiographic evaluation in patients suspected of first non-massive pulmonary embolism

    DEFF Research Database (Denmark)

    Kjaergaard, Jesper; Schaadt, Bente Krogsgaard; Lund, Jens Otto


    AIMS: Patients suspected of acute pulmonary embolism (PE) frequently undergo echocardiography as a part of the initial work-up. Prognostic implication of routine echocardiography in patients suspected of PE remain to be established. METHODS AND RESULTS: Transthoracic echocardiography, including...

  6. The evaluation of suspected child physical abuse. (United States)

    Christian, Cindy W


    Child physical abuse is an important cause of pediatric morbidity and mortality and is associated with major physical and mental health problems that can extend into adulthood. Pediatricians are in a unique position to identify and prevent child abuse, and this clinical report provides guidance to the practitioner regarding indicators and evaluation of suspected physical abuse of children. The role of the physician may include identifying abused children with suspicious injuries who present for care, reporting suspected abuse to the child protection agency for investigation, supporting families who are affected by child abuse, coordinating with other professionals and community agencies to provide immediate and long-term treatment to victimized children, providing court testimony when necessary, providing preventive care and anticipatory guidance in the office, and advocating for policies and programs that support families and protect vulnerable children. Copyright © 2015 by the American Academy of Pediatrics.

  7. Stopping and Questioning Suspected Shoplifters Without Creating Civil Liability (United States)

    Reed, Jack R., Jr.


    Legal problems concerned with shoplifting suspects are addressed, including common law, criminal penalties, and the merchant's liability. Tangential questions and answers are presented along with discussion of pertinent court cases. (LBH)

  8. Suspected poisoning of domestic animals by pesticides. (United States)

    Caloni, Francesca; Cortinovis, Cristina; Rivolta, Marina; Davanzo, Franca


    A retrospective study was carried out by reviewing all suspected cases of domestic animal poisoning attributed to pesticides, reported to the Milan Poison Control Centre (MPCC) between January 2011 and December 2013. During this period, pesticides were found to be responsible for 37.3% of all suspected poisoning enquiries received (815). The most commonly species involved was the dog (71.1% of calls) followed by the cat (15.8%), while a limited number of cases involved horses, goats and sheep. Most cases of exposure (47.1%) resulted in mild to moderate clinical signs. The outcome was reported in 59.9% of these cases, with death occurring in 10.4% of them. Insecticides (40.8%) proved to be the most common group of pesticides involved and exposure to pyrethrins-pyrethroids accounted for the majority of calls. According to the MPCC data, there has been a decrease in the number of suspected poisonings cases attributed to pesticides that have been banned by the EU, including aldicarb, carbofuran, endosulfan and paraquat. In contrast, there has been an increase of suspected poisoning cases attributed to the neonicotinoids, imidacloprid and acetamiprid, probably due to their widespread use in recent years. Cases of suspected poisoning that involved exposure to rodenticides accounted for 27.6% of calls received by the MPCC and anticoagulant rodenticides were the primary cause of calls, with many cases involving brodifacoum and bromadiolone. Herbicides were involved in 14.2% of calls related to pesticides and glyphosate was the main culprit in cases involving dogs, cats, horses, goats and sheep. As far as exposure to molluscicides (11.5%) and fungicides (5.9%), most of the cases involved dogs and the suspected poisoning agents were metaldehyde and copper compounds respectively. The data collected are useful in determining trends in poisoning episodes and identifying newly emerging toxicants, thus demonstrating the prevalence of pesticides as causative agents in animal

  9. Identification and assessment of students with disabilities. (United States)

    Reschly, D J


    Students with disabilities or suspected disabilities are evaluated by schools to determine whether they are eligible for special education services and, if eligible, to determine what services will be provided. In many states, the results of this evaluation also affect how much funding assistance the school will receive to meet the students' special needs. Special education classification is not uniform across states or regions. Students with identical characteristics can be diagnosed as disabled in one state but not in another and may be reclassified when they move across state or school district lines. Most disabilities with a clear medical basis are recognized by the child's physician or parents soon after birth or during the preschool years. In contrast, the majority of students with disabilities are initially referred for evaluation by their classroom teacher (or parents) because of severe and chronic achievement or behavioral problems. There is evidence that the prevalence of some disabilities varies by age, the high-incidence disabilities such as learning disabilities and speech-language disabilities occur primarily at the mild level, the mild disabilities exist on broad continua in which there are no clear demarcations between those who have and those who do not have the disability, and even "mild" disabilities may constitute formidable barriers to academic progress and significantly limit career opportunities. Problems with the current classification system include stigma to the child, low reliability, poor correlation between categorization and treatment, obsolete assumptions still in use in treatment, and disproportionate representation of minority students. Both African-American and Hispanic students are disproportionately represented in special education but in opposite directions. The disproportionately high number of African Americans in special education reflects the fact that more African-American students than white students are diagnosed with

  10. Tocolytics for suspected intrapartum fetal distress. (United States)

    Kulier, R; Hofmeyr, G J


    Prophylactic tocolysis with betamimetics and other agents has become widespread as a treatment for fetal distress. Uterine relaxation may improve placental blood flow and therefore fetal oxygenation. However there may also be adverse maternal cardiovascular effects. The objective of this review was to assess the effects of tocolytic therapy for suspected fetal distress on fetal, maternal and perinatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: February 1999. Randomised trials comparing tocolytic therapy with no treatment or treatment with another tocolytic agent for suspected fetal distress. Two reviewers assessed trial quality and extracted data. Three studies were included. Compared with no treatment, there were fewer failed improvements in fetal heart rate abnormalities with tocolytic therapy (relative risk 0.26, 95% 0.13 to 0.53). Betamimetic therapy compared with magnesium sulphate showed a non-significant trend towards reduced uterine activity (relative risk 0.07, 95% confidence interval 0.00 to 1.10). Betamimetic therapy appears to be able to reduce the number of fetal heart rate abnormalities and perhaps reduce uterine activity. However there is not enough evidence based on clinically important outcomes to evaluate the use of betamimetics for suspected fetal distress.

  11. B Plant/WESF suspect/counterfeit parts identification program

    Energy Technology Data Exchange (ETDEWEB)

    Mertz, D.W.


    This document describes a suspect/counterfeit parts inspection program required by DOE conducted in accordance with Internal Memo 16710-94-DWM-048, J.A. O`Brien to J. N. Nansen, B Plant Suspect/ Counterfeit Parts Action Plan, dated May 24, 1994. The program included: physical inspection of all spare parts inventories within the plant; screening of installed B Plant/WESF (Waste Encapsulation and Storage Facility) systems for applications where the use and subsequent potential failure of suspect/counterfeit parts could have critical consequences; and a physical inspection based upon this screening.

  12. SSA Disability Claim Data (United States)

    Social Security Administration — The dataset includes fiscal year data for initial claims for SSA disability benefits that were referred to a state agency for a disability determination. Specific...

  13. Learning Disabilities (United States)

    ... Situations Talking to Your Parents - or Other Adults Learning Disabilities KidsHealth > For Teens > Learning Disabilities Print A ... study engineering as he'd hoped? What Are Learning Disabilities? For someone diagnosed with a learning disability, ...

  14. Pre-admission antibiotics for suspected cases of meningococcal disease. (United States)

    Sudarsanam, Thambu D; Rupali, Priscilla; Tharyan, Prathap; Abraham, Ooriapadickal Cherian; Thomas, Kurien


    Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis. To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different pre-admission antibiotic regimens in decreasing mortality, clinical failure and morbidity in people suspected of meningococcal disease. We updated searches of CENTRAL (2013, Issue 4), MEDLINE (1966 to April week 4, 2013), EMBASE (1980 to May 2013), Web of Science (1985 to May 2013), CAB Abstracts (1985 to May 2013), LILACS (1982 to May 2013) and prospective trials registries to May 2013. Randomised controlled trials (RCTs) or quasi-RCTs comparing antibiotics versus placebo or no intervention, in people with suspected meningococcal infection, or different antibiotics administered before admission to hospital or confirmation of the diagnosis. Two review authors independently assessed trial quality and extracted data from the search results. We calculated the risk ratio (RR) and 95% confidence interval (CI) for dichotomous data. We included only one trial so data synthesis was not performed. We assessed the overall quality of the evidence using the GRADE approach. We found no RCTs that compared pre-admission antibiotics versus no pre-admission antibiotics or placebo. One open-label, non-inferiority RCT, conducted during an epidemic in Niger, evaluated a single dose of intramuscular ceftriaxone versus a single dose of intramuscular long-acting (oily) chloramphenicol. Ceftriaxone was not inferior to chloramphenicol in reducing mortality (RR 1.2, 95% CI 0.6 to 2.6; N = 503; 308 confirmed meningococcal meningitis; 26 deaths; moderate-quality evidence), clinical failures (RR 0.8, 95% CI 0.3 to 2.2; N = 477, 18 clinical failures; moderate-quality evidence) or neurological sequelae (RR 1.3, 95% CI 0.6 to 2.6; N

  15. Including People with Disabilities: An Indigenous Perspective (United States)

    Bevan-Brown, Jill


    Being victims of racial prejudice, religious intolerance, poverty, disempowerment and language loss it could be expected that indigenous people would be supportive of the Inclusion Movement with its philosophy of valuing and acceptance of all people. This supposition is examined for Maori, the indigenous people of Aotearoa/New Zealand. In…

  16. A model for developing disability confidence. (United States)

    Lindsay, Sally; Cancelliere, Sara


    Many clinicians, educators, and employers lack disability confidence which can affect their interactions with, and inclusion of people with disabilities. Our objective was to explore how disability confidence developed among youth who volunteered with children who have a disability. We conducted 30 in-depth interviews (16 without a disability, 14 with disabilities), with youth aged 15-25. We analyzed our data using an interpretive, qualitative, thematic approach. We identified four main themes that led to the progression of disability confidence including: (1) "disability discomfort," referring to lacking knowledge about disability and experiencing unease around people with disabilities; (2) "reaching beyond comfort zone" where participants increased their understanding of disability and became sensitized to difference; (3) "broadened perspectives" where youth gained exposure to people with disabilities and challenged common misperceptions and stereotypes; and (4) "disability confidence" which includes having knowledge of people with disabilities, inclusive, and positive attitudes towards them. Volunteering is one way that can help to develop disability confidence. Youth with and without disabilities both reported a similar process of developing disability confidence; however, there were nuances between the two groups. Implications for Rehabilitation The development of disability confidence is important for enhancing the social inclusion of people with disabilities. Volunteering with people who have a disability, or a disability different from their own, can help to develop disability confidence which involves positive attitudes, empathy, and appropriate communication skills. Clinicians, educators, and employers should consider promoting working with disabled people through such avenues as volunteering or service learning to gain disability confidence.

  17. Book Review: Placing the Suspect behind the Keyboard: Using Digital Forensics and Investigative Techniques to Identify Cybercrime Suspects

    Directory of Open Access Journals (Sweden)

    Thomas Nash


    Full Text Available Shavers, B. (2013. Placing the Suspect behind the Keyboard: Using Digital Forensics and Investigative Techniques to Identify Cybercrime Suspects. Waltham, MA: Elsevier, 290 pages, ISBN-978-1-59749-985-9, US$51.56. Includes bibliographical references and index.Reviewed by Detective Corporal Thomas Nash (, Burlington Vermont Police Department, Internet Crime against Children Task Force. Adjunct Instructor, Champlain College, Burlington VT.In this must read for any aspiring novice cybercrime investigator as well as the seasoned professional computer guru alike, Brett Shaver takes the reader into the ever changing and dynamic world of Cybercrime investigation.  Shaver, an experienced criminal investigator, lays out the details and intricacies of a computer related crime investigation in a clear and concise manner in his new easy to read publication, Placing the Suspect behind the Keyboard. Using Digital Forensics and Investigative techniques to Identify Cybercrime Suspects. Shaver takes the reader from start to finish through each step of the investigative process in well organized and easy to follow sections, with real case file examples to reach the ultimate goal of any investigation: identifying the suspect and proving their guilt in the crime. Do not be fooled by the title. This excellent, easily accessible reference is beneficial to both criminal as well as civil investigations and should be in every investigator’s library regardless of their respective criminal or civil investigative responsibilities.(see PDF for full review

  18. Nonreferral of Nursing Home Patients With Suspected Breast Cancer

    NARCIS (Netherlands)

    Hamaker, Marije E.; Hamelinck, Victoria C.; van Munster, Barbara C.; Bastiaannet, Esther; Smorenburg, Carolien H.; Achterberg, Wilco P.; Liefers, Gerrit-Jan; de Rooij, Sophia E.


    Introduction: People with suspected breast cancer who are not referred for diagnostic testing remain unregistered and are not included in cancer statistics. Little is known about the extent of and motivation for nonreferral of these patients. Methods: A Web-based survey was sent to all elderly care

  19. Medical Evaluation of Suspected Child Sexual Abuse: 2011 Update (United States)

    Adams, Joyce A.


    The medical evaluation of children with suspected sexual abuse includes more than just the physical examination of the child. The importance of taking a detailed medical history from the parents and a history from the child about physical sensations following sexual contact has been emphasized in other articles in the medical literature. The…

  20. Ajmaline challenge in young individuals with suspected Brugada syndrome

    NARCIS (Netherlands)

    Sorgente, A.; Sarkozy, A.; Asmundis, C. de; Chierchia, G.B.; Capulzini, L.; Paparella, G.; Henkens, S.; Brugada, P.


    BACKGROUND: The clinical characteristics and the results of ajmaline challenge in young individuals with suspected Brugada syndrome (BS) have not been systematically investigated. METHODS: Among a larger series of patients included in the BS database of our Department, 179 patients undergoing

  1. Disability Identity--Disability Pride (United States)

    Martin, Nicola


    This paper discusses a way of thinking about disability which has emerged out of the UK Disabled People's Movement over the last three decades in opposition to the preceding medical model of disability which viewed disability as synonymous with problem. Disabled people are increasingly challenging the notion that their embodiment is inherently…

  2. FY 2014 Workload Data - Disability Decisions (United States)

    Social Security Administration — This dataset provides yearly data for Disability Decisions that includes Title II, Title XVI, and concurrent initial disability determinations and appeals decisions...

  3. Learning disabilities: the need for neuropsychological evaluation. (United States)

    Silver, Cheryl H; Ruff, Ronald M; Iverson, Grant L; Barth, Jeffrey T; Broshek, Donna K; Bush, Shane S; Koffler, Sandra P; Reynolds, Cecil R


    A learning disability (LD) is a neurobiological disorder that presents as a serious difficulty with reading, arithmetic, and/or written expression that is unexpected, given the individual's intellectual ability. A learning disability is not an emotional disorder nor is it caused by an emotional disorder. If inadequately or improperly evaluated, a learning disability has the potential to impact an individual's functioning adversely and produce functional impairment in multiple life domains. When a learning disability is suspected, an evaluation of neuropsychological abilities is necessary to determine the source of the difficulty as well as the areas of neurocognitive strength that can serve as a foundation for compensatory strategies and treatment options.

  4. Prevalence of IgE sensitization in Danish children with suspected asthma

    DEFF Research Database (Denmark)

    Hoffmann-Petersen, Benjamin; Høst, Arne; Larsen, Kirsten Toksvig


    OBJECTIVE: The aim of this article was to estimate the prevalence of IgE sensitization in Danish children with suspected asthma and to characterize the pattern of sensitization. STUDY DESIGN: We performed a cross-sectional study including 1744 children from 0 to 15 yr suspected of asthma who were...

  5. A case of suspect “cyanosis”


    Elisabetta Antonucci; Matteo Conte; Michele Di Pumpo; Giuseppe Antonucci


    CLINICAL CASE A 70-year old woman was admitted to our hospital because of fever, asthenia and a suspected stroke. Her medical history showed a congenital cardiopathy (Patent Foramen Ovale, PFO). Skin and oral mucosa pigmentation, orthostatic hypotension, hypoglycemia and hyponatriemia arose the suspect of Addison’s disease. The diagnosis was confirmed by the evaluation of basal levels of plasma ACTH and serum cortisol, and serum cortisol levels after ACTH stimulation. Abdominal CT scan showed...

  6. MRI for clinically suspected pediatric appendicitis: case interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Brian, James M.; Methratta, Sosamma T.; Hulse, Michael A.; Choudhary, Arabinda K.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Division of Pediatric Radiology, Department of Radiology, Hershey, PA (United States)


    As utilization of MRI for clinically suspected pediatric appendicitis becomes more common, there will be increased focus on case interpretation. The purpose of this pictorial essay is to share our institution's case interpretation experience. MRI findings of appendicitis include appendicoliths, tip appendicitis, intraluminal fluid-debris level, pitfalls of size measurements, and complications including abscesses. The normal appendix and inguinal appendix are also discussed. (orig.)

  7. Disability and global development. (United States)

    Durocher, Joan; Lord, Janet; Defranco, Allison


    The United States invests billions of taxpayer dollars each year into foreign assistance programs that foster international diplomacy and development directed toward improving the quality of life for people around the world. These programs develop economies and combat poverty, promote democracy and governance, build new infrastructure, advance and protect human rights, among other development goals. The United States cannot effectively accomplish the goals of foreign assistance programs unless it undertakes measures to ensure that the programs are accessible to and inclusive of people with disabilities. The United States has been a leader in advancing the rights of people with disabilities and must continue to promote disability rights through its international development work. Overseas economic development will not be successful unless people with disabilities are included. Because of the significant number of people with disabilities in developing countries, if they are not included, the very economic growth the United States is trying to foster will be hindered. The goals of democracy and governance programs cannot be achieved without the inclusion of people with disabilities. In many countries, domestic law contains blatant discriminatory provisions for people with disabilities that undermine access to justice and full participation in society. The provisions that discriminate against people with disabilities include arbitrary exclusions in electoral codes, sweeping plenary guardianship laws with no due-process protections, discriminatory banking practices, and inaccessible court proceedings. National disability legal frameworks remain underdeveloped throughout the world. Copyright © 2012. Published by Elsevier Inc.

  8. Magnetic resonance imaging versus bone scintigraphy in suspected scaphoid fracture

    Energy Technology Data Exchange (ETDEWEB)

    Tiel-van Buul, M.M.C. [Dept. of Nuclear Medicine, Academic Medical Center, Univ. of Amsterdam (Netherlands); Roolker, W. [Dept. of Nuclear Medicine, Academic Medical Center, Univ. of Amsterdam (Netherlands); Verbeeten, B.W.B. Jr. [Dept. of Radiology, Academic Medical Center, Univ. of Amsterdam (Netherlands); Broekhuizen, A.H. [Dept. of Traumatology, Academic Medical Center, Univ. of Amsredam (Netherlands)


    Magnetic resonance imaging (MRI) has become increasingly useful in the evaluation of musculoskeletal problems, including those of the wrist. In patients with a wrist injury, MRI is used mainly to assess vascularity of scaphoid non-union. However, the use of MRI in patients in the acute phase following carpal injury is not common. Three-phase bone scintigraphy is routinely performed from at least 72 h after injury in patients with suspected scaphoid fracture and negative initial radiographs. We evaluated MRI in this patient group. The bone scan was used as the reference method. Nineteen patients were included. Bone scintigraphy was performed in all 19 patients, but MRI could be obtained in only 16 (in three patients, MRI was stopped owing to claustrophobia). In five patients, MRI confirmed a scintigraphically suspected scaphoid fracture. In one patient, a perilunar luxation, without a fracture, was seen on MRI, while bone scintigraphy showed a hot spot in the region of the lunate bone, suspected for fracture. This was confirmed by surgery. In two patients, a hot spot in the scaphoid region was suspected for scaphoid fracture, and immobilization and employed for a period of 12 weeks. MRI was negative in both cases; in one of them a scaphoid fracture was retrospectively proven on the initial X-ray series. In another two patients, a hot spot in the region of MCP I was found with a negative MRI. In both, the therapy was adjusted. In the remaining six patients, both modalities were negative. We conclude that in the diagnostic management of patients with suspected scaphoid fracture and negative initial radiographs, the use of MRI may be promising, but is not superior to three-phase bone scintigraphy. (orig.)

  9. Magnetic resonance imaging of suspected atrial tumors. (United States)

    Menegus, M A; Greenberg, M A; Spindola-Franco, H; Fayemi, A


    Two-dimensional echocardiography has become the standard technique for evaluation of cardiac and paracardiac mass lesions. We have used magnetic resonance imaging (MRI) as an independent assessment of cardiac-associated masses in patients with echocardiograms demonstrating sessile atrial tumors. MRI was performed in seven patients, ages 33 to 84, whose echocardiographic diagnoses included left atrial mass (five), right atrial mass (one), and interatrial mass (one). In four of the patients with a diagnosis of left atrial mass, MRI showed extracardiac compression of the atrium, simulating a tumor (hiatal hernia, tortuous descending aorta, bronchogenic cyst). MRI was entirely normal in one patient with an apparent left atrial mass. MRI elucidated extension of an extracavitary mass into the interatrial septum in two patients. One of these patients with an echocardiographic right atrial mass had extension of a lipoma into the interatrial septum without atrial tumor. MRI confirmed the echocardiographic diagnosis of an interatrial mass in the other patient. We conclude that MRI, because of its ability to define anatomic relationships and tissue characteristics, is a powerful noninvasive tool for evaluating suspected cardiac mass lesions. Although echocardiography remains the primary screening test for the detection of cardiac masses, MRI is a more specific modality for precise diagnosis. Correct MRI interpretation may obviate the need for invasive studies or surgery.

  10. Rounding up the usual suspects

    DEFF Research Database (Denmark)

    Dimitrov, Dimitar; Benevidas, Ligia R.; Arnedo, Miquel A.


    We test the limits of the spider superfamily Araneoidea and reconstruct its interfamilial relationships using standard molecular markers. The taxon sample (363 terminals) comprises for the first time representatives of all araneoid families, including the first molecular data of the family Synaph...

  11. The phenomenology of specialization of criminal suspects.

    Directory of Open Access Journals (Sweden)

    Michele Tumminello

    Full Text Available A criminal career can be either general, with the criminal committing different types of crimes, or specialized, with the criminal committing a specific type of crime. A central problem in the study of crime specialization is to determine, from the perspective of the criminal, which crimes should be considered similar and which crimes should be considered distinct. We study a large set of Swedish suspects to empirically investigate generalist and specialist behavior in crime. We show that there is a large group of suspects who can be described as generalists. At the same time, we observe a non-trivial pattern of specialization across age and gender of suspects. Women are less prone to commit crimes of certain types, and, for instance, are more prone to specialize in crimes related to fraud. We also find evidence of temporal specialization of suspects. Older persons are more specialized than younger ones, and some crime types are preferentially committed by suspects of different ages.

  12. Ecological Congruence and the Identification of Learning Disabilities (United States)

    Riddle, Shayna


    Background: In the debate about how to evaluate students suspected of having a learning disability, the role of context in learning has been consistently minimized in the United States. Objective: This article explores the implications of the current, deficit-based approach to the definition and assessment of learning disabilities and offers a…

  13. A case of suspect “cyanosis”

    Directory of Open Access Journals (Sweden)

    Elisabetta Antonucci


    Full Text Available CLINICAL CASE A 70-year old woman was admitted to our hospital because of fever, asthenia and a suspected stroke. Her medical history showed a congenital cardiopathy (Patent Foramen Ovale, PFO. Skin and oral mucosa pigmentation, orthostatic hypotension, hypoglycemia and hyponatriemia arose the suspect of Addison’s disease. The diagnosis was confirmed by the evaluation of basal levels of plasma ACTH and serum cortisol, and serum cortisol levels after ACTH stimulation. Abdominal CT scan showed atrophy and calcification of adrenal glands. CONCLUSIONS In most cases, Addison’s disease is provoked by autoimmune destruction of the adrenal cortex; however, in our reported patient, tuberculosis could be a possible cause.

  14. Suspected side effects to the quadrivalent human papilloma vaccine

    DEFF Research Database (Denmark)

    Brinth, Louise; Theibel, Ann Cathrine; Pors, Kirsten


    INTRODUCTION: The quadrivalent vaccine that protects against human papilloma virus types 6, 11, 16 and 18 (Q-HPV vaccine, Gardasil) was included into the Danish childhood vaccination programme in 2009. During the past years, a collection of symptoms primarily consistent with sympathetic nervous...... system dysfunction have been described as suspected side effects to the Q-HPV vaccine. METHODS: We present a description of suspected side effects to the Q-HPV vaccine in 53 patients referred to our Syncope Unit for tilt table test and evaluation of autonomic nervous system function. RESULTS: All...... consistency in the reported symptoms as well as between our findings and those described by others. Our findings neither confirm nor dismiss a causal link to the Q-HPV vaccine, but they suggest that further research is urgently warranted to clarify the pathophysiology behind the symptoms experienced...

  15. Percutaneous cholecystocentesis in cats with suspected hepatobiliary disease. (United States)

    Byfield, Victoria L; Callahan Clark, Julie E; Turek, Bradley J; Bradley, Charles W; Rondeau, Mark P


    Objectives The objective was to evaluate the safety and diagnostic utility of percutaneous ultrasound-guided cholecystocentesis (PUC) in cats with suspected hepatobiliary disease. Methods Medical records of 83 cats with suspected hepatobiliary disease that underwent PUC were retrospectively reviewed. Results At the time of PUC, at least one additional procedure was performed in 79/83 cats, including hepatic aspiration and/or biopsy (n = 75) and splenic aspiration (n = 18). Complications were noted in 14/83 cases, including increased abdominal fluid (n = 11), needle-tip occlusion (n = 1), failed first attempt to penetrate the gall bladder wall (n = 1) and pneumoperitoneum (n = 1). There were no reports of gall bladder rupture, bile peritonitis or hypotension necessitating treatment with vasopressor medication. Blood products were administered to 7/83 (8%) cats. Seventy-two cats (87%) survived to discharge. Of the cats that were euthanized (9/83) or died (2/83), none were reported as a definitive consequence of PUC. Bacteria were identified cytologically in 10/71 samples (14%); all 10 had a positive aerobic bacterial culture. Bile culture was positive in 11/80 samples (14%). Of the cases with a positive bile culture, cytological description of bacteria corresponded to the organism cultured in fewer than 50% of cases. The most common cytologic diagnosis was hepatic lipidosis (49/66). The most common histopathologic diagnosis was cholangitis (10/21). Conclusions and relevance PUC was safe in this group of cats with suspected hepatobiliary disease. Complications were likely associated with ancillary procedures performed at the time of PUC. Bile analysis yielded an abnormal result in nearly one-third of cats with suspected hepatobiliary disease. Complete agreement between bile cytology and culture was lacking. Further evaluation of the correlation between bile cytology and bile culture is warranted.

  16. Epidemiology of suspected wrist joint infection versus inflammation. (United States)

    Skeete, Kshamata; Hess, Erik P; Clark, Tod; Moran, Steven; Kakar, Sanjeev; Rizzo, Marco


    To determine the cumulative prevalence of septic arthritis presenting to the emergency department of an academic medical center and evaluate the use of clinical data to diagnose infection versus inflammation. We conducted a records review of a single institution with 80,000 annual emergency room visits. We included a consecutive series of patients with suspected wrist infection from January 1, 2007, to December 31, 2008. Adults complaining of atraumatic wrist pain with either erythema or swelling on physical examination or a final diagnosis of septic arthritis, gout, pseudogout, cellulitis, wrist hematoma/edema, or wrist arthritic flare were suspected to have infection. We collected data using a standardized data abstraction form. We reviewed 804 patient records. A total of 104 patients meeting inclusion criteria for suspected wrist joint infection during the 2-year study period were included. Mean age was 62.5 years (SD, 20.2 y); 63 were men. There were 12 patients with a history of gout, 4 with a history of pseudogout, and 19 with a history of diabetes. Wrist arthrocentesis was performed in 31 patients, and 11 underwent surgical treatment. There were 16 patients with a final diagnosis of gout, 11 with pseudogout, 43 with cellulitis, 13 with upper extremity hematoma/edema, and 15 with wrist arthritic flare. The cumulative prevalence of septic arthritis was 5%. In this series of emergency department patients with suspected wrist joint infection, gout, pseudogout, and cellulitis were the most common etiologies. The cumulative incidence of septic wrist arthritis was low. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  17. Congenital Malaria Among Newborns Admitted for Suspected ...

    African Journals Online (AJOL)

    Background: Signs and symptoms of congenital malaria do not differ much from those of neonatal sepsis: both can co-exist, and most times very difficult to differentiate clinically. Objective: To document the prevalence, risk factors for congeni tal malar ia among neonates admitted for suspected neonatal sepsis, and ...

  18. Congenital Malaria Among Newborns Admitted for Suspected ...

    African Journals Online (AJOL)

    None of the clinical feature had good sensitivity, specificity or predictive value for congenital malaria, and only 1.6% death was recorded in a baby with high parasite density. Conclusion: Congenital malaria is common in newborns with suspected neonatal sepsis. History of peripartum pyrexia, prematurity and intrauterine ...

  19. MRI for clinically suspected appendicitis during pregnancy.

    NARCIS (Netherlands)

    Cobben, L.P.; Groot, I.; Haans, L.; Blickman, J.G.; Puylaert, J.


    OBJECTIVE: The purpose of this study was to evaluate whether MRI can be used to accurately diagnose or exclude appendicitis in pregnant patients with clinically suspected appendicitis. CONCLUSION: Our results suggest that MRI is helpful in the examination and diagnosis of acute appendicitis in

  20. Biomechanical properties of keratoconus suspect eyes. (United States)

    Saad, Alain; Lteif, Yara; Azan, Elodie; Gatinel, Damien


    Measuring corneal biomechanical properties may help detect keratoconus suspect corneas and eliminate the risk of ectasia after LASIK. Data of 504 eyes separated into three groups were retrospectively reviewed: normal (n = 252), keratoconus suspect (n = 80), and keratoconus (n = 172). Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with an ocular biomechanics analyzer. Mean corneal hysteresis was 10.6 +/- 1.4 (SD) mm Hg in the normal group, compared with 10.0 +/- 1.6 mm Hg in the keratoconus suspect group and 8.1 +/- 1.4 mm Hg in the keratoconus group. The mean CRF was 10.6 +/- 1.6 mm Hg in the normal group compared with 9.7 +/- 1.7 in the keratoconus suspect group and 7.1 +/- 1.6 mm Hg in the keratoconus group. Mean CH and CRF were significantly different between the three groups (P corneas. Analyzing signal curves obtained with the biomechanics analyzer may provide additional valuable information for selecting qualified patients for refractive surgery.

  1. Characterization of suspected illegal skin whitening cosmetics. (United States)

    Desmedt, B; Van Hoeck, E; Rogiers, V; Courselle, P; De Beer, J O; De Paepe, K; Deconinck, E


    An important group of suspected illegal cosmetics consists of skin bleaching products, which are usually applied to the skin of the face, hands and décolleté for local depigmentation of hyper pigmented regions or more importantly, for a generalized reduction of the skin tone. These cosmetic products are suspected to contain illegal active substances that may provoke as well local as systemic toxic effects, being the reason for their banning from the EU market. In that respect, illegal and restricted substances in cosmetics, known to have bleaching properties, are in particular hydroquinone, tretinoin and corticosteroids. From a legislative point of view, all cosmetic products containing a prohibited whitening agent are illegal and must be taken off the EU market. A newly developed screening method using ultra high performance liquid chromatography-time off flight-mass spectrometry allows routine analysis of suspected products. 163 suspected skin whitening cosmetics, collected by Belgian inspectors at high risk sites such as airports and so-called ethnic cosmetic shops, were analyzed and 59% were classified as illegal. The whitening agents mostly detected were clobetasol propionate and hydroquinone, which represent a serious health risk when repeatedly and abundantly applied to the skin. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Suspecting Neurological Dysfunction From E Mail Messages ...

    African Journals Online (AJOL)

    A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

  3. Workers with disabilities. (United States)

    Blanck, P D; Pransky, G


    Individuals with disabilities constitute a sizable portion of the workforce and represent the majority of working-age persons who are unable to work. Historically, barriers to employment have included attitudinal discrimination by employers, lack of workplace accommodations, and inadequate job training. The disability rights movement has achieved considerable success in promoting legislation to remove these barriers and uphold equal employment. Research suggests that many employers actively attempt to incorporate persons with disabilities into the workforce and gain substantial economic benefit from their participation, without incurring burdensome expenses. Occupational health providers are asked by employers and others to provide input on feasibility and safety, a difficult task given the lack of scientific study on the occupational abilities and risks associated with specific disabilities. Providers have an important role in promoting the equal employment of disabled persons, by providing objective opinions on their ability and risks on the job and suggesting workplace accommodations and treatments that enhance the ability to work.

  4. Predictors of bacteremia in emergency department patients with suspected infection. (United States)

    Chase, Maureen; Klasco, Richard S; Joyce, Nina R; Donnino, Michael W; Wolfe, Richard E; Shapiro, Nathan I


    The goal of this study is to identify clinical variables associated with bacteremia. Such data could provide a rational basis for blood culture testing in emergency department (ED) patients with suspected infection. This is a secondary analysis of a prospective cohort of ED patients with suspected infection. Data collected included demographics, vital signs, medical history, suspected source of infection, laboratory and blood culture results and outcomes. Bacteremia was defined as a positive blood culture by Centers for Disease Control criteria. Clinical variables associated with bacteremia on univariate logistic regression were entered into a multivariable model. There were 5630 patients enrolled with an average age of 59.9 ± 19.9 years, and 54% were female. Blood cultures were obtained on 3310 (58.8%). There were 409 (12.4%) positive blood cultures, of which 68 (16.6%) were methicillin-resistant Staphylococcus aureus (MRSA) and 161 (39.4%) were Gram negatives. Ten covariates (respiratory failure, vasopressor use, neutrophilia, bandemia, thrombocytopenia, indwelling venous catheter, abnormal temperature, suspected line or urinary infection, or endocarditis) were associated with all-cause bacteremia in the final model (c-statistic area under the curve [AUC], 0.71). Additional factors associated with MRSA bacteremia included end-stage renal disease (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.9-7.8) and diabetes (OR, 2.0; 95% CI, 1.1-3.6) (AUC, 0.73). Factors strongly associated with Gram-negative bacteremia included vasopressor use in the ED (OR, 2.8; 95% CI, 1.7-4.6), bandemia (OR, 3.5; 95% CI, 2.3-5.3), and suspected urinary infection (OR, 4.0; 95% CI, 2.8-5.8) (AUC, 0.75). This study identified several clinical factors associated with bacteremia as well as MRSA and Gram-negative subtypes, but the magnitude of their associations is limited. Combining these covariates into a multivariable model moderately increases their predictive value. Copyright

  5. MR delayed enhancement imaging findings in suspected acute myocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Gahide, Gerald [CHU de Montpellier, Radiologie centrale - Pole Cardiovasculaire et Thoracique, Montpellier (France); Centre Hospitalo-Universitaire de Montpellier, Hopital A de Villeneuve, Montpellier (France); Bertrand, D.; Dacher, J.N. [CHU de Rouen, Radiologie centrale - Hopital Charles Nicolle, Rouen (France); Roubille, F.; Skaik, S.; Piot, C.; Leclerq, F. [CHU de Montpellier, Departement de Cardiologie - Pole Cardiovasculaire et Thoracique, Montpellier (France); Tron, C.; Cribier, A. [CHU de Rouen, Departement de Cardiologie - Hopital Charles Nicolle, Rouen (France); Vernhet, H. [CHU de Montpellier, Radiologie centrale - Pole Cardiovasculaire et Thoracique, Montpellier (France)


    The purpose of the study was to prospectively assess the clinical impact of routinely performed delayed enhancement imaging in suspected acute myocarditis. A two-centre prospective study was performed in patients with suspected acute myocarditis. The protocol included horizontal long axis, vertical long axis and short axis cine MR and delayed enhancement imaging after Gd-DTPA infusion (0.2 mmol/kg). Sixty consecutive patients were enrolled (aged 49.4{+-}17.8 years). MRI demonstrated delayed enhancement sparing the subendocardicardial layer in 51.6% of patients, concordant with the diagnosis of acute myocarditis; 16.7% of patients exhibited delayed enhancement involving the subendocardial layer with irregular margins, concordant with the diagnosis of acute myocardial infarction; 31.7% of patients had delayed enhancement imaging that was considered normal. Routine imaging to identify delayed enhancement provided crucial information in suspected acute myocarditis by reinforcing the diagnosis in 51.6% of patients and correcting a misdiagnosed acute myocardial infarction in 16.7% of patients. (orig.)

  6. Limitation of personal freedom by detention of suspect

    Directory of Open Access Journals (Sweden)

    Knežević Saša


    Full Text Available The right of personal freedom is one of the most important right from the set of basic human rights and freedoms, contained in the most important acts of international legal character, and the constitutions of states based on the rule of law. This right is directly related to the very human existence, and, therefore, it is necessary to make its legal articulation. Personal freedom means the right to security of the citizen, that he will not be arrested and detained in prison by the state authorities, as well as the right to be free to move and inhabit. However, from the very nature of Criminal Law protection of social values, arises the need to limit the right to personal freedom in exceptional circumstances, including the detention of the suspect. Keeping the suspect is a measure of procedural compulsion, by which, through the police decision, detained prison is temporarily imprisoned, for gathering information and hearing. The basic principles of humanity require that the detained suspect retains all the rights, derived from the principle of personal liberty.

  7. MRI for clinically suspected pediatric appendicitis: an implemented program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Gustas, Cristy N.; Choudhary, Arabinda K.; Methratta, Sosamma T.; Hulse, Michael A.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Department of Radiology, Mail Code H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Geeting, Glenn [Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, PA (United States)


    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  8. Suspects in criminal investigations of rape

    Directory of Open Access Journals (Sweden)

    Marinković Darko


    Full Text Available Investigations of sexual assaults mostly focus on victims and their credibility, which may cause lack of firm evidence in relation to suspects. Given the fact that the criminal offence of rape is characterised by a high incidence of false reports and accusations, frequently indicating specific persons as the perpetrators, certain caution is necessary in the investigation in order to avoid false accusations and/or convictions. As regards the personality of the rapist and motives for committing a forcible sexual act, certain types or rather certain categories of perpetrators can be distinguished, although it should be noted that a large number of rapists do not belong to one category only, but rather combine characteristics of several different types. During a criminal investigation it is of vital importance to differentiate between a rape as a surprise attack and a rape as abuse of trust, as they are compatible with the nature of the suspect's defence. The suspect shall be subjected to a forensic examination in the course of the investigation in order to find traces which prove vaginal, anal or oral penetration, coerced sexual intercourse and identity of the rapist. While conducting an interrogation of a suspected rapist, a crime investigating officer shall use either factual or emotional approach to his interviewee, depending on his psychological and motivational characteristics. In this regard, the factual approach is believed to be more efficient with anger rapists and sadistic rapists, whereas the compassionate approach gives good results with the gentlemen-rapists and partly with the power asserting rapists.

  9. Glaucoma suspect & Humphrey Field Analyzer a correlation

    Directory of Open Access Journals (Sweden)

    P Dahal


    Full Text Available Glaucoma originally meant "clouded", in Greek.The term glaucoma refers to a group of diseases that have in common characteristic optic neuropathy with associated visual field loss for which elevated intraocular pressure is one of the primary risk factor. The purpose of the study is to correlate the clinically diagnosed cases of glaucoma suspect with the Humphrey Field Analyzer (HFA. Fifty cases of glaucoma suspect who attended the glaucoma clinic of Nepal Eye Hospital Tripureswor, Kathmandu, Nepal and who meets at least two criteria, among the four types of glaucoma suspects were advised for the HFA for the study. In this study out of 50 patient, 36 (72% patients had normal visual field. 14 (28% patients had thinning of the neural retinal rim (NRR in both eyes. The significant relation with thinning of neural retina rim and glaucomatous hemifield test was found in the study. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 23-28 DOI:

  10. Infertility: Inability or Disability?

    Directory of Open Access Journals (Sweden)

    Abha Khetarpal


    Full Text Available Disability is a complex phenomenon. It reflects an interaction between features of a person’s body and features of the society in which he or she lives. International Classification of Functioning, Disability and Health (ICF, lays stress on the functional as well as the structural problem of a person. All the definitions of disability also include the disorders of the reproductive and endocrine system. So infertility and impotency should also be included in the category of disability. It affects the participation in areas of life and can have a disabling affect on an individual. Like any other disability the couple has to adapt and integrate infertility in their sense of self thus infertility comes as a major life crisis. Medically, infertility, in most cases, is considered to be the result of a physical impairment or a genetic abnormality. Socially, couples are incapable of their reproductive or parental roles. On social level, infertility in most cultures remains associated with social stigma and taboo just like the social model of disability. Couples who are unable to reproduce may be looked down upon due to social stigmatisation. Infertility can lead to divorces and separation leading to a broken family life. Without labelling infertility as a disability, it is difficult for the people to access services and welfare benefits offered by the government. Infertility treatments are highly sophisticated so they are very expensive and are even not covered by insurance and government aid.In the light of all this it becomes imperative to categorise infertility as disability.

  11. Learning Disabilities. (United States)

    McCarthy, James J.; McCarthy, Joan F.

    An attempt to collate basic knowledge concerning learning disabilities, the text discusses the background and definition of learning disabilities, and its identification, etiology, and epidemiology. Guidelines for diagnostic evaluation are presented as are approaches from perceptual motor, developmental, visual, neurophysiological, linguistic, and…

  12. Resuscitation characteristics and outcomes in suspected drug overdose-related out-of-hospital cardiac arrest. (United States)

    Koller, Allison C; Salcido, David D; Callaway, Clifton W; Menegazzi, James J


    We sought to compare characteristics of emergency medical services-treated out-of-hospital cardiac arrests resulting from suspected drug overdose with non-overdose cases and test the relationship between suspected overdose and survival to hospital discharge. Data from emergency medical services-treated, non-traumatic out-of-hospital cardiac arrests from 2006 to 2008 and late 2009 to 2011 were obtained from four EMS agencies in the Pittsburgh, Pennsylvania metropolitan area. Case definition for suspected drug overdose was naloxone administration, indication on the patient care report and/or indication by a review of hospital records. Resuscitation parameters included chest compression fraction, rate, and depth and the administration of resuscitation drugs. Demographic and outcome variables compared by suspected overdose status included age, sex, and survival to hospital discharge. From 2342 treated out-of-hospital cardiac arrests, 180 were suspected overdose cases (7.7%) and were compared to 2162 non-overdose cases. Suspected overdose cases were significantly younger (45 vs. 65, pcardiac arrest were younger, received different resuscitative care, and survived more often than non-overdose cases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Prevalence of glaucoma suspects and pattern of intra-ocular ...

    African Journals Online (AJOL)

    Background: Glaucoma is the commonest cause of irreversible blindness in the world. Some glaucoma patients start out as glaucoma suspects for years. Aim: To determine the prevalence of glaucoma suspects and pattern of intra-ocular pressure distribution in glaucoma suspects. Methods: This survey was carried out in ...

  14. Multiple Disabilities. NICHCY Disability Fact Sheet #10 (United States)

    National Dissemination Center for Children with Disabilities, 2013


    The term "multiple disabilities" is general and broad. From the term, you cannot tell how many disabilities a child has; which disabilities are involved; or how severe each disability is. Many combinations of disabilities are possible. The different disabilities will also have a combined impact. That is why it is also important to ask:…

  15. Disability Case Review of Administrative Law Judge Hearing Decisions (United States)

    Social Security Administration — The Disability Case Review is a post-effectuation quality review of administrative law judge (ALJ) disability hearing decisions. This dataset includes results from...

  16. Nuclear Pedigree Criteria of Suspected HNPCC

    Directory of Open Access Journals (Sweden)

    Kładny Józef


    Full Text Available Abstract The criteria for the diagnosis of HNPCC established by the ICG-HNPCC are very restrictive as they do not allow for the diagnosis of a large number of "suspected HNPCC" cases - these are families which do no fulfill the strict diagnostic "Amsterdam criteria", but do present with several pedigree and clinical features characteristic for HNPCC. Several series of families suspected of harboring germline mutations in DNA mismatch repair genes have been studied for germline changes in DNA mismatch repair genes and a mutation rate of somewhere between 8-60% was found. Therefore a subgroup of members of the ICG-HNPCC has been working on pedigree/clinical diagnostic criteria for suspected HNPCC. Materials and methods Part I The study was based on two series of colorectal cancer (CRC cases: 1 HNPCC - this group comprised 190 patients affected by CRC from randomly selected families which fulfilled the Amsterdam II criteria registered in Düsseldorf, Germany (102 cases of CRC, Denmark (18 CRCs, Leiden, Holland (23 CRCs and Szczecin, Poland (47 CRCs. 2 Consecutive CRCs - this group comprised 629 (78.0% of 806 individuals with CRC diagnosed in 1991-1997 in the city of Szczecin (ca. 400,000 of inhabitants, Poland. Nuclear pedigrees in both groups were compared for frequency of occurrence of clinical features, that have been shown to be associated with HNPCC. Part II 52 consecutive CRC cases from Szczecin, matching the criteria recognized in part I as appropriate for diagnosis of cases "suspected of HNPCC" were studied for the occurrence of germline hMSH2/hMLH1 constitutional mutations using "exon by exon" sequencing. Results The combination of features - i.e. the occurrence of an HNPCC associated cancer (CRC or cancer of the endometrium, small bowel or urinary tract in a 1st degree relative of a CRC patient; at least one of the patients being diagnosed under age of 50 - appeared to be strongly associated to HNPCC with an OR - 161. Constitutional

  17. Disability as Cultural Difference: Implications for Special Education (United States)

    Anastasiou, Dimitris; Kauffman, James M.


    This article critiques the treatment of disability as cultural difference by the theorists of the "social model" and "minority group model" of disability. Both models include all of the various disabling conditions under one term--disability--and fail to distinguish disabilities from cultural differences (e.g., race, ethnicity, or gender…

  18. Icare rebound tonometry in children with known and suspected glaucoma. (United States)

    Flemmons, Meghan S; Hsiao, Ya-Chuan; Dzau, Jacqueline; Asrani, Sanjay; Jones, Sarah; Freedman, Sharon F


    Accurate intraocular pressure (IOP) measurement, important in managing pediatric glaucoma, often presents challenges. The Icare rebound tonometer shows promise for screening healthy children and has been reported comparable with Goldmann applanation in adults with glaucoma. The purpose of this study was to evaluate the Icare tonometer against Goldmann applanation for clinic IOP measurement in pediatric glaucoma. This was a prospective study comparing Icare versus Goldmann tonometry in pediatric glaucoma. Children with known or suspected glaucoma were recruited from scheduled clinic visits. IOP was measured with the Icare tonometer by a clinician and subsequently measured with Goldmann applanation tonometry (GAT) by a different single masked clinician. A total of 71 eyes of 71 children with known or suspected glaucoma were included. IOP by GAT ranged from 9 to 36 mm Hg. Icare readings ranged from 11 to 44 mm Hg. Mean difference between Icare and GAT was 2.3 ± SD 3.7 mm Hg, p IOPs were within ± 3 mm Hg of GAT in 63%. Icare IOPs were ≥GAT IOPs in 75%. The following factors were not associated with Icare IOPs greater than GAT: child's age, glaucoma diagnosis, strabismus, nystagmus, central corneal thickness, Icare instrument-reported reliability, number of glaucoma surgeries or medications, corneal abnormalities, and visual acuity. IOP by Icare tonometry was within 3 mm Hg of IOP by GAT in 63% and greater than GAT in 75%. This device may be reasonable to estimate IOP in selected children with known or suspected glaucoma whose IOP cannot otherwise be obtained in clinic; however, correlation of Icare IOPs with clinical findings must continue to be considered in each case. Copyright © 2011 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  19. Herbal hepatotoxicity: suspected cases assessed for alternative causes. (United States)

    Teschke, Rolf; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel; Frenzel, Christian


    Alternative explanations are common in suspected drug-induced liver injury (DILI) and account for up to 47.1% of analyzed cases. This raised the question of whether a similar frequency may prevail in cases of assumed herb-induced liver injury (HILI). We searched the Medline database for the following terms: herbs, herbal drugs, herbal dietary supplements, hepatotoxic herbs, herbal hepatotoxicity, and herb-induced liver injury. Additional terms specifically addressed single herbs and herbal products: black cohosh, Greater Celandine, green tea, Herbalife products, Hydroxycut, kava, and Pelargonium sidoides. We retrieved 23 published case series and regulatory assessments related to hepatotoxicity by herbs and herbal dietary supplements with alternative causes. The 23 publications comprised 573 cases of initially suspected HILI; alternative causes were evident in 278/573 cases (48.5%). Among them were hepatitis by various viruses (9.7%), autoimmune diseases (10.4%), nonalcoholic and alcoholic liver diseases (5.4%), liver injury by comedication (DILI and other HILI) (43.9%), and liver involvement in infectious diseases (4.7%). Biliary and pancreatic diseases were frequent alternative diagnoses (11.5%), raising therapeutic problems if specific treatment is withheld; pre-existing liver diseases including cirrhosis (9.7%) were additional confounding variables. Other diagnoses were rare, but possibly relevant for the individual patient. In 573 cases of initially assumed HILI, 48.5% showed alternative causes unrelated to the initially incriminated herb, herbal drug, or herbal dietary supplement, calling for thorough clinical evaluations and appropriate causality assessments in future cases of suspected HILI.

  20. Suspected side effects to the quadrivalent human papilloma vaccine. (United States)

    Brinth, Louise; Theibel, Ann Cathrine; Pors, Kirsten; Mehlsen, Jesper


    The quadrivalent vaccine that protects against human papilloma virus types 6, 11, 16 and 18 (Q-HPV vaccine, Gardasil) was included into the Danish childhood vaccination programme in 2009. During the past years, a collection of symptoms primarily consistent with sympathetic nervous system dysfunction have been described as suspected side effects to the Q-HPV vaccine. We present a description of suspected side effects to the Q-HPV vaccine in 53 patients referred to our Syncope Unit for tilt table test and evaluation of autonomic nervous system function. All patients had symptoms consistent with pronounced autonomic dysfunction including different degrees of orthostatic intolerance, severe non-migraine-like headache, excessive fatigue, cognitive dysfunction, gastrointestinal discomfort and widespread pain of a neuropathic character. We found consistency in the reported symptoms as well as between our findings and those described by others. Our findings neither confirm nor dismiss a causal link to the Q-HPV vaccine, but they suggest that further research is urgently warranted to clarify the pathophysiology behind the symptoms experienced in these patients and to evaluate the possibility and the nature of any causal link and hopefully establish targeted treatment options. not relevant. not relevant.

  1. The changing rate of suspected rabies bites after begin to act animal shelter in erzurum city. (United States)

    Vancelik, Serhat; Set, Turan; Akturk, Zekeriya; Calikoglu, Oksan; Kosan, Zahide


    We aimed to evaluate the relationship between establishing an animal shelter in Erzurum and the number of suspected rabies bites between the years 2005 and 2012. A retrospective, repeated cross-sectional study was planned in Erzurum in the year 2013. Records between the years 2005 and 2012 were obtained from the Communicable Diseases Department of the Erzurum Health Directorate. Data for 5789 cases exposed to suspected rabies bites were analyzed. 5789 suspected rabies bites were encountered in Erzurum between the years 2005 and 2012. After establishing the animal shelter in 2009, 4239 dogs were collected from the streets within four years and 426 of them were released after immunization. Additionally, the following services were given in the animal shelter between 2009 and 2012: immunization of 2935 dogs, sterilization of 1735 dogs, and release of 2082 dogs back to the street. 4-years before the establishment of the animal shelter, the number of dog-bites had decreased from 3403 cases to 2386 cases; 4-years after the establishment of the shelter, it declined by 29.8%. While there were 1096 suspected rabies cases during the year 2008, this ratio decreased by 40.9% after the establishment of the animal shelter in the year 2009. During the year 2010, where we had the highest number of homeless dog collection to the animal shelter, the decrease in suspected rabies bites reached the maximum decrease, namely 51.0%. Spearman correlation analysis showed a strong negative correlation between the number of collected animals and suspected rabies bites (r = -0,862; p=0.006). Suspected rabies cases are common in Turkey and some cases of rabies are encountered. The number of suspected rabies bites in Erzurum has decreased significantly after establishing the animal shelter. It is an evident that establishing rehabilitation centers for homeless animals in all cities will have an important role in controlling zoonotic diseases including rabies.

  2. Learning Disabilities (United States)

    ... NICHD) See all related organizations Publications Problemas de aprendizaje Order NINDS Publications Patient Organizations CHADD - Children and ... NICHD) See all related organizations Publications Problemas de aprendizaje Order NINDS Publications Definition Learning disabilities are disorders ...

  3. Sports and disability. (United States)

    Wilson, Pamela E; Clayton, Gerald H


    Participation in recreational and competitive sports at an early age has long been touted as a positive influence on growth and development, and for fostering lifelong healthy lifestyles. The benefits of an active lifestyle include not only fitness, but the promotion of a sense of inclusion and improved self-esteem. These benefits are well documented in all populations, and their importance has been summarized in the recent Healthy People 2010 guidelines. The American Academy of Pediatrics has recently produced a summary statement on the benefits of activity for disabled children. They note that children with disabilities tend to have an overall lower level of fitness and an increased level of obesity. For this population, developing a lifelong desire to be active can be a simple means for limiting illness and much of the morbidity associated with sedentary lifestyles often associated with disability. For disabled youth, participation in disabled sports programs available nationally and internationally can be an effective means to promote such precepts. The goal of this focused review is to improve the learner's knowledge of the positive impact that active lifestyles can have on overall health in the disabled youth population and, as a result, modify their practice by incorporating recreational and competitive sport activities as part of improving overall patient care. Copyright 2010 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  4. Medical students' attitudes towards disability and support for disability in medicine. (United States)

    Miller, Sarah; Ross, Sarah; Cleland, Jennifer


    The number of medical students disclosing a disability is lower than the number of disabled doctors. This study aimed to examine rates and types of disability in medical students, whether students disclosed this disability and their support needs, and, if not, possible reasons for non-disclosure. This was a cross-sectional questionnaire study of all medical students registered at the University of Aberdeen in October 2007 (n = 944). Six percent of respondents considered they had a disability on application to medical school, but only 4% had disclosed this on admission. After reading the legal definition of disability, the percentage of respondents considering themselves as having a disability increased to 13%. Disabilities included: specific learning difficulties; mental health issues; sensory impairment; chronic illness; and mobility problems. Challenges to their studies due to disability were reported by nearly half of the disabled respondents but two-thirds had not sought support. Twelve percent reported experiencing discrimination due to their disability. Broader attitudes to disability indicated that many (75%) respondents believed some disabilities would prevent the study of medicine. Non-disclosure of disability in medical students may be due to several factors including narrow definitions of disability and negative attitudes towards disability from the wider student body.

  5. Pre-surgery Disability Compensation Predicts Long-Term Disability among Workers with Carpal Tunnel Syndrome (United States)

    Spector, June T.; Turner, Judith A.; Fulton-Kehoe, Deborah; Franklin, Gary


    Background We sought to identify early risk factors for work disability compensation prior to and after carpal tunnel syndrome (CTS) surgery, and to determine whether pre-surgery disability compensation is associated with long-term disability. Methods Washington State workers’ compensation administrative data and data from interviews with workers 18 days (median) after submitting new workers’ compensation claims for CTS were examined. Baseline risk factors for pre-surgery disability compensation and for long-term disability (≥365 days of work disability compensation prior to two years after claim filing) were evaluated for workers who underwent CTS surgery and had at least one day of disability compensation (N=670). Results After adjustment for baseline long-term disability risk factors, workers with pre-surgery disability compensation had over five times the odds of long-term disability. Baseline factors in multiple domains, including job, psychosocial, clinical, and worker pain and function, were associated with both pre-surgery disability compensation and long-term disability. Conclusions Risk factors for work disability prior to and after CTS surgery are similar, and early work disability is a risk factor for long-term CTS-related disability. An integrated approach to CTS-related disability prevention could include identifying and addressing combined risk factors soon after claim filing, more efficient use of conservative treatments and appropriate work modifications to minimize early work loss, and, when indicated, timely surgical intervention. PMID:22392804

  6. MRI diagnosis of suspected atlanto-occipital dissociation in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Grabb, B.C.; Frye, T.A.; Hedlund, G.L.; Vaid, Y.N.; Royal, S.A. [Department of Radiology, The Children`s Hospital of Alabama, Birmingham (United States); Grabb, P.A. [Department of Neurosurgery, University of Alabama at Birmingham (United States)


    Objective. To demonstrate the utility of magnetic resonance (MR) imaging in the diagnosis of complete and partial ligamentous injuries in patients with suspected atlanto-occipital dissociation (AOD). Materials and methods. Five patients with suspected AOD had MR imaging performed within an average of 4 days after injury. MR scans were reviewed with specific analysis of craniocervical ligamentous structures. Charts were reviewed to obtain clinical information regarding presentation, treatment, hospital course, and outcome. Results. Two patients demonstrated MR evidence of complete AOD. One had disruption of all visualized major ligamentous structures at the craniocervical junction with anterolisthesis and evidence of cord damage. The second had injuries to the tectorial membrane, superior band of the cruciform ligament, apical ligament, and interspinous ligament at C 1-2. The remaining three patients sustained incomplete severance of the ligamentous structures at the craniocervical junction. All patients demonstrated subtle radiographic findings suggestive of AOD, including soft tissue swelling at the craniocervical junction without fracture. The two patients with complete AOD died. The three patients with partial AOD were treated with stabilization. On follow-up, these three children were asymptomatic following their craniocervical injury. Conclusion. MR imaging of acute AOD provides accurate identification of the craniocervical ligaments injured, classification of full versus partial ligamentous disruption, and analysis of accompanying spinal cord injury. This information is important for early appropriate neurosurgical management and preservation of neurologic function in survivors. (orig.) With 7 figs., 1 tab., 14 refs.

  7. MRI diagnosis of suspected atlanto-occipital dissociation in childhood. (United States)

    Grabb, B C; Frye, T A; Hedlund, G L; Vaid, Y N; Grabb, P A; Royal, S A


    To demonstrate the utility of magnetic resonance (MR) imaging in the diagnosis of complete and partial ligamentous injuries in patients with suspected atlanto-occipital dissociation (AOD). Five patients with suspected AOD had MR imaging performed within an average of 4 days after injury. MR scans were reviewed with specific analysis of craniocervical ligamentous structures. Charts were reviewed to obtain clinical information regarding presentation, treatment, hospital course, and outcome. Two patients demonstrated MR evidence of complete AOD. One had disruption of all visualized major ligamentous structures at the craniocervical junction with anterolisthesis and evidence of cord damage. The second had injuries to the tectorial membrane, superior band of the cruciform ligament, apical ligament, and interspinous ligament at C 1-2. The remaining three patients sustained incomplete severance of the ligamentous structures at the craniocervical junction. All patients demonstrated subtle radiographic findings suggestive of AOD, including soft tissue swelling at the craniocervical junction without fracture. The two patients with complete AOD died. The three patients with partial AOD were treated with stabilization. On follow-up, these three children were asymptomatic following their craniocervical injury. MR imaging of acute AOD provides accurate identification of the craniocervical ligaments injured, classification of full versus partial ligamentous disruption, and analysis of accompanying spinal cord injury. This information is important for early appropriate neurosurgical management and preservation of neurologic function in survivors.

  8. CT Pulmonary Angiography and Suspected Acute Pulmonary Embolism

    Energy Technology Data Exchange (ETDEWEB)

    Enden, T.; Kloew, N.E. [Ullevaal Univ. Hospital, Oslo (Norway). Dept. of Cardiovascular Radiology


    Purpose: To evaluate the use and quality of CT pulmonary angiography in our department, and to relate the findings to clinical parameters and diagnoses. Material and Methods: A retrospective study of 324 consecutive patients referred to CT pulmonary angiography with clinically suspected pulmonary embolism (PE). From the medical records we registered clinical parameters, blood gases, D-dimer, risk factors and the results of other relevant imaging studies. Results: 55 patients (17%) had PE detected on CT. 39 had bilateral PE, and 8 patients had isolated peripheral PE. 87% of the examinations showing PE had satisfactory filling of contrast material including the segmental pulmonary arteries, and 60% of the subsegmental arteries. D-dimer test was performed in 209 patients, 85% were positive. A negative D-dimer ruled out PE detected at CT. Dyspnea and concurrent symptoms or detection of deep vein thrombosis (DVT), contraceptive pills and former venous thromboembolism (VTE) were associated with PE. The presence of only one clinical parameter indicated a negative PE diagnosis (p < 0.017), whereas two or more suggested a positive PE diagnosis (p < 0.002). CT also detected various ancillary findings such as consolidation, pleural effusion, nodule or tumor in nearly half of the patients; however, there was no association with the PE diagnosis. Conclusion: The quality of CT pulmonary angiography was satisfactory as a first-line imaging of PE. CT also showed additional pathology of importance in the chest. Our study confirmed that a negative D-dimer ruled out clinically suspected VTE.

  9. Diagnosing autism in adults with intellectual disability


    Sappok, Tanja


    Individuals with intellectual disability (ID) are at risk for additional autism spectrum disorders (ASD). One in four individuals with ID is diagnosed with additional ASD. However, ASD often remains unrecognized until adulthood. Carefully diagnosing ASD in affected individuals would allow for more tailored clinical interventions that would improve mental health and quality of life. The aim of the present study was to optimize the diagnostic process for adults with ID and suspected comorbid AS...

  10. Video Game Effects--Confirmed, Suspected, and Speculative: A Review of the Evidence (United States)

    Barlett, Christopher P.; Anderson, Craig A.; Swing, Edward L.


    This literature review focuses on the confirmed, suspected, and speculative effects of violent and non-violent video game exposure on negative and positive outcomes. Negative outcomes include aggressive feelings, aggressive thoughts, aggressive behavior, physiological arousal, and desensitization, whereas positive outcomes include various types of…

  11. Teicoplanin versus vancomycin for proven or suspected infection. (United States)

    Cavalcanti, Alexandre B; Goncalves, Anderson R; Almeida, Claudia S; Bugano, Diogo Dg; Silva, Eliezer


    Vancomycin and teicoplanin are commonly used to treat gram-positive infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). There is uncertainty regarding the effects of teicoplanin compared to vancomycin on kidney function with some previous studies suggesting teicoplanin is less nephrotoxic than vancomycin. To investigate the efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. We searched the Cochrane Renal Group's Specialised Register, CENTRAL, MEDLINE, EMBASE, reference lists of nephrology textbooks, review articles with relevant studies and sent letters seeking information about unpublished or incomplete studies to investigators involved in previous studies. We searched for randomised controlled trials (RCTs) in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Two authors independently evaluated methodological quality and extracted data using standardised data extraction forms. Study investigators were contacted for information not available in the original manuscripts. Random effects model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). We included 24 studies (2,610 patients) in this review. Teicoplanin reduced the risk of nephrotoxicity compared to vancomycin (RR 0.66, 95% CI 0.48 to 0.90).The effects of teicoplanin or vancomycin were similar for clinical cure (RR 1.03, 95% CI 0.98 to 1.08), microbiological cure (RR 0.98, 95% CI 0.93 to 1.03) and mortality (RR 1.02, 95% CI 0.79 to1.30). Six studies reported no cases of acute kidney injury (AKI) needing dialysis. Adverse events were less frequent with teicoplanin including cutaneous rash (RR 0.57, 95% CI 0.35 to 0.92), red man syndrome (RR 0.21, 95% CI 0.08 to 0.59) and total adverse events (RR 0.73, 95% CI 0.53 to 1.00). A lower risk of nephrotoxicity with teicoplanin was observed in patients either with (RR 0.51, 95% CI 0.30 to 0.88) or

  12. Specific Learning Disability Identification: What Constitutes a Pattern of Strengths and Weaknesses? (United States)

    Schultz, Edward Karl; Simpson, Cynthia G.; Lynch, Sharon


    The 2004 Individuals with Disabilities Education Improvement Act (IDEA) and subsequent regulations published in 2006 have significantly changed the identification process for students suspected of having specific learning disabilities. Rather than using a discrepancy model contrasting intellectual and achievement test results, assessment…

  13. 78 FR 61809 - National Disability Employment Awareness Month, 2013 (United States)


    ... workforce that offers inclusion and opportunity for all. Since the passage of the Americans with... 20 percent of Americans with disabilities, including veterans who became disabled while serving our... recruit, hire, and promote qualified individuals with disabilities, including disabled veterans. And...

  14. Prevalence of suspected nonalcoholic fatty liver disease in Hispanic/Latino individuals differs by heritage. (United States)

    Kallwitz, Eric R; Daviglus, Martha L; Allison, Matthew A; Emory, Kristen T; Zhao, Lihui; Kuniholm, Mark H; Chen, Jinsong; Gouskova, Natalia; Pirzada, Amber; Talavera, Gregory A; Youngblood, Marston E; Cotler, Scott J


    Nonalcoholic fatty liver disease (NAFLD) was shown to disproportionally affect Hispanic persons. We examined the prevalence of suspected NAFLD in Hispanic/Latino persons with diverse backgrounds. We studied the prevalence of suspected NAFLD among 12,133 persons included in the Hispanic Community Health Study/Study of Latinos. We collected data on levels of aminotransferase, metabolic syndrome (defined by National Cholesterol Education Program-Adult Treatment Panel III guidelines), demographics, and health behaviors. Suspected NAFLD was defined on the basis of increased level of aminotransferase in the absence of serologic evidence for common causes of liver disease or excessive alcohol consumption. In multivariate analyses, data were adjusted for metabolic syndrome, age, acculturation, diet, physical activity, sleep, and levels of education and income. In multivariate analysis, compared with persons of Mexican heritage, persons of Cuban (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.57-0.85), Puerto Rican (OR, 0.67; 95% CI, 0.52-0.87), and Dominican backgrounds (OR, 0.71; 95% CI, 0.54-0.93) had lower rates of suspected NAFLD. Persons of Central American and South American heritage had a similar prevalence of suspected NAFLD compared with persons of Mexican heritage. NAFLD was less common in women than in men (OR, 0.49; 95% CI, 0.40-0.60). Suspected NAFLD associated with metabolic syndrome and all 5 of its components. On the basis of an analysis of a large database of health in Latino populations, we found the prevalence of suspected NAFLD among Hispanic/Latino individuals to vary by region of heritage. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  15. Identification of Learning Disabled Bilingual Hispanic Students. (United States)

    Zavala, Jesus; Mims, Joan


    The study compared 10 learning disabled and 10 non-learning disabled limited English proficient Mexican American elementary grade children. Six tests were identified as predicting learning disabilities including the Prueba de Lectura y Lenguaje Escrito and the Test of Nonverbal Intelligence. (Author/DB)

  16. Violence Exposure among Children with Disabilities (United States)

    Sullivan, Patricia M.


    The focus of this paper is children with disabilities exposed to a broad range of violence types including child maltreatment, domestic violence, community violence, and war and terrorism. Because disability research must be interpreted on the basis of the definitional paradigm employed, definitions of disability status and current prevalence…

  17. Aetiology of intellectual disability in paediatric outpatients in Northern India. (United States)

    Jauhari, Prashant; Boggula, Raju; Bhave, Anupama; Bhargava, Roli; Singh, Chandrakanta; Kohli, Neera; Yadav, Rajesh; Kumar, Rashmi


    To study the aetiology of intellectual disability in patients presenting to hospital and the diagnostic yield of a standardized examination. Over a 1-year period, the first three children presenting to the paediatric outpatients department (OPD) on 2 selected weekdays with developmental delay, suspected intellectual disability, or school failure were enrolled for study if they satisfied standard definitions of global developmental delay (GDD), or intellectual disability as tested by scales for Indian children: Developmental Assessment for Indian Infants, Binet Karnat Test, and the Vineland Social Maturity Scale (Malin's Adaptation). Detailed history, and physical and neurological examinations were recorded. An algorithmic approach to investigations was followed. Also, neuroimaging, thyroid function, electroencephalograph, karyotyping, and studies for fragile-X syndrome were conducted. Aetiological diagnosis was considered established only if clinical features were supported by investigations. Clinical features associated with a successful aetiological diagnosis were computed. A total of 122 children were enrolled in a cross-sectional analytic study (mean age 43.5 mo [SD 40.66]; 84 males, 38 females). Of these, a definite aetiology could be assigned in 66 children (54.1%); 17 prenatal, 38 perinatal/neonatal, and 11 postneonatal. Factors associated with reaching a definite diagnosis included younger age at presentation, presence of seizures, microcephaly, adverse neonatal events, and abnormal motor signs. Clinical history and examination gave important clues to the aetiology in 89 (72.9%) patients. Neuroimaging was abnormal in 91 out of 114 children, with aetiological findings in 48 children. Perinatal/neonatal causes predominate as the cause of GDD or intellectual disability in India. The study highlights that a large majority of cases seen here were preventable. © The Authors. Journal compilation © Mac Keith Press 2010.

  18. 75 FR 2119 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and... (United States)


    ... knowledge and understanding of the unique needs of traditionally underserved populations; (3) determine best... employing workers with disabilities increased the cost of doing business, that workers with disabilities... and productivity. Analysis of the responses revealed that employer characteristics, including company...

  19. Intellectual disability

    NARCIS (Netherlands)

    Peters-Scheffer, N.C.; Didden, H.C.M.; Lang, R.


    Perhaps the most common and most debilitating comorbid disorder with autism spectrum disorder (ASD) is intellectual disability (ID). The overlap of these conditions has been studied extensively. This chapter provides an overview of the research that has been published on the topic. Subjects such as

  20. Facing suspected child abuse--what keeps Swedish general practitioners from reporting to child protective services? (United States)

    Talsma, Marijke; Bengtsson Boström, Kristina; Östberg, Anna-Lena


    The aim of this study was to examine the reporting of suspected child abuse among Swedish general practitioners (GPs), and to investigate factors influencing them in their decision whether or not to report to child protective services (CPS). A cross-sectional questionnaire study. Primary health care centres in western Sweden. 177 GPs and GP trainees. Demographic and educational background, education on child abuse, attitudes to reporting and CPS, previous experience of reporting suspected child abuse, and need of support. Despite mandatory reporting, 20% of all physicians had at some point suspected but not reported child abuse. Main reasons for non-reporting were uncertainty about the suspicion and use of alternative strategies; for instance, referral to other health care providers or follow-up of the family by the treating physician. Only 30% of all physicians trusted CPS's methods of investigating and acting in cases of suspected child abuse, and 44% of all physicians would have wanted access to expert consultation. There were no differences in the failure to report suspected child abuse that could be attributed to GP characteristics. However, GPs educated abroad reported less frequently to CPS than GPs educated in Sweden. This study showed that GPs see a need for support from experts and that the communication and cooperation between GPs and CPS needs to be improved. The low frequency of reporting indicates a need for continued education of GPs and for updated guidelines including practical advice on how to manage child abuse.

  1. Mathematics for the Learning Disabled Child in the Regular Classroom. (United States)

    Sears, Carol J.


    Assists teachers by helping them to recognize problems in mathematics that are often demonstrated by students with suspected or diagnosed learning disabilities. Also suggests remedial and compensatory techniques to help these teachers cope with such problems. Dyscalculia, hyperactivity, distractability, and perseveration are among the problems…

  2. Association between QRS duration on prehospital ECG and mortality in patients with suspected STEMI

    DEFF Research Database (Denmark)

    Hansen, Rikke; Frydland, Martin; Møller-Helgestad, Ole Kristian


    BACKGROUND: QRS duration has previously shown association with mortality in patients with acute myocardial infarction treated with thrombolytics, less is known in patients with suspected ST segment elevation myocardial infarction (STEMI) when assessing QRS duration on prehospital ECG. Thus......, the objective was to investigate the prognostic effect of QRS duration on prehospital ECG and presence of classic left and right bundle branch block (LBBB/RBBB) for all-cause mortality in patients with suspected STEMI. METHOD: In total 2105 consecutive patients (mean age 64±13years, 72% men) with suspected...... STEMI were prospectively included. QRS duration was registered from automated QRS measurement on prehospital ECG and patients were divided according to quartiles of QRS duration (111ms). Primary endpoint was all-cause 30-day mortality. Predictors of all-cause mortality were...

  3. Detection of Rabies antigen in brains of suspected Rabid dogs ...

    African Journals Online (AJOL)

    Objective: To detect the presence of rabies antigen in brains of suspected rabid dogs. Materials and Methods: Ninety six (96) brain specimens from suspected rabid dogs were examined for the presence of rabies antigen using Seller's staining technique and enzyme immunoassay. Results: The two techniques were both ...

  4. 48 CFR 803.806 - Processing suspected violations. (United States)


    ... GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Limitation on the Payment of Funds to Influence Federal Transactions 803.806 Processing suspected violations. A VA employee must report suspected violations of 31 U.S.C. 1352, Limitation on Use of Appropriated Funds to Influence Certain Federal...

  5. The clinical course of patients with suspected pulmonary embolism

    NARCIS (Netherlands)

    van Beek, E. J.; Kuijer, P. M.; Büller, H. R.; Brandjes, D. P.; Bossuyt, P. M.; ten Cate, J. W.


    BACKGROUND: The outcome of patients with suspected pulmonary embolism is known to a limited extent only. OBJECTIVE: To address this limited knowledge in a cohort in whom pulmonary embolism was proved or ruled out. METHODS: Consecutive patients with clinically suspected pulmonary embolism underwent

  6. Cost-effectiveness of routine imaging of suspected appendicitis. (United States)

    D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S


    Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

  7. Reliability of Examination Findings in Suspected Community-Acquired Pneumonia. (United States)

    Florin, Todd A; Ambroggio, Lilliam; Brokamp, Cole; Rattan, Mantosh S; Crotty, Eric J; Kachelmeyer, Andrea; Ruddy, Richard M; Shah, Samir S


    The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included. We excluded children hospitalized ≤14 days before the study visit and those with a chronic medical condition or aspiration. Two clinicians performed independent examinations and completed identical forms reporting examination findings. Interrater reliability for each finding was reported by using Fleiss' kappa (κ) for categorical variables and intraclass correlation coefficient (ICC) for continuous variables. No examination finding had substantial agreement (κ/ICC > 0.8). Two findings (retractions, wheezing) had moderate to substantial agreement (κ/ICC = 0.6-0.8). Nine findings (abdominal pain, pleuritic pain, nasal flaring, skin color, overall impression, cool extremities, tachypnea, respiratory rate, and crackles/rales) had fair to moderate agreement (κ/ICC = 0.4-0.6). Eight findings (capillary refill time, cough, rhonchi, head bobbing, behavior, grunting, general appearance, and decreased breath sounds) had poor to fair reliability (κ/ICC = 0-0.4). Only 3 examination findings had acceptable agreement, with the lower 95% confidence limit >0.4: wheezing, retractions, and respiratory rate. In this study, we found fair to moderate reliability of many findings used to diagnose CAP. Only 3 findings had acceptable levels of reliability. These findings must be considered in the clinical management and research of pediatric CAP. Copyright © 2017 by the American Academy of Pediatrics.

  8. Seasonal variation among tuberculosis suspects in four countries

    DEFF Research Database (Denmark)

    Mabaera, Biggie; Naranbat, Nymadawa; Katamba, Achilles


    The objective of the study was to analyze monthly trends across a calendar year in tuberculosis suspects and sputum smear-positive cases based on nationally representative samples of tuberculosis laboratory registers from Moldova, Mongolia, Uganda and Zimbabwe. Out of the 47 140 suspects registered...... in the tuberculosis laboratory registers, 13.4% (6312) were cases. The proportion varied from country to country, Moldova having the lowest (9%) and Uganda the highest (21%). From the monthly proportion of suspects and cases among total suspects and cases, seasonal variations were most marked in Mongolia which, among...... attendance to diagnostic laboratory services, evidenced by the contrasting findings of Mongolia (extreme continental northern climate) compared to Uganda (equatorial climate). A combination of external and possibly endogenous factors seems to determine whether tuberculosis suspects and cases present...

  9. Neurohormonal activation and diagnostic value of cardiac peptides in patients with suspected mild heart failure

    DEFF Research Database (Denmark)

    Mikkelsen, Kirsten V.; Bie, Peter; Møller, Jacob E.


    accuracy of cardiac peptides to detect any left ventricular dysfunction (LVD) in patients referred from primary care with suspected HF before institution of medical therapy. METHODS: Of 166 referred patients 150 were consecutively included (14 were excluded and two refused consent). Echocardiography...

  10. 32 CFR 644.530 - Conditions in conveying land suspected of contamination. (United States)


    ... contamination. 644.530 Section 644.530 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... Contamination from Proposed Excess Land and Improvements § 644.530 Conditions in conveying land suspected of contamination. The following conditions, appropriately modified to conform to local law, will be included in...

  11. MR imaging of neuropathic feet in leprosy patients with suspected osteomyelitis

    NARCIS (Netherlands)

    Maas, Mario; Slim, Erik J.; Heoksma, Agnes F.; van der Kleij, Ad J.; Akkerman, Erik M.; den Heeten, Gerard J.; Faber, William R.


    This study was undertaken to analyze MRI findings in leprosy patients with neuropathic feet, which are suspected of having osteomyelitis. As far as we know, there is no literature concerning osteomyelitis and MRI in neuropathic leprosy feet at present. Therefore, we have included MRI examination of

  12. Prediction of Suspect Location Based on Spatiotemporal Semantics

    Directory of Open Access Journals (Sweden)

    Lian Duan


    Full Text Available The prediction of suspect location enables proactive experiences for crime investigations and offers essential intelligence for crime prevention. However, existing studies have failed to capture the complex social location transition patterns of suspects and lack the capacity to address the issue of data sparsity. This paper proposes a novel location prediction model called CMoB (Crime Multi-order Bayes model based on the spatiotemporal semantics to enhance the prediction performance. In particular, the model groups suspects with similar spatiotemporal semantics as one target suspect. Then, their mobility data are applied to estimate Markov transition probabilities of unobserved locations based on a KDE (kernel density estimating smoothing method. Finally, by integrating the total transition probabilities, which are derived from the multi-order property of the Markov transition matrix, into a Bayesian-based formula, it is able to realize multi-step location prediction for the individual suspect. Experiments with the mobility dataset covering 210 suspects and their 18,754 location records from January to June 2012 in Wuhan City show that the proposed CMoB model significantly outperforms state-of-the-art algorithms for suspect location prediction in the context of data sparsity.

  13. The Global Context of Disability

    Directory of Open Access Journals (Sweden)

    Christine O'Rourke - Lang


    Full Text Available This issue of Global Education Review examines the global context of disability and how in different geographic locations, socioeconomic factors, domestic policy, and disability perspectives impact access to special education services, and the types of resources and interventions available to individuals with diverse learning needs. Practices in countries including India, Singapore, South Korea, Hong Kong, El Salvador, Ethiopia, Liberia, and Kenya were studied and implications for meeting the special education needs for children and adults with disabilities and their families are discussed

  14. Sexuality and Disability in Adolescents. (United States)

    Holland-Hall, Cynthia; Quint, Elisabeth H


    Healthy sexual development is important for adolescents with and without disabilities, yet the topic of sexuality is often ignored in the disabled population. Adolescents with mild or moderate degrees of disability have rates of sexual activity and reproductive health needs comparable to their typically developing peers. Their need for support, risk reduction, and education in sexual health may exceed that of their peers. The medical provider may support healthy sexual development through education, anticipatory guidance, menstrual and contraceptive management, and by expanding the notion of sexuality to include a broader conceptualization of sexual behavior and expression. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. When Supporting Children with Disabilities is Both Including and Excluding

    DEFF Research Database (Denmark)

    Engsig, Thomas Thyrring

    A recent political decree in Denmark outlined an ambitious goal regarding the inclusion of students with special needs in the general education. 97% of the country’s students are to receive their education in the public school’s general education by 2020. Research indicates that the use of in......-class support is a central pedagogical approach towards a more inclusive school, and that in-class supportive practices can entail positive implications for students with special educational needs. However, research also indicates that the application of in-class support may lead to more negative consequences...... for these students (Alborz, 2009; Blatchford et al., 2009; Blatchford, Bassett, Brown, & Webster, 2009; Dyssegaard & Larsen, 2013). The traditional understandings and definitions of inclusive education in a Danish educational context seem to be inadequate due to the fact, that the student’s subjective experience...

  16. Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications (United States)

    Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos


    Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy. PMID:20811612

  17. Chest pain and behavior in suspected coronary artery disease. (United States)

    Young, L D; Barboriak, J J; Anderson, A J


    This study assessed behavioral activity, dietary and emotional variables among patient cohorts with angina pectoris, atypical chest pain, and no chest pain in whom coronary disease is suspected. Questionnaire responses of 3,899 employed male patients at the time of coronary arteriography were analyzed. Patients with angina pectoris had high levels of coronary-prone and neurotic attitudes, and fatigue variables including feeling unrested on awakening, easy fatiguability, reducing activity at work and arriving home tired. Atypical chest pain patients showed coronary-prone and neurotic attitudes similar to the angina pectoris group but had less coronary occlusion and lower levels of fatigue variables. Compared to the other groups, atypical chest pain patients were more likely to skip breakfast and showed a trend to eat fast. These findings suggest that including assessment of activity levels, fatiguability, eating behavior, neurotic traits and coronary-prone attitudes at time of coronary arteriography can have some limited value for patients with chest pain who may seek cardiac treatment but could benefit from alternative approaches.

  18. The optimal diagnostic workup for children with suspected food allergy. (United States)

    Berni Canani, Roberto; Di Costanzo, Mara; Troncone, Riccardo


    Food allergy is defined as an abnormal immunologic reaction to food proteins that causes an adverse clinical reaction. In addition to well-known acute allergic reactions and anaphylaxis triggered by immunoglobulin E antibody-mediated immune responses to food proteins, there is an increasing recognition of cell-mediated disorders such as eosinophilic esophagitis and food protein-induced enterocolitis syndrome. More than 90% of food allergies in childhood are caused by eight foods: cow's milk, hen's egg, soy, peanuts, tree nuts, wheat, fish, and shellfish. The diagnostic workup for a child with suspected food allergy includes a detailed medical history, physical examination, food allergy screening tests, and responses to an elimination diet and an oral food challenge. None of the screening tests, alone or in combination, can definitely diagnose or exclude a food allergy. Novel diagnostic methods including those that focus on immune responses to specific food proteins or epitopes of specific proteins are under active study. Unconventional diagnostic methods are increasingly used, but they lack scientific rationale, standardization, and reproducibility. In selected cases, such as eosinophilic esophageal gastroenteropathies or food protein-induced gastroesophageal reflux disease, invasive procedures are mandatory for an accurate diagnosis. Properly done, an oral food challenge is still the gold standard in the diagnostic workup. An incorrect diagnosis is likely to result in unnecessary dietary restrictions, which, if prolonged, may adversely affect the child's nutritional status and growth. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Suspected vitreous seeding of uveal melanoma: relevance of diagnostic vitrectomy. (United States)

    Metz, Claudia H D; Bornfeld, Norbert; Metz, Klaus A; Gök, Mete


    To review all cases of suspected vitreous seeding of treated or untreated uveal melanoma at our clinic and to compare clinical, cytological and histological findings with patients' survival. Retrospective non-randomised study of 23 patients with consecutive uveal melanoma who underwent diagnostic vitrectomy in our clinic between January 2000 and November 2013. Reason for vitrectomy was suspected dissemination of tumour cells inside the eye. Treated as well as treatment-naïve primary uveal melanomas were included in this study. Follow-up data of all patients were collected. The study included 23 patients with a mean age of 66 years. Four patients presented pigmented vitreous debris at initial presentation prior to treatment of the uveal melanoma. All but one of these four patients has been enucleated as a consequence of cytology-proven vitreous spreading of vital melanoma cells. The remaining 19 patients presented pigmented vitreous debris at a mean of 60 months following local tumour treatment. Thirteen of these patients had been treated with a ruthenium plaque (mean scleral dose 1295 Gy, mean apex dose 152 Gy), three with binuclid plaque (mean scleral dose 1005 Gy, mean apex dose 70 Gy) and three with proton beam radiation. Of the 19 patients, 10 showed only melanophages in the vitreous specimen, while the remaining 9 patients had vital tumour cells in vitreous cytology. Four out of these nine patients have been enucleated in the course of follow-up. During follow-up of our cohort of 23 patients, 4 patients died, but only 1 of them due to metastatic disease. The outcome of this small cohort study shows that obtaining a vitreous specimen helps to distinguish melanophages from vital tumour cells. We could not observe an increased risk of metastasis in patients who showed melanoma cell dissemination inside the eye, compared with those patients only showing melanophages. We therefore suggest to carefully re-evaluate the necessity of enucleation in every


    Directory of Open Access Journals (Sweden)

    S. R. Gilarevsky


    Full Text Available Abstract. Contemporary algorithm of diagnostic examination of patients with suspected blunt cardiac trauma is presented. General aspects of monitoring and treatment of such patients are also discussed. 

  1. Suspect confession of child sexual abuse to investigators. (United States)

    Lippert, Tonya; Cross, Theodore P; Jones, Lisa; Walsh, Wendy


    Increasing the number of suspects who give true confessions of sexual abuse serves justice and reduces the burden of the criminal justice process on child victims. With data from four communities, this study examined confession rates and predictors of confession of child sexual abuse over the course of criminal investigations (final N = 282). Overall, 30% of suspects confessed partially or fully to the crime. This rate was consistent across the communities and is very similar to the rates of suspect confession of child sexual abuse found by previous research, although lower than that from a study focused on a community with a vigorous practice of polygraph testing. In a multivariate analysis, confession was more likely when suspects were younger and when more evidence of abuse was available, particularly child disclosure and corroborative evidence. These results suggest the difficulty of obtaining confession but also the value of methods that facilitate child disclosure and seek corroborative evidence, for increasing the odds of confession.

  2. Disability in anxiety disorders

    NARCIS (Netherlands)

    Hendriks, S.M.; Spijker, J.; Licht, C.M.M.; Beekman, A.T.F.; Hardeveld, F.; Graaf, R. de; Batelaan, N.M.; Penninx, B.W.J.H.


    Background: This study compares disability levels between different anxiety disorders and healthy controls. We further investigate the role of anxiety arousal and avoidance behaviour in disability, and whether differences in these symptom patterns contribute to disability differences between anxiety

  3. Disability in anxiety disorders

    NARCIS (Netherlands)

    Hendriks, S.M.; Spijker, J.; Licht, C.M.; Beekman, A.T.; Hardeveld, F.; Graaf, R. de; Batelaan, N.M.; Penninx, B.W.J.H.


    BACKGROUND: This study compares disability levels between different anxiety disorders and healthy controls. We further investigate the role of anxiety arousal and avoidance behaviour in disability, and whether differences in these symptom patterns contribute to disability differences between anxiety

  4. Disability in anxiety disorders

    NARCIS (Netherlands)

    Hendriks, S.M.; Spijker, J.; Licht, C.M.M.; Beekman, A.T.F.; Hardeveld, F.; de Graaf, R.; Batelaan, N.M.; Penninx, B.W.J.H.


    Background This study compares disability levels between different anxiety disorders and healthy controls. We further investigate the role of anxiety arousal and avoidance behaviour in disability, and whether differences in these symptom patterns contribute to disability differences between anxiety

  5. GIS Application Management for Disabled People (United States)

    Tongkaw, Sasalak


    This research aimed to develop and design Geographical Information Systems (GIS) for facilitating disabled people by presenting some useful disabled information on the Google Map. The map could provide information about disabled types of people such as blind, deaf and physical movement. This research employed the Multiview 2 theory and method to plan and find out the problems in real world situation. This research used many designing data structure methods such as Data Flow Diagram, and ER-Diagram. The research focused into two parts: server site and client site which included the interface for Web-based application. The clear information of disable people on the map was useful for facilitating disabled people to find some useful information. In addition, it provided specialized data for company and government officers for managing and planning local facilities for disabled people in the cities. The disable could access the system through the Internet access at any time by using mobile or portable devices.

  6. Disabled graduate-entry medical student experience. (United States)

    Tso, Simon


    This study explored the experiences of graduate-entry medicine degree programme students who were disabled on the disclosure of their disability and the challenging disability issues they encountered during their degree programme. Eight student volunteers with a disability from the University of Warwick graduate-entry medicine degree programme took part in this study. Audio recordings of their semi-structured interviews were transcribed verbatim and analysed thematically. Contributory factors to a reluctance or delay in disclosing disability to the medical school included confidentiality concerns, the potential impact of disclosure on their medical school application outcome and not perceiving their disability had an impact on their ability to function. They disclosed their disability for a range of professional and practical considerations. One participant was investigated and diagnosed with dyslexia following failure in a medical school examination. Disabled medical students encountered challenging issues such as having concerns about their future fitness to practice and employability, repeated disclosure of disability, confidentiality, abuse and difficulties in organising reasonable adjustments. Disabled medical students encounter challenging issues DISCUSSION: Medical school staff should keep an open mind about undiagnosed disability as a potential contributory factor to graduate students' academic underperformance. Participants expressed concerns about the management of their disability information that could potentially be addressed through regular dialogue between the students with a disability and medical school representatives, to define who, when and how other staff members could have access to the students' disability information. Despite the challenges students with a disability encountered during their degree programme, they viewed themselves as individuals who were in a good position to empathise with patients and understand their needs. © 2017 John

  7. Suspect aggression and victim resistance in multiple perpetrator rapes. (United States)

    Woodhams, Jessica; Cooke, Claire


    Several research studies have reported an elevated level of aggression in rapes committed by multiple perpetrators compared to rapes committed by lone suspects. Several factors that have been linked to elevated aggression in generic samples of rape were examined for the first time with a sample of multiple perpetrator rapes. Factors that might be associated with victim resistance were also investigated. Victim and offender characteristics, as well as the behaviors displayed by victims and offenders, were extracted from the police files of 89 multiple perpetrator stranger rapes perpetrated against female victims in the United Kingdom. These behaviors were rated for their level of suspect (non-sexual) aggression and victim resistance, respectively. Degree of victim resistance was significantly and positively associated with suspect aggression. Older victims were the recipients of significantly higher levels of suspect aggression. Victims who were incapacitated from drugs and/or alcohol were less likely to be the recipients of suspect aggression. Group leaders displayed more aggression towards the victim than the followers in the groups. The number of perpetrators was significantly related to the degree of resistance displayed by the victim with offences perpetrated by fewer suspects being characterized by more victim resistance. Research regarding cognitive appraisal during criminal interactions and the respective roles of offenders is referred to in considering these relationships.

  8. Interviewing strategically to elicit admissions from guilty suspects. (United States)

    Tekin, Serra; Granhag, Pär Anders; Strömwall, Leif; Giolla, Erik Mac; Vrij, Aldert; Hartwig, Maria


    In this article we introduce a novel interviewing tactic to elicit admissions from guilty suspects. By influencing the suspects' perception of the amount of evidence the interviewer holds against them, we aimed to shift the suspects' counterinterrogation strategies from less to more forthcoming. The proposed tactic (SUE-Confrontation) is a development of the Strategic Use of Evidence (SUE) framework and aims to affect the suspects' perception by confronting them with statement-evidence inconsistencies. Participants (N = 90) were asked to perform several mock criminal tasks before being interviewed using 1 of 3 interview techniques: (a) SUE-Confrontation, (b) Early Disclosure of Evidence, or (c) No Disclosure of Evidence. As predicted, the SUE-Confrontation interview generated more statement-evidence inconsistencies from suspects than the Early Disclosure interview. Importantly, suspects in the SUE-Confrontation condition (vs. Early and No disclosure conditions) admitted more self-incriminating information and also perceived the interviewer to have had more information about the critical phase of the crime (the phase where the interviewer lacked evidence). The findings show the adaptability of the SUE-technique and how it may be used as a tool for eliciting admissions. (c) 2015 APA, all rights reserved).

  9. Disaster case management and individuals with disabilities. (United States)

    Stough, Laura M; Sharp, Amy N; Decker, Curt; Wilker, Nachama


    To examine the case management and disaster recovery needs of individuals with disabilities following Hurricane Katrina. The case managers and supervisors in this study provided case management to individuals with disabilities as part of the largest coordinated disaster case management program in U.S. history, the Katrina Aid Today consortium. This study provides an account of the disaster case management needs of individuals with disabilities as well as a picture of their long-term recovery process two years following the disaster. Forty-two case managers and 12 case management supervisors from this program provided services to a collective caseload of 2,047 individuals with disabilities and their families. Interviews and telephone surveys were conducted with these participants 20-24 months after the disaster. The qualitative data were analyzed using grounded theory methodology, and descriptive statistics summarize the demographic data. Findings suggest that the disaster recovery process is typically more complex and lengthy for individuals with disabilities and requires negotiation of a service system sometimes unprepared for disability-related needs. Barriers to disaster recovery for individuals with disabilities included a lack of accessible housing, transportation, and disaster services. Supports to disaster recovery included the individual effort and advocacy of a case manager, connecting with needed resources, collaboration with other agencies, and client motivation and persistence. Results suggest that disaster recovery is facilitated by case managers with disability expertise, including knowledge about the needs of individuals with disabilities and about disability-related services.

  10. Diagnostic Value of Bronchoalveolar Lavage for Diagnosis of Suspected Peripheral Lung Cancer. (United States)

    Bezel, Pascal; Tischler, Verena; Robinson, Cecile; Baumueller, Stephan; Bode-Lesniewska, Beata; Kohler, Malcolm; Freitag, Lutz; Franzen, Daniel


    There is a paucity of data concerning the benefit of bronchoalveolar lavage (BAL) for the diagnosis of suspected peripheral lung cancer (PLC). The aim of this study was to investigate the diagnostic value of BAL for the diagnosis of suspected PLC. All flexible bronchoscopies that included BAL among other modalities (brush, forceps, washing) for the diagnosis of a suspected PLC performed between 2009 and 2013 were analyzed in this retrospective study. A total of 260 patients were included. Malignancy was present in 61%. BAL's sensitivity for the diagnosis of malignancy was 29%, and overall diagnostic yield of BAL was 46%. However, only 1% of cancer diagnoses would have been missed in the absence of BAL. In the multivariable analysis, the size of lesion (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.02-1.33; P = .023), the presence of bronchus sign (OR, 4.73; 95% CI, 1.06-21.08; P = .042), and the presence of mediastinal/hilar lymphadenopathy (OR, 3.37; 95% CI, 1.53-7.41; P = .002) were associated with improved BAL true-positive ratio relating to diagnosis of malignancy. However, the effect of lesion size on sensitivity was small (area under the curve, 0.31; 95% CI, 0.23-0.40; P diagnosis of malignancy or pulmonary infection was 37. Conventional BAL has a low diagnostic value for the diagnosis of suspected PLC, and the low number needed to test does not qualify BAL as a recommended routine investigation for the diagnosis of suspected PLC for either solid or ground-glass lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. MR enterography versus capsule endoscopy in paediatric patients with suspected Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Casciani, Emanuele; Masselli, Gabriele; Polettini, Elisabetta; Bertini, Luca; Gualdi, Gianfranco [University, Radiology DEA, Azienda Policlinico Umberto I, Rome (Italy); Di Nardo, Giovanni; Oliva, Salvatore; Cucchiara, Salvatore [University, Pediatric Gastroenterology, Rome (Italy); Floriani, Irene [Istituto di Ricerche Farmacologiche ' ' Mario Negri' ' , Milan (Italy)


    The aim of this prospective study was to compare the diagnostic yield of MR enterography (MRE) with small-bowel capsule endoscopy (SBCE) in paediatric patients with suspected Crohn's disease (CD). Paediatric patients with suspected CD were considered eligible to be enrolled in the study. All patients underwent diagnostic work-up including 1.5-T MRE, ileo-colonoscopy and oesophagogastroduodenoscopy. SBCE was not performed if MRE showed SB stricture or extra-intestinal findings consistent with symptoms. Sixty consecutive paediatric patients (36 male; average age 14) were enrolled into the study. A positive diagnosis for CD was made in 19 patients, 29 had a negative result and 12 were affected by other gastro-intestinal conditions. SBCE was performed in 37 patients (61.7%); 23 patients were excluded (strictures in five, extra-intestinal findings in 11 and parents' refusal in seven cases). The accuracy, sensitivity, and specificity of MRE and SBCE were 98.3%, 100%, 97.6%, and 91.9%, 90.9%, 92.3%, respectively. Both MRE and SBCE are accurate methods for patients with suspected CD. MRE can be used as a primary imaging technique in suspected CD, in that it allows access to the ileal stricture, which forms a contra-indication for SBCE and provides extra-intestinal information. (orig.)

  12. Unexpected MRI findings in clinically suspected Legg-Calve-Perthes disease

    Energy Technology Data Exchange (ETDEWEB)

    Lobert, Philip F.; Dillman, Jonathan R.; Strouse, Peter J.; Hernandez, Ramiro J. [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children' s Hospital/F3503, Ann Arbor, MI (United States)


    In the setting of clinically suspected Legg-Calve-Perthes (LCP) disease and negative/equivocal radiographs, contrast-enhanced MRI can be performed to confirm the diagnosis. To determine the frequency of unexpected causes of hip pain as identified by MRI in children with clinically suspected LCP disease and negative/equivocal radiographs. All pediatric contrast-enhanced MRI examinations of the pelvis and hips performed between January 2000 and February 2009 to evaluate for possible LCP disease in the setting of negative/equivocal radiographs were identified. MRI examinations performed to evaluate for secondary avascular necrosis were excluded. Imaging reports were retrospectively reviewed for unexpected clinically important causes of hip pain. Thirty-six pediatric patients underwent contrast-enhanced MRI examinations for clinically suspected LCP disease in the setting of negative/equivocal radiographs. Twenty-two (61%) imaging studies were normal, while four (11%) imaging studies demonstrated findings consistent with LCP disease. Ten (28%) imaging studies revealed unexpected clinically important causes of hip pain, including nonspecific unilateral joint effusion and synovitis (n = 7, juvenile chronic arthritis was eventually diagnosed in 3 patients), sacral fracture (n = 1), apophyseal injury (n = 1), and femoral head subluxation (n = 1). MRI frequently reveals unexpected clinically important causes of hip pain in children with suspected LCP disease and negative/equivocal radiographs. (orig.)

  13. Nurse Reporting of Known and Suspected Child Abuse and Neglect Cases in Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Yu Lee


    Full Text Available Despite the frontline role of taking care of children, nurses in Taiwan have been reluctant to report known and suspected cases of child abuse and neglect (CAN. This problem threatens the success of legislation aimed at reducing CAN cases in Taiwan. The purpose of this study was to examine the influence of nurses' perceptions, attitudes, and knowledge on suspecting and reporting CAN cases in health care settings in Taiwan. Two hundred and thirty-eight nurses were surveyed using structured questionnaires with a return rate of 79.3%. Health care settings surveyed in this study included emergency units, pediatric units, and community centers from eight hospitals in southern Taiwan. Almost 3/4 (70% of the sample of nurses thought they needed more training courses on CAN. Correlation analysis showed a significant relationship between suspecting and reporting CAN with perception, attitude, and knowledge. Stepwise multiple regression analysis revealed that perception (β= 0.475, knowledge (β= 0.265, and attitude (β= 0.246 accounted for 60% of the variance in suspecting and reporting CAN. The focus and scope of training programs for nurses in Taiwan should take these findings into consideration.

  14. Cost analysis of inappropriate treatments for suspected dermatomycoses

    Directory of Open Access Journals (Sweden)

    Emanuela Fiammenghi


    Full Text Available Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1 to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2 to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II” in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination were defined as inappropriate: (1 cortisone in a patient with at least one positive site; (2 antifungals in (a patients with all negative sites or (b ineffective antifungal treatment (in terms of drug chosen, dose or duration in those with all positive sites; or (3 antibiotics; (4 antivirals or (5 antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease

  15. Neurological signs in 23 dogs with suspected rostral cerebellar ischaemic stroke

    DEFF Research Database (Denmark)

    Thomsen, Barbara Blicher; Garosi, Laurent; Skerritt, Geoff


    Background: In dogs with ischaemic stroke, a very common site of infarction is the cerebellum. The aim of this study was to characterise neurological signs in relation to infarct topography in dogs with suspected cerebellar ischaemic stroke and to report short-term outcome confined...... to the hospitalisation period. A retrospective multicentre study of dogs with suspected cerebellar ischaemic stroke examined from 2010–2015 at five veterinary referral hospitals was performed. Findings from clinical, neurological, and paraclinical investigations including magnetic resonance imaging were assessed....... Results: Twenty-three dogs, 13 females and 10 males with a median age of 8 years and 8 months, were included in the study. The Cavalier King Charles Spaniel (n = 9) was a commonly represented breed. All ischaemic strokes were located to the vascular territory of the rostral cerebellar artery including...

  16. Control of Suspect/Counterfeit and Defective Items

    Energy Technology Data Exchange (ETDEWEB)

    Sheriff, Marnelle L.


    This procedure implements portions of the requirements of MSC-MP-599, Quality Assurance Program Description. It establishes the Mission Support Alliance (MSA) practices for minimizing the introduction of and identifying, documenting, dispositioning, reporting, controlling, and disposing of suspect/counterfeit and defective items (S/CIs). employees whose work scope relates to Safety Systems (i.e., Safety Class [SC] or Safety Significant [SS] items), non-safety systems and other applications (i.e., General Service [GS]) where engineering has determined that their use could result in a potential safety hazard. MSA implements an effective Quality Assurance (QA) Program providing a comprehensive network of controls and verification providing defense-in-depth by preventing the introduction of S/CIs through the design, procurement, construction, operation, maintenance, and modification of processes. This procedure focuses on those safety systems, and other systems, including critical load paths of lifting equipment, where the introduction of S/CIs would have the greatest potential for creating unsafe conditions.

  17. Presumed prevalence analysis on suspected and highly suspected breast cancer lesions in São Paulo using BIRADS® criteria

    Directory of Open Access Journals (Sweden)

    Vivian Milani

    Full Text Available CONTEXT AND OBJECTIVE: Breast cancer screening programs are critical for early detection of breast cancer. Early detection is essential for diagnosing, treating and possibly curing breast cancer. Since there are no data on the incidence of breast cancer, nationally or regionally in Brazil, our aim was to assess women by means of mammography, to determine the prevalence of this disease. DESIGN AND SETTING: The study protocol was designed in collaboration between the Department of Diagnostic Imaging (DDI, Institute of Diagnostic Imaging (IDI and São Paulo Municipal Health Program. METHODS: A total of 139,945 Brazilian women were assessed by means of mammography between April 2002 and September 2004. Using the American College of Radiology (ACR criteria (Breast Imaging Reporting and Data System, BIRADS®, the prevalence of suspected and highly suspected breast lesions were determined. RESULTS: The prevalence of suspected (BIRADS® 4 and highly suspected (BIRADS® 5 lesions increased with age, especially after the fourth decade. Accordingly, BIRADS® 4 and BIRADS® 5 lesions were more prevalent in the fourth, fifth, sixth and seventh decades. CONCLUSION: The presumed prevalence of suspected and highly suspected breast cancer lesions in the population of São Paulo was 0.6% and it is similar to the prevalence of breast cancer observed in other populations.

  18. Independent oversight review of the Department of Energy Quality Assurance Program for suspect/counterfeit parts. Revision 1

    Energy Technology Data Exchange (ETDEWEB)



    To address the potential threat that suspect/counterfeit parts could pose to DOE workers and the public, the Office of the Deputy Assistant Secretary for Oversight initiated a number of activities beginning in mid-1995. Oversight placed increased emphasis on the field`s quality assurance-suspect/counterfeit parts programs during safety management evaluations, in keeping with the Office of Environment, Safety and Health (EH) oversight responsibilities, which include oversight of the Department`s quality assurance (QA) programs. In addition, Oversight reviewed relevant policy documents and occurrence reports to determine the nature and magnitude of the problem within the Department. The results of that review, contained in an Office of Oversight report, Independent Oversight Analysis of Suspect/Counterfeit Parts Within the Department of Energy (November 1995), indicate a lack of consistency and comprehensiveness in the Department`s QA-suspect/counterfeit parts program. A detailed analysis of the causes and impacts of the problem was recommended. In response, this review was initiated to determine the effectiveness of the Department`s QA program for suspect/counterfeit parts. This study goes beyond merely assessing and reporting the status of the program, however. It is the authors intention to highlight the complex issues associated with suspect/counterfeit parts in the Department today and to present approaches that DOE managers might consider to address these issues.

  19. Adolescent sexuality and disability. (United States)

    Neufeld, Jacob A; Klingbeil, Fred; Bryen, Diane Nelson; Silverman, Brett; Thomas, Anila


    Regardless of what our beliefs about sex and disability may be, as health care providers we can promote the health and well being of our patients with disabilities in several ways. First and perhaps foremost, physical and programmatic barriers to accessing general health care including routine gynecologic care must be dramatically reduced. The promise of Title III of the Americans with Disabilities Act must be aggressively extended to our health care system to ensure equal access to routine health care for all. Second, knowledge of community resources that can support the healthy development and exercise of responsible and satisfying sexuality is critical. For example, health care providers should know about adaptive and assistive technologies as well as the use of personal care assistants to support the healthy although sometimes nontypical expression of one's sexuality. Centers for Independent Living are community resources that are often underutilized by the medical profession. These centers--run by and for people with disabilities--are likely resources and allies for providing education, role models, and peer mentoring around relationships, intimacy, sexuality, sexual expression, and parenting with a disability. Finally, sex education is a must and should include the following: Basic facts of life, reproduction, and sexual intercourse; Human growth and development Human reproduction and anatomy Self-pleasuring/masturbation and the use of sexual aids Intimacy and privacy Pregnancy and child birth Contraception and abortion Family life and parenthood Sexual response and consensual sex Sexual orientation Sexual abuse HIV/AIDS and other sexually transmitted diseases. The question should not be whether sex education is provided to persons with disabilities, but rather how it is most effectively provided. Health sex education must include the development of effective communication skills, decision-making skills, assertiveness, and the ability to say "no." It must

  20. Legal Rights of the Disabled and Disadvantaged. (United States)

    Allen, Richard C.

    The movement of the disabled and disadvantaged from charity to rights is described, and laws defining and applying to these individuals are reviewed. Specific attention is given to the socially and economically disadvantaged, including minority ethnic groups, the offender, and the poor, and to the mentally and physically disabled, including the…

  1. Suspect/Counterfeit Items Information Guide for Subcontractors/Suppliers

    Energy Technology Data Exchange (ETDEWEB)

    Tessmar, Nancy D. [Los Alamos National Laboratory; Salazar, Michael J. [Los Alamos National Laboratory


    Counterfeiting of industrial and commercial grade items is an international problem that places worker safety, program objectives, expensive equipment, and security at risk. In order to prevent the introduction of Suspect/Counterfeit Items (S/CI), this information sheet is being made available as a guide to assist in the implementation of S/CI awareness and controls, in conjunction with subcontractor's/supplier's quality assurance programs. When it comes to counterfeit goods, including industrial materials, items, and equipment, no market is immune. Some manufactures have been known to misrepresent their products and intentionally use inferior materials and processes to manufacture substandard items, whose properties can significantly cart from established standards and specifications. These substandard items termed by the Department of Energy (DOE) as S/CI, pose immediate and potential threats to the safety of DOE and contractor workers, the public, and the environment. Failure of certain systems and processes caused by an S/CI could also have national security implications at Los Alamos National Laboratory (LANL). Nuclear Safety Rules (federal Laws), DOE Orders, and other regulations set forth requirements for DOE contractors to implement effective controls to assure that items and services meet specified requirements. This includes techniques to implement and thereby minimizing the potential threat of entry of S/CI to LANL. As a qualified supplier of goods or services to the LANL, your company will be required to establish and maintain effective controls to prevent the introduction of S/CI to LANL. This will require that your company warrant that all items (including their subassemblies, components, and parts) sold to LANL are genuine (i.e. not counterfeit), new, and unused, and conform to the requirements of the LANL purchase orders/contracts unless otherwise approved in writing to the Los Alamos National Security (LANS) contract administrator

  2. Disability-related content in nursing textbooks. (United States)

    Smeltzer, Suzanne C; Robinson-Smith, Gale; Dolen, Mary Anne; Duffin, Janice M; Al-Maqbali, Majid


    Although the American with Disabilities Act in 1990 mandated that people with disabilities (PWDs) have equal access to facilities and services, men and women with disabilities continue to report receiving inadequate health care. The need to address disability in health professions education, including nursing, has been identified by the U.S. Surgeon General, researchers, and the disability community. This study examined how disability issues are integrated in textbooks commonly used in nursing programs and differences in coverage by seven textbook categories (e.g., medical-surgical, pediatrics). A total of 33 textbooks used in undergraduate nursing curricula were systematically reviewed for inclusion of disability content using a review grid developed with the input of PWDs. Two researchers independently reviewed each textbook and at least three members of the team developed consensus ratings for each of 224 content items for each textbook. Sums of consensus ratings were calculated for each topic, each textbook, and all seven categories of textbooks. Ratings of each category of disability-related content were calculated and ranked from highest to lowest. Two investigators reviewed the consensus ratings for each category of book as well as written comments provided during the initial steps of the review. Analysis revealed that disability-related content was largely absent from textbooks and categories of textbooks. Although disabling conditions were discussed, issues related to lifelong or preexisting disability were often not addressed. Abuse, a major issue for PWDs, was barely addressed in detail in any of the textbooks. There were significant differences (p = .005) in inclusion of disability-related content by type of textbook; the highest ranked category was community health. Topics that would be expected in specific categories were often addressed infrequently or not at all. The results of this study suggest the need for faculty members to address disability in

  3. Facing suspected child abuse – what keeps Swedish general practitioners from reporting to child protective services? (United States)

    Bengtsson Boström, Kristina; Östberg, Anna-Lena


    Abstract Objective. The aim of this study was to examine the reporting of suspected child abuse among Swedish general practitioners (GPs), and to investigate factors influencing them in their decision whether or not to report to child protective services (CPS). Design. A cross-sectional questionnaire study. Setting. Primary health care centres in western Sweden. Subjects. 177 GPs and GP trainees. Main outcome measures. Demographic and educational background, education on child abuse, attitudes to reporting and CPS, previous experience of reporting suspected child abuse, and need of support. Results. Despite mandatory reporting, 20% of all physicians had at some point suspected but not reported child abuse. Main reasons for non-reporting were uncertainty about the suspicion and use of alternative strategies; for instance, referral to other health care providers or follow-up of the family by the treating physician. Only 30% of all physicians trusted CPS's methods of investigating and acting in cases of suspected child abuse, and 44% of all physicians would have wanted access to expert consultation. There were no differences in the failure to report suspected child abuse that could be attributed to GP characteristics. However, GPs educated abroad reported less frequently to CPS than GPs educated in Sweden. Conclusions. This study showed that GPs see a need for support from experts and that the communication and cooperation between GPs and CPS needs to be improved. The low frequency of reporting indicates a need for continued education of GPs and for updated guidelines including practical advice on how to manage child abuse. PMID:25676563


    Directory of Open Access Journals (Sweden)

    Nazire Diker


    Full Text Available This paper aims to question the living conditions of disabled people in the 21st century from  the framework of social justice. The concept of “social justice” has a long history, influenced  by the works of numerous writers including Rawls (1971, Miller (1999, Reeves (2005, Fainstein (2009, Marcuse (2009 and Harvey (1992, 2009 and by the recent debates on  inequality, diversity, segregation, exclusion, and discrimination. The debates on segregation, exclusion and discrimination are generally focused on inequalities in terms of economic,  ethnic and gender dimensions; however, in these debates, there is very little reference to unequal opportunities of disabled people. On the other hand, the diversity issue is generally discussed with respect to ethnic and cultural elements, again with very little concern for the  rights of disabled people. In many developing countries, including Turkey, a legal framework  for addressing disability issues has started to be put in place. Awareness among governments and society of the needs and rights of people with disabilities is growing. In the  last decade in Turkey, the difficulties faced by disabled people have started to be taken into  consideration seriously. Before that, the only information about the disabled population could  be obtained from General Population Census in Turkey. In 2002 “Turkey Disability Survey” was carried out collectively by the State Institute of Statistics and the Presidency of  Administration on Disabled People. In this survey, it has been targeted to estimate the number of disabled people and comprehend their socio-economic characteristics, their  problems in social life, expectations, types and causes of disability, regional differences and also the proportion of population having chronic illnesses. After this survey, many projects  have started to be realized in order to propose strategies for eliminating discrimination in  Turkey. In this paper, we will

  5. 34 CFR 303.15 - Include; including. (United States)


    ... 34 Education 2 2010-07-01 2010-07-01 false Include; including. 303.15 Section 303.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH...

  6. The myth and reality of disability prevalence: measuring disability for research and service. (United States)

    McDermott, Suzanne; Turk, Margaret A


    The concept of disability has medical, functional, and social components. We review the frameworks for the definition of disability and endorse a multidimensional approach that is parsimonious and has utility for epidemiology. We need to be able to count people with disabilities to quantify service and support needs, to study the life course of people with specific disabilities, and to accurately target prevention strategies. In addition, it is important to have some precise measures of disability so comparisons can be made between impairments, to identify disparities and differences, and to measure changes over time. We need to ensure that there is no confusion about cause and effect (attributing associated conditions as outcomes of disability when they are in fact the cause of the functional limitation) and that comparisons to people without disabilities are fair. If people who experience disability due to a condition such as obesity are included in the case definition of disability, then we cannot say people with disability are more likely to be obese. The credibility of disability epidemiology and the disability field is at stake. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Stennis Space Center observes Disability Awareness Day (United States)


    Members of STARC, a non-profit organization in Slidell, La., that seeks to help people with disabilities lead meaningful, productive lives, pose with their appreciation awards during Disability Awareness Day at Stennis Space Center on Oct. 15. The group members received appreciation awards for their dedicated service to the rocket engine testing facility. Disability Awareness Day was hosted by the Stennis Diversity Council and included guest speakers from several area agencies.

  8. 34 CFR 300.20 - Include. (United States)


    ... 34 Education 2 2010-07-01 2010-07-01 false Include. 300.20 Section 300.20 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES...

  9. Psychosocial Influences in Onset and Progression of Late Life Disability


    Mendes de Leon, Carlos F; Rajan, Kumar B


    Objectives. Disability in older age has been related to several psychosocial characteristics, including social networks, social engagement, and depression. However, the exact role of these characteristics in the disablement process remains uncertain.

  10. Identifying genes responsible for intellectual disability in consanguineous families

    NARCIS (Netherlands)

    Iqbal, Z.; Bokhoven, H. van


    Consanguinity is an important determinant of birth defects including intellectual disability (ID). Consanguineous populations have a relative high prevalence of autosomal recessive forms of intellectual disability (ARID), which constitute a highly heterogeneous group of disorders both in their

  11. The Gifted/Learning Disabled. (United States)

    Jacobson, Vivienne

    Identification and programing are central topics in the discussion of gifted learning disabled (LD) students. Characteristics of gifted LD students are described, including talent in the creative arts. Reasons for overlooking this population are noted, including their ability to compensate for their problems. The degree of giftedness and of…

  12. Persistent disabling breathlessness in chronic obstructive pulmonary disease. (United States)

    Sundh, Josefin; Ekström, Magnus


    To determine the prevalence, change in breathlessness status over time, and risk factors for disabling and persistent disabling breathlessness in relation to treatments in chronic obstructive pulmonary disease (COPD). Longitudinal analysis of data from the Swedish National Register of COPD with breathlessness measured using modified Medical Research Council (mMRC) scores at two subsequent visits. Prevalence of disabling breathlessness (mMRC ≥2 at baseline) and persistent disabling breathlessness (disabling breathlessness at baseline and follow-up) was investigated in relation to COPD treatment. Risk factors for disabling breathlessness, change from non-disabling to disabling breathlessness, and persistent disabling breathlessness were analyzed using multiple logistic regression. A total of 1,689 patients were included in the study with a median follow-up of 12 months (interquartile range: 4 months). Prevalence of disabling breathlessness was 54% at baseline. Persistent disabling breathlessness was present in 43% of patients despite treatment and in 74% of patients despite combined inhaled triple therapy and physiotherapy. Risk factors for disabling breathlessness or change to disabling breathlessness were higher age, lower lung function, frequent exacerbations, obesity, heart failure, depression, and hypoxic respiratory failure (all P COPD despite treatment, which calls for improved symptomatic treatments and consideration of factors influencing disabling breathlessness. Factors influencing disabling breathlessness should be considered for COPD management.

  13. The use of psychoactive prescription drugs among DUI suspects. (United States)

    Karjalainen, Karoliina; Haukka, Jari; Lintonen, Tomi; Joukamaa, Matti; Lillsunde, Pirjo


    The study seeks to increase understanding of the use of psychoactive prescription drugs among persons suspected of driving under the influence (DUI). We studied whether the use of prescribed psychoactive medication was associated with DUI, and examined the difference in the use of prescription drugs between DUI recidivists and those arrested only once. In this register-based study, persons suspected of DUI (n=29470) were drawn from the Register of DUI suspects, and an age- and gender-matched reference population (n=30043) was drawn from the Finnish general population. Data on prescription drug use was obtained by linkage to the National Prescription Register. The associations of DUI arrest and use of psychoactive prescription drugs in different DUI groups (findings for alcohol only, prescription drugs, prescription drugs and alcohol, illicit drugs) were estimated by using mixed-effect logistic regression. The use of psychoactive prescription drugs and DUI appeared to be strongly associated, with DUI suspects significantly more likely to use psychoactive prescription drugs compared to the reference population. Gender differences existed, with the use of benzodiazepines being more common among female DUI suspects. Moreover, DUI recidivists were more likely to use psychoactive prescription drugs compared to those arrested only once. In addition to alcohol and/or illicit drug use, a significant proportion of DUI suspects were using psychoactive prescription drugs. When prescribing psychoactive medication, especially benzodiazepines, physicians are challenged to screen for possible substance use problems and also to monitor for patients' alcohol or illicit drug use while being medicated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Suspected Rhinolithiasis Associated With Endodontic Disease in a Cat. (United States)

    Ng, Kevin; Fiani, Nadine; Peralta, Santiago


    Rhinoliths are rare, intranasal, mineralized masses formed via the precipitation of mineral salts around an intranasal nidus. Clinical signs are typically consistent with inflammatory rhinitis and nasal obstruction, but asymptomatic cases are possible. Rhinoliths may be classified as exogenous or endogenous depending on the origin of the nidus, with endogenous rhinoliths reportedly being less common. This case report describes a suspected case of endogenous rhinolithiasis in a cat which was detected as an incidental finding during radiographic assessment of a maxillary canine tooth with endodontic disease. Treatment consisted of removal of the suspected rhinolith via a transalveolar approach after surgical extraction of the maxillary canine tooth.

  15. Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis

    DEFF Research Database (Denmark)

    Lauritsen, K B; Sommer, W; Hahn, L


    The diagnostic power of combined cholescintigraphy and ultrasonography was tested in 67 patients suspected of having acute cholecystitis; of these, 42 (63%) had acute cholecystitis. The predictive value of a positive scintigraphy (PVpos) was 95% and that of a negative (PVneg) was 91% (n = 67...... that in patients suspected of having acute cholecystitis cholescintigraphy should be the first diagnostic procedure performed. If the scintigraphy is positive, additional ultrasonographic detection of gallstones makes the diagnosis almost certain. If one diagnostic modality is inconclusive, the other makes a fair...

  16. Symptomatic Patency Capsule Retention in Suspected Crohn's Disease

    DEFF Research Database (Denmark)

    Rasmussen, Bjørn; Nathan, Torben; Jensen, Michael Dam


    The main limitation of capsule endoscopy is the risk of capsule retention. In patients with suspected Crohn's disease, however, this complication is rare, and if a small bowel stenosis is not reliably excluded, small bowel patency can be confirmed with the Pillcam patency capsule. We present two...... patients examined for suspected Crohn's disease who experienced significant symptoms from a retained patency capsule. Both patients had Crohn's disease located in the terminal ileum. In one patient, the patency capsule caused abdominal pain and vomiting and was visualized at magnetic resonance enterography...

  17. Situational leadership and persons with disabilities. (United States)

    Cubero, Christopher G


    Does situational leadership style impact workers with disabilities? Situational leadership as a model and style of organizational management is defined. With a concentration on workers with disabilities, employer and employee perceptions of the workplace environment are analyzed as a contributing factor to the choice of leadership styles. Leadership style and its potential impact on workers with disabilities are included. Advantages of situational leadership style as an organizational model for managers that matches the intricate needs of workers with disabilities are argued. Methods for increasing awareness of the needs of persons with disabilities in the workplace and improving leadership models are discussed. Implications and potential outcomes for workers with disabilities based on the use of situational leadership by managers are discussed.

  18. Sexuality among People with Physical Disability

    Directory of Open Access Journals (Sweden)

    Birgul Elbozan Cumurcu


    Full Text Available Physical disability is termed as disturbance or defect which impede or eliminate human body’s ability by disturbing human structure and shape. Physical disability may occur due to neonatal, natal or postnatal causes. People with physical disability have some natural needs as everyone. They are known to have difficulties in many areas of life. In society, sexual lives of these individuals are treated as an unknown and ignored issue, and moreover it has been assumed that they have no such needs. Disabled patients experience many troubles in their life domains including sexuality. This article provides information about physical disability and sexuality, and difficulties with which disabled people faces in their sexual life and overviews literature on this topic.

  19. Psychotherapy with people with developmental disabilities

    Directory of Open Access Journals (Sweden)

    Barbara Zafošnik


    Full Text Available People with developmental disabilities can experience any psychological abnormalitiy and psychiatric illness as do people without developmental disabilities. Due to different diagnostic criteria, assessment procedures and instruments, we lack definite prevalence rates for people with developmental disabilities, also suffering from mental health problems, eventhough most studies place the rate at 20 to 40%. One of the possible treatment alternatives for augmenting psychological well-being is psychotherapy, but is extremely rarely used for people with severe and profound disabilities, where speech cannot be the main therapeutic medium. So, those that are included in the psychotherapuetic process are predominantly clients with mild developmental disabilities, and they are mostly in cognitive-behavioral therapy. Recently, two models of (psychotherapy for persons with severe and profound developmental disabilities were developed: developmental-dynamic relationship therapy and attachment-based behaviour therapy for children. Conceptually, they both originate form developmental psychoanalytic theories.

  20. Investigation of a suspected outbreak of lipoatrophia semicircularis in children. (United States)

    Rius, Cristina; Baselga, Eulalia; Tizón, Jorge; Fuentes, Paulina; Muñoz-Garza, Fania Zamantta; Roigé, Glòria; Llebaria, Xavier; Caylà, Joan A


    Recent reports of outbreaks of lipoatrophia semicircularis (LS) in various countries have generated discussion regarding the potential role of the environmental characteristics of office workplaces in new buildings. The objective of this study was to investigate a suspected outbreak of LS among children in a public school in Barcelona, which generated tremendous alarm. We performed an epidemiological assessment including descriptive and prevalence analyses, and an environmental investigation followed by a psychiatric assessment according to Small's criteria. We compared the prevalence of LS and its 95% confidence interval between children and staff attending the day-care centre under study and other centres. Among 86 children attending a day-care centre we detected 11 confirmed and 2 possible cases of LS (15.1%) while among 41 children attending other day-care centres we identified 8 cases and 4 possible cases (29.3%) (P=.10). Among 12 day-care staff, we detected 8 cases of LS (66.7%) while among 19 women working different jobs we identified 14 with the same condition as the staff (73.7%) (P=.98). All lesions were finally classified as indentations with different locations. The environmental evaluation didn't identify any exposure factors with a significant role in the onset of the outbreak. The outbreak shared 13 of Small's 16 criteria regarding epidemic somatoform disorder ("mass hysteria"). The presence of indentations can be considered a normal variant in the lower extremities of children. The characteristic development of the process leads us to the conclusion that this outbreak was an epidemic somatoform disorder. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  1. [Breath tests in children with suspected lactose intolerance]. (United States)

    Parra, P Ángela; Furió, C Simone; Arancibia, A Gabriel


    Up to 70% of the world population is lactose intolerance. However, there are no epidemiological studies among Chilean pediatric population affected by this condition. Clinical characterization of a series of children who underwent the lactose intolerance breath test for lactose intolerance study, establishing intolerance and malabsorption frequencies, the most frequent symptoms, and test performance depending on the origin. Patients under 18 years old who took the lactose intolerance breath test in the Gastroenterology Laboratory of the Catholic University of Chile, and who were admitted due to clinically suspected lactose intolerance. Malabsorption was considered when there was as an increase of ≥20ppm above the baseline (H2) or ≥34ppm of H2 and methane (CH4) combined. Intolerance was considered when the above was associated with a symptom intensity score ≥7 during registration. The analysis included194 patients aged 1 to17 years of age. Of these, 102 (53%) presented with malabsorption, and 53 (27%) were intolerant. The frequency of lactose intolerance varied from 7.1 to 45.4%, and it occurred more frequently at older ages. The most common reported symptoms were abdominal pain, bloating and rumbling. Lactose malabsorption and intolerance can be investigated from the first years of life using the lactose breath test plus a symptom questionnaire. An increase in the frequency of intolerance with age, and a greater number of positive tests, if they were requested by a gastroenterologist, were observed. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Chabanova, Elizaveta, E-mail: [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Balslev, Ingegerd, E-mail: [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Achiam, Michael, E-mail: [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Nielsen, Yousef W., E-mail: [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Adamsen, Sven, E-mail: [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Gocht-Jensen, Peter, E-mail: [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Brisling, Steffen K., E-mail: [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Logager, Vibeke B., E-mail: [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Thomsen, Henrik S., E-mail: [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark)


    Purpose: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. Materials and methods: The prospective study included 48 consecutive patients (29 female, 19 male, 18-70 years old, mean age = 37.1 years). MRI examination was designed to be comfortable and fast; no contrast was administered. The sequences were performed during quiet respiration. The MRI findings were reviewed by two radiologists and one surgeon independent of each other and compared with surgical and pathological records. Results: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14 patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate ({kappa} = 0.51) and fair ({kappa} = 0.31) interobserver agreements in the MR diagnosis of acute appendicitis were found between the reviewers. Sensitivity, specificity and accuracy values for overall performance of MRI in detecting pelvic abnormalities were 100%, 75% (3 of 4 healthy patients were identified by MRI) and 98%, respectively. Conclusion: Unenhanced fast MRI is feasible as an additional fast screening before the appendectomy. It may prevent unnecessary surgeries. The fast MRI examination can be adequately performed on an MRI unit of broad range of field strengths.

  3. Infusing Disability Sport into the Sport Management Curriculum

    Directory of Open Access Journals (Sweden)

    Jimmy Calloway


    Full Text Available Disability sport is growing around the world with momentum and is described as a “movement” (Bailey, 2008; DePauw & Gavron, 2005. While there are more similarities than differences with sport management for able-bodied athletes and those with disabilities, there are additional needs and considerations for persons with disabilities (DePauw & Gavron, 2005. The noticeable visibility of individuals with disabilities in society, including sport, raises concerns about the degree to which sport management academic programs have modified their curricula to ensure that individuals working in the sport management field are prepared to deal with theuniqueness of disability sport. This paper (a discusses theoretical perspectives toward understanding and thinking about disability, (b explores ways to enhance sport management curricula through infusion of disability sport, (c reflects upon current social practices for curriculum integration of athletes with disabilities in sport, and (d acknowledges infusion of disability sport businesses, organizations and events.

  4. Comparison of cortisol and thyroid hormones between tuberculosis-suspect and healthy elephants of Nepal. (United States)

    Paudel, Sarad; Brown, Janine L; Thapaliya, Sharada; Dhakal, Ishwari P; Mikota, Susan K; Gairhe, Kamal P; Shimozuru, Michito; Tsubota, Toshio


    We compared cortisol and thyroid hormone (T3 and T4) concentrations between tuberculosis (TB)-suspected (n=10) and healthy (n=10) elephants of Nepal. Whole blood was collected from captive elephants throughout Nepal, and TB testing was performed using the ElephantTB STAT-PAK® and DPP VetTB® serological assays that detect antibodies against Mycobacterium tuberculosis and M. bovis in elephant serum. Cortisol, T3 and T4 were quantified by competitive enzyme immunoassays, and the results showed no significant differences in hormone concentrations between TB-suspect and healthy elephants. These preliminary data suggest neither adrenal nor thyroid function is altered by TB disease status. However, more elephants, including those positively diagnosed for TB by trunk wash cultures, need to be evaluated over time to confirm results.

  5. Routine deferred computed tomography for patients with suspected urolithiasis is low-value healthcare. (United States)

    Rosenlund, Ingvild M; Førde, Olav H; Revhaug, Arthur


    The aim of this study was to investigate the benefits of deferred routine computed tomography of the kidneys, ureters and bladder (CT KUB) for patients with a self-limiting episode of suspected urolithiasis. The study comprised a case series of consecutive patients examined with deferred routine CT KUB for control of suspected urolithiasis. Patients examined with CT KUB at the University Hospital of North Norway, between 1 January 2010 and 31 December 2013, were included. The final analysis included 189 CT KUBs (response rate 48%). All data were extracted from the patient case files. The primary endpoint was the proportion of asymptomatic patients with a confirmed diagnosis of urolithiasis on CT KUB that led to surgical intervention within 1 year from the initial CT scan. At the time of CT KUB, 171 patients (90%) were asymptomatic, of whom three (1.8%) were treated. Urolithiasis was confirmed on CT KUB in 23% of asymptomatic patients. Deferred CT KUB did not alter the clinical outcome for the great majority of asymptomatic patients. The majority of patients who received adequate pain relief in primary care remained asymptomatic, and did not need specialized healthcare. Refraining from CT KUB involves little risk. Deferred CT KUB for patients with suspected urolithiasis is a low-value healthcare service.

  6. Efficacy of lithium carbonate on public and compulsive masturbation: a female case with mild mental disability. (United States)

    Nishimura, H; Suzuki, M; Kasahara, H; Ushijima, S


    The efficacy of lithium carbonate in the first reported case of a female with mild mental disability who engaged in public and compulsive masturbation is described. The patient was born in 1975, and was 19 years old at first admission. A diagnosis of schizophrenia was initially suspected, therefore the patient was given medication including pimozide, haloperidol, carbamazepine, diazepam and levomepromazine. These medications, however, did not control the symptoms, and the patient showed several side effects, such as incontinence. Only lithium carbonate was efficacious among the medications administered; the patient's abnormal sexual behavior was significantly reduced and no conspicuous side effects were recognized. The mechanisms of lithium carbonate in controlling abnormal sexual behavior are discussed.

  7. Raising Expectations for U.S. Youth with Disabilities: Federal Disability Policy Advances Integrated Employment

    Directory of Open Access Journals (Sweden)

    Jeanne Novak


    Full Text Available While conversations around the inclusion of individuals with disabilities often focus on the educational rights and needs of children with disabilities during their school years, there is a growing recognition that the period of transition from secondary school to adult roles is a critical time in the lives of individuals with disabilities. For young people, gaining meaning ful employment in a typical community job is an important step towards realising full community membership. The present article examines how contemporary U.S. federal disability policy has heightened expectations that youth with disabilitiesincluding those with significant disabilities – can and should be prepared to work in integrated workplaces. The article begins with a consideration of how evolving assumptions about the nature of disability and the employment potential of individuals with significant disabilities have influenced the development of federal disability policy in the U.S. This is followed by an overview of key legislative and policy developments in the areas of civil rights and workforce development that have the potential to dramatically impact the employment outlook for young people with disabilities. The article concludes with a discussion of challenges in translating the legislative intent of federal disability policy into noticeable improvements in employment outcomes, along with recommendations for aligning legislation, funding priorities and service delivery systems to achieve policy goals.

  8. Technology, Disability, and Law: Then and Now (United States)

    Dalsen, Jennifer


    Disability law and technology services share a rich history. This article investigates this transformative relationship through the contextual framework of the Individuals with Disabilities Education Act. A summary of legal cases, accommodation services, and barriers to access are explored. This includes an overview of the challenges facing…

  9. Child Disability: A Study of Three Families. (United States)

    Bloom, Barbara

    This qualitative study used questionnaires, interviews, and observations to assess what having children with disabilities means to three families. The disabilities include severe mental retardation and seizure disorder, Down syndrome, and neurofibromatosis. Interview data were categorized into the following five areas: the children,…

  10. Learning Disabled and Gifted: Success or Failure? (United States)

    Wolf, Joan; Gygi, Janice


    Many gifted learning disabled (LD) students are identified by their handicapping condition rather than by their giftedness. Some suggestions for dealing with these students include providing opportunities for concentration on strengths as well as weaknesses and finding ways to circumvent the specific disability so that enrichment can take place.…

  11. Programs for Individuals with Developmental Disabilities. Revised. (United States)

    Sizemore, C. J.

    This publication describes the programs and services offered through the Office of Developmental Disabilities of the Illinois Department of Human Services. Introductory information includes an overview of supports and service, a definition of "developmental disability," and a guide to the publication. This is followed by a description of…

  12. PMS2 Involvement in Patients Suspected of Lynch Syndrome

    NARCIS (Netherlands)

    Niessen, Renee C.; Kleibeuker, Jan H.; Westers, Helga; Jager, Paul O. J.; Rozeveld, Dennie; Bos, Krista K.; Boersma-van Ek, Wytske; Hollema, Harry; Sijmons, Rolf H.; Hofstra, Robert M. W.

    It is well-established that germline mutations in the mismatch repair genes MLH1, MSH2, and MSH6 cause Lynch syndrome. However, mutations in these three genes do not account for all Lynch syndrome (suspected) families. Recently, it was shown that germline mutations in another mismatch repair gene,

  13. Faecal Calprotectin in Suspected Paediatric Inflammatory Bowel Disease

    NARCIS (Netherlands)

    Degraeuwe, Pieter L. J.; Beld, Monique P. A.; Ashorn, Merja; Canani, Roberto Berni; Day, Andrew S.; Diamanti, Antonella; Fagerberg, Ulrika L.; Henderson, Paul; Kolho, Kaija-Leena; Van de Vijver, Els; van Rheenen, Patrick F.; Wilson, David C.; Kessels, Alfons G. H.

    Objectives: The diagnostic accuracy of faecal calprotectin (FC) concentration for paediatric inflammatory bowel disease (IBD) is well described at the population level, but not at the individual level. We reassessed the diagnostic accuracy of FC in children with suspected IBD and developed an

  14. Stabilization of the spine in patients with suspected cervical spine ...

    African Journals Online (AJOL)

    Stabilization of the spine in patients with suspected cervical spine injury in Mulago Hospital. BM Ndeleva, T Beyeza. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · · AJOL African Journals ...

  15. Talking heads : interviewing suspects from a cultural perspective

    NARCIS (Netherlands)

    Beune, K.


    Although the literature on the interviewing of suspects has increased over the past decade, research on the use and effectiveness of police strategies and their boundary conditions is very rare. The present dissertation aims to fill this void by identifying behaviors that appeal to and persuade

  16. DNA typing from vaginal smear slides in suspected rape cases

    Directory of Open Access Journals (Sweden)

    Dayse Aparecida da Silva

    Full Text Available In an investigation of suspected rape, proof of sexual assault with penetration is required. In view of this, detailed descriptions of the genitalia, the thighs and pubic region are made within the forensic medical service. In addition, vaginal swabs are taken from the rape victim and some of the biological material collected is then transferred to glass slides. In this report, we describe two rape cases solved using DNA typing from cells recovered from vaginal smear slides. In 1999, two young women informed the Rio de Janeiro Police Department that they had been victims of sexual assaults. A suspect was arrested and the victims identified him as the offender. The suspect maintained that he was innocent. In order to elucidate these crimes, vaginal smear slides were sent to the DNA Diagnostic Laboratory for DNA analysis three months after the crimes, as unique forensic evidence. To get enough epithelial and sperm cells to perform DNA analysis, we used protocols modified from the previously standard protocols used for DNA extraction from biological material fixed on glass slides. The quantity of cells was sufficient to perform human DNA typing using nine short tandem repeat (STR loci. It was 3.3 billion times more probable that it was the examined suspect who had left sperm cells in the victims, rather than any other individual in the population of Rio de Janeiro.

  17. Cognitive Linguistic Performances of Multilingual University Students Suspected of Dyslexia (United States)

    Lindgren, Signe-Anita; Laine, Matti


    High-performing adults with compensated dyslexia pose particular challenges to dyslexia diagnostics. We compared the performance of 20 multilingual Finnish university students with suspected dyslexia with 20 age-matched and education-matched controls on an extensive test battery. The battery tapped various aspects of reading, writing, word…

  18. Differential Diagnosis of Children with Suspected Childhood Apraxia of Speech (United States)

    Murray, Elizabeth; McCabe, Patricia; Heard, Robert; Ballard, Kirrie J.


    Purpose: The gold standard for diagnosing childhood apraxia of speech (CAS) is expert judgment of perceptual features. The aim of this study was to identify a set of objective measures that differentiate CAS from other speech disorders. Method: Seventy-two children (4-12 years of age) diagnosed with suspected CAS by community speech-language…

  19. A suspected case of Addison’s disease in cattle


    Lambacher, Bianca; Wittek, Thomas


    A 4.75-year old Simmental cow was presented with symptoms of colic and ileus. The clinical signs and blood analysis resulted in the diagnosis of suspected primary hypoadrenocorticism (Addison’s disease). Although Addison’s disease has been frequently described in other domestic mammals, to our knowledge, this disease has not previously been reported in cattle.

  20. Is extended biopsy protocol justified in all patients with suspected ...

    African Journals Online (AJOL)

    Objective: To determine the significance of an extended 10-core transrectal biopsy protocol in different categories of patients with suspected prostate cancer using digital guidance. Materials and Methods: We studied 125 men who were being evaluated for prostate cancer. They all had an extended 10-core digitally guided ...

  1. Correlates and Suspected Causes of Obesity in Children (United States)

    Crothers, Laura M.; Kehle, Thomas J.; Bray, Melissa A.; Theodore, Lea A.


    The correlates and suspected causes of the intractable condition obesity are complex and involve environmental and heritable, psychological and physical variables. Overall, the factors associated with and possible causes of it are not clearly understood. Although there exists some ambiguity in the research regarding the degree of happiness in…

  2. Selective screening in neonates suspected to have inborn errors of ...

    African Journals Online (AJOL)

    Background: Inborn errors of metabolism (IEM) have a high morbidity and mortality in neonates. Unfortunately, there is no nationwide neonatal screen in Egypt, so several cases may be missed. Objective: The aim of this work was to detect the prevalence of IEM among neonates with suspected IEM, and to diagnose IEM as ...

  3. Sexual Health Before Treatment in Women with Suspected Gynecologic Malignancy. (United States)

    Bretschneider, C Emi; Doll, Kemi M; Bensen, Jeannette T; Gehrig, Paola A; Wu, Jennifer M; Geller, Elizabeth J


    Sexual health in survivors of gynecologic cancer has been studied; however, sexual health in these women before treatment has not been thoroughly evaluated. The objective of our study was to describe the pretreatment characteristics of sexual health of women with suspected gynecologic cancer before cancer treatment. We performed a cross-sectional analysis of women with a suspected gynecologic cancer, who were prospectively enrolled in a hospital-based cancer survivorship cohort from August 2012 to June 2013. Subjects completed the validated Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction Questionnaire. Pretreatment sexual health was assessed in terms of sexual interest, desire, lubrication, discomfort, orgasm, enjoyment, and satisfaction. Of 186 eligible women with suspected gynecologic cancer, 154 (82%) completed the questionnaire pretreatment. Mean age was 58.1 ± 13.3 years. Sexual health was poor: 68.3% reported no sexual activity, and 54.7% had no interest in sexual activity. When comparing our study population to the general U.S. population, the mean pretreatment scores for the subdomains of lubrication and vaginal discomfort were similar, while sexual interest was significantly lower and global satisfaction was higher. In a linear regression model, controlling for cancer site, age remained significantly associated with sexual function while cancer site did not. Problems with sexual health are prevalent in women with suspected gynecologic malignancies before cancer treatment. Increasing awareness of the importance of sexual health in this population will improve quality of life for these women.

  4. Use of budesonide Turbuhaler in young children suspected of asthma

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Nikander, K


    The question addressed in this study was the ability of young children to use a dry-powder inhaler, Turbuhaler. One hundred and sixty five children suspected of asthma, equally distributed in one year age-groups from 6 months to 8 yrs, inhaled from a Pulmicort Turbuhaler, 200 micrograms budesonid...

  5. Doppler ultrasound in the assessment of suspected intra-uterine ...

    African Journals Online (AJOL)


    obesity with hypertension and non-insulin-dependent diabetes mellitus.[3] In this review, a brief discussion about the ultrasound diagnosis of suspected IUGR, and thereafter about the use of Doppler ultrasound in the diagnosis of IUGR, will be ... before that, all fetuses have relatively larger heads, which will mask the brain-.

  6. Candida meningitis in a suspected immunosuppressive patient - A ...

    African Journals Online (AJOL)

    Candida meningitis in a suspected immunosuppressive patient - A case report. EO Sanya, NB Ameen, BA Onile. Abstract. No Abstract. West African Journal of Medicine Vol. 25 (1) 2006: pp.79-81. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  7. A Diagnostic Program for Patients Suspected of Having Lung Cancer

    NARCIS (Netherlands)

    Stigt, Jos A.; Uil, Steven M.; Oostdijk, Ad H.; Boers, James E.; van den Berg, Jan-Willem K.; Groen, Harry J. M.


    In 297 patients suspected of having lung cancer, invasive diagnostic procedures followed positron emission tomography/computed tomography (PET-CT) on the same day. For patients with a diagnosis of malignancy (215/297), investigations were finalized on 1 day in 85%, and bronchoscopy was performed in

  8. Use of Chest Radiography In Patients Suspected of Pulmonary ...

    African Journals Online (AJOL)

    may be rushed into treatfng all cases of cough, fever and weight loss with negative sputums as PTB, and other diagnoses may be overlooked. A cheaper, quicker way of screening TB suspects would help con- siderably in this common problem. In Febuary 1991, the Norwegian Government do- nated two Odelka camer;l,s to ...

  9. Opioid analgesic administration in patients with suspected drug use. (United States)

    Kreling, Maria Clara Giorio Dutra; Mattos-Pimenta, Cibele Andrucioli de


    To identify the prevalence of patients suspected of drug use according to the nursing professionals' judgement, and compare the behavior of these professionals in opioid administration when there is or there is no suspicion that patient is a drug user. A cross-sectional study with 507 patients and 199 nursing professionals responsible for administering drugs to these patients. The Chi-Square test, Fisher's Exact and a significance level of 5% were used for the analyzes. The prevalence of suspected patients was 6.7%. The prevalence ratio of administration of opioid analgesics 'if necessary' is twice higher among patients suspected of drug use compared to patients not suspected of drug use (p = 0.037). The prevalence of patients suspected of drug use was similar to that of studies performed in emergency departments. Patients suspected of drug use receive more opioids than patients not suspected of drug use. Identificar a prevalência de pacientes com suspeita de uso de drogas conforme opinião de profissionais de enfermagem e comparar a conduta desses profissionais na administração de opioides quando há ou não suspeita de que o paciente seja usuário de drogas. Estudo transversal com 507 pacientes e 199 profissionais de enfermagem responsáveis pela administração de medicamentos a esses pacientes. Para as análises foram utilizados os testes de Qui-Quadrado, Exato de Fisher e um nível de significância de 5%. A prevalência de pacientes suspeitos foi 6,7%. A razão de prevalência de administração de analgésicos opioides "se necessário" é duas vezes maior entre os pacientes suspeitos em relação aos não suspeitos (p=0,037). A prevalência de suspeitos foi semelhante à de estudos realizados em departamentos de emergência. Os suspeitos de serem usuários de drogas recebem mais opioides do que os não suspeitos.

  10. Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement. (United States)

    Gil-Martínez, Alfonso; Grande-Alonso, Mónica; López-de-Uralde-Villanueva, Ibai; López-López, Almudena; Fernández-Carnero, Josué; La Touche, Roy


    The objective was to compare and correlate disability, pain intensity, the impact of headache on daily life and the fear of movement between subgroups of patients with chronic temporomandibular disorder (TMD). A cross-sectional study was conducted in patients diagnosed with chronic painful TMD. Patients were divided into: 1) joint pain (JP); 2) muscle pain (MP); and 3) mixed pain. The following measures were included: Craniomandibular pain and disability (Craniofacial pain and disability inventory), neck disability (Neck Dsiability Index), pain intensity (Visual Analogue Scale), impact of headache (Headache Impact Test 6) and kinesiophobia (Tampa Scale of Kinesiophobia-11). A total of 154 patients were recruited. The mixed pain group showed significant differences compared with the JP group or MP group in neck disability (p pain and disability (p pain and disability for the MP group (β = 0.62; p pain group, neck disability (β = 0.40; p pain and disability. Mixed chronic pain patients show greater craniomandibular and neck disability than patients diagnosed with chronic JP or MP. Neck disability predicted the variance of craniofacial pain and disability for patients with MP. Neck disability and kinesiophobia predicted the variance of craniofacial pain and disability for those with chronic mixed pain.

  11. Optimizing imaging in suspected appendicitis (OPTIMAP-study: A multicenter diagnostic accuracy study of MRI in patients with suspected acute appendicitis. Study Protocol

    Directory of Open Access Journals (Sweden)

    Bossuyt Patrick MM


    Full Text Available Abstract Background In patients with clinically suspected appendicitis, imaging is needed to substantiate the clinical diagnosis. Imaging accuracy of ultrasonography (US is suboptimal, while the most accurate technique (CT is associated with cancer related deaths through exposure to ionizing radiation. MRI is a potential replacement, without associated ionizing radiation and no need for contrast medium administration. If MRI is proven to be sufficiently accurate, it could be introduced in the diagnostic pathway of patients with suspected appendicitis, increasing diagnostic accuracy and improving clinical outcomes, without the risk of radiation induced cancer or iodinated contrast medium-related drawbacks. The multicenter OPTIMAP study was designed to estimate the diagnostic accuracy of MRI in patients with suspected acute appendicitis in the general population. Methods/Design Eligible for this study are consecutive patients presenting with clinically suspected appendicitis at the emergency department in six centers. All patients will undergo imaging according to the Dutch guideline for acute appendicitis: initial ultrasonography in all and subsequent CT whenever US does not confirm acute appendicitis. Then MRI is performed in all patients, but the results are not used for patient management. A final diagnosis assigned by an expert panel, based on all available information including 3-months follow-up, except MRI findings, is used as the reference standard in estimating accuracy. We will calculate the sensitivity, specificity, predictive values and inter-observer agreement of MRI, and aim to include 230 patients. Patient acceptance and total imaging costs will also be evaluated. Discussion If MRI is found to be sufficiently accurate, it could replace CT in some or all patients. This will limit or obviate the ionizing radiation exposure associated risk of cancer induction and contrast medium induced nephropathy with CT, preventing the burden and

  12. Universal design in housing for people with disabilities: A review

    Directory of Open Access Journals (Sweden)

    Siti Kalkhalah Shahrom


    Full Text Available Housing standard for disabled people is a new dimension in quality of life. To the disabled people who are housebound, the house is the central focus of their existence. Over the last ten years, more focused studies have been conducted on the relationship between housing and people with disabilities. This paper reveals the needs of universal design in housing for disabled people and policies that can be improved. The main focus is on housing design for people with disabilities that begins with an overview on housing needs concept, theory and model, and followed by the topics on housing crisis for disabled people. These reviews looked at the existing literatures on universal design in residential remodeling including the principles of universal design, housing features, design, space and accessibility. It concludes by providing housing strategy for people with disabilities including disabled rights, information and advocacy from various countries.

  13. Parent Report of Conversations with Their Adolescents with Intellectual Disability (United States)

    Jones, Jennifer L.; Oseland, Lauren M.; Morris, Kathryn L.; Larzelere, Robert E.


    Background: The purpose of this study was to examine parent report of conversations about difference and disability in families of adolescents with intellectual disability. Materials and Methods: Participants included 50 parents (44 mothers, four fathers, and two other caregivers) and their adolescents with intellectual disability (M age = 15.9).…

  14. Deaf Children with Disabilities: Rights under the IDEA (United States)

    Raimondo, Barbara


    Parents of children who are deaf and who have disabilities often face barriers in ensuring that their children receive the services they need. Some of these barriers include lack of awareness about deafness-disability constellations, shortages of professionals knowledgeable about how deaf children learn or the impact of the disability on deaf…

  15. Intellectual Disability in the Context of a South African Population (United States)

    Kromberg, Jennifer; Zwane, Esther; Manga, Prashiela; Venter, Andre; Rosen, Eric; Christianson, Arnold


    Childhood disabilities, including intellectual disabilities (ID), are thought to occur in 5-17% of children in developing countries around the world. In order to identify and describe the childhood disabilities occurring in a rural South African population, as well as the context in which they occur, a study was carried out in the Bushbuckridge…

  16. The Challenge of Identifying Gifted/Learning Disabled Students (United States)

    Krochak, Linda A.; Ryan, Thomas G.


    The following contemporary review illuminates several of the "best methods" to accurately identify gifted/learning disabled (GLD) students? Explanations which clearly define what it means to be gifted, learning disabled (LD) and gifted/learning disabled (GLD) are included and incorporated into a typology of three identities of GLD…

  17. 78 FR 73683 - International Day of Persons With Disabilities, 2013 (United States)


    ... with Disabilities Act (ADA), a landmark civil rights bill that enshrined the principles of inclusion... high standards of access and inclusion, and expand opportunities for Americans with disabilities-- including our 5.5 million disabled veterans--to work, study, and travel abroad. My Administration remains...

  18. What is an Intellectual Disability? (United States)

    ... Too Tall or Too Short What Is an Intellectual Disability? KidsHealth > For Kids > What Is an Intellectual Disability? ... and becoming an independent person. continue What Causes Intellectual Disabilities? Intellectual disabilities happen because the brain gets injured ...

  19. Towards rational use of antibiotics for suspected secondary infections in Buruli ulcer patients. (United States)

    Barogui, Yves T; Klis, Sandor; Bankolé, Honoré Sourou; Sopoh, Ghislain E; Mamo, Solomon; Baba-Moussa, Lamine; Manson, Willem L; Johnson, Roch Christian; van der Werf, Tjip S; Stienstra, Ymkje


    The emerging disease Buruli ulcer is treated with streptomycin and rifampicin and surgery if necessary. Frequently other antibiotics are used during treatment. Information on prescribing behavior of antibiotics for suspected secondary infections and for prophylactic use was collected retrospectively. Of 185 patients that started treatment for Buruli ulcer in different centers in Ghana and Bénin 51 were admitted. Forty of these 51 admitted patients (78%) received at least one course of antibiotics other than streptomycin and rifampicin during their hospital stay. The median number (IQR) of antibiotic courses for admitted patients was 2 (1, 5). Only twelve patients received antibiotics for a suspected secondary infection, all other courses were prescribed as prophylaxis of secondary infections extended till 10 days on average after excision, debridement or skin grafting. Antibiotic regimens varied considerably per indication. In another group of BU patients in two centers in Bénin, superficial wound cultures were performed. These cultures from superficial swabs represented bacteria to be expected from a chronic wound, but 13 of the 34 (38%) S. aureus were MRSA. A guide for rational antibiotic treatment for suspected secondary infections or prophylaxis is needed. Adherence to the guideline proposed in this article may reduce and tailor antibiotic use other than streptomycin and rifampicin in Buruli ulcer patients. It may save costs, reduce toxicity and limit development of further antimicrobial resistance. This topic should be included in general protocols on the management of Buruli ulcer.

  20. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review. (United States)

    Zafrir, Yaron; Trattner, Akiva; Hodak, Emmillia; Eldar, Oren; Lapidoth, Moshe; Ben Amitai, Dan


    Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background. © 2017 Wiley Periodicals, Inc.

  1. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Mai E.; Valdehueza, Zaldy D.; Wiarda, Bart M. [Medical Centre Alkmaar, Department of Radiology, Alkmaar (Netherlands); Leeuwenburgh, Marjolein M.N. [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands); Academic Medical Centre Amsterdam, Department of Surgery, Amsterdam (Netherlands); Bouman, Donald E. [Medical Spectrum Twente, Department of Radiology, Enschede (Netherlands); Bruin, Ivar G.J.M. de; Schreurs, W.H.; Houdijk, Alexander P.J. [Medical Centre Alkmaar, Department of Surgery, Alkmaar (Netherlands); Stoker, Jaap [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands)


    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h, with the reader blinded to other imaging findings. An expert panel established the final diagnosis after 3 months. We evaluated the diagnostic accuracy of three imaging strategies: ultrasound only, conditional MRI after negative or inconclusive ultrasound, and MRI only. Significance between sensitivity and specificity was calculated using McNemar's test statistic. Between April and December 2009 we included 104 consecutive children (47 male, mean age 12). According to the expert panel, 58 patients had appendicitis. The sensitivity of MRI only and conditional MRI was 100 % (95 % confidence interval 92-100), that of ultrasound was significantly lower (76 %; 63-85, P < 0.001). Specificity was comparable among the three investigated strategies; ultrasound only 89 % (77-95), conditional MRI 80 % (67-89), MRI only 89 % (77-95) (P values 0.13, 0.13 and 1.00). In children with suspected appendicitis, strategies with MRI (MRI only, conditional MRI) had a higher sensitivity for appendicitis compared with a strategy with ultrasound only, while specificity was comparable. (orig.)

  2. Positron emission tomography myocardial perfusion imaging in children with suspected coronary abnormalities. (United States)

    Singh, T P; Muzik, O; Forbes, T F; Di Carli, M F


    Positron emission tomography (PET) myocardial perfusion imaging has higher spatial resolution than conventional single photon emission computed tomography (SPECT) imaging and allows accurate and reproducible quantification of myocardial blood flow (MBF). In this article, we describe the role of PET myocardial perfusion imaging in clinical decision making in children with suspected coronary abnormalities. We performed a PET myocardial perfusion study using N-13 ammonia in 10 children (median age, 14 years; range, 1-17 years). The indications included exercise-induced chest pain and ST segment changes during exercise testing, coronary artery ectasia, hypertrophic cardiomyopathy with myocardial bridging of the left anterior descending coronary artery, and suspected left coronary stenosis in an infant with William's syndrome. MBF was assessed at baseline and during adenosine hyperemia in all 10 patients and postexercise in 8 patients. Myocardial perfusion was homogeneous at baseline in all 10 patients, during adenosine perfusion in 9 of 10 patients, and postexercise in all 8 patients. Three patients with homogeneous rest and stress perfusion had impaired myocardial flow reserve. The infant with William's syndrome developed a large, reversible perfusion defect in the left coronary territory during adenosine stress and underwent surgical repair. Myocardial flow reserve findings were valuable for clinical decision making in individual patients. We conclude that MBF quantification with N-13 ammonia and PET provides supplemental perfusion information and is helpful in clinical decision making in children with suspected coronary abnormalities.

  3. Incidental findings at MRI-enterography in patients with suspected or known Crohn's disease

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Nathan, Torben; Kjeldsen, Jens


    AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine, not previou......AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine......, not previously known or suspected at the time of referral, and not related to inflammatory bowel disease. Through a systematic review of medical charts we analyzed the clinical impact of incidental findings, and compared the MRI findings with subsequent diagnostic procedures. RESULTS: A total of 283 patients...... were included in the analysis, and MRI detected active CD in 31%, fistula in 1.4% and abscess in 0.7%. Extra-intestinal findings not related to CD were recorded in 72 patients (25%), of which 58 patients (20%) had 74 previously unknown lesions. Important or incompletely characterized findings were...

  4. The yield of high-detail radiographic skeletal surveys in suspected infant abuse. (United States)

    Barber, Ignasi; Perez-Rossello, Jeannette M; Wilson, Celeste R; Kleinman, Paul K


    Skeletal surveys are routinely performed in cases of suspected child abuse, but there are limited data regarding the yield of high-detail skeletal surveys in infants. To determine the diagnostic yield of high-detail radiographic skeletal surveys in suspected infant abuse. We reviewed the high-detail American College of Radiology standardized skeletal surveys performed for suspected abuse in 567 infants (median: 4.4 months, SD 3.47; range: 4 days-12 months) at a large urban children's hospital between 2005 and 2013. Skeletal survey images, radiology reports and medical records were reviewed. A skeletal survey was considered positive when it showed at least one unsuspected fracture. In 313 of 567 infants (55%), 1,029 definite fractures were found. Twenty-one percent (119/567) of the patients had a positive skeletal survey with a total of 789 (77%) unsuspected fractures. Long-bone fractures were the most common injuries, present in 145 children (26%). The skull was the site of fracture in 138 infants (24%); rib cage in 77 (14%), clavicle in 24 (4.2%) and uncommon fractures (including spine, scapula, hands and feet and pelvis) were noted in 26 infants (4.6%). Of the 425 infants with neuroimaging, 154 (36%) had intracranial injury. No significant correlation between positive skeletal survey and associated intracranial injury was found. Scapular fractures and complex skull fractures showed a statistically significant correlation with intracranial injury (P = 0.029, P = 0.007, respectively). Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population.

  5. The yield of high-detail radiographic skeletal surveys in suspected infant abuse

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Ignasi [Hospital Vall d' Hebron, Universitat Autonoma de Barcelona, Pediatric Radiology Department, Barcelona (Spain); Perez-Rossello, Jeannette M.; Kleinman, Paul K. [Boston Children' s Hospital, Radiology Department, Boston, MA (United States); Wilson, Celeste R. [Boston Children' s Hospital, Division of General Pediatrics, Boston, MA (United States)


    Skeletal surveys are routinely performed in cases of suspected child abuse, but there are limited data regarding the yield of high-detail skeletal surveys in infants. To determine the diagnostic yield of high-detail radiographic skeletal surveys in suspected infant abuse. We reviewed the high-detail American College of Radiology standardized skeletal surveys performed for suspected abuse in 567 infants (median: 4.4 months, SD 3.47; range: 4 days-12 months) at a large urban children's hospital between 2005 and 2013. Skeletal survey images, radiology reports and medical records were reviewed. A skeletal survey was considered positive when it showed at least one unsuspected fracture. In 313 of 567 infants (55%), 1,029 definite fractures were found. Twenty-one percent (119/567) of the patients had a positive skeletal survey with a total of 789 (77%) unsuspected fractures. Long-bone fractures were the most common injuries, present in 145 children (26%). The skull was the site of fracture in 138 infants (24%); rib cage in 77 (14%), clavicle in 24 (4.2%) and uncommon fractures (including spine, scapula, hands and feet and pelvis) were noted in 26 infants (4.6%). Of the 425 infants with neuroimaging, 154 (36%) had intracranial injury. No significant correlation between positive skeletal survey and associated intracranial injury was found. Scapular fractures and complex skull fractures showed a statistically significant correlation with intracranial injury (P = 0.029, P = 0.007, respectively). Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population. (orig.)

  6. Detecting special nuclear materials in suspect containers using high-energy gamma rays emitted by fission products (United States)

    Norman, Eric B [Oakland, CA; Prussin, Stanley G [Kensington, CA


    A method and a system for detecting the presence of special nuclear materials in a suspect container. The system and its method include irradiating the suspect container with a beam of neutrons, so as to induce a thermal fission in a portion of the special nuclear materials, detecting the gamma rays that are emitted from the fission products formed by the thermal fission, to produce a detector signal, comparing the detector signal with a threshold value to form a comparison, and detecting the presence of the special nuclear materials using the comparison.

  7. Disability and Obesity (United States)

    ... CDC Employees and Reasonable Accommodations (RA) Disability and Obesity Language: English (US) Español (Spanish) Recommend on Facebook ... and Disability at The Obesity Epidemic Obesity affects different people in different ways ...

  8. Learning Disabilities. NICHCY Disability Fact Sheet #7 (United States)

    National Dissemination Center for Children with Disabilities, 2007


    "Learning disability" is a general term that describes specific kinds of learning problems. A learning disability can cause a person to have trouble learning and using certain skills. The skills most often affected are: reading, writing, listening, speaking, reasoning, and doing math. Following a brief story about a child with a learning…

  9. Federal Policy and the Rise in Disability Enrollment: Evidence for the VA's Disability Compensation Program


    Mark Duggan; Robert Rosenheck; Perry Singleton


    The U.S. Department of Veterans' Affairs (VA) currently provides disability benefits to 2.72 million veterans of U.S. military service through the Disability Compensation (DC) program. Until recently, the medical eligibility criteria for this program were the same across service eras, with the key condition being that the disability was caused or aggravated by military service. But in July of 2001, the VA relaxed the eligibility criteria for Vietnam veterans by including diabetes in the list ...

  10. Suspected herniated lumbar disc - computed tomography in differential diagnosis of non-disc-related sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, T.; Koehler, D.; Treisch, J.; Claussen, C.; Felix, R.


    The most common reason a patient is referred for spinal CT examination is to exclude a ruptured intervertebral disc. Besides nerve root entrapment due to herniated disc, a number of unusual or unexpected conditions have been encountered in the course of CT lumbar spine studies. These include spondylolisthesis, spinal dysraphism, Paget's disease, and inflammatory, neoplastic, or metastatic lesions. The application of spinal (small-circle) target imaging includes the risk of overlooking soft tissue lesions that extend beyond the reconstruction circle. Therefore, complete (large-circle) circumferential abdominal scanning is recommended in case of a suspected extraspinal cause of sciatica.

  11. Developmental Disabilities (United States)

    ... treatment can help the symptoms. Treatments include physical, speech, and occupational therapy. Special education classes and psychological counseling can also help. NIH: National Institute of Child Health and Human Development

  12. Science and Learning Disabilities. (United States)

    Stanovich, Keith E.


    Reactions to H. Lee Swanson's paper "Toward a Metatheory of Learning Disabilities" are outlined, and his arguments are applied to reading disabilities, focusing on the importance of the scientific attitude, the misuse of ecological validity, interpretation of Thomas Kuhn's work, modularity and reading disability, and scientific progress…

  13. Social Psychoanalytic Disability Studies (United States)

    Goodley, Dan


    This paper explores connections and tensions between psychoanalysis and disability studies. The first part of the paper considers contemporaneous engagements with the psyche by a number of disability studies writers. These scholars have remained accountable to a politicised disability studies but have pushed for critical encounters with the…

  14. Enabling Disabled Students. (United States)

    Murphy, Diane Makar; Murphy, John T.


    The Americans with Disabilities Act requires reasonable accommodations for the disabled in public and private colleges and universities. Faculty must understand the difference between equal opportunity and equal treatment. Specific suggestions are made for teaching learning-disabled, mobility- impaired, visually-impaired, and hearing-impaired…

  15. Changes in ocular biometry and anterior chamber parameters after pharmacologic mydriasis and peripheral iridotomy in primary angle closure suspects

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Razeghinejad


    Conclusions: This study showed no change in the ocular biometric and anterior chamber parameters including iridocorneal angle after PI and/or pharmacologic mydriasis except for increments in anterior chamber volume. This factor has the potential to be used as a numerical proxy for iris position in evaluating and monitoring patients with primary angle closure suspects after PI.

  16. Dating persons with physical disabilities: the perceptions of South Africans without disabilities. (United States)

    Hunt, Xanthe; Swartz, Leslie; Carew, Mark Thomas; Braathen, Stine Hellum; Chiwaula, Mussa; Rohleder, Poul


    There is good reason to believe that the attitudes of persons without disability towards dating a person with a physical disability might be unfavourable. However, in general, and in the Global South in particular, there is a dearth of research in this area. This study sought to take the first step in addressing this lack of enquiry, by surveying the attitudes of a general population sample in South Africa towards dating people with physical disabilities, using a vignette. Data from 1723 survey respondents were analysed thematically. Findings reveal largely negative attitudes towards people with physical disabilities. Respondents without disability perceived numerous barriers to dating a person with a physical disability, including social stigma, anxiety and concerns about the burden of care they believed such a relationship would place upon them. However, there was some evidence to suggest that some positive attitudes do exist, and a few respondents were open to dating a person with physical disabilities. Findings contribute to a nuancing and expanding of the 'myth of asexuality' among physically disabled people by showing that people with physical disabilities are actively desexualised by persons without disability. Future research is needed to explore how the inclusive attitudes, of which we did find evidence here, can be further cultivated.

  17. Clinical psychology and disability studies: bridging the disciplinary divide on mental health and disability. (United States)

    Simpson, Jane; Thomas, Carol


    Clinical psychology and disability studies have traditionally occupied very different academic, philosophical and political spaces. However, this paper aims to illustrate the positive consequences and implications of attempts to understand and bridge this disciplinary divide. A narrative review format was used with evidence selected pragmatically as opposed to systematically. The construction of the argument determined the evidence selected. The concept of psycho-emotional disablism, which originated within disability studies, is argued to be a useful concept to bridge the divide between understandings of distress from both disability studies and clinical psychology perspectives. However, this can be usefully augmented by psychological research on the mechanisms through which disablism can affect individuals. Perspectives from both disability studies and clinical psychology can be usefully combined to bring important new perspectives; combined, these perspectives should help - on theoretical, service and social levels - to improve the mental health of disabled people. Implications for Rehabilitation Mental health is an important determinant of overall health-related quality of life and psychological therapy should be available for those disabled people who would value it. Psychological therapists working with disabled people should be more aware of the challenging social context in which disabled people live. Understandings of distress should not just include individual factors but also incorporate the psychological impact of stresses caused by societal barriers preventing inclusion. Psychologists should be more willing to work and engage at a societal and political level to influence change.

  18. The First Critical Steps through the Criminal Justice System for Persons with Intellectual Disabilities (United States)

    Mercier, Celine; Crocker, Anne G.


    This paper deals with the initial steps of the judicial process for persons with intellectual disabilities who are suspected of a minor offense; a stage where plaintiffs, police officers, and crown attorneys make a series of decisions that will have a significant impact on the course of the judicial process. The objective of this study was…

  19. Reading Fluency: Implications for the Assessment of Children with Reading Disabilities (United States)

    Meisinger, Elizabeth B.; Bloom, Juliana S.; Hynd, George W.


    The current investigation explored the diagnostic utility of reading fluency measures in the identification of children with reading disabilities. Participants were 50 children referred to a university-based clinic because of suspected reading problems and/or a prior diagnosis of dyslexia, where children completed a battery of standardized…

  20. A rational clinical approach to suspected insulin allergy

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Wittrup, M


    AIMS: Allergy to recombinant human (rDNA) insulin preparations is a rare complication of insulin therapy. However, insulin preparations contain several allergens, and several disorders can resemble insulin allergy. Studies evaluating the diagnostic procedures on suspected insulin allergy...... technique (n = 5), skin disease (n = 3) and other systemic allergy (n = 1). Nine other patients were found to be allergic to protamine (n = 3) or rDNA insulin (n = 6), and specific treatment was associated with relief in 8 patients (89%). Four patients had local reactions of unknown causes but symptom...... relief was obtained in three cases by unspecific therapy. Overall, 20 (91%) reported relief of symptoms. CONCLUSION: Our standardized investigative procedure of suspected insulin preparation (IP) allergy was associated with relief of symptoms in > 90% of patients. IP allergy was diagnosed in 41...

  1. Interdisciplinary action of nurses to children with suspected sexual abuse

    Directory of Open Access Journals (Sweden)

    Lia Leão Ciuffo


    Full Text Available Objective. Understanding the role of nurses as members of interdisciplinary teams in the care of children with suspected sexual abuse. Methodology. This is a qualitative research based on the sociological phenomenology of Alfred Schutz. In 2008 were interviewed eleven nurses who worked in reference institutions for the care of child victims of sexual abuse in Rio de Janeiro. Results. The category called 'Interacting with other professionals in child care' emerged from the analysis of performance of professionals. The intersubjective relations between the nurses and the interdisciplinary team will enable to understand the intent of care from the perspective of social, emotional and psychological needs of children and their families. Conclusion. Interdisciplinarity favored the development of actions based on acceptance, listening and agreements on possible solutions in the care of children with suspected sexual abuse.

  2. Atlantoaxial subluxation and nasopharyngeal necrosis complicating suspected granulomatosis with polyangiitis. (United States)

    Mohapatra, Anand; Holekamp, Terrence F; Diaz, Jason A; Zebala, Lukas; Brasington, Richard


    Granulomatosis polyangiitis (GPA, formerly Wegener granulomatosis) is a vasculitis that typically involves the upper respiratory tract, lungs, and kidneys. The 2 established methods to confirm a suspicion of GPA are the antineutrophil cytoplasmic antibody (ANCA) test and biopsy. However, ANCA-negative cases have been known to occur, and it can be difficult to find biopsy evidence of granulomatous disease.We report a case of suspected granulomatosis with polyangiitis limited to the nasopharynx. With a negative ANCA and no histological evidence, our diagnosis was founded on the exclusion of other diagnoses and the response to cyclophosphamide therapy. This case is unique because the patient's lesion resulted in atlantoaxial instability, which required a posterior spinal fusion at C1-C2. This is the first reported case of suspected GPA producing damage to the cervical spine and threatening the spinal cord.

  3. Radiological (scintigraphic) evaluation of patients with suspected pulmonar thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

    Biello, D.R.


    The optimal strategy for diagnostic evaluation of patients with suspected pulmonary thromboembolism (PE) is subject of controversial and often conflicting opinions. If untreated, as many as 30% of patients with PE may die. Conversely, anticoagulant therapy significantly decreases mortality from PE, but bleeding complications occur. Underdiagnosis may result in a preventable death, and overdiagnosis may lead to significant hemorrhage from unnecessary anticoagulant therapy. This article outlines a practical guide for the use of pulmonary ventilation-perfusion (V-P) scintigraphy in patients with suspected PE. Perfusion imaging involves the intravenous injection of radiolabeled particles ranging from 10 to 60 in diameter (technetium Tc 99m macroaggregated albumin or technetium Tc 99m serum albumin microspheres); these particles are trapped in the capillaries and precapillary arterioles of the lung. The radiolabeled particles are distributed to the lungs in proportion to regional pulmonary blood flow. The correspondence of perfusion defects to bronchopulmonary segments is best appreciated in the posterior oblique views.

  4. Radiotherapy in three suspect cases of feline thymoma. (United States)

    Kaser-Hotz, B; Rohrer, C R; Fidel, J L; Nett, C S; Hörauf, A; Hauser, B


    Radiation therapy for three cases of suspect feline thymoma is described. The thymoma was controlled for 4 years in case no. 1. Case no. 2 responded well to radiation therapy but was euthanized after 2 months because of a nasal adenocarcinoma. Case no. 3 continues to do well more than 8 months after radiotherapy. Difficulties in diagnosing feline thymomas are discussed, and biological behavior as well as different treatment modalities of feline and human thymomas are compared.

  5. Interviewing strategically to elicit admissions from guilty suspects


    Tekin, Serra; Granhag, Pär Anders; Strömwall, Leif; Giolla, Erik Mac; Vrij, Aldert; Hartwig, Maria


    In this article we introduce a novel interviewing tactic to elicit admissions from guilty suspects. By influencing the suspects’ perception of the amount of evidence the interviewer holds against them, we aimed to shift the suspects’ counterinterrogation strategies from less to more forthcoming. The proposed tactic (SUE-Confrontation) is a development of the Strategic Use of Evidence (SUE) framework and aims to affect the suspects’ perception by confronting them with statement-evidence incons...

  6. Suspected spinocellular carcinoma of the inferior eyelid resulted multiple chalazion. (United States)

    Onesti, Maria Giuseppina; Troccola, Antonietta; Maruccia, Michele; Conversi, Andrea; Scuderi, Gianluca


    Chalazion is a subacute granulomatous inflammation of the eyelid caused by retention of tarsal gland secretions and it's the most common inflammatory lesion of the eyelid. In cases of doubtful clinical presentation the diagnosis with a biopsy and a histopathological examination is important because it can orientate an appropriate surgical treatment. We report a case of a 64-years-old diabetic man, suspected for a spinocellular lesion of the inferior eyelid of the left eye, it resulted unexpectedly a chalazion.

  7. CT-guided biopsy of suspected malignancy: A potential pitfall

    Directory of Open Access Journals (Sweden)

    Steven Henderson


    Full Text Available Paragangliomas are rare catecholamine-secreting neuro-endocrine tumours that can arise from sympathetic or parasympathetic tissue. Any manipulation of these tumours, without appropriate medical therapy, can result in excess catecholamine release leading to a catecholamine crisis. Neuro-endocrine tumours must be considered prior to interventional biopsy of an unknown soft-tissue mass, and appropriate biochemical investigations should be performed in suspected cases to prevent catastrophic complications.

  8. Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials. (United States)

    Magro-Malosso, E R; Saccone, G; Chen, M; Navathe, R; Di Tommaso, M; Berghella, V


    Several randomized controlled trials (RCTs) compared induction of labour with expectant management in non-diabetic women with suspected fetal macrosomia. To evaluate the effects of labour induction for suspected fetal macrosomia. Literature search in electronic databases. We included all RCTs of suspected fetal macrosomia comparing labour induction with expectant management in term pregnancy. The primary outcome was the incidence of caesarean delivery. Four RCTs, including 1190 non-diabetic women with suspected fetal macrosomia at term, were analysed. Pooled data did not show a significant difference in incidence of caesarean delivery [relative risk (RR) 0.91, 95% confidence interval (CI) 0.76-1.09], operative and spontaneous vaginal delivery, shoulder dystocia, intracranial haemorrhage, brachial plexus palsy, Apgar score macrosomia is associated with a significant decrease in fetal fractures, and therefore can be considered as a reasonable option. TWEETABLE ABSTRACT: #Induction of labour for #macrosomia improves neonatal outcome. © 2016 Royal College of Obstetricians and Gynaecologists.

  9. A model for pediatric and neuropsychological screening assessment of children with learning disabilities

    Directory of Open Access Journals (Sweden)

    Claudia Berlim de Mello

    Full Text Available ABSTRACT Objectives: The high frequency of learning difficulties, attention disorders or developmental delay in children in the early years of schooling has resulted in a greater demand for pediatric services. Such services generally include assessments covering various specialties, are lengthy and often inaccessible to families due to prohibitively high cost. This paper presents an economically efficient model of interdisciplinary diagnosis. Methods: A group of 109 Brazilian students from public schools aged between 5 and 14 years old, referred by teachers for a history of learning disabilities, behavioral changes or language problems, was evaluated at the NANI (Nucleo de Atendimento Neuropsicologico Infantil. Assessments were performed simultaneously during a single day's attendance and comprised clinical-genetic examination, behavioral assessment and neuropsychological screening, specially developed for the process. The multiaxial system of DSM-IV was adopted for diagnostic description. Results: The results revealed heterogeneity in diagnoses which included specific learning disorders (25.7%, mild intellectual disabilities (17.43%, as well as suspected dysmorphic features (11.93%. Logistic regression showed good sensitivity of neuropsychological screening in the detection of predictive factors for specific developmental disorders, while working memory (p=0.05 and language (p=0.02 problems were found to be higher risk. Conclusions: The model adopted proved to be useful for defining the diagnosis of several conditions in infancy, and can be incorporated into specialized clinics such as psychiatric or developmental pediatric services.

  10. A model for pediatric and neuropsychological screening assessment of children with learning disabilities (United States)

    de Mello, Claudia Berlim; Brunoni, Leila Raquel Russowsky; Pilla, Ana Luiza; Taddei, José Augusto Aguiar Carrazedo; Barbosa, Thais; Sinnes, Elaine Girão; Rodrigues, Camila Cruz; Miranda, Monica Carolina; Muzskat, Mauro; Bueno, Orlando Francisco Amodeo


    Objectives The high frequency of learning difficulties, attention disorders or developmental delay in children in the early years of schooling has resulted in a greater demand for pediatric services. Such services generally include assessments covering various specialties, are lengthy and often inaccessible to families due to prohibitively high cost. This paper presents an economically efficient model of interdisciplinary diagnosis. Methods A group of 109 Brazilian students from public schools aged between 5 and 14 years old, referred by teachers for a history of learning disabilities, behavioral changes or language problems, was evaluated at the NANI (Nucleo de Atendimento Neuropsicologico Infantil). Assessments were performed simultaneously during a single day's attendance and comprised clinical-genetic examination, behavioral assessment and neuropsychological screening, specially developed for the process. The multiaxial system of DSM-IV was adopted for diagnostic description. Results The results revealed heterogeneity in diagnoses which included specific learning disorders (25.7%), mild intellectual disabilities (17.43%), as well as suspected dysmorphic features (11.93%). Logistic regression showed good sensitivity of neuropsychological screening in the detection of predictive factors for specific developmental disorders, while working memory (p=0.05) and language (p=0.02) problems were found to be higher risk. Conclusions The model adopted proved to be useful for defining the diagnosis of several conditions in infancy, and can be incorporated into specialized clinics such as psychiatric or developmental pediatric services. PMID:29213768

  11. [Three cases of suspected re-infection of mumps virus]. (United States)

    Hatanaka, Akio; Kamada, Tomoko; Honda, Keiji; Tazaki, Akihisa; Kishine, Naomi; Kawashima, Yoshiyuki


    A 32-year-old woman, 5-year-old girl, and 33-year-old man visited our otorhinolaryngology outpatient clinic with tumentia of the unilateral parotid gland. A high titer of serum IgG antibodies against the mumps virus was detected. Around the same time, other members of their families had the same parotid tumentia, and they were diagnosed as having their first mumps infection. Therefore, the diagnosis of the three cases was strongly suspected to be re-infection with mumps. In Japan, it was classically believed that the mumps virus infection occurs only once in patients and reinfection doesn't occur. However, some pediatricians in Japan have reported that re-infection with mumps is strongly suspected when high titers of serum IgG antibodies against the mumps virus are found at the initial visit. It is now believed many more examples of mumps re-infection cases have existed than we previously believed. When high titers of serum IgG antibodies against the mumps virus are detected at an initial visit in patients who have had mumps previously, re-infection should be strongly suspected. And to make it certain, we suggest that the mumps IgG antibodies should be checked twice to confirm the diagnosis. If elevation of the IgG antibodies persist, the diagnosis will be much more certain.

  12. Ten-day observation of live rabies suspected dogs. (United States)

    Tepsumethanon, V; Wilde, H; Sitprija, V


    This study aimed at analyzing a ten-day observation period of rabies suspected dogs and cats according to six criteria. Dogs and cats suspected of being rabid were brought for observation when they had either bitten a person or another animal or when abnormal behaviour or unusual illness was observed. Between 1985 and 2005, retrospective and prospective data from 1,222 dogs and 303 cats was collected during the ten-day observation period. If an animal had died, brain examination using fluorescent antibody testing was routinely performed. If an animal had survived for > or =10 days, it was released to its owner or transferred to the municipal dog shelter. A total of 644 dogs and 58 cats found rabid died within 10 days of observation. In addition, for 208 dogs confirmed rabid with laboratory tests between 1997 and 2005, six criteria were analysed from the day of submission. This experience with the implemented 10-day observation period confirms the WHO recommendation on identifying suspected rabid dogs or cats under veterinary supervision following a human exposure.

  13. Low dose computed tomography in suspected acute renal colic. (United States)

    Meagher, T; Sukumar, V P; Collingwood, J; Crawley, T; Schofield, D; Henson, J; Lakin, K; Connolly, D; Giles, J


    To evaluate whether computed tomography (CT) of the renal tract in suspected renal colic using reduced exposure factors maintains diagnostic accuracy. Prospective multi-centre cohort study. Patients with suspected renal colic were examined using computed tomography (CT) of the renal tract followed by intravenous urography (IVU) in four different centres with five different CT systems. Sixty-nine patients with suspected renal colic had CT of the renal tract followed by IVU. CT was performed with reduced exposure factors, giving a mean CT effective dose of 3.5 (range 2.8-4.5) mSv compared with 1.5 mSv for IVU. Ureteric calculi were detected in 43 patients: CT and IVU detected 40 (93%) ureteric calculi. CT identified other lesions causing symptoms in five patients and identified renal calculi in 24 patients. IVU identified renal calculi in six patients and made false positive diagnosis of renal calculi in seven patients. Mean examination time for CT was 5 minutes and for IVU was 80 minutes. CT examination at reduced exposure factors maintains the diagnostic accuracy recorded in other series. Copyright 2001 The Royal College of Radiologists.

  14. The economics of cardiac biomarker testing in suspected myocardial infarction. (United States)

    Goodacre, Steve; Thokala, Praveen


    Suspected myocardial infarction (MI) is a common reason for emergency hospital attendance and admission. Cardiac biomarker measurement is an essential element of diagnostic assessment of suspected MI. Although the cost of a routinely available biomarker may be small, the large patient population and consequences in terms of hospital admission and investigation mean that the economic impact of cardiac biomarker testing is substantial. Economic evaluation involves comparing the estimated costs and effectiveness (outcomes) of two or more interventions or care alternatives. This process creates some difficulties with respect to cardiac biomarkers. Estimating the effectiveness of cardiac biomarkers involves identifying how they help to improve health and how we can measure this improvement. Comparison to an appropriate alternative is also problematic. New biomarkers may be promoted on the basis of reducing hospital admission or length of stay, but hospital admission for low risk patients may incur significant costs while providing very little benefit, making it an inappropriate comparator. Finally, economic evaluation may conclude that a more sensitive biomarker strategy is more effective but, by detecting and treating more cases, is also more expensive. In these circumstances it is unclear whether we should use the more effective or the cheaper option. This article provides an introduction to health economics and addresses the specific issues relevant to cardiac biomarkers. It describes the key concepts relevant to economic evaluation of cardiac biomarkers in suspected MI and highlights key areas of uncertainty and controversy. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. MIBG in the evaluation of suspected pheochromocytoma: Mayo Clinic experience

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.L.; Sheps, S.G.; Sizemore, G.; Swensen, S.J.; Gharib, H.; Grant, C.S.; van Heerden, J.A.


    Work done at the University of Michigan has shown that I-131 metaiodobenzylguanidine (MIBG) is an effective agent for the diagnosis and localization of pheochromocytoma. A recent report questioned the sensitivity of this test. In 1983, 40 patients at Mayo Clinic had 42 scans during the workup of suspected spontaneous pheochromocytoma or metastatic pheochromocytoma. All patients were given 500 I-131 MIBG supplied by the University of Michigan. The final diagnosis of pheochromocytoma (true positive (TP) and false negative (FN) and false positive (FP)) was made by surgery and pathology. True negative (TN) diagnosis was made by normal plasma and urinary catecholamines, and in many patients CT. There were 15 TP studies (six spontaneous pheochrocytoma, nine metastatic or recurrent pheochromoctyoma), and 22 TN studies. There was one FP study of recurrent paraganglioma near the bladder (CT was also FP) and four FN studies (two spontaneous and two metastatic) where one CT was also FN. This results in a sensitivity of 79%, specificity of 96%, and accuracy of 88%. MIBG is very useful in the workup of patients with known or suspected recurrent or metastatic pheochromocytoma and is helpful in the evaluation of the patient suspected of having a spontaneous pheochromocytoma when CT is normal.

  16. Thinking With Disability Studies

    Directory of Open Access Journals (Sweden)

    Nirmala Erevelles


    Full Text Available In this essay, I offer tentative ruminations about the possibilities/challenges of theory and praxis in the field of disability studies. I begin the essay by thinking through my own positionality as a non-disabled woman of color scholar/ally in the field. Cautiously situating myself in a location of outsider-within (Hill-Collins,1998, I explore how disability studies is disruptive of any boundaries that claim to police distinctions between disabled/non-disabled subject positions. Noting the dangers of claiming that everyone is disabled at some historical moment, I propose instead a relational analysis to engage the materiality of disability at the intersections of race, class, gender, nation, and sexual identity within specific historical contexts and discuss the complicated impasses that continue to plague disability studies at these intersections. I conclude the essay by recognizing the labor of scholar/activists in the field who call for a committed politics of accountability and access via disability justice.    Keywords: disability studies, historical materialism, identity politics and intersectionality, disability justice, politics of accountability/allyship

  17. Integrated Disability Management

    Directory of Open Access Journals (Sweden)

    Silvia Angeloni


    Full Text Available This article sets out to increase awareness regarding the wide and universal significance of disability, as well as the important benefits of an Integrated Disability Management (IDM approach. The scientific basis for IDM is explored in the first place through an analysis of its relationship to the International Classification of Functioning, Disability and Health (ICF. The conceptual paradigm of the ICF shares an ideological position with the IDM approach in that they are both underpinned by dynamic and multidimensional constructions of disability, which imply equally holistic and interdisciplinary responses. The IDM approach can be applied across a diversity of human situations to provide solutions that reflect the multifaceted and widespread nature of disability. The IDM approach is intended as a strategy capable of handling: inclusion of people with disabilities, active aging of human resources, health and safety in the workplace, prevention of disabilities and various diseases, return-to-work, absenteeism, and presenteeism.

  18. Beyond (Models of) Disability? (United States)

    Beaudry, Jonas-Sébastien


    The strategy of developing an ontology or models of disability as a prior step to settling ethical issues regarding disabilities is highly problematic for two reasons. First, key definitional aspects of disability are normative and cannot helpfully be made value-neutral. Second, if we accept that the contested concept of disability is value-laden, it is far from obvious that there are definitive reasons for choosing one interpretation of the concept over another. I conclude that the concept of disability is better left ethically open-ended or broad enough to encompass the examination of various ethical issues (such as oppression, minority rights, or physical discomfort). Alternatively, the concept of disability could be altogether abandoned in order to focus on specific issues without being hindered by debates about the nature of disability. Only political costs, rather than conceptual considerations internal to the models, could be weighed against such a conclusion. PMID:26892249

  19. Facing up to disability

    Directory of Open Access Journals (Sweden)

    Tom Shakespeare


    Full Text Available Ways of thinking about and responding to disability have radically changed in recent decades. Traditionally, disability was regarded in terms of sin, karma, or divine punishment. More recently, disability was made a medical issue and defined in terms of shortcomings of body or mind, which had to be prevented or cured at all costs. In the late 20th century, people with disabilities worldwide became more organised and created national and international disabled people’s organisations. They successfully demanded that disability be seen as a matter of equal opportunities and human rights, a shift which has now been described in the United Nations Convention on the Rights of Persons with Disabilities. This is a global treaty which has so far been signed by 155 states and passed into law by 127.

  20. Early Intervention in Children with Developmental Disabilities

    Directory of Open Access Journals (Sweden)

    Beena Johnson


    Full Text Available Developmental disabilities consist of conditions that delay or impair the physical, cognitive, and/or psychological development of children. If not intervened at the earliest, these disabilities will cause significant negative impact on multiple domains of functioning such as learning, language, self-care and capacity for independent living. Common developmental disabilities include autism spectrum disorders, intellectual disabilities, developmental delay and cerebral palsy. About one fourth of young children in developing countries are at risk for or have developmental delay or disabilities. Inadequate stimulation has significant negative impact on physical, socioemotional and cognitive development of children. Hence early scientific intervention programs are necessary in the management of children at risk for developmental delay.

  1. Predictors of increasing injury severity across suspected recurrent episodes of non-accidental trauma: a retrospective cohort study. (United States)

    Thackeray, Jonathan; Minneci, Peter C; Cooper, Jennifer N; Groner, Jonathan I; Deans, Katherine J


    Little is known about how the severity of injury changes with recurrent events of suspected non-accidental trauma (NAT). Our objective was to determine risk factors for escalating severity of injury in children with multiple events of suspected NAT. This retrospective longitudinal cohort study included children from a pediatric Medicaid accountable care organization with ≥ 1 non-birth related episode containing an International Classification of Diseases, Ninth Revision, Clinical Modification or Current Procedural Terminology code for NAT or a skeletal survey between 2007 and 2011. Subsequent potential NAT events were defined as independent episodes with codes for either NAT, a skeletal survey, or injuries suspicious for abuse. Severity of injury was calculated using the New Injury Severity Score (NISS). Multivariable Cox proportional hazards regression modeling was used with results expressed as hazard ratios and 95 % confidence intervals. Of the 914 children with at least one suspected NAT event, 39 % had at least one suspected recurrent NAT event; 12 % had 2 events and 5 % had ≥ 3 events during follow-up. Factors associated with an increased risk for a recurrent episode of suspected NAT with higher NISS were living in a rural area (1.69, 1.02-2.78, p = 0.04) and having an open wound (2.12, 1.24-3.62, p = 0.006), or superficial injury (2.28, 1.31-3.98, p = 0.004). In contrast, a greater number of injuries was associated with a decreased risk for a recurrent episode of suspected NAT with higher NISS (p injuries are either not reported to child protective services or not removed from the unsafe environment with either situation leading to subsequent events. The medical and child welfare systems need to better identify these potential victims of recurrent events..

  2. Effectiveness of a fluid chart in outpatient management of suspected dengue fever: A pilot study. (United States)

    Nasir, Nazrila Hairin; Mohamad, Mohazmi; Lum, Lucy Chai See; Ng, Chirk Jenn


    Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever. To assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting. This feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake. Among the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance. This is a feasible and acceptable study to perform in a primary care setting. The fluid chart is a simple, inexpensive

  3. Imaging trends in suspected appendicitis-a Canadian perspective. (United States)

    Tan, Victoria F; Patlas, Michael N; Katz, Douglas S


    The purpose of our study was to assess trends in the imaging of suspected appendicitis in adult patients in emergency departments of academic centers in Canada. A questionnaire was sent to all 17 academic centers in Canada to be completed by a radiologist who works in emergency radiology. The questionnaires were sent and collected over a period of 4 months from October 2015 to February 2016. Sixteen centers (94%) responded to the questionnaire. Eleven respondents (73%) use IV contrast-enhanced computed tomography (CT) as the imaging modality of choice for all patients with suspected appendicitis. Thirteen respondents (81%) use ultrasound as the first modality of choice in imaging pregnant patients with suspected appendicitis. Eleven respondents (69%) use ultrasound (US) as the first modality of choice in patients younger than 40 years of age. Ten respondents (67%) use ultrasound as the first imaging modality in female patients younger than 40 years of age. When CT is used, 81% use non-focused CT of the abdomen and pelvis, and 44% of centers use oral contrast. Thirteen centers (81%) have ultrasound available 24 h a day/7 days a week. At 12 centers (75%), ultrasound is performed by ultrasound technologists. Four centers (40%) perform magnetic resonance imaging (MRI) in suspected appendicitis in adult patients at the discretion of the attending radiologist. Eleven centers (69%) have MRI available 24/7. All 16 centers (100%) use unenhanced MRI. Various imaging modalities are available for the work-up of suspected appendicitis. Although there are North American societal guidelines and recommendations regarding the appropriateness of the multiple imaging modalities, significant heterogeneity in the first-line modalities exist, which vary depending on the patient demographics and resource availability. Imaging trends in the use of the first-line modalities should be considered in order to plan for the availability of the imaging examinations and to consider plans for

  4. Earthquake Protection Measures for People with Disabilities (United States)

    Gountromichou, C.; Kourou, A.; Kerpelis, P.


    The problem of seismic safety for people with disabilities not only exists but is also urgent and of primary importance. Working towards disability equality, Earthquake Planning and Protection Organization of Greece (E.P.P.O.) has developed an educational scheme for people with disabilities in order to guide them to develop skills to protect themselves as well as to take the appropriate safety measures before, during and after an earthquake. The framework of this initiative includes a number of actions have been already undertaken, including the following: a. Recently, the main guidelines have been published to help people who have physical, cognitive, visual, or auditory disabilities to cope with a destructive earthquake. Of great importance, in case of people with disabilities, is to be prepared for the disaster, with several measures that must be taken starting today. In the pre-earthquake period, it is important that these people, in addition to other measures, do the following: - Create a Personal Support Network The Personal Support Network should be a group of at least three trustful people that can assist the disabled person to prepare for a disastrous event and to recover after it. - Complete a Personal Assessment The environment may change after a destructive earthquake. People with disabilities are encouraged to make a list of their personal needs and their resources for meeting them in a disaster environment. b. Lectures and training seminars on earthquake protection are given for students, teachers and educators in Special Schools for disabled people, mainly for informing and familiarizing them with earthquakes and with safety measures. c. Many earthquake drills have already taken place, for each disability, in order to share good practices and lessons learned to further disaster reduction and to identify gaps and challenges. The final aim of this action is all people with disabilities to be well informed and motivated towards a culture of earthquake

  5. Age, gender and disability predict future disability in older people: The Rotterdam Study

    NARCIS (Netherlands)

    U. Taş (Ümit); E.W. Steyerberg (Ewout); S.M. Bierma-Zeinstra (Sita); A. Hofman (Albert); B.W. Koes (Bart); A.P. Verhagen (Arianne)


    textabstractBackground: To develop a prediction model that predicts disability in community-dwelling older people. Insight in the predictors of disability is needed to target preventive strategies for people at increased risk. Methods. Data were obtained from the Rotterdam Study, including subjects

  6. Aged and Dependency Ratios among Autism, Intellectual Disability and Other Disabilities: 10-Year Trend Analysis (United States)

    Lin, Jin-Ding; Lin, Lan-Ping; Sung, Chang-Lin; Wu, Jia-Ling


    Dependency ratios are useful as general indicators of future economic and social health. The present paper focuses on the description of dependency ratios and over time change in different kind of disability which include autism, intellectual disability, vision, hearing, and limb impairments. We analyzed data mainly from the public web-access…

  7. Disability-Aware Adaptive and Personalised Learning for Students with Multiple Disabilities (United States)

    Nganji, Julius T.; Brayshaw, Mike


    Purpose: The purpose of this paper is to address how virtual learning environments (VLEs) can be designed to include the needs of learners with multiple disabilities. Specifically, it employs AI to show how specific learning materials from a huge repository of learning materials can be recommended to learners with various disabilities. This is…

  8. Ultrasound findings of teres minor denervation in suspected quadrilateral space syndrome. (United States)

    Brestas, Paraskevas S; Tsouroulas, Marinos; Nikolakopoulou, Zoi; Malagari, Katerina; Drossos, Charalampos


    Isolated teres minor denervation is an uncommon finding on sonographic examination. We present a case of a 64-year-old man with increased echogenity of the teres minor muscle and a slight reduction in muscle bulk. Investigation of a suspected axillary nerve lesion included a detailed sonographic examination of the posterior shoulder and the axillary space, followed by MR imaging and electrophysiologic testing. This case demonstrates the potential importance of examining rotator cuff muscles when performing sonographic examination of the shoulder in patients with persistent symptoms, no history of trauma, and absence of tendon tears.

  9. Music and dance as learning interventions for children with intellectual disabilities


    Jhalukpreya Surujlal


    Amongst the many disadvantaged groups of people in the world, an important minority are children with intellectual disabilities. Relative to their counterparts without intellectual disabilities, children with intellectual disabilities face a wide spectrum of challenges, including learning difficulties, social segregation and negative stereotyping. Children with intellectual disabilities find it difficult to perform various functions such as communicating and socialising with others, and, in m...

  10. Disability in the Classroom: Current Trends and Impacts on Music Education (United States)

    Abramo, Joseph


    This article covers current trends in disability rights and raises questions about how society's views of disability influence the music education of students in need of special education services. Brief overviews of the disability-rights movement in the United States and of federal laws pertaining to disabilities and education are included. Next,…

  11. Diagnostic accuracy of placental growth factor in women with suspected preeclampsia: a prospective multicenter study. (United States)

    Chappell, Lucy C; Duckworth, Suzy; Seed, Paul T; Griffin, Melanie; Myers, Jenny; Mackillop, Lucy; Simpson, Nigel; Waugh, Jason; Anumba, Dilly; Kenny, Louise C; Redman, Christopher W G; Shennan, Andrew H


    Hypertensive disorders of pregnancy are a major contributor to death and disability for pregnant women and their infants. The diagnosis of preeclampsia by using blood pressure and proteinuria is of limited use because they are tertiary, downstream features of the disease. Placental growth factor (PlGF) is an angiogenic factor, a secondary marker of associated placental dysfunction in preeclampsia, with known low plasma concentrations in the disease. In a prospective multicenter study, we studied the diagnostic accuracy of low plasma PlGF concentration (preeclampsia between 20 and 35 weeks' gestation (and up to 41 weeks' gestation as a secondary analysis). The outcome was delivery for confirmed preeclampsia within 14 days. Of 625 women, 346 (55%) developed confirmed preeclampsia. In 287 women enrolled before 35 weeks' gestation, PlGF preeclampsia within 14 days; specificity was lower (0.55; 0.48-0.61). Area under the receiver operating characteristic curve for low PlGF (0.87, standard error 0.03) for predicting preeclampsia within 14 days was greater than all other commonly used tests, singly or in combination (range, 0.58-0.76), in women presenting with suspected preeclampsia (Ppreeclampsia, low PlGF has high sensitivity and negative predictive value for preeclampsia within 14 days, is better than other currently used tests, and presents an innovative adjunct to management of such women.

  12. From Impairment to Empowerment: A Longitudinal Medical School Curriculum on Disabilities. (United States)

    Sarmiento, Cristina; Miller, Sonya R; Chang, Eleanor; Zazove, Philip; Kumagai, Arno K


    All physicians will care for individuals with disabilities; however, education about disabilities is lacking at most medical schools. Most of the schools that do include such education exclusively teach the medical model, in which disability is viewed as an impairment to be overcome. Disability advocates contest this approach because it overlooks the social and societal contexts of disability. A collaboration between individuals with disabilities, educators, and physicians to design a medical school curriculum on disabilities could overcome these differences. A curriculum on disabilities for first- and second-year medical students was developed during the 2013-2014 academic year and involved a major collaboration between a medical student, medical educators, disability advocates, and academic disability specialists. The guiding principle of the project was the Disability Rights Movement motto, "Nothing about us without us." Two small-group sessions were created, one for each medical school class. They included discussions about different models of disability, video and in-person narratives of individuals with disabilities, and explorations of concepts central to social perceptions of disability, such as power relationships, naming and stigmatization, and disability as identity. According to evaluations conducted after each session, students reported positive feedback about both sessions. Through this curriculum, first- and second-year medical students learned about the obstacles faced by individuals with disabilities and became better equipped to understand and address the concerns, hopes, and societal challenges of their future patients. This inclusive approach may be used to design additional curricula about disabilities for the clinical and postgraduate years.

  13. Optical modulator including grapene

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Ming; Yin, Xiaobo; Zhang, Xiang


    The present invention provides for a one or more layer graphene optical modulator. In a first exemplary embodiment the optical modulator includes an optical waveguide, a nanoscale oxide spacer adjacent to a working region of the waveguide, and a monolayer graphene sheet adjacent to the spacer. In a second exemplary embodiment, the optical modulator includes at least one pair of active media, where the pair includes an oxide spacer, a first monolayer graphene sheet adjacent to a first side of the spacer, and a second monolayer graphene sheet adjacent to a second side of the spacer, and at least one optical waveguide adjacent to the pair.

  14. The Unusual Suspects: Myths and Misconceptions Associated with PECS (United States)

    Bondy, Andy


    The Picture Exchange Communication System (PECS) is an alternative/augmentative communication protocol designed to help children and adults with autism and related disabilities to engage in functional communication. The protocol was developed over a number of years and was based on Skinner's analysis of verbal behavior. Publications about the…

  15. Infusing Disability Sport into the Sport Management Curriculum

    National Research Council Canada - National Science Library

    Shapiro, Deborah R; Pitts, Brenda G; Hums, Mary A; Calloway, Jimmy


    ...). The noticeable visibility of individuals with disabilities in society, including sport, raises concerns about the degree to which sport management academic programs have modified their curricula...

  16. Visual Impairment, Including Blindness (United States)

    ... Who Knows What? (log-in required) Select Page Visual Impairment, Including Blindness Mar 31, 2017 Links updated, ... doesn’t wear his glasses. Back to top Visual Impairments in Children Vision is one of our ...

  17. MRI-suspected low-grade glioma: is there a need to perform dynamic FET PET?

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, Nathalie L.; Graute, Vera; Cumming, Paul; Bartenstein, Peter; Fougere, Christian la [Ludwig-Maximilians-University Munich, Department of Nuclear Medicine, Munich (Germany); Armbruster, Lena; Suchorska, Bogdana; Tonn, Joerg-Christian; Kreth, Friedrich Wilhelm [Ludwig-Maximilians-University Munich, Department of Neurosurgery, Munich (Germany); Lutz, Juergen [Ludwig-Maximilians-University Munich, Department of Neuroradiology, Munich (Germany); Eigenbrod, Sabina [Ludwig-Maximilians-University Munich, Department of Neuropathology, Munich (Germany)


    Since differentiation between low-grade glioma (LGG) and high-grade glioma (HGG) remains challenging according to MRI criteria alone, we investigated the discriminative value of additional dynamic FET PET in patients with MRI-suspected LGG. Included in this retrospective study were 127 patients with newly diagnosed MRI-suspected LGG and dynamic FET PET prior to histopathological assessment. FET PET lesions were visually classified as having reduced, normal, or increased tracer uptake. Maximal tumour uptake scaled to the mean background uptake (SUV{sub max}/BG), mean tumour uptake (SUV{sub mean}/BG), biological tumour volume and kinetics were evaluated and correlated with individual histopathological findings. Histopathological analysis revealed 71 patients with LGG, 47 patients with HGG (including 5 glioblastoma multiforme), 2 patients with low-grade ganglioglioma and 7 patients with non-neoplastic lesions. Of the 127 patients, 97 had lesions with increased FET uptake, of which 93 were neoplastic. Increased uptake was found in 49/71 LGG (69 %) and 42/47 HGG (89 %). None of the conventional uptake parameters differed significantly between the HGG and LGG groups. Kinetic analysis reliably identified HGG (sensitivity 95 %, specificity 72 %, PPV 74 %, NPV 95 %). Normal tracer uptake was observed in 19 patients (15 with LGG, 1 with HGG and 3 with non-neoplastic lesions) and reduced uptake in 11 patients (7 with LGG and 4 with HGG). Among the MRI-suspected LGG, kinetic but not conventional analysis of FET uptake enabled remarkably high sensitivity for detection of HGG. This held true even for lesions with low or diffuse tracer uptake. Lesions with reduced tracer uptake must be interpreted with caution, as they can also harbour HGG tissue. (orig.)

  18. Medical History for Prognostic Risk Assessment and Diagnosis of Stable Patients with Suspected Coronary Artery Disease (United States)

    Min, James K.; Dunning, Allison; Gransar, Heidi; Achenbach, Stephan; Lin, Fay Y.; Al-Mallah, Mouaz; Budoff, Matthew J.; Callister, Tracy Q.; Chang, Hyuk-Jae; Cademartiri, Filippo; Chinnaiyan, Kavitha; Chow, Benjamin J. W.; D’Agostino, Ralph; DeLago, Augustin; Friedman, John; Hadamitzky, Martin; Hausleiter, Joerg; Hayes, Sean; Kaufmann, Philipp; Raff, Gilbert L.; Shaw, Leslee J.; Thomson, Louise; Villines, Todd; Cury, Ricardo C.; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Berman, Daniel S.; Pencina, Michael


    Aims To develop a clinical cardiac risk algorithm for stable patients with suspected CAD based upon angina typicality and CAD risk factors. Methods and Results Between 2004 and 2011, 14,004 adults with suspected CAD referred for cardiac imaging were followed: 1) 9,093 patients for CCTA (CCTA-1) followed for 2.0 years; 2) 2,132 patients for CCTA (CCTA-2) followed for 1·6 years, and 3) 2,779 patients for exercise myocardial perfusion scintigraphy followed for 5.0 years. A best-fit model from CCTA-1 for prediction of death or myocardial infarction (MI) was developed, with integer values proportional to regression coefficients. Discrimination was assessed using C-statistic. The validated model was also tested for estimation of the likelihood of obstructive CAD, defined as ≥50% stenosis, as compared to method of Diamond and Forrester (D-F). Primary outcomes included all-cause mortality and non-fatal MI. Secondary outcomes included prevalence of angiographically obstructive CAD. In CCTA-1, best-fit model discriminated individuals at risk of death or MI (C-statistic 0·76). The integer model ranged from 3-13, and corresponded to 3-year death risk or MI of 0·25% to 53·8%. When applied to the CCTA-2 and MPS, the model demonstrated C-statistics of 0·71 and 0·77. Both best-fit (C=0·76, 95% CI 0·746-0·771) and integer model (C=0·71, 95% CI 0·693-0·719) performed better than D-F (C=0·64; 95% CI, 0·628-0·659) for estimating obstructive CAD. Conclusions For stable symptomatic patients with suspected CAD, we developed a history-based method for prediction of death and obstructive CAD. PMID:25865923

  19. Ultrasonography for suspected deep vein thrombosis: how useful is single-point augmentation?

    Energy Technology Data Exchange (ETDEWEB)

    McQueen, A.S. [Department of Radiology, Freeman Hospital, Newcastle upon Tyne (United Kingdom)], E-mail:; Elliott, S.T. [Department of Radiology, Freeman Hospital, Newcastle upon Tyne (United Kingdom); Keir, M.J. [Department of Medical Physics, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)


    Aims: To assess the role of single-point augmentation of spectral Doppler flow in the diagnosis of acute deep vein thrombosis (DVT). Secondary objectives included identifying the augmentation response in non-DVT diagnoses. Methods: Patients attending the ultrasound departments of two hospitals for investigation of suspected acute DVT during an 8-month period were recruited to the study group. Spectral Doppler assessment of the superficial femoral vein was recorded during Valsalva and calf compression manoeuvres in the asymptomatic and symptomatic legs. The Doppler waveforms from the symptomatic limb were characterized as 'normal' or 'abnormal' by the operator. Standard compression ultrasonography of the symptomatic leg was then performed with the presence of DVT or an alternative diagnosis documented. Results: One hundred and sixty-seven patients underwent ultrasound examinations using the study methodology. Nine patients were subsequently excluded due to bilateral DVT or inability to tolerate calf compression. The mean age of the remaining 158 patients was 65.4 years with 28 DVTs identified (18% of patients). Calf compression elicited a normal response in 118/130 of non-DVT examinations (specificity 91%) and an abnormal response in 18/28 DVT examinations (sensitivity 64%). Diminished or absent augmentation was identified in alternative diagnoses that included haematoma and Baker's cyst. Conclusions: This study demonstrates that single-point augmentation has a low sensitivity in suspected lower-limb DVT, and that the majority of undetected DVTs are isolated to the calf veins. An abnormal augmentation response is a poor predictor of lower-limb DVT as alternative diagnoses can produce diminished or reduced augmentation. Therefore, single-point augmentation does not add to the standard compression ultrasound examination for suspected DVT and should not be routinely performed.

  20. Developing and Reflecting on a Black Disability Studies Pedagogy: Work from the National Black Disability Coalition

    Directory of Open Access Journals (Sweden)

    Jane Dunhamn


    Full Text Available This collection of writing has grown from the work of the National Black Disability Coalition, led by Jane Dunhamn and Leroy Moore. The Coalition met on June 7, 2013, in the historic Shiloh Baptist Church in Trenton, New Jersey to discuss the future of Black Disability Studies (BDS. Since that time, members of the Coalition have written an outline for a BDS course, presented at conferences, and developed strategies to incorporate BDS into the disciplines of Black Studies and Disability Studies. We have also reflected deeply on what the introduction of BDS will mean, both for Black Studies and for disability studies. Our writings in this collection are intended to mark the work of the National Black Disability Coalition thus far, but also to provide a platform from which further work in BDS can grow. By underscoring the development and potential of BDS, this article articulates the need for BDS within mainstream disability studies, and advocates for BDS not to be taken as a marginalized special-topic course, but rather to be engaged in every and at the heart of Disability Studies courses and pedagogies. Although we believe that BDS should be integrated into every Disability Studies course, we recognize that, like disability itself, it cannot simply be “added and stirred”; rather, the inclusion of BDS is a paradigm-shifting change. The pieces included in this collection are enactments of an ongoing conversation--a conversation that we hope the readers of Disability Studies Quarterly will join thoughtfully. The sections comprise statements from the leaders of the National Black Disability Coalition, Jane Dunhamn and Leroy Moore; reflective writings from three instructors and two students of Black Disability Studies; and a copy of the course outline.

  1. Assessment of Integration of Disability Content into Social Work Education. (United States)

    Ogden, Lydia; McAllister, Carolyn; Neely-Barnes, Susan


    Three hundred members of the Council on Social Work Education (CSWE) responded to a survey regarding the inclusion of disability content in social work courses and supports needed to increase disability content. Although respondents generally agreed that disability content is important in social work education, its inclusion is inconsistent, with most frequent inclusion in courses on diversity and least frequent inclusion in courses on research. Respondents identified barriers to increasing disability content, including lack of resources for teaching, lack of relevant faculty expertise, and an overcrowded curriculum. Strategies and resources for infusing disability content into social work education are discussed.

  2. Disability prevalence among healthy weight, overweight, and obese adults. (United States)

    Armour, Brian S; Courtney-Long, Elizabeth A; Campbell, Vincent A; Wethington, Holly R


    Obesity is associated with adverse health outcomes in people with and without disabilities. However, little is known about disability prevalence among people who are obese. The purpose of this study is to determine the prevalence and type of disability among adults who are obese. Pooled data from the 2003-2009 National Health Interview Survey (NHIS) were analyzed to obtain national prevalence estimates of disability, disability type and obesity. The disability prevalence was stratified by body mass index (BMI): healthy weight (BMI 18.5-<25.0), overweight (BMI 25.0-<30.0), and obese (BMI ≥ 30.0). In this pooled sample, among the 25.4% of US adults who were obese, 41.7% reported a disability. In contrast, 26.7% of those with a healthy weight and 28.5% of those who were overweight reported a disability. The most common disabilities among respondents with obesity were movement difficulty (32.5%) and work limitation (16.6%). This research contributes to the literature on obesity by including disability as a demographic in assessing the burden of obesity. Because of the high prevalence of disability among those who are obese, public health programs should consider the needs of those with disabilities when designing obesity prevention and treatment programs. Copyright © 2013 The Obesity Society.

  3. Benefits of sonography in diagnosing suspected uncomplicated acute diverticulitis. (United States)

    King, Welfur C; Shuaib, Waqas; Vijayasarathi, Arvind; Fajardo, Carlos G; Cabrera, Waldo E; Costa, Juan L


    Despite evidence demonstrating equivalent accuracy of sonography and computed tomography (CT) in the workup of mild/uncomplicated acute diverticulitis, CT is overwhelmingly performed as the initial diagnostic test, particularly in the acute setting. Our study evaluated potential radiation and turnaround time savings associated with performing sonography instead of CT as the initial diagnostic examination in the workup of suspected uncomplicated acute diverticulitis. We retrospectively reviewed medical records from January 2010 to December 2012 for patients presenting with clinical symptoms of acute diverticulitis. Patients were categorized as a whole and subgrouped by age (>40 and 40 years and 121 diverticulitis. © 2015 by the American Institute of Ultrasound in Medicine.

  4. A Suspected Pelvic Aneurysmal Bone Cyst in Pregnancy

    Directory of Open Access Journals (Sweden)

    Rayan Elkattah


    Full Text Available Albeit rare, the majority of identified bone lesions in pregnancy spare the pelvis. Once encountered with a pelvic bone lesion in pregnancy, the obstetrician may face a challenging situation as it is difficult to determine and predict the effects that labor and parturition impart on the pelvic bones. Bone changes and pelvic bone fractures have been well documented during childbirth. The data regarding clinical outcomes and management of pregnancies complicated by pelvic ABCs is scant. Highly suspected to represent an aneurysmal bone cyst, the clinical evaluation of a pelvic lesion in the ilium of a pregnant individual is presented, and modes of delivery in such a scenario are discussed.

  5. Patch Testing in Suspected Allergic Contact Dermatitis to Cosmetics


    Pramod Kumar; Rekha Paulose


    Background. Increasing use of cosmetics has contributed to a rise in the incidence of allergic contact dermatitis (ACD) to cosmetics. It is estimated that 1–5.4% of the population is sensitized to a cosmetic ingredient. Patch testing helps to confirm the presence of an allergy and to identify the actual allergens which are chemical mixtures of various ingredients. Objectives. The aims of this study are to perform patch testing in suspected ACD to cosmetics and to identify the most common alle...

  6. Injuries and Individuals with Disabilities (United States)

    Waldman, H. Barry; Perlman, Steven P.; Chaudhry, Ramiz A.


    Children and adults with disabilities are at an increased risk of injury. Falls are the leading mechanism of injury regardless of the disability status and are even more common in those with moderate or severe disabilities. The setting for the injury differs with the disability status. Compared to individuals with moderate or no disabilities,…

  7. 77 FR 46606 - Enforcement of Nondiscrimination on the Basis of Disability in Programs and Activities Conducted... (United States)


    ... designed to benefit individuals with disabilities or a given class of individuals with disabilities to..., auxiliary aids useful for persons with impaired vision include readers, Brailled materials, audio recordings... include telephone handset amplifiers, telephones compatible with hearing aids, telecommunications devices...

  8. Listening to Include (United States)

    Veck, Wayne


    This paper attempts to make important connections between listening and inclusive education and the refusal to listen and exclusion. Two lines of argument are advanced. First, if educators and learners are to include each other within their educational institutions as unique individuals, then they will need to listen attentively to each other.…

  9. Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Danielle I. Miano


    Full Text Available Introduction: Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US or computed tomography (CT studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods: We conducted a retrospective chart review including emergency department (ED and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results: 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4] compared to those without (57%, 95% CI [52.9,61.0]. Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7] and those without (13%, 95% CI [10.3,15.7]. The proportion of

  10. Nasogastric tube feeding in cats with suspected acute pancreatitis: 55 cases (2001-2006). (United States)

    Klaus, Jennifer A; Rudloff, Elke; Kirby, Rebecca


    To evaluate the complications and outcome associated with different nasogastric tube (NGT) feeding techniques in cats with suspected acute pancreatitis. Descriptive retrospective case series. Small animal emergency and referral hospital. The patient database (2001-2006) was searched for cats with suspected acute pancreatitis that received NGT liquid enteral feeding within 72 hours of admission and ≥12 hours during hospitalization. Signalment, history, clinical signs, laboratory data and abdominal ultrasonographic examinations were used for suspected diagnosis. Cats were grouped based upon whether they received bolus feeding or continuous rate infusion (CRI) of a liquid diet via the NGT, and whether or not administration of an intravenous amino acid and carbohydrate solution occurred prior to NGT feeding (AAS and non-AAS group, respectively). Fifty-five cats were included. For all cats, NGT feeding was initiated at a mean of 33.5 ± 15.0 hours and the target caloric intake (1.2 X {(30 X BW [kg]) +70}) was reached at 58.0 ± 28.4 hours from presentation. There was a significantly longer time from admission to the initiation of NGT feeding in the 34/55 cats in the AAS group vs. the 21/55 cats in the non-AAS group (P = 0.009). The 8 bolus-fed cats took longer to reach target caloric intake vs. the 47 CRI-fed cats (P = 0.002). Complications associated with NGT feeding for all cats included: mechanical problems (13%), diarrhea (25%), vomiting following NGT placement (20%) and vomiting following NGT feeding (13%). Mean time to discharge for all cats occurred after 78.6 ± 29.5 hours with an overall weight gain of 0.08 ± 0.52 kg. Fifty cats survived 28 days post-discharge. NGT feeding in this group of cats with suspected acute pancreatitis was well tolerated, and associated with a low incidence of diarrhea, vomiting, and mechanical complications. © Veterinary Emergency and Critical Care Society 2009.

  11. Working while on a disability pension in Finland: Association of diagnosis and financial factors to employment. (United States)

    Polvinen, Anu; Laaksonen, Mikko; Rantala, Juha; Hietaniemi, Marjukka; Kannisto, Jari; Kuivalainen, Susan


    The aim of this study was to find out whether health and financial factors are associated with engagement in paid work during a disability pension. The data included a 10 per cent sample of Finns aged 20-62 years who were drawing earnings-related full or partial disability pension in 2012 ( n = 14,418). Logistic regression analysis was used to estimate odds ratios for working while on a full or partial disability pension. Fourteen per cent of full disability pensioners and 76 per cent of partial disability pensioners were engaged in paid work. Full disability pensioners due to mental disorders were working less often than full disability pensioners due to other diseases. Partial disability pensioners due to cardiovascular diseases were working more than partial disability pensioners due to other diseases. More recent timing of disability pension was associated with working for both partial and full disability pensioners. Working while on disability pension was more common among those with higher education. Partial disability pensioners with average pension worked more often than those with high pension. By knowing the factors associated with working while on a disability pension, policies could be more efficiently allocated to encourage disability pensioners to take up work. One way would be to support disability pensioners with low education to work more. Another way to increase work among disability pensioners is to support the recently retired in working longer.

  12. Investigation of suspected chronic fatigue syndrome/myalgic encephalopathy. (United States)

    Owe, Jone Furlund; Næss, Halvor; Gjerde, Ivar Otto; Bødtker, Jørn Eilert; Tysnes, Ole-Bjørn


    Chronic fatigue is a frequently occurring problem in both the primary and specialist health services. The Department of Neurology at Haukeland University Hospital has established a standard assessment for patients referred with suspected CFS/ME. This study reports diagnoses and findings upon assessment, and considers the benefit of supplementary examinations. Diagnoses and findings from examinations of 365 patients assessed for suspected CFS/ME are retrospectively reported. A total of 48 patients (13.2%) were diagnosed with CFS/ME, while a further 18 patients (4.9%) were diagnosed with post-infectious fatigue. Mental and behavioural disorders were diagnosed in 169 patients (46.3%), and these represented by far the largest group. Serious, but unrecognised somatic illness was discovered in two patients, while changes of uncertain significance were identified by MRI and lumbar puncture in a few patients. Fatigue is a frequently occurring symptom in the population. Thorough somatic and psychiatric investigation is necessary before referral to the specialist health services. Mental disorders and reactions to life crises are common and important differential diagnoses for CFS/ME. Long waiting times in the specialist health services may result in delayed diagnosis for these patients.

  13. Perioperative sexual interest in women with suspected gynecologic malignancies. (United States)

    Bretschneider, C E; Bensen, Jeannette T; Geller, Elizabeth J; Gehrig, Paola A; Wu, Jennifer M; Doll, Kemi M


    For women with gynecologic cancer, the impact of surgery on sexual interest and desire in the immediate and later postoperative period is not well characterized. The objective of this study was to report the perioperative trends of changing sexual interest and desire in a cohort of women undergoing surgery for suspected gynecologic malignancies. This is an ancillary analysis of a cohort study analyzing health-related outcomes in women who underwent primary surgical management of a suspected gynecologic malignancy between 10/2013 and 10/2014. Subjects completed the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction Questionnaire (PROMIS-SFQ) preoperatively and questions on sexual interest and desire at one, three, and six months postoperatively. Bivariate tests and multiple linear regression were used to analyze data. Of 231 women who completed a baseline PROMIS-SFQ, 187 (81%) completed one-month, 170 (74%) three-month, and 174 (75%) six-month follow-up interviews. Following surgery, 71% of enrolled subjects were diagnosed with a malignancy. Women age women age >55 (-5.5±1.0 vs -2.3±0.9, p=0.02). In a multivariable analysis, age women of all ages (-5.6, 95% CI: -9.6, -1.5). This study provides new data regarding the timing and magnitude of changes in sexual interest following gynecologic oncology procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Ocular lesions following suspected lightning injury in a horse. (United States)

    Evans, Paige M; Armour, Micki D; Dubielzig, Richard R


      To describe the gross and histopathological ocular findings in a horse following suspected lightning injury.   The eyes of a 2-year-old thoroughbred gelding were clinically and histopathologically evaluated following a severe lightning storm following euthanasia because of visual impairment.   Severe corneal edema and hydrops were noted clinically oculus dexter. Indirect ophthalmoscopy revealed bilateral symmetrical raised hyporeflective peripapillary geographic lesions. Histopathologic evaluation revealed corneal edema in the right eye with normal corneal endothelium. Posterior segment evaluation revealed localized, pericentral choroidal lesions characterized by the presence of hemorrhage, early fibrosis, and minimal lymphoplasmacytic, neutrophilic, and histiocytic inflammation with spindle cell proliferation. The retinas overlying the choroidal lesions were necrotic and mostly absent. Peripheral to the focal lesion, the retina abruptly returned to normal architecture peripheral to a zone of apoptotic photoreceptors. Centrally, swollen axons extended into the optic disc.   There have been few descriptions of ocular lesions in animals following suspected lightning injury. We believe these findings to be unique because of the type of thermal injury that may be characteristic of lightening injury. We do not know whether these lesions would have progressed over time. © 2011 American College of Veterinary Ophthalmologists.

  15. Patch Testing in Suspected Allergic Contact Dermatitis to Cosmetics (United States)

    Paulose, Rekha


    Background. Increasing use of cosmetics has contributed to a rise in the incidence of allergic contact dermatitis (ACD) to cosmetics. It is estimated that 1–5.4% of the population is sensitized to a cosmetic ingredient. Patch testing helps to confirm the presence of an allergy and to identify the actual allergens which are chemical mixtures of various ingredients. Objectives. The aims of this study are to perform patch testing in suspected ACD to cosmetics and to identify the most common allergen and cosmetic product causing dermatitis. Methods. Fifty patients with suspected ACD to cosmetics were patch-tested with 38 antigens of the Indian Cosmetic Series and 12 antigens of the Indian Standard Series. Results. The majority (58%) of patients belonged to the 21–40 years age group. The presence of ACD to cosmetics was confirmed in 38 (76%) patients. Face creams (20%), hair dyes (14%), and soaps (12%) were the most commonly implicated. The most common allergens identified were gallate mix (40%), cetrimide (28%), and thiomersal (20%). Out of a total of 2531 patches applied, positive reactions were obtained in 3.75%. Conclusion. Incidence of ACD to cosmetics was greater in females. Face creams and hair dyes were the most common cosmetic products implicated. The principal allergens were gallate mix, cetrimide, and thiomersal. PMID:25295057

  16. Feline toxicological emergencies: when to suspect and what to do. (United States)

    Grave, Tobias W; Boag, Amanda K


    Confirmed or suspected intoxications with a wide variety of agents represent a small but important group of feline emergency cases. Generally it is thought that toxicities are less common in cats compared with dogs, with a higher proportion relating to dermal as opposed to oral exposure. Once toxicity is suspected or diagnosed, it must be recognised that treatment regimes may need modification compared with those established for dogs. Different drugs or different dosages may be warranted and the choice of available drugs may be reduced. This review draws on published studies, case reports and clinical experience to summarise key features of the general management of the intoxicated feline patient before describing some of the more serious and common intoxications in more detail. The focus throughout the review is on the peculiarities of feline metabolism and how they may impact on presentation and treatment. The aim is to assist companion animal and feline practitioners, who are in the frontline when it comes to managing these emergency cases. Copyright © 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

  17. The social model of disability: dichotomy between impairment and disability. (United States)

    Anastasiou, Dimitris; Kauffman, James M


    The rhetoric of the social model of disability is presented, and its basic claims are critiqued. Proponents of the social model use the distinction between impairment and disability to reduce disabilities to a single social dimension-social oppression. They downplay the role of biological and mental conditions in the lives of disabled people. Consequences of denying biological and mental realities involving disabilities are discussed. People will benefit most by recognizing both the biological and the social dimensions of disabilities.

  18. Disability and the post-2015 development agenda. (United States)

    Tardi, Rachele; Njelesani, Janet


    The article considers the extent to which disability has been recognized and included in two main documents produced to date as part of the United Nations Post-2015 Development agenda process. This is the process that is defining the Sustainable Development Goals (SDGs), which will succeed the UN Millennium Development Goals (MDGs) after the latter reach their target date in 2015. The two documents examined in the article are the Outcome Document (July 2014) of the Open Working Group (OWG) on SDGs and the Report (August 2014) of the Intergovernmental Committee of Experts on Sustainable Development Financing (ICESDF). The OWG consisted of 30 seats shared by 70 UN Member States and was in charge of proposing goals and targets for the SDGs. The ICESDF worked in parallel to the OWG and its report proposed options on an effective financing strategy. The article emphasizes the importance of including persons with disabilities in the Post-2015 Agenda, especially in view of the latter's overarching focus on eradicating poverty. The inclusion of persons with disabilities is being recognized in the Post-2015 Agenda discussions as central to achieving sustainable development. Disability has been explicitly mentioned in the OWG and ICESDF documents. Although the results so far have been very good, more work still needs to be done to ensure that these explicit references are maintained in the final version of the SDGs, which will be adopted in September 2015. Furthermore, the new framework needs to have a stronger human rights foundation on which to ground these references and future indicators. Light for the World is an international confederation of national development non-governmental organizations (NGOs) aiming at an inclusive society, where the rights of persons with disabilities are realized without discrimination. Through a rights-based approach, Light for the World supports 175 programs in 25 countries in the areas of prevention of blindness, rehabilitation, inclusive

  19. Influenza Illness among Case-Patients Hospitalized for Suspected Dengue, El Salvador, 2012.

    Directory of Open Access Journals (Sweden)

    Rafael Chacon

    Full Text Available We estimate the proportion of patients hospitalized for suspected dengue that tested positive for influenza virus in El Salvador during the 2012 influenza season. We tested specimens from 321 hospitalized patients: 198 patients with SARI and 123 patients with suspected dengue. Among 121 hospitalized suspected dengue (two co-infected excluded patients, 28% tested positive for dengue and 19% positive for influenza; among 35 with suspected dengue and respiratory symptoms, 14% were positive for dengue and 39% positive for influenza. One percent presented co-infection between influenza and dengue. Clinicians should consider the diagnosis of influenza among patients with suspected dengue during the influenza season.

  20. Influenza Illness among Case-Patients Hospitalized for Suspected Dengue, El Salvador, 2012. (United States)

    Chacon, Rafael; Clara, Alexey Wilfrido; Jara, Jorge; Armero, Julio; Lozano, Celina; El Omeiri, Nathalie; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo


    We estimate the proportion of patients hospitalized for suspected dengue that tested positive for influenza virus in El Salvador during the 2012 influenza season. We tested specimens from 321 hospitalized patients: 198 patients with SARI and 123 patients with suspected dengue. Among 121 hospitalized suspected dengue (two co-infected excluded) patients, 28% tested positive for dengue and 19% positive for influenza; among 35 with suspected dengue and respiratory symptoms, 14% were positive for dengue and 39% positive for influenza. One percent presented co-infection between influenza and dengue. Clinicians should consider the diagnosis of influenza among patients with suspected dengue during the influenza season.

  1. Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Francisco Flávio Costa Filho


    Full Text Available AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD, a clinical (non-invasive evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77, age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26, diabetes (OR, 2.01; CI 95%, 1.40 - 2.90, dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07, typical angina (OR, 2.92; CI 95%, 1.77 - 4.83 and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27.Conclusions:In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.

  2. Peripapillary retinal splitting visualized on OCT in glaucoma and glaucoma suspect patients.

    Directory of Open Access Journals (Sweden)

    Dilraj S Grewal

    Full Text Available To identify the risk factors for development of peripapillary retinal splitting (schisis in patients with glaucoma or suspicion of glaucoma.Glaucoma Clinic, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL.In this institutional cross-sectional study, 495 patients (990 eyes who had undergone spectral-domain optical coherence tomography (OCT Spectralis HRA-OCT, Heidelberg Engineering optic nerve head (ONH imaging and did not have identifiable optic nerve pits, pseudopits or coloboma were included. OCT scans were reviewed by two observers.Presence of peripapillary retinal splitting identified on OCT raster scans.Eleven of 990 glaucoma and glaucoma suspect eyes (1.1% of 7 patients (2 females, 5 males, mean age 64.5 ± 9.2 years had peripapillary retinal splitting. Two of these 11 eyes had extension of the splitting into the macula but none to the fovea. Of these 11 patients, 2 (28.6% were glaucoma suspects, 3 (42.9% had primary open-angle glaucoma, 1 (14.3% had chronic angle-closure glaucoma and 1 (14.3% had pigmentary glaucoma. 7/11 (63.6% eyes had vitreous traction to the disc visualized on OCT and 6/11 eyes (54.5% had beta-zone peripapillary atrophy.We observed peripapillary retinal splitting in 1.1% of a series of 990 glaucoma and glaucoma-suspect eyes. Evidence of adherent vitreous with traction and peripapillary atrophy was found in a majority of the involved eyes. A comparison to an age and axial length matched cohort is required to determine if this is a condition that is associated with glaucoma.

  3. Association of naso-Oro-pharyngeal structures with the sleep architecture in suspected obstructive sleep apnea. (United States)

    Singhal, Pawan; Gupta, Ravi; Sharma, Rajanish; Mishra, Prakash


    The study was conducted to find out the association of various naso-oro-pharyngeal structures with sleep macro-architecture in suspected obstructive sleep apnea subjects. Study included 51 subjects with suspected obstructive sleep apnea. Subjects with possible central apnea and those consuming any substance that can affect sleep architecture were excluded. Level I polysomnography was performed after thorough physical examination. Overnight study was scored in 30 s epochs to find out the polysomnographic variables. Surgical treatment was offered wherever indicated. Subjects with moderate to severe obstructive sleep apnea were manually titrated on CPAP with the polysomnogram. SPSS v 17.0 was used for statistical analysis. We did not find any difference in the sleep architecture between genders. Sleep Efficiency was better in subjects with dental overjet, dental attrition, high tongue base, macroglossia, lesser oral cavity volume, edematous uvula, increased submental fat, hypertrophied facial muscles and Mallampatti grade III-IV. Shorter Sleep Latency was seen in subjects with tender TMJ and Mallampatti Gr III-IV. REM latency was shorter in subjects with high tongue base, macroglossia and hypertrophied muscles of mastication. Increased REM was observed in subjects with high tongue base, edematous uvula and tender TMJ. Enlarged tonsils had reversed effect with poor sleep efficiency, increased REM latency and decreased REM. CPAP therapy (N = 20) lessened awake time, decreased N2 and increased REM. Oro-pharyngeal structures affect the sleep architecture in suspected OSA subjects. Nasal structures do not affect the sleep architecture in these subjects and enlarged tonsils have opposite effect. Sleep architecture changes on the titration night with CPAP.

  4. Endosonography for suspected obstructive jaundice with no definite pathology on ultrasonography. (United States)

    Chen, Chien-Hua; Yang, Chi-Chieh; Yeh, Yung-Hsiang; Yang, Tsang; Chung, Tieh-Chi


    Ultrasonography (US) cannot demonstrate all the etiologies of biliary tract dilatation in patients with jaundice. Thus, we evaluated the etiologic yield of endosonography (EUS) for suspected obstructive jaundice when no definite pathology was found on US. Additionally, we sought to identify the predictors of the most common etiologies. We performed a retrospective review of 123 consecutive patients who had undergone EUS for suspected obstructive jaundice when no definite pathology was identified on US. The most common diagnoses included no pathological obstruction (n = 43), pancreatobiliary malignancy (n = 41), and choledocholithiasis (n = 28). Pancreatobiliary malignancy was associated with common bile duct (CBD) dilatation, and fever and elevated alanine aminotransferase were predictors of choledocholithiasis (p jaundice, 100% (40/40) for no pathological finding, 100% (23/23) for ampullary cancer, 100% (13/13) for pancreatic cancer, 75% (3/4) for CBD cancer, and 92.9% (26/28) for choledocholithiasis, respectively. Besides the two patients with focal chronic pancreatitis misdiagnosed as with pancreatic cancer, EUS missed the lesions in one CBD cancer patient and two patients with choledocholithiasis. The overall accuracy of EUS in ascertaining pancreatobiliary malignancy and choledocholithiasis was comparable (97.6%, 40/41 vs. 92.9%, 26/28; p > 0.05). Marked CBD dilatation (≥12 mm) should remind us of the high risk of malignancy, and the presence of CBD dilatation and fever is suggestive of choledocholithiasis. Negative EUS findings cannot assure any pathological obstruction in patients with clinically suspected obstructive jaundice. Copyright © 2013. Published by Elsevier B.V.

  5. Peripapillary retinal splitting visualized on OCT in glaucoma and glaucoma suspect patients. (United States)

    Grewal, Dilraj S; Merlau, Daniel J; Giri, Pushpanjali; Munk, Marion R; Fawzi, Amani A; Jampol, Lee M; Tanna, Angelo P


    To identify the risk factors for development of peripapillary retinal splitting (schisis) in patients with glaucoma or suspicion of glaucoma. Glaucoma Clinic, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL. In this institutional cross-sectional study, 495 patients (990 eyes) who had undergone spectral-domain optical coherence tomography (OCT Spectralis HRA-OCT, Heidelberg Engineering) optic nerve head (ONH) imaging and did not have identifiable optic nerve pits, pseudopits or coloboma were included. OCT scans were reviewed by two observers. Presence of peripapillary retinal splitting identified on OCT raster scans. Eleven of 990 glaucoma and glaucoma suspect eyes (1.1%) of 7 patients (2 females, 5 males, mean age 64.5 ± 9.2 years) had peripapillary retinal splitting. Two of these 11 eyes had extension of the splitting into the macula but none to the fovea. Of these 11 patients, 2 (28.6%) were glaucoma suspects, 3 (42.9%) had primary open-angle glaucoma, 1 (14.3%) had chronic angle-closure glaucoma and 1 (14.3%) had pigmentary glaucoma. 7/11 (63.6%) eyes had vitreous traction to the disc visualized on OCT and 6/11 eyes (54.5%) had beta-zone peripapillary atrophy. We observed peripapillary retinal splitting in 1.1% of a series of 990 glaucoma and glaucoma-suspect eyes. Evidence of adherent vitreous with traction and peripapillary atrophy was found in a majority of the involved eyes. A comparison to an age and axial length matched cohort is required to determine if this is a condition that is associated with glaucoma.

  6. Analytic device including nanostructures

    KAUST Repository

    Di Fabrizio, Enzo M.


    A device for detecting an analyte in a sample comprising: an array including a plurality of pixels, each pixel including a nanochain comprising: a first nanostructure, a second nanostructure, and a third nanostructure, wherein size of the first nanostructure is larger than that of the second nanostructure, and size of the second nanostructure is larger than that of the third nanostructure, and wherein the first nanostructure, the second nanostructure, and the third nanostructure are positioned on a substrate such that when the nanochain is excited by an energy, an optical field between the second nanostructure and the third nanostructure is stronger than an optical field between the first nanostructure and the second nanostructure, wherein the array is configured to receive a sample; and a detector arranged to collect spectral data from a plurality of pixels of the array.

  7. Adherence to standard of care in the diagnosis and treatment of suspected bacterial meningitis. (United States)

    Chia, David; Yavari, Youness; Kirsanov, Eugeny; Aronin, Steven I; Sadigh, Majid


    Acute bacterial meningitis (ABM) is a rare but deadly neurological emergency. Accordingly, Infectious Diseases Society of America (IDSA) guidelines summarize current evidence into a straightforward algorithm for its management. The goal of this study is to evaluate the overall compliance with these guidelines in patients with suspected ABM. A retrospective cross-sectional study was conducted of adult patients who underwent lumbar puncture for suspected ABM to ascertain local adherence patterns to IDSA guidelines for bacterial meningitis. Primary outcomes included appropriate utilization of neuroimaging, blood cultures, antibiotics, corticosteroids, and lumbar puncture. In all, 160 patients were included in the study. Overall IDSA compliance was only 0.6%. Neuroimaging and blood cultures were appropriately utilized in 54.3% and 47.5% of patients, respectively. Steroids and antibiotics were appropriately administered in only 7.5% and 5.6% of patients, respectively. Adherence to IDSA guidelines is poor. Antibiotic choice is often incorrect, corticosteroids are rarely administered, and there is an overutilization of neuroimaging. © The Author(s) 2014.

  8. Importance of Wells score and Geneva score for the evaluation of patients suspected of pulmonary embolism. (United States)

    Gruettner, Joachim; Walter, Thomas; Lang, Siegfried; Meyer, Michael; Apfaltrer, Paul; Henzler, Thomas; Viergutz, Tim


    The European Society of Cardiology guidelines for pulmonary embolism (PE) published in 2008 and updated in 2014 recommend a risk stratification including risk scores like Wells and the Geneva score. The utility and practicability of these scores are controversially discussed. Recently, in a trauma cohort and in spinal surgery patients, no correlation between Wells Score and PE diagnosis was found. The aim of the study was the evaluation of Wells and Geneva scores in patients presenting with chest pain, dyspnoea or syncope in an emergency department. We retrospectively examined 326 patients suspected of PE, including assessment, according to Wells and Geneva scores. PE was detected in 13.5 %. The average Wells score was 1.0, the average Geneva score 3.9. The receiver operating characteristic (ROC) curve analyses showed for both scores a high significant area under the curve (Wells score 0.68; Geneva score 0.64). The association between the scores and the diagnosis of PE was calculated with logistic regression analysis and showed high significant odds ratios (OR) for both scores (Wells score 1.38; Geneva score 1.24). There was no significant difference between the area under the curve (AUC) of Wells score and Geneva score. The utility of Wells and Geneva scores for the evaluation of patients suspected of PE in an emergency patient cohort. Copyright © 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  9. Cardiac magnetic resonance imaging in suspected blunt cardiac injury: A prospective, pilot, cohort study. (United States)

    Burrell, Aidan Jc; Kaye, David M; Fitzgerald, Mark C; Cooper, David J; Hare, James L; Costello, Benedict T; Taylor, Andrew J


    The aim of this study was to evaluate the incidence and severity of blunt cardiac injury (BCI) as determined by cardiac magnetic resonance imaging (CMR), and to compare this to currently used diagnostic methods in severely injured patients. We conducted a prospective, pilot cohort study of 42 major trauma patients from July 2013 to Jan 2015. The cohort underwent CMR within 7 days, enrolling 21 patients with evidence of chest injury and an elevated Troponin I compared to 21 patients without chest injury who acted as controls. Major adverse cardiac events (MACE) including ventricular arrhythmia, unexplained hypotension requiring inotropes, or a requirement for cardiac surgery were recorded. 6/21 (28%) patients with chest injuries had abnormal CMR scans, while all 21 control patients had normal scans. CMR abnormalities included myocardial oedema, regional wall motion abnormalities, and myocardial haemorrhage. The left ventricle was the commonest site of injury (5/6), followed by the right ventricle (2/6) and tricuspid valve (1/6). MACE occurred in 5 patients. Sensitivity and specificity values for CMR at predicting MACE were 60% (15-95) and 81% (54-96), which compared favourably with other tests. In this pilot trial, CMR was found to give detailed anatomic information of myocardial injury in patients with suspected BCI, and may have a role in the diagnosis and management of patients with suspected BCI. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Excessive online computer use and learning disabilities


    Griffiths, MD


    Online gaming has become a very popular leisure activity among adolescents. Research suggests that a small minority of adolescents may display problematic gaming behaviour and that some of these individuals may be addicted to online games, including those who have learning disabilities. This article begins by examining a case study of a 15-year old adolescent with a learning disability who appeared to be addicted to various computer and internet applications. Despite the potential negative ef...

  11. Disability in anxiety disorders. (United States)

    Hendriks, Sanne M; Spijker, Jan; Licht, Carmilla M M; Beekman, Aartjan T F; Hardeveld, Florian; de Graaf, Ron; Batelaan, Neeltje M; Penninx, Brenda W J H


    This study compares disability levels between different anxiety disorders and healthy controls. We further investigate the role of anxiety arousal and avoidance behaviour in disability, and whether differences in these symptom patterns contribute to disability differences between anxiety disorders. Data were from 1826 subjects from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose anxiety disorders. The World Health Organization Disability Assessment Schedule II was used to measure disability in six domains (cognition, mobility, selfcare, social interaction, life activities, participation). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire. All anxiety disorders were associated with higher disability. Disability was generally highest in multiple anxiety disorder (e.g. mean disability in cognition=33.7) and social anxiety disorder (mean=32.7), followed by generalized anxiety disorder (mean=27.2) and panic disorder with agoraphobia (mean=26.3), and lowest in panic disorder without agoraphobia (mean=22.1). Anxiety arousal was more associated with disability in life activities (B=8.5, panxiety disorders were not completely explained by anxiety arousal and avoidance behaviour. The cross-sectional study design precludes any causal interpretations. In order to examine the full range of comorbidity among anxiety, a greater range of anxiety disorders would have been preferable. Disability is highest in social anxiety disorder and multiple anxiety disorder. Both anxiety arousal and avoidance behaviour are associated with higher disability levels but do not fully explain the differences across anxiety disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination


    van Brakel, Wim H.; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I.; Wilder-Smith, Annelies


    Background: Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. Methods: We conducted a survey on disability among persons affecte...

  13. The Danish Neck Disability Index

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein; O'Neill, Lotte; Kongsted, Alice


    Objective: To (1) translate and culturally adapt and (2) determine the clinimetric properties of the Danish 8-item Neck Disability Index (NDI-8) in primary sector patients (PSPs) and secondary sector patients (SSPs). Methods: Analyses included 326 patients with neck pain. Validity and reliability...... were assessed using a cross-validation factor analytical design, hypothesis testing, internal consistency, measurement error, the smallest detectable change (SDC), and a generalizability study. Criterion and construct responsiveness, minimal important change (MIC), and floor and ceiling effects were...

  14. Induction of labour at or near term for suspected fetal macrosomia. (United States)

    Boulvain, Michel; Irion, Olivier; Dowswell, Therese; Thornton, Jim G


    Women with a suspected large-for-dates fetus or a fetus with suspected macrosomia (birthweight greater than 4000 g) are at risk of operative birth or caesarean section. The baby is also at increased risk of shoulder dystocia and trauma, in particular fractures and brachial plexus injury. Induction of labour may reduce these risks by decreasing the birthweight, but may also lead to longer labours and an increased risk of caesarean section. To assess the effects of a policy of labour induction at or shortly before term (37 to 40 weeks) for suspected fetal macrosomia on the way of giving birth and maternal or perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2016), contacted trial authors and searched reference lists of retrieved studies. Randomised trials of induction of labour for suspected fetal macrosomia. Review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We contacted study authors for additional information. For key outcomes the quality of the evidence was assessed using the GRADE approach. We included four trials, involving 1190 women. It was not possible to blind women and staff to the intervention, but for other 'Risk of bias' domains these studies were assessed as being at low or unclear risk of bias.Compared to expectant management, there was no clear effect of induction of labour for suspected macrosomia on the risk of caesarean section (risk ratio (RR) 0.91, 95% confidence interval (CI) 0.76 to 1.09; 1190 women; four trials, moderate-quality evidence) or instrumental delivery (RR 0.86, 95% CI 0.65 to 1.13; 1190 women; four trials, low-quality evidence). Shoulder dystocia (RR 0.60, 95% CI 0.37 to 0.98; 1190 women; four trials, moderate-quality evidence), and fracture (any) (RR 0.20, 95% CI 0.05 to 0.79; 1190 women; four studies, high-quality evidence) were reduced in the induction of labour group. There were no clear differences

  15. Perceptions of a disability sport unit in general physical education. (United States)

    Grenier, Michelle; Collins, Karen; Wright, Steven; Kearns, Catherine


    The purpose of this qualitative study was to assess the effectiveness of a disability sport unit in shaping perceptions of disability. Data from interviews, observations, and documents were collected on 87 elementary-aged students, one physical education teacher, and one teaching intern. Comparisons were drawn between fifth graders engaged in a five-week disability sport unit to fourth graders participating in their standard physical education curriculum. Findings revealed differences in the way fourth and fifth graders came to view individuals with disabilities. The results support an analysis of curriculum development that underscores the significance of the social model in positively impacting constructions of disability. Recommendations include the use of disability sports in physical education as an effective strategy for educating students in game play, knowledge of the Paralympics, and the inclusion of individuals with disabilities in a variety of sporting venues.

  16. Disability, economic globalization and privatization: A case study of India

    DEFF Research Database (Denmark)

    Hiranandani, Vanmala Sunder


    People with disabilities are one of the most disenfranchised groups in India. Standardized measurements of disability in India and internationally have overlooked the linkages between the economy and disability. In recent decades, neo-liberal economic reforms imposed in developing countries, under...... investigates the implications of economic restructuring in the arenas of social programs, education, employment, accessibility, health, agriculture and food security, and water and land acquisition from a disability perspective. Our analysis shows that while increased employment opportunities and accessibility...... have benefitted middle-class and highly-skilled disabled persons, the majority of people with disabilities have been left out of India's economic affluence. We contend that India's globalized economy and reduced state role necessitate renewed understanding of human rights, including disability rights....

  17. Physical Abuse Related Death of a Disabled Child in Nursery

    Directory of Open Access Journals (Sweden)

    Ali Metin


    Full Text Available People with disabilities constitute a large portion of our society as approximately 12.3%. İndividuals with disabilities have been in the risk group of violence. Disabled people have been target of physical, sexual, economic, emotional violence  such as children, women and elderly. As a result of the violence experience they may have physical, mental problems, increasing disabled level or die. Many national and international research include that people with disabilities  are exposed to different type of violence especially physical and sexual violence. 9 year old child that had lived in disabled care service, exposed to severe violence and neglect from care service worker. To show the incidence and result of violence  and neglect contribute destruction the source of violence. Key words: Disabled child, Physical abuse, Death.

  18. Children with intellectual disability and hospice utilization. (United States)

    Lindley, Lisa C; Colman, Mari Beth; Meadows, John T


    Over 42,000 children die each year in the United States, including those with intellectual disability (ID). Survival is often reduced when children with intellectual disability also suffer from significant motor dysfunction, progressive congenital conditions, and comorbidities. Yet, little is known about hospice care for children with intellectual disability. The purpose of this study was to explore the relationship between intellectual disability and hospice utilization. Additionally, we explored whether intellectual disability combined with motor dysfunction, progressive congenital conditions, and comorbidities influenced pediatric hospice utilization. Using a retrospective cohort design and data from the 2009 to 2010 California Medicaid claims files, we conducted a multivariate analysis of hospice utilization. This study shows that intellectual disability was negatively related to hospice enrollment and length of stay. We also found that when children had both intellectual disability and comorbidities, there was a positive association with enrolling in hospice care. A number of clinical implications can be drawn from the study findings that hospice and palliative care nurses use to improve their clinical practice of caring for children with ID and their families at end of life.

  19. Preventing disability in inflammatory bowel disease. (United States)

    Allen, Patrick B; Gower-Rousseau, Corinne; Danese, Silvio; Peyrin-Biroulet, Laurent


    Disability is a common worldwide health challenge and it has been increasing over the past 3 decades. The treatment paradigm has changed dramatically in inflammatory bowel diseases (IBDs) from control of symptoms towards full control of disease (clinical and endoscopic remission) with the goal of preventing organ damage and disability. These aims are broadly similar to rheumatoid arthritis and multiple sclerosis. Since the 1990s, our attention has focused on quality of life in IBD, which is a subjective measure. However, as an objective end-point in clinical trials and population studies, measures of disability in IBD have been proposed. Disability is defined as '…any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.' Recently, after 10 years of an international collaborative effort with the World Health Organization (WHO), a disability index was developed and validated. This index ideally would assist with the assessment of disease progression in IBD. In this review, we will provide the evidence to support the use of disability in IBD patients, including experience from rheumatoid arthritis and multiple sclerosis. New treatment strategies, and validation studies that have underpinned the interest and quantification of disability in IBD, will be discussed.

  20. Sexual Health of Polish Athletes with Disabilities

    Directory of Open Access Journals (Sweden)

    Ryszard Plinta


    Full Text Available The purpose of this study was to determine sexual functioning of Polish athletes with disabilities (including paralympians. The study encompassed 218 people with physical disabilities, aged between 18 and 45 (149 men and 69 women. The entire research population was divided into three groups: Polish paralympians (n = 45, athletes with disabilities (n = 126 and non-athletes with disabilities (n = 47. The quality of sexual life of Polish paralympians was measured by using the Polish version of Female Sexual Function Index and International Index of Erectile Function. Clinically significant erectile dysfunctions were most often diagnosed in non-athletes (83.33% with 50% result of severe erectile dysfunctions, followed by athletes and paralympians with comparable results of 56.98% and 54.17% respectively (p = 0.00388. Statistically significant clinical sexual dysfunctions concerned lubrication, orgasm as well as pain domains, and prevailed among female non-athletes (68.42%, 68.42% and 57.89%. Practising sports at the highest level has a favourable effect on the sexuality of men and women with physical disabilities. Men with physical disabilities manifest more sexual disorders than women, an aspect which should be considered by health-care professionals working with people with disabilities.

  1. Media portrayal of elite athletes with disability - a systematic review. (United States)

    Rees, Leanne; Robinson, Priscilla; Shields, Nora


    The media plays an important role in shaping society's beliefs about disability and sport. The aim of this systematic review is to identify how elite athletes with disability are portrayed in the media. Six electronic databases were searched from 2001 to March 2017 for quantitative or qualitative content analysis of media coverage of elite athletes with disability: SportsDiscus, CINAHL, PsychInfo, Medline 1996-, Embase, and Proquest. Quality assessment and data extraction were performed by two independent assessors. Seventeen moderate quality articles were included. Six themes emerged from the data such as frequency of articles and photos about elite athletes with disability; athlete gender; athlete nationality; disability; athleticism; and Olympic Games versus Paralympic Games. Our results show that elite athletes with disability are less visible in the media than their nondisabled counterparts; female athletes received less coverage than male; the media favored domestic athletes and certain types of disability; and, although there was a focus on athleticism, this was underpinned by a "supercrip" narrative and a medicalised description of disability. Although there has been a positive shift in the narrative around elite athletes with disability in media, relative absence and differing portrayal is present. Considering the power of media shaping society's perceptions of disability, further investigation is warranted. Implications for Rehabilitation Media has a role in how elite athletes with disability are portrayed and consequently perceived by the public. Elite athletes with disability rarely feature in media. Images of disability are minimized, and certain types of disabilities are favored. An athletic narrative is emerging; however, a medicalised description of athletes remains, shifting the focus from athleticism. "Supercrip" and "Superhuman" terms are commonly used, but may negatively impact the broader disability community.

  2. Negotiating hearing disability and hearing disabled identities

    DEFF Research Database (Denmark)

    Lykke Hindhede, Anette


        Using disability theory as a framework and social science theories of identity to strengthen the arguments, this paper explores empirically how working-age adults confront the medical diagnosis of hearing impairment. For most participants hearing impairment threatens the stability of social...... interaction and the construction of hearing disabled identities is seen as shaped in the interaction with the hearing impaired person‟s surroundings. In order to overcome the potential stigmatisation the „passing‟ as normal becomes predominant. For many the diagnosis provokes radical redefinitions of the self....... The discursively produced categorisation and subjectivity of senescence mean that rehabilitation technologies such as hearing aids identify a particular life-style (disabled) which determines their social significance. Thus wearing a hearing aid works against the contemporary attempt to create socially ideal...

  3. Disability, human rights and justice


    Diniz, Debora; Barbosa, Lívia; Santos, Wederson Rufino dos


    ABSTRACT This paper aims to demonstrate how the feld of disability studies consolidated the concept of disability as social oppression. By reviewing the main ideas of the social model of disability, this article presents the genesis of the concept of disability as a restriction of participation for disabled people, as adopted by the United Nations Convention on the Rights of Persons with Disabilities, which Brazil ratifed in 2008.

  4. Disabilities in Written Expression (United States)

    Gardner, Teresa J.


    Regular education teachers may have received inadequate preparation to work with the variety of student disabilities encountered in the classroom, or they may have received limited training regarding the full range of learning disabilities and their effects on classroom performance. Along with problems in the area of math, students may also have…

  5. Parents with intellectual disability

    NARCIS (Netherlands)

    Schuengel, Carlo; Kef, Sabina; Hodes, Marja W.; Meppelder, Marieke


    Questions around parents with intellectual disability have changed according to sociocultural shifts in the position and rights of people with intellectual disability. The early research focus on capacity for parenting has given way to a contextual model of parenting and child outcomes, increasingly

  6. Disability and Health (United States)

    ... Over a billion people, about 15% of the world's population, have some form of disability. Between 110 million and 190 million adults have significant difficulties in functioning. Rates of disability are increasing due to population ageing and increases in chronic health conditions, among other ...

  7. Intellectual disabilities and yoga

    National Research Council Canada - National Science Library

    Singh, Satendra


    ... Syndrome. [sup][3] In another study, Uma et al . found the efficacy of yoga as an effective therapeutic tool in the management of children with cognitive disability. [sup][4] The authors used the term "mentally retarded children," which I shall discourage, since being the Coordinator of Enabling Unit for medical students with disabilities, I fin...

  8. Disability and Human Supports

    Directory of Open Access Journals (Sweden)

    Jeff McNair


    Full Text Available This article provides a brief overview of models of disability growing out of the field of disability studies and leading to a call for interventions going beyond a simply medical model approach. A brief discussion of human supports/services is provided such that readers engaged in the development of services/supports can base them on best principles.

  9. Moving beyond Disability

    NARCIS (Netherlands)

    Geertzen, Jan H. B.


    Moving beyond Disability was the theme of the 12th World Congress of the International Society for Prosthetics and Orthotics. This paper is a reflection of one of the keynote lectures discussing the International Classification of Functioning, Disability and Health (ICF). Multicultural aspects in

  10. Categorizing clients with disabilities

    DEFF Research Database (Denmark)

    Kjeldsen, Lena; Amby, Finn

    Danish governments have continuously proclaimed goals of raising the employment rate for people with disabilities, most recently in the publication “10 goal for social mobility” (Government 2016). In spite of this, the employment rate for people with disabilities has been more than 30 percent less...

  11. Extremism and Disability Chic (United States)

    Kauffman, James M.; Badar, Jeanmarie


    The word chic refers to something fashionable or stylish. Chic varies for individuals and groups and with time and place. Something chic may have desirable or undesirable long-term consequences. Disability and extremism are also changeable concepts, depending on comparison to social norms. People with disabilities should have the option of being…

  12. Intervention for Reading Disabilities. (United States)

    Catts, Hugh W.; Kamhi, Alan G.


    The article provides specific suggestions of how speech language pathologists can use their language expertise in intervention with reading-disabled students. Strategies appropriate for use in individual therapy are discussed and the importance of collaboration with classroom teachers and learning disabilities specialists is stressed. (Author/DB)

  13. Introduction: Childhood and Disability. (United States)

    Salter, Erica K


    From growth attenuation therapy for severely developmentally disabled children to the post-natal management of infants with trisomy 13 and 18, pediatric treatment decisions regularly involve assessments of the probability and severity of a child's disability. Because these decisions are almost always made by surrogate decision-makers (parents and caregivers) and because these decision-makers must often make decisions based on both prognostic guesses and potentially biased quality of life judgments, they are among the most ethically complex in pediatric care. As the introduction to HEC Forum's special thematic issue on Childhood and Disability, this article orients the reader to the history of bioethics' relationship to both pediatric ethics and disability studies and introduces the issue's five manuscripts. As clinicians, disability scholars, philosophers and clinical ethicists writing on various aspects of pediatric disability, the articles' authors all invite readers to dig beneath an overly-simplified version of what disability might mean to children and families and instead embrace a posture of genuine humility, recognizing both the limits and harms of traditional medical and bioethical responses (or indifferences) to the disabled child.

  14. Factors associated with late presentation of suspected tuberculosis cases to tuberculosis management facilities: The case in Dagoretti district, Nairobi, Kenya (United States)

    Njau, Irene Wambui; Karanja, Simon Muturi; Wanzala, Peter; Omolo, Jared Odhiambo


    Background Tuberculosis is a highly contagious disease accounting for a high number of deaths in the developing countries; its control can be effectively achieved if individuals with the disease receive adequate and timely treatment. The objective of this study was to determine the factors associated with late presentation of suspects to tuberculosis management facilities in Dagoretti district in Nairobi, Kenya. Method A cross sectional study was conducted on patients aged 18 years and above attending TB clinics in Dagoretti District, Nairobi Kenya. A total of 426 TB suspects were interviewed. The study covered 8 clinics in Dagoretti district. Analysis was done using SPSS version 16.0 and Epi info version 6, this included Chi Square for Bivariate analysis and Binary Logistic Regression for Multivariate Analysis. Results Out of the 426 tuberculosis suspects, 248 (58.2%) suspects had delayed in seeking medical care. In Bivariate analysis male gender (P = 0.039, O.R = 1.51; 95% Confidence Interval; 1.00- 2.27), level of education (Primary class 5-8) (P = 0.001, O.R= 2.06; 95% C.I 1.34-3.19) and place of first medical care (drug store) (P= 0.013, O.R = 1.63; 95% C.I 1.09-2.46) were all significantly associated with late presentation. After multivariate logistic regression, gender (P = 0,019, OR = 1.6), level of education (p = 0.029, OR = 1.26) and place of first medical care (P= 0.01 OR = 1.27), were found to be significantly associated with late presentation. Conclusion This study shows that age, level of education and place of first medical care are the factors associated with late presentation of suspects to tuberculosis management facilities. PMID:23077714

  15. Translation, Validation, and Crosscultural Adaptation of the Hebrew Version of the Neck Disability Index. (United States)

    Shashua, Anat; Geva, Yaron; Levran, Igal


    The present study's design was translation and crosscultural validation of the Neck Disability Index (NDI). The aim of the study was to translate and culturally adapt the NDI into Hebrew language and to evaluate the psychometric properties of this version. As yet, no Hebrew language neck pain and disability questionnaires exist. The NDI is widely used and validated among different patient populations with neck pain. The English version of the NDI was translated into Hebrew according to the published guidelines. A total of 100 patients with neck pain participated in the study. Inclusion criteria were age 18 years and older, neck pain, and ability to read and speak Hebrew. Exclusion criteria were cancer or suspected tumor, neck pain related to vertebral fracture, or neurological disease. Participants were asked to complete the NDI-Hebrew version (NDI-H), Numeric Pain Rating Scale (NPRS), and Patient-Specific Functional Scale (PSFS). Seventy-three patients completed the NDI-H twice in an interval of 2 days. Psychometric properties included test-retest reliability (intraclass correlation coefficient), internal consistency (Cronbach α), convergent validity (Pearson correlation), and factor analysis. The NDI-H demonstrated excellent test-retest reliability (intraclass correlation coefficient ranged from 0.827 to 0.929; Pv < 0.001). Cronbach α value was excellent (0.855). A very good correlation was found between the NDI-H and NPRS scores (r = 0.611, P < 0.001) and a good correlation between the NDI-H and PSFS score (r = 0.417, P < 0.001). Factor analysis revealed a two-factor solution representing daily function and pain and symptoms. The NDI-H is a valid and reliable instrument to measure functional limitations and disability in Hebrew-speaking patients with neck pain. NA.

  16. Being Included and Excluded

    DEFF Research Database (Denmark)

    Korzenevica, Marina


    Following the civil war of 1996–2006, there was a dramatic increase in the labor mobility of young men and the inclusion of young women in formal education, which led to the transformation of the political landscape of rural Nepal. Mobility and schooling represent a level of prestige that rural...... politics. It analyzes how formal education and mobility either challenge or reinforce traditional gendered norms which dictate a lowly position for young married women in the household and their absence from community politics. The article concludes that women are simultaneously excluded and included from...... people regard as a prerequisite for participating in local community politics. Based on a fieldwork in two villages of Panchthar district in eastern Nepal, this article explores how these changes strengthen or weaken women’s political agency and how this is reflected in their participation in community...

  17. Access to health care and employment status of people with disabilities in South India, the SIDE (South India Disability Evidence) study. (United States)

    Gudlavalleti, Murthy Venkata S; John, Neena; Allagh, Komal; Sagar, Jayanthi; Kamalakannan, Sureshkumar; Ramachandra, Srikrishna S


    Data shows that people with disability are more disadvantaged in accessing health, education and employment opportunities compared to people without a disability. There is a lack of credible documented evidence on health care access and barriers to access from India. The South India Disability Evidence (SIDE) Study was undertaken to understand the health needs of people with disabilities, and barriers to accessing health services. The study was conducted in one district each in two States (Andhra Pradesh and Karnataka) in 2012. Appropriate age and sex-matched people without a disability were recruited to compare with people with disability who were identified through a population-based survey and available government disability records by trained key informants. These people were then examined by a medical team to confirm the diagnosis. Investigators administered questionnaire schedules to people with and without a disability to harness information on employment and health service access, utilization and barriers. A total of 839 people with disabilities and 1153 age and sex matched people without a disability, aged 18 years or more were included. People with disability had significantly lower employment rates. On univariate analysis, people with disability (18.4%) needed to visit a hospital significantly more often in the preceding year compared to people without a disability (8.8%) (X2- 40.0562; P disability and the risk was significantly higher in males compared to females with disability. People with disability faced significantly more barriers to accessing health services compared to people without a disability. Barriers included ignorance regarding availability of services, costs of services and transportation. This study highlights the challenges that people with disability face in accessing health-care and employment opportunities. The study findings have public health implications and should be used for planning need-based appropriate strategies to

  18. Using Internet Artifacts to Profile a Child Pornography Suspect

    Directory of Open Access Journals (Sweden)

    Marcus K. Rogers


    Full Text Available Digital evidence plays a crucial role in child pornography investigations. However, in the following case study, the authors argue that the behavioral analysis or “profiling” of digital evidence can also play a vital role in child pornography investigations. The following case study assessed the Internet Browsing History (Internet Explorer Bookmarks, Mozilla Bookmarks, and Mozilla History from a suspected child pornography user’s computer. The suspect in this case claimed to be conducting an ad hoc law enforcement investigation. After the URLs were classified (Neutral; Adult Porn; Child Porn; Adult Dating sites; Pictures from Social Networking Profiles; Chat Sessions; Bestiality; Data Cleaning; Gay Porn, the Internet history files were statistically analyzed to determine prevalence and trends in Internet browsing. First, a frequency analysis was used to determine a baseline of online behavior. Results showed 54% (n = 3205 of the URLs were classified as “neutral” and 38.8% (n = 2265 of the URLs were classified as a porn website. Only 10.8% of the URLs were classified as child pornography websites. However when the IE history file was analyzed by visit, or “hit,” count, the Pictures/Profiles (31.5% category had the highest visit count followed by Neutral (19.3%, Gay Porn (17%, and Child Porn (16.6%. When comparing the frequency of URLs to the Hit Count for each pornography type, it was noted that the accused was accessing gay porn, child porn, chat rooms, and picture profiles (i.e., from Facebook more often than adult porn and neutral websites. The authors concluded that the suspect in this case was in fact a child pornography user and not an ad hoc investigator, and the findings from the behavioral analysis were admitted as evidence in the sentencing hearing for this case. The authors believe this case study illustrates the ability to conduct a behavioral analysis of digital evidence. More work is required to further validate the

  19. The contribution of osteoarthritis to functional limitations and disability (United States)

    McDonough, Christine M.; Jette, Alan M.


    Synopsis This article uses the Disablement Model conceptual framework to guide an analysis of the importance of OA in the development of disability. The Disablement Model describes the development and progression of disablement from impairments to specific functional limitations and disability, and the hypothesized role of predisposing risk factors, extra-individual factors, and intra-individual factors. A wide range of population and clinical studies have characterized the unequivocal contribution of arthritis to the development of functional limitations and disability. Evidence overwhelmingly supports a significant, moderate independent contribution of arthritis to the onset and progression of functional limitations and disability. With respect to important risk factors for the development of functional limitations and disability among those with OA, the evidence provides strong support for the role of physical impairments along with other predisposing and intra-individual factors such as age; body mass index, obesity, lack of exercise, comorbid conditions, depression; and depressive symptoms. Extra-individual factors included need for aids and assistance, and lack of access to public or private transportation. Future disablement research must clarify the causal mechanisms behind a potential risk factor’s impact on disability and delineate the interplay between and among the various hypothesized steps in the disablement process. PMID:20699161

  20. Psychosocial influences in onset and progression of late life disability. (United States)

    Mendes de Leon, Carlos F; Rajan, Kumar B


    Disability in older age has been related to several psychosocial characteristics, including social networks, social engagement, and depression. However, the exact role of these characteristics in the disablement process remains uncertain. Data come from a population-based study of black and white adults aged ≥65 years (N = 5,306), with up to 9 yearly data on the primary outcome measure, activities of daily living (ADL) disability. We use a two-part regression model to simultaneously test the association between each psychosocial characteristic and both onset and progression of ADL disability, while controlling for demographic variables, education, and mode of interview in the first model and health status variables in the second model. Social networks were negatively associated with onset of ADL disability but not associated with progression. The association became non-significant after adjustment for health status. Social engagement was negatively associated with both onset and progression of disability, even after adjustment for health status. Depression was significantly associated with onset of disability after adjustment for health status but not with progression of disability. The results suggest a differential role for psychosocial characteristics in the disablement process, with generally stronger associations for transitions to onset of ADL disability than progression of ADL disability.

  1. Psychosocial Influences in Onset and Progression of Late Life Disability (United States)


    Objectives. Disability in older age has been related to several psychosocial characteristics, including social networks, social engagement, and depression. However, the exact role of these characteristics in the disablement process remains uncertain. Method. Data come from a population-based study of black and white adults aged ≥65 years (N = 5,306), with up to 9 yearly data on the primary outcome measure, activities of daily living (ADL) disability. We use a two-part regression model to simultaneously test the association between each psychosocial characteristic and both onset and progression of ADL disability, while controlling for demographic variables, education, and mode of interview in the first model and health status variables in the second model. Results. Social networks were negatively associated with onset of ADL disability but not associated with progression. The association became non-significant after adjustment for health status. Social engagement was negatively associated with both onset and progression of disability, even after adjustment for health status. Depression was significantly associated with onset of disability after adjustment for health status but not with progression of disability. Discussion. The results suggest a differential role for psychosocial characteristics in the disablement process, with generally stronger associations for transitions to onset of ADL disability than progression of ADL disability. PMID:24389123

  2. Defining Disability: Understandings of and Attitudes Towards Ableism and Disability

    Directory of Open Access Journals (Sweden)

    Carli Friedman


    Full Text Available Disabled people, amidst political and social gains, continue to experience discrimination in multiple areas. Understanding how such discrimination, named here as ableism, operates is important and may require studying perspectives of people who do not claim a disability identity.  Ableism may be expressed in a number of ways, and examining how a particular group, in this case siblings of disabled people, understand and value disability may contribute to overall understandings about how ableism works. Thus, the purpose of this study is to explore relationships between siblings of disabled people's broad societal understandings of disability and their attitudes towards it. In order to tease out this relationship further we have also examined factors that impact how people define disability. Using both social psychological and sociological approaches, we have contextualized individual attitudes as providing additional new information about social meanings of disability, and set this study's results against the larger backdrops of debates over meanings of disability within Disability Studies. In our research, participants revealed complex understandings of disability, but most often defined disability as preventing or slowing action, as an atypical function, a lack of independence, and as a socially constructed obstacle. Participants' unconscious (implicit disability attitudes significantly related to their understandings of disability as lacking independence, impairment, and/or in relation to the norm, and their conscious (explicit disability attitudes. Moreover, longer employment in a disability-related industry was correlated with defining disability as a general difference, rather than as slowing or limiting of tasks.

  3. Consensus statement of the International Summit on Intellectual Disability and Dementia on valuing the perspectives of persons with intellectual disability. (United States)

    Watchman, Karen; Janicki, Matthew P; Udell, Leslie; Hogan, Mary; Quinn, Sam; Beránková, Anna


    The International Summit on Intellectual Disability and Dementia covered a range of issues related to dementia and intellectual disability, including the dearth of personal reflections of persons with intellectual disability affected by dementia. This article reflects on this deficiency and explores some of the personal perspectives gleaned from the literature, from the Summit attendees and from the experiences of persons with intellectual disability recorded or scribed in advance of the two-day Summit meeting. Systemic recommendations included reinforcing the value of the involvement of persons with intellectual disability in (a) research alongside removing barriers to inclusion posed by institutional/ethics review boards, (b) planning groups that establish supports for dementia and (c) peer support. Practice recommendations included (a) valuing personal perspectives in decision-making, (b) enabling peer-to-peer support models, (c) supporting choice in community-dwelling arrangements and (d) broadening availability of materials for persons with intellectual disability that would promote understanding of dementia.

  4. Sudden Suspected Death in Emergency Department: Autopsy Results

    Directory of Open Access Journals (Sweden)

    Mehtap GURGER


    Full Text Available SUMMARY: Objectives: Sudden deaths occur within 24 hours after symptoms' onset and are caused by cardiac, neurological and pulmonary diseases. Autopsy is the gold standard in determining cause of death. In this study, death's etiology was evaluated in cases applied to our department that underwent autopsy with sudden death indication. Methods: This study included cases aged 18 or older with sudden, suspected, non-traumatic death applying to our department between 2008 and 2012. Patients' age, sex, death time, co-morbid diseases, initial signs, cardiac rhythm, and autopsy findings were recorded after reviewing patient charts. Results: The study included 46 patients. Mean age was 45.73±19.6. Of the cases, 84.78% applied to emergency with cardiopulmonary arrest. Thirty-two cases (69.6% were male. The most frequent cause of death was cardiovascular diseases (52.2%, followed by central nervous system disorders (21.7%, intoxications (15.2%, and respiratory diseases (10.9%. The most common diseases were myocardial infarction (45.7%, subarachnoid hemorrhage (8.7%, and chronic obstructive pulmonary disease. There were three drug ingestions, three carbon monoxide intoxications, and one corrosive material ingestion among the intoxication cases. Conclusions: Sudden deaths are rarely encountered. Emergency clinicians should consider cause in differential diagnosis and provide appropriate approaches at first evaluation. ÖZET: Amaç: Ani ölümler semptomlar başladıktan sonra 24 saat içerisinde oluşur. En yaygın nedenleri kardiyak, nörolojik ve pulmoner hastalıkları içerir. Otopsi bu ölümlerin nedenini tespit etmede altın standarttır. Bu çalışmada acil servisimize başvuran ani ölüm olgularının otopsi bulgularına göre ölüm nedenlerini değerlendirdik. Gereç ve Yöntem: Bu retrospektif çalışmaya 2008–2012 yılları arasında acil servisimize başvuran, yaşları 18 ve üzeri olan, nontravmatik, ani, şüpheli ölüm vakaları al

  5. Pararenal splenosis encountered during the evaluation of a suspected pheochromocytoma. (United States)

    Brown, Joel D; Kwee, Sandi


    The authors describe a patient in whom pararenal splenosis nodules were initially interpreted as probable pheochromocytoma. A 22-year-old man with chronic glomerulonephritis, hypertension and a childhood history of splenectomy was hospitalized for a hypertensive emergency. He did not improve with aggressive antihypertensive therapy. A pheochromocytoma was suspected, and a renal ultrasound and a magnetic resonance imaging showed 2 left pararenal masses. Laboratory evaluation for pheochromocytoma and aldosteronoma were negative. Biopsies of the masses were planned, but the masses were subsequently shown to be splenic tissue by a (99m)technnetium heat-damaged red blood cell scan. Ectopic splenic masses, eg, splenosis or accessory spleens, should be considered in patients with undiagnosed abdominal or kidney masses and a history of splenectomy.

  6. Seroprevalance of brucellosis among suspected cases in Malaysia. (United States)

    Jama'ayah, M Z; Heu, J Y; Norazah, A


    Brucellosis is a zoonotic disease which can be transmitted by direct or indirect contact with infected animal or their products. It is an important public health problem but little is known on brucellosis in the Malaysian population. The aim of this study was to determine the presence of Brucella antibodies using commercial Brucella IgG and IgM ELISA kits (Vircell, SL, Barcelona Spain). A total of 184 sera from suspected patients were received from 16 hospitals in Malaysia over the years 2004 to 2009. Only 10 serum samples (5.4%) were positive for Brucella antibodies in which 5 showed the presence of both IgM and IgG. Most of the positive patients were occupationally involved with animals. This study suggests the seroprevalance of brucellosis among individuals who have contact with infected animals in Malaysia is low.

  7. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael


    PURPOSE: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. MATERIALS...... radiologists and one surgeon independent of each other and compared with surgical and pathological records. RESULTS: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14...... patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate (kappa=0.51) and fair (kappa=0.31) interobserver agreements in the MR diagnosis of acute...

  8. CT diagnosis of suspected acute appendicitis in adult patients

    Energy Technology Data Exchange (ETDEWEB)

    Yamase, Hiroshi; Sahashi, Kiyomi; Kawai, Masayuki; Kishida, Yoshihiko; Sumida, Kei; Kawamura, Ken-ichi [Gifu Syakaihoken Hospital (Japan)


    In order to assess the CT diagnosis of suspected acute appendicitis, we performed abdominal contrasted CT measurements in 77 patients from 20 to 86 years old, and of 50 men and 27 women from June 1993 to June 1996. The surgical findings were compared with the preoperative CT findings. By the preoperative CT imaging, we can know the degree and the position of inflammation in appendix vermiformis and the degree and the spread of periappendicular inflammation in the case of appendicitis, and can make a differential diagnosis of diverticulitis or gynecological diseases from appendicitis. It is important to make a preoperative diagnosis by the objectively excellent abdominal CT imaging and to avoid unnecessary surgery. (K.H.)

  9. Herbs and herbal combinations used to treat suspected malaria in Bo, Sierra Leone. (United States)

    Ranasinghe, Shamika; Ansumana, Rashid; Lamin, Joseph M; Bockarie, Alfred S; Bangura, Umaru; Buanie, Jacob A G; Stenger, David A; Jacobsen, Kathryn H


    Most adults in West Africa treat acute febrile illnesses with local herbs, but the patterns of herbs used for malaria have not been recently described in Sierra Leone. We used a population-based cross-sectional approach to interview 810 randomly-sampled rural and urban adult residents of Bo, Sierra Leone, in December 2013 and January 2014 about their use of herbal remedies when they suspect they have malaria. In total, 55% of the participants reported taking one or more of seven herbs to treat symptoms of malaria. Among herb users, the most commonly used anti-malarial herbs were Moringa oleifera (moringa, 52%) and Sarcocephalus latifolius (yumbuyambay, 50%). The other herbs used included Senna siamea (shekutoure, 18%), Cassia sieberiana (gbangba, 18%), Uvaria afzelii (gone-botai, 14%), Morinda chrysorhiza (njasui, 14%), and Craterispermum laurinum (nyelleh, 7%). Combination herbal therapy was common, with 37% of herb users taking two or more herbs together when ill with suspected malaria. Indigenous medical knowledge about herbal remedies and combinations of local herbs remains an integral part of malaria case management in Sierra Leone. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Prevalence of Clostridium perfringens toxin in patients suspected of having antibiotic-associated diarrhea. (United States)

    Kim, Young Jin; Kim, Si Hyun; Ahn, Junggu; Cho, Soongmoon; Kim, Dongchun; Kim, Kwanghyun; Lee, Heegun; Son, Hyunwoo; Lee, Hee Joo; Yong, Dongeun; Choi, Jun Yong; Kim, Hye Ran; Shin, Jeong Hwan


    Although Clostridium perfringens has been reported as a cause of antibiotic-associated diarrhea (AAD), it is uncommon to detect this pathogen in clinical microbiology laboratories in Korea. The aim of this study was to investigate the prevalence of C. perfringens toxin in patients suspected of having AAD. A total of 135 stool specimens submitted to a clinical microbiology laboratory for C. difficile toxin assay were tested. We tried to detect both C. difficile and C. perfringens toxins using the Seeplex Diarrhea ACE Detection kit (Seegene, Seoul, Korea). We evaluated the prevalence of 10 bacteria and 5 viruses. A total of 40 Clostridium spp. were detected in 34 specimens (29.6%). The C. perfringens toxin was detected in 14 of 135 specimens (10.4%), while C. difficile toxin was detected in 26 specimens (19.3%). Other bacteria and viruses, including 8 Aeromonas spp., were detected in 15 specimens. All tests were negative in 92 of the 135 specimens (68.1%). Clostridium perfringens toxin is relatively common, and we should consider the possibility of its presence in patients suspected of having AAD, especially if C. difficile tests are negative. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Magnetic resonance urography in children: evaluation of suspected ureteral ectopia in duplex systems. (United States)

    Staatz, G; Rohrmann, D; Nolte-Ernsting, C C; Stollbrink, C; Haage, P; Schmidt, T; Günther, R W


    We evaluate the diagnostic accuracy of magnetic resonance urography in children with suspected ectopic ureters and ureteroceles in duplex systems. A total of 14 children 4 weeks to 8 years old with a total of 18 duplex systems underwent magnetic resonance urography using a 1.5 tesla scanner. After injection of low dose furosemide, half-Fourier rapid acquisition with relaxation enhancement images were obtained for T2-weighted static fluid magnetic resonance urography. Respiratory gated 3-dimensional gradient echo images were acquired for T1-weighted excretory magnetic resonance urography 5 to 30 minutes after intravenously administered gadolinium. All magnetic resonance examinations were successfully performed without sedation. The diagnostic accuracy of T1-weighted excretory magnetic resonance urography depended on the renal function. Twelve duplex systems with a normal excretory function, including 6 bifid ureters and 6 upper moieties with inferomedial ectopic ureters, were analyzed correctly with the exception of a 6 mm. ureterocele in 1 case. In 6 duplex systems with poor or nonfunctioning upper moieties ectopic ureters were only demonstrated on T2-weighted magnetic resonance urograms. Respiratory gated excretory and static fluid magnetic resonance urography complement each other in the evaluation of duplex systems in children and provide high accuracy in the evaluation of suspected ectopic ureters and ureteroceles.

  12. Longitudinal growth assessment for the prediction of adverse perinatal outcome in SGA-suspected fetuses. (United States)

    Caradeux, Javier; Eixarch, Elisenda; Mazarico, Edurne; Basuki, Tri Rahmat; Gratacos, Eduard; Figueras, Francesc


    Fetal growth restriction (FGR) is associated with an increased risk of adverse perinatal outcome (APO). However, distinguishing this condition from smallness-for-gestational age remains elusive. A set of criteria has recently been proposed for such purpose, including the severity of smallness, Doppler parameters and growth velocity. To establish whether the use of growth velocity adds to Doppler evaluation in predicting APO among SGA-suspected fetuses. A prospective cohort of consecutive singleton pregnancies with late (diagnosis > 32.0 weeks) SGA (estimated fetal weight [EFW] SGA. Of them, 231 (48.9%) qualified as late FGR. Univariate analysis showed a significant trend towards higher frequency of EFW z-velocity in the lowest decile in pregnancies with APO (14.5% vs. 8.2%; p = 0.041). Nonetheless, the addition of z-velocity neither improved the association nor the prediction performance of standard criteria of FGR for the occurrence of APO. Longitudinal assessment of fetal growth by means of z-velocity did not have any independent predictive value for adverse perinatal outcome when used in combination with Doppler in SGA-suspected fetuses. This article is protected by copyright. All rights reserved.

  13. Neonatal BCG has no effect on allergic sensitization and suspected food allergy until 13 months

    DEFF Research Database (Denmark)

    Thøstesen, Lisbeth Marianne; Kjaer, Henrik Fomsgaard; Pihl, Gitte Thybo


    BACKGROUND: Vaccination with Bacillus Calmette-Guérin (BCG) is used in many countries as protection against tuberculosis. Studies have suggested that BCG may also have non-specific effects, reducing non-tuberculosis mortality, morbidity, and atopic manifestations. In this study we evaluated...... the effect of neonatal BCG vaccination on allergic sensitization and suspected food allergy at 13 months of age. METHODS: The Danish Calmette Study was conducted from 2012-2015 at three Danish hospitals. Within 7 days of birth, the 4262 newborns of 4184 included mothers were randomized 1:1 to BCG or to a no...... of age. RESULTS: By 13 months of age the parents and/or general practitioners of 5.6% (117/2089) of the children in the BCG group and 6.1% (126/2061) of the control group suspected food allergy, resulting in a risk ratio comparing BCG-vaccinated children with control children of 0.91 (95% CI 0.71 to 1...

  14. Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Ajaj, Waleed; Lauenstein, Thomas; Goehde, Susanne; Kuehle, Christiane; Herborn, Christoph U. [University Hospital, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Ruehm, Stefan G. [University of California, Department of Radiology, David Geffen School of Medicine, Los Angeles, CA (United States); Langhorst, Jost; Zoepf, Thomas; Gerken, Guido [University Hospital, Department of Gastroenterology and Hepatology, Essen (Germany); Goyen, Mathias [Medical Center Hamburg-Eppendorf, Hamburg (Germany)


    To assess dark-lumen magnetic resonance colonography (MRC) for the evaluation of patients with suspected sigmoid diverticulitis. Forty patients with suspected sigmoid diverticulitis underwent MRC within 72 h prior to conventional colonoscopy (CC). A three-dimensional T1-weighted volumetric interpolated breath-hold examination sequence was acquired after an aqueous enema and intravenous administration of gadolinium-based contrast agents. All MRC data were evaluated by two radiologists. Based on wall thickness and focal uptake of contrast material and pericolic reaction including mesenteric infiltration on T1-weighted sequence the sigmoid colon was assessed for the presence of diverticulitis. MRC classified 17 of the 40 patients as normal with regard to sigmoid diverticulitis. However, CC confirmed the presence of light inflammatory signs in four patients which were missed in MRC. MRC correctly identified wall thickness and contrast uptake of the sigmoid colon in the other 23 patients. In three of these patients false-positive findings were observed, and MRC classified the inflammation of the sigmoid colon as diverticulitis whereas CC and histopathology confirmed invasive carcinoma. MRC detected additionally relevant pathologies of the entire colon and could be performed in cases where CC was incomplete. MRC may be considered a promising alternative to CC for the detection of sigmoid diverticulitis. (orig.)

  15. A management programme for suspected heart failure in primary care in cooperation with specialists in cardiology. (United States)

    Mejhert, Märit; Kahan, Thomas


    The diagnosis of new onset congestive heart failure (CHF) is often difficult as symptoms and signs are non-specific. Proper diagnostic investigations and treatments are underused in primary care. To describe a management programme for patients with suspected CHF in primary care in cooperation with specialists in cardiology. Prospective study of 102 consecutive primary care patients with suspected new onset CHF referred to an easily accessible hospital-based cardiology outpatient clinic management programme. Following clinical examination, ECG, echocardiography, blood chemistry including NT-proBNP, and assessment of NYHA class and quality of life (EQ5D), patients with a confirmed diagnosis of CHF were prescribed medication with advice on titration and target doses. Trained CHF nurses gave Information on CHF and provided follow up. Half (47%) of the referred patients had the diagnosis of CHF confirmed. Low NT-proBNP values (CHF group was 86% ACE-inhibitors/angiotensin receptor blockers, 61% ß-blocking agents, and 81% diuretics (P CHF in primary care, with referral to a hospital-based specialist team, can be applied successfully.

  16. Intraoperative ultrasonography in nine dogs with intra-abdominal neoplasm suspect

    Directory of Open Access Journals (Sweden)

    Daniella Matos da Silva

    Full Text Available ABSTRACT: Intraoperative ultrasonography (IOUS is used in medicine for diagnosis and guidance during oncologic surgery. The aims of this study were to assess the performance, feasibility, advantages and difficulties of the IOUS technique in dogs with suspected intra-abdominal tumors. The study included nine client-owed dogs that had suspected intra-abdominal tumors (spleen, liver or bowel based on transabdominal ultrasound examination and that were subsequently referred for exploratory laparotomy surgery. During surgery, IOUS was performed; results of preoperative transabdominal ultrasonography, inspection by the surgeon and IOUS were compared on a case-by-case basis. IOUS was helpful in determining lesion resection in all cases. Lesions detected solely by the use of IOUS were observed in seven out of nine cases. Analysis of these cases demonstrated that IOUS can be a tool to assist during oncology surgery on the liver, spleen or bowel. Dogs with hepatic tumors can have small non-palpable intraparenchymal nodules, which may be visible by IOUS.

  17. Comprehensive training in suspected child abuse and neglect for dental students: a hybrid curriculum. (United States)

    Ivanoff, Chris S; Hottel, Timothy L


    Child abuse and neglect are tragic realities of American society. However, most U.S. dental schools do not provide students with adequate training to deal with the problem. This article proposes expanding the predoctoral dental curriculum with a problem-based learning model that can effectively stimulate critical thinking skills to assist graduates in screening and reporting suspected child abuse and neglect throughout their careers. The unique multicultural environment of dental school offers students an unprecedented opportunity to develop awareness about child abuse and domestic violence, while increased vigilance can potentially save innocent young lives. Educating students about proper protocol when they suspect child abuse or neglect is imperative, particularly for dental schools involving students in community sealant and other preventive programs in public schools. By expanding their curriculum to include recognition and intervention, dental schools can help break the cycle of violence and transform attitudes towards taking decisive action. Clinical curricula that have moved to private practice preceptor models are well suited to screen for child abuse. The goal is to motivate dental schools to deal with this critical issue, develop reporting protocols and procedures for appropriate response, and provide their students with consummate training.

  18. Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?

    Energy Technology Data Exchange (ETDEWEB)

    McQueen, A.S. [Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)], E-mail:; Worthy, S. [Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom); Keir, M.J. [Department of Medical Physics, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)


    Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve

  19. Role of DR-70 immunoassay in suspected malignant pleural effusion (United States)

    Sengupta, Amitabha; Saha, Kaushik; Jash, Debraj; Banerjee, Sourindra Nath; Biswas, Nirendra Mohan; Dey, Atin


    Context: A good proportion of patients with undiagnosed pleural effusion (PE) turn into malignancy over a period of time. Identification of positive biomarker may help in selecting the individuals who require close follow-up. Aims: The aims of this study were to evaluate the role of DR-70 immunoassay in suspected malignant PE. Settings and Design: We conducted a cross-sectional study among 89 patients of suspected malignant PE and 50 normal subjects (NS) were taken as control. Materials and Methods: Patients with exudative PE; who had pleural fluid lymphocyte count greater than 50% and adenosine deaminase less than 30 U/L were taken as cases. We had selected NSs among relatives of patients having normal blood chemistry and radiological investigations. Sensitivity and specificity of the test to differentiate malignant and non-malignant PE and also to identify PE with underlying malignancy was analyzed. Results: Mean value of DR-70 in NS was found to be 0.83 ± 0.273 mg/L without any significant difference between males (0.82 mg/L) and females (0.85 mg/L). Mean value of DR-70 in PE with underlying cancer was 5.03 ± 3.79 mg/L. Sensitivity (80%) and specificity (77.78%) of the test was maximum in PE with underlying cancer using cut-off value of 2 mg/L. Mean value DR-70 in malignant PE was 5.18 ± 3.75 mg/L and in non-malignant PE was 3.73 ± 3.74 mg/L without any statistically significant difference (P = 0.08). Conclusions: DR-70 assay has high sensitivity in detecting underlying lung cancer, but has no role in differentiating malignant PE from non-malignant PE. PMID:24339491

  20. Intellectual Disabilities. NICHCY Disability Fact Sheet #8 (United States)

    National Dissemination Center for Children with Disabilities, 2011


    "Intellectual disability" is a term used when a person has certain limitations in mental functioning and in skills such as communicating, taking care of him or herself, and social skills. These limitations will cause a child to learn and develop more slowly than a typical child. Following a brief story about a child with an intellectual…

  1. Imaging the child with right lower quadrant pain and suspected appendicitis: current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Sivit, Carlos J. [Departments of Radiology and Pediatrics, Rainbow Babies and Childrens Hospital of the University Hospitals of Cleveland and Case Western Reserve School of Medicine, Euclid Avenue, 11100, 44106-5056, Cleveland, OH (United States)


    Acute appendicitis is the most common condition presenting with right lower quadrant pain requiring acute surgical intervention in childhood. The clinical diagnosis of acute appendicitis is often not straightforward and can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed non-operatively. Complications usually result from perforation and include abscess formation, peritonitis, sepsis, bowel obstruction and death. Cross-sectional imaging with sonography and computed tomography (CT) have proven useful for the evaluation of suspected acute appendicitis in children. The principal advantages of sonography are its lower cost, lack of ionizing radiation, and ability to precisely delineate gynecologic disease. The principal advantages of CT are its operator independency with resultant higher diagnostic accuracy, enhanced delineation of disease extent in perforated appendicitis, and improved patient outcomes including decreased negative laparotomy and perforation rates. (orig.)

  2. People with intellectual disabilities and dysphagia. (United States)

    Robertson, Janet; Chadwick, Darren; Baines, Susannah; Emerson, Eric; Hatton, Chris


    Dysphagia (difficulties in eating, drinking or swallowing) is associated with serious health complications and psychosocial sequelae. This review aims to summarise the state of the evidence regarding dysphagia in people with intellectual disabilities (excluding prevalence), identify gaps in the evidence base and highlight future research priorities. Studies published from 1 January 1990 to 19 July 2016 were identified using Medline, Cinahl, PsycINFO, Web of Science, email requests and cross citations. Studies were reviewed narratively in relation to identified themes. A total of 35 studies were included in the review. Themes identified were as follows: health conditions associated with dysphagia; mortality; health service use; practice and knowledge in supporting people with intellectual disabilities and dysphagia; intervention effectiveness and quality of life. Dysphagia is associated with respiratory infections and choking and may be under-recognised. Silent aspiration is common and may go unnoticed. Management practices exist, but there are few intervention studies and no randomised controlled trials (RCTs), and hence, the effectiveness of these is currently unclear. Dysphagia is a key concern in relation to people with intellectual disabilities. There is urgent need for research on the management of dysphagia in people with intellectual disabilities, including mealtime support offered, positioning, dietary modification and impact on wellbeing. Implications for Rehabilitation Dysphagia is common in people with intellectual disabilities, associated with serious health risks and may be under-recognised. Caregivers of people with intellectual disabilities should be educated about dysphagia. There is an urgent need for research on improving the management of dysphagia in people with intellectual disabilities. Improved recognition and management of dysphagia may reduce the occurrence of associated health conditions and reduce hospital admissions and premature death

  3. Risk factors for recurrent injuries in victims of suspected non-accidental trauma: a retrospective cohort study. (United States)

    Deans, Katherine J; Thackeray, Jonathan; Groner, Jonathan I; Cooper, Jennifer N; Minneci, Peter C


    Many children who are victims of non-accidental trauma (NAT) may be repeatedly evaluated for injuries related to maltreatment. The purpose of this study was to identify risk factors for repeated injuries in children with suspected NAT. We conducted a retrospective cohort study using claims data from a pediatric Medicaid accountable care organization. Children with birth claims and at least one non-birth related claim indicating a diagnosis of NAT or skeletal survey in 2007-2011 were included. Recurrent events were defined as independent episodes of care involving an urgent/emergent care setting that included a diagnosis code specific for child abuse, a CPT code for a skeletal survey, or a diagnosis code for an injury suspicious for abuse. Cox proportional hazards models were used to examine risk factors for recurrent events. Of the 1,361 children with suspected NAT, a recurrent NAT event occurred in 26% within 1 year and 40% within 2 years of their initial event. Independent risk factors for a recurrent NAT event included a rural residence, age < 30 months old, having only 1 or 2 initially detected injuries, and having a dislocation, open wound, or superficial injury at the previous event (p ≤ 0.01 for all). Over 25% of children who experienced a suspected NAT event had a recurrent episode within one year. These children were younger and more likely to present with "minor" injuries at their previous event.

  4. Disability impact and coping in mothers of children with intellectual disabilities and multiple disabilities. (United States)

    Kishore, M Thomas


    Understanding the disability impact on parenting and caregiving is important for intervention. The present study was designed to understand the differences in perceived disability impact and related coping in mothers having children with intellectual disabilities alone compared to those having children with intellectual disabilities and additional disabilities. Accordingly, 30 mothers of children with intellectual disabilities and 30 mothers of children with intellectual and additional disabilities were assessed for disability impact and coping. Group differences for disability impact were present in specific domains but not overall. Despite variations in coping pattern, both positive and negative coping strategies were observed in both groups. The results may imply that the impact of intellectual disability is so pervasive that except in certain domains mothers may not perceive the further impact of additional disabilities. Positive coping does not rule out negative coping strategies. These findings have specific relevance to service delivery in a cultural context.

  5. Sexual rights and disability. (United States)

    Di Nucci, Ezio


    This paper argues against Appel's recent proposal-in this journal-that there is a fundamental human right to sexual pleasure, and that therefore the sexual pleasure of severely disabled people should be publicly funded-by thereby partially legalising prostitution. An alternative is proposed that does not need to pose a new positive human right; does not need public funding; does not need the legalisation of prostitution; and that would offer a better experience to the severely disabled: charitable non-profit organisations whose members would voluntarily and freely provide sexual pleasure to the severely disabled.

  6. 20 CFR 404.1312 - World War II service included. (United States)


    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false World War II service included. 404.1312... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1312 World War II service included. Your service was in the active service of the United...

  7. 20 CFR 416.710 - What reports must include. (United States)


    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What reports must include. 416.710 Section..., BLIND, AND DISABLED Reports Required Report Provisions § 416.710 What reports must include. When you make a report you must tell us— (a) The name and social security number under which benefits are paid...

  8. Which dimensions of disability does the HIV Disability Questionnaire (HDQ) measure? A factor analysis. (United States)

    O'Brien, Kelly K; Bayoumi, Ahmed M; Stratford, Paul; Solomon, Patricia


    conditions, a concept that may be termed disability. Measuring disability is important to understand the impact of HIV and its comorbidities. The HIV Disability Questionnaire (HDQ) is a self-administered questionnaire developed to describe the presence, severity and episodic nature of disability experienced by people living with HIV. The HDQ is comprised of six domains of disability including: physical symptoms and impairments (20 items); cognitive symptoms and impairments (3 items); mental and emotional health symptoms and impairments (11 items); uncertainty (14 items); difficulties with day-to-day activities (9 items) and challenges to social inclusion (12 items). These domains represent the dimensions of disability measured by the HDQ. The HDQ is the first known HIV-specific disability measure for adults living with HIV. The HDQ may be used by clinicians and researchers to assess disability experienced by adults living with HIV.

  9. Specificity of school readiness assessment of children with mental disability


    Klausová, Markéta


    This thesis is focused on the school readiness assessment of children with mental disability. Thesis is devoted to theoretical knowledge in relation to pre-school age and also specifically for children with mental disability. Thesis describes the school readiness of child and compares foreign and local view on it. It also includes the issue of school readiness of children with mental disability. Furthermore, the thesis focuses on the school readiness assessment and on resources and tools that...

  10. Rethinking disability: the social model of disability and chronic disease. (United States)

    Goering, Sara


    Disability is commonly viewed as a problem that exists in a person's body and requires medical treatment. The social model of disability, by contrast, distinguishes between impairment and disability, identifying the latter as a disadvantage that stems from a lack of fit between a body and its social environment. This paper describes the social model of disability and then considers how it might deal with chronic disease or impairment and why medical professionals should learn about disability perspectives to improve their practice.

  11. Rethinking disability: the social model of disability and chronic disease


    Goering, Sara


    Disability is commonly viewed as a problem that exists in a person’s body and requires medical treatment. The social model of disability, by contrast, distinguishes between impairment and disability, identifying the latter as a disadvantage that stems from a lack of fit between a body and its social environment. This paper describes the social model of disability and then considers how it might deal with chronic disease or impairment and why medical professionals should learn about disability...

  12. Interdependence: a new model for the global approach to disability

    Directory of Open Access Journals (Sweden)

    Nathan Grills


    Full Text Available Disability affects over 1 billion people and the WHO estimates that over 80% of individuals with disability live in low and middle income countries, where access to health and social services to respond to disability are limited 1. Compounding this poverty is that medical and technological approaches to disability, however needed, are usually very expensive. Yet, much can be done at low cost to increase the wellbeing of people with disability, and the church and Christians need to take a lead. The WHO’s definition of disability highlights the challenge to us in global health. It has been defined by the WHO as “the interaction between a person’s impairments and the attitudinal and environmental barriers that hinder their full and effective participation in society on an equal basis with others” 2. This understanding of disability requires us to go beyond mere healing and towards inclusion in our response to chronic diseases and disability. This is known as the social model and requires societal attitudinal change and modification of disabling environments in order to facilitate those with disability to be included in our community and churches. These are good responses but the church needs to consider alternative models to those that are currently promoted which strive for independence as the ultimate endpoint. In this paper I introduce some disability-related articles in this issue and outline an approach that goes beyond the Social Model towards an Interdependence Model which I think is a more Biblical model of disability and one which we Christians and churches in global health should consider. This model would go beyond changing society to accommodate for people with disabilities towards acknowledging they play an important part in our community and indeed in our church. We need those people with disability to contribute, love and bless those with and without disabilities. And of course those with disability need the love, care and

  13. Disability Studies. NRC Fact Sheet (United States)

    Harris, Perri


    Over the past several decades, what people now refer to as "disability studies" has been a powerful influence on policy and practice in regards to people with disabilities. Disability studies has evolved as a means of addressing how people with disabilities have been treated historically and how they continue to be treated. The field of disability…

  14. Paralympic Athletes and "Knowing Disability" (United States)

    Fitzgerald, Hayley


    This article explores non-disabled young people's understandings of Paralympic athletes and the disability sports they play. The article examines how society has come to know disability by discussing medical and social model views of disability. The conceptual tools offered by Pierre Bourdieu are utilised as a means of understanding the nature and…

  15. Neurological signs in 23 dogs with suspected rostral cerebellar ischaemic stroke. (United States)

    Thomsen, Barbara; Garosi, Laurent; Skerritt, Geoff; Rusbridge, Clare; Sparrow, Tim; Berendt, Mette; Gredal, Hanne


    In dogs with ischaemic stroke, a very common site of infarction is the cerebellum. The aim of this study was to characterise neurological signs in relation to infarct topography in dogs with suspected cerebellar ischaemic stroke and to report short-term outcome confined to the hospitalisation period. A retrospective multicentre study of dogs with suspected cerebellar ischaemic stroke examined from 2010-2015 at five veterinary referral hospitals was performed. Findings from clinical, neurological, and paraclinical investigations including magnetic resonance imaging were assessed. Twenty-three dogs, 13 females and 10 males with a median age of 8 years and 8 months, were included in the study. The Cavalier King Charles Spaniel (n = 9) was a commonly represented breed. All ischaemic strokes were located to the vascular territory of the rostral cerebellar artery including four extensive and 19 limited occlusions. The most prominent neurological deficits were gait abnormalities (ataxia with hypermetria n = 11, ataxia without hypermetria n = 4, non-ambulatory n = 6), head tilt (n = 13), nystagmus (n = 8), decreased menace response (n = 7), postural reaction deficits (n = 7), and proprioceptive deficits (n = 5). Neurological signs appeared irrespective of the infarct being classified as extensive or limited. All dogs survived and were discharged within 1-10 days of hospitalisation. Dogs affected by rostral cerebellar ischaemic stroke typically present with a collection of neurological deficits characterised by ataxia, head tilt, and nystagmus irrespective of the specific cerebellar infarct topography. In dogs with peracute to acute onset of these neurological deficits, cerebellar ischaemic stroke should be considered an important differential diagnosis, and neuroimaging investigations are indicated. Although dogs are often severely compromised at presentation, short-term prognosis is excellent and rapid clinical improvement may be observed within the

  16. Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?

    Directory of Open Access Journals (Sweden)

    Jovan Lovrenski


    Full Text Available Objective. To compare lung ultrasound (LUS with auscultation findings in children with clinical suspicion of pneumonia. Patients and methods. A prospective study including 95 patients (age: from 2 months to 17.5 years; mean age: 5.1 y, SD 4.5 y with referral diagnosis of suspected pneumonia. In all patients LUS and auscultatory examinations were performed within an hour. These findings were compared separately in each hemithorax. The radiologist performing LUS was blinded to the patient’s clinical information. Positive auscultatory findings included: crackles and/or abnormal breath sounds (decreased, asymmetric, absent, or bronchial. For LUS examinations a combined transthoracic – transabdominal approach was used. A pneumonia-positive LUS finding included subpleural consolidation with air-bronchogram, or an adjacent area of interstitial edema. For each subpleural consolidation the cranio-caudal (CC diameter was measured, and 95% confidence intervals (CI of the sizes of subpleural consolidations for positive and negative auscultatory findings were compared. The p-value between LUS and auscultation was calculated using McNemar’s test. Results. LUS and auscultation showed pneumonia-positive findings in 98 and 64 hemithoraces, i.e. in 67 and 45 patients respectively. In positive auscultatory findings the CI for CC diameters of subpleural consolidations ranged from 32.46 to 54.14 mm, and in negative auscultatory findings the CI was between 16.52 and 29.83 mm, which showed a statistically significant difference. McNemar’s test showed a statistically significant difference between LUS and auscultation. Conclusions. LUS showed positive findings in more hemithoraces than auscultation in children with suspected pneumonia. A cranio-caudal size of subpleural consolidation of less than 30 mm significantly reduces the possibility of auscultatory detection.

  17. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. (United States)

    van der Hulle, Tom; Cheung, Whitney Y; Kooij, Stephanie; Beenen, Ludo F M; van Bemmel, Thomas; van Es, Josien; Faber, Laura M; Hazelaar, Germa M; Heringhaus, Christian; Hofstee, Herman; Hovens, Marcel M C; Kaasjager, Karin A H; van Klink, Rick C J; Kruip, Marieke J H A; Loeffen, Rinske F; Mairuhu, Albert T A; Middeldorp, Saskia; Nijkeuter, Mathilde; van der Pol, Liselotte M; Schol-Gelok, Suzanne; Ten Wolde, Marije; Klok, Frederikus A; Huisman, Menno V


    Validated diagnostic algorithms in patients with suspected pulmonary embolism are often not used correctly or only benefit subgroups of patients, leading to overuse of computed tomography pulmonary angiography (CTPA). The YEARS clinical decision rule that incorporates differential D-dimer cutoff values at presentation, has been developed to be fast, to be compatible with clinical practice, and to reduce the number of CTPA investigations in all age groups. We aimed to prospectively evaluate this novel and simplified diagnostic algorithm for suspected acute pulmonary embolism. We did a prospective, multicentre, cohort study in 12 hospitals in the Netherlands, including consecutive patients with suspected pulmonary embolism between Oct 5, 2013, to July 9, 2015. Patients were managed by simultaneous assessment of the YEARS clinical decision rule, consisting of three items (clinical signs of deep vein thrombosis, haemoptysis, and whether pulmonary embolism is the most likely diagnosis), and D-dimer concentrations. In patients without YEARS items and D-dimer less than 1000 ng/mL, or in patients with one or more YEARS items and D-dimer less than 500 ng/mL, pulmonary embolism was considered excluded. All other patients had CTPA. The primary outcome was the number of independently adjudicated events of venous thromboembolism during 3 months of follow-up after pulmonary embolism was excluded, and the secondary outcome was the number of required CTPA compared with the Wells' diagnostic algorithm. For the primary outcome regarding the safety of the diagnostic strategy, we used a per-protocol approach. For the secondary outcome regarding the efficiency of the diagnostic strategy, we used an intention-to-diagnose approach. This trial is registered with the Netherlands Trial Registry, number NTR4193. 3616 consecutive patients with clinically suspected pulmonary embolism were screened, of whom 151 (4%) were excluded. The remaining 3465 patients were assessed of whom 456 (13%) were

  18. Evaluation of an interferon-gamma release assay in children with suspected tuberculosis in Papua New Guinea. (United States)

    Uluk, Tarcisius; Allison, Waridibo E; Vince, John; Wand, Handan; Tefuarani, Nakapi; Causer, Louise M; Ripa, Paulus; Kariko, Maylene; Kaminiel, Oscillah; Cunningham, Philip; Graham, Steve M; Kaldor, John M


    There are few data from tuberculosis (TB) endemic settings of the performance and outcome predictors of the QuantiFERON-TB Gold in Tube assay (QFT) in children with suspected TB. A prospective cross-sectional study was conducted in Papua New Guinea children with suspected TB evaluated at Port Moresby General Hospital (Port Moresby, Papua New Guinea). Two hundred sixteen children were enrolled including 106 probable TB, 87 possible TB and 23 without TB. Concordance between QFT and tuberculin skin test results was 86% (P < 0.001, κ = 0.70). QFT was significantly more likely to be positive than tuberculin skin test, overall and within the probable or possible TB categories, with no difference in prevalence of positivity between these 2 categories. The role of QFT in supporting the clinical diagnosis of TB in endemic settings, where resources are limited, remains uncertain especially as cost and technical requirements remain considerable.

  19. 76 FR 32971 - Proposed Priority for the Disability and Rehabilitation Research Projects and Centers Program (United States)


    ... and Rehabilitation Research Project (DRRP)--Center on Knowledge Translation for Disability and... notice proposes a priority for a center on knowledge translation for disability and rehabilitation..., demonstration projects, training, and related activities, including international activities, to develop methods...

  20. Disabilities and Health

    Centers for Disease Control (CDC) Podcasts


    In this podcast for kids, the Kidtastics talk about learning more about kids who have disabilities.  Created: 5/22/2014 by National Center for Environmental Health (NCEH).   Date Released: 5/22/2014.

  1. Intellectual and Developmental Disabilities (United States)

    ... Videos Get to Know NICHD Podcasts and Audio Social Media Join NICHD Listservs About NICHD Organization Office of ... IDDs; and the effect of individual factors on social interactions, behavior, and emotions. Common Name Intellectual and developmental disabilities (IDDs) Medical ...

  2. Resettlement for disabled refugees

    Directory of Open Access Journals (Sweden)

    Mansha Mirza


    Full Text Available Over the past few decades there have been some positive (albeit inconsistent changes in US refugee admissions policy as well as in UNHCR’s guidelines for resettlement, especially relating to refugees with disabilities.

  3. In-house (disability

    Directory of Open Access Journals (Sweden)

    Safak Pavey


    Full Text Available In May 2007 UNHCR established an internal working group to look at developing in-house policies for people with disabilities both for the benefit of people of concern to us and for staff members.

  4. Facts about Developmental Disabilities (United States)

    ... an autism spectrum disorder. Low birthweight , premature birth, multiple birth, and infections during pregnancy are associated with an increased risk for many developmental disabilities. Untreated newborn jaundice (high levels of bilirubin in ...

  5. International protection of persons with mental disabilities

    Directory of Open Access Journals (Sweden)

    Radivojević Zoran


    Full Text Available In International law, the status of persons with mental disabilities is regulated within the framework on the protection of persons with disabilities. Their rights are protected not only by international treaties comprising legal provisions of binding character for the parties but also by means of the so-called "soft law" comprising international documents which are not legally binding. Most of the general and subject specific treaties on human rights do not explicitly deal with the status of persons with disabilities. Only recently have some treaties been made containing legal provisions on special protection of persons with disabilities. The most important treaty of this kind is the UN Convention on the Rights of Persons with Disabilities, adopted in the year 2006. The protection of such persons is regulated in much more detail by "soft law" which includes a number of documents adopted by the UN, the Council of Europe and the European Union. Although most of these documents primarily pertain to the rights and the status of persons with disabilities, there are a few that exclusively deal with the protection of persons with mental disorder.

  6. Functional disability in elderly with dementia

    Directory of Open Access Journals (Sweden)

    Tainã Alves Fagundes


    Full Text Available Introduction: Dementia represents one of the major causes of disability and dependence in old age and can affect functional capacity in all areas of occupational performance, including basic and instrumental activities of daily living (BADL and IADL, respectively, leisure, social participation and others. Objectives: To characterize the functional disability level in elderly people with dementia and verify the existence of correlation between functionality and the stage or type of dementia. Method: Quantitative, exploratory, cross-sectional study, with a sample of 25 caregivers of elderly with dementia. For the characterization of the participants were used structured questionnaires and to assess functional disability, the Disability Assessment Scale for Dementia - DAD was applied. Results: Greater incapacity was observed in the IADL sub item. This finding is compatible with the literature on the hierarchy in functional decline in the elderly: decline begins in IADL, while BADL remain unaffected for a longer period. There was no significant correlation between the type of dementia, age or gender and disability. It was verified through the Spearman coefficient (rho = 0.87, a significant correlation of high magnitude between functional disability and stage of dementia (p = 0.0001. Conclusion: Such findings reiterate the importance of giving priority to early detection and prevention of the functional decline, which is the manifestation of vulnerability among the elderly.

  7. Development of the WHOQOL disabilities module. (United States)

    Power, M J; Green, A M


    This paper describes the development of an add-on module for the World Health Organization WHOQOL measures of quality of life for use with adults with physical or intellectual disabilities. The add-on module, known as the WHOQOL-DIS, was derived following standard WHOQOL methodology and is designed to assess people with disabilities. In the pilot phase of the study, 12 centres from around the world carried out focus groups with people with physical disabilities, people with intellectual disabilities, with their carers, and with relevant professionals in order to identify gaps in the coverage of the WHOQOL-BREF that were relevant for their quality of life. Items generated from the focus groups were then tested in a pilot study with 1,400 respondents from 15 different centres worldwide, with items being tested and reduced using both classical and modern psychometric methods. A field trial study was then carried out with almost 3,800 respondents, again with the use of both classical and modern psychometric methods. The outcome of the two rounds of data collection and analysis is a 12-item module that can be used in conjunction with the WHOQOL-BREF or the WHOQOL-100 for assessment of quality of life in physically or intellectually disabled people. Further modifications are also proposed for the use of the WHOQOL-BREF with adults with intellectual disabilities, including simplification of wording of some of the items, the use of a three-point response scale, and the inclusion of smiley faces.

  8. Disability in Herefordshire, 1851-1911. (United States)

    Jones, Christine


    Disability history is a comparatively new field of study, and to date little use has been made of the British census as a source because of its perceived difficulties. This article shows that it is possible to study a local, disabled population in the second half of the nineteenth century from this source, even thought the way in which individuals' disabilities are described can sometimes vary from one census to the next. Age distribution for each condition and was found to vary between those with congenital and those with acquired conditions. Among those with a handicap of sight, hearing or speech a higher proportion remained unmarried. Disabled people were likely to remain in the parental home until their late thirties, and when their parents died they moved in with siblings or became a lodger or inmate. Although few of the disabled children seemed to be receiving education, over 60 per cent of the adult males were found to be working and almost 25 per cent of the adult females. Disabled people, it appears, were viewed not merely as statistics, but were included as members of the local population, and not always dependent members.

  9. Characteristics of fetuses evaluated due to suspected anencephaly: a population-based cohort study in southern Brazil

    Directory of Open Access Journals (Sweden)

    Emanuele Pelizzari

    Full Text Available CONTEXT AND OBJECTIVE: Anencephaly is considered to be the most common type of neural tube defect. Our aim was to assess the clinical and gestational features of a cohort of fetuses with suspected anencephaly. DESIGN AND SETTING: Population-based retrospective cohort study in a referral hospital in southern Brazil. METHODS: The sample consisted of fetuses referred due to suspected anencephaly, to the Fetal Medicine Service of Hospital Materno Infantil Presidente Vargas, between January 2005 and September 2013. Clinical, radiological, pathological and survival data were gathered. RESULTS: Our sample was composed of 29 fetuses. The diagnosis of suspected anencephaly was made on average at 21.3 weeks of gestation. Seven fetuses had malformations that affected other organs, and these included oral clefts (n = 4 and congenital heart defects (n = 2. In 16 cases, there was termination of pregnancy (n = 12 or intrauterine death (n = 4. Regarding those who were born alive (n = 13, all of them died in the first week of life. After postnatal evaluation, the diagnosis of anencephaly was confirmed in 22 cases (75.9%. Other conditions included amniotic band disruption complex (6.9%, microhydranencephaly (6.9%, merocrania (3.4% and holoprosencephaly (3.4%. CONCLUSIONS: Different conditions involving the cranial vault may be confused with anencephaly, as seen in our sample. However, these conditions also seem to have a poor prognosis. It seems that folic acid supplementation is not being properly performed.

  10. Estimating the extra cost of living with disability in Vietnam. (United States)

    Minh, Hoang Van; Giang, Kim Bao; Liem, Nguyen Thanh; Palmer, Michael; Thao, Nguyen Phuong; Duong, Le Bach


    Disability is shown to be both a cause and a consequence of poverty. However, relatively little research has investigated the economic cost of living with a disability. This study reports the results of a study on the extra cost of living with disability in Vietnam in 2011. The study was carried out in eight cities/provinces in Vietnam, including Hanoi and Ho Chi Minh cities (two major metropolitan in Vietnam) and six provinces from each of the six socio-economic regions in Vietnam. Costs are estimated using the standard of living approach whereby the difference in incomes between people with disability and those without disability for a given standard of living serves as a proxy for the cost of living with disability. The extra cost of living with disability in Vietnam accounted for about 8.8-9.5% of annual household income, or valued about US$200-218. Communication difficulty was shown to result in highest additional cost of living with disability and self-care difficulty was shown to lead to the lowest levels of extra of living cost. The extra cost of living with disability increased as people had more severe impairment. Interventions to promote the economic security of livelihood for people with disabilities are needed.

  11. Are maternal social networks and perceptions of trust associated with suspected autism spectrum disorder in offspring? A population-based study in Japan.

    Directory of Open Access Journals (Sweden)

    Takeo Fujiwara

    Full Text Available To investigate the associations of maternal social networks and perceptions of trust with the prevalence of suspected autism spectrum disorders in 18-month-old offspring in Japan.Questionnaires included measurements of maternal social networks (number of relatives or friends they could call upon for assistance, maternal perceptions of trust, mutual assistance (i.e. individual measures of "cognitive social capital", and social participation (i.e. individual measures of "structural social capital" as well as the Modified Checklist for Autism in Toddlers to detect suspected autism spectrum disorder (ASD. These tools were mailed to all families with 18-month-old toddlers in Chiba, a city near Tokyo (N = 6061; response rate: 64%. The association between social capital or social network indicators and suspected ASD were analyzed, adjusted for covariates by logistic regression analysis.Low maternal social trust was found to be significantly positively associated with suspected ASD in toddlers compared with high maternal social trust (adjusted odds ratio [OR]: 1.82, 95% confidence interval [CI]: 1.38 to 2.40; mutual aid was also significantly positively related (low vs. high: OR, 2.08, 95% CI: 1.59 to 2.73 [corrected]. However, maternal community participation showed U-shape association with suspected ASD of offspring. Maternal social network showed consistent inverse associations with suspected ASD of offspring, regardless of the type of social connection (e.g., relatives, neighbors, or friends living outside of their neighborhood.Mothers' cognitive social capital and social networks, but not structural social capital, might be associated with suspected ASD in offspring.

  12. Drugs, discrimination and disability. (United States)

    Gibson, Frances


    Whether addiction to prohibited drugs should be classified as a disability for the purposes of disability discrimination is a controversial question in Australia. The leading Australian case of Marsden v Human Rights Equal Opportunity Commission & Coffs Harbour & District Ex-Servicemen & Women's Memorial Club Ltd (HREOC, No H98/51, 30 August 1999); [2000] FCA 1619 concerned a disability discrimination complaint brought by Mr Marsden as a result of his treatment by the club. The case was brought as a public interest test case by the New South Wales Legal Aid Commission. Mr Marsden was on a methadone program at the time. The reasoning of the decision at the Federal Court opened the way for a finding that dependence on illegal drugs constituted a disability under disability discrimination legislation. The media reaction to the court's decision led to State and federal governments proposing legislation limiting legal protection from discrimination for people addicted to illegal drugs on the basis of their drug use. While the proposed federal legislation lapsed after objections from a coalition of medical, legal and other advocacy groups, the New South Wales legislation still provides that, in employment matters, it is not unlawful to discriminate against a person on the ground of disability if the disability relates to the person's addiction to a prohibited drug and the person is actually addicted to a prohibited drug at the time of the discrimination. The article details the sequence of events in the Marsden case, reflects on the role of public interest litigation in achieving social justice outcomes and suggests that Australia's recent ratification of the Convention on the Rights of Persons with Disabilities on 17 July 2008 should encourage legislators to review legislation which may have a discriminatory effect on people suffering from addictions.

  13. Prostitution, disability and prohibition

    DEFF Research Database (Denmark)

    Thomsen, Frej Klem


    Criminalisation of prostitution, and minority rights for disabled persons, are important contemporary political issues. The article examines their intersection by analysing the conditions and arguments for making a legal exception for disabled persons to a general prohibition against purchasing...... sexual services. It explores the badness of prostitution, focusing on and discussing the argument that prostitution harms prostitutes, considers forms of regulation and the arguments for and against with emphasis on a liberty-based objection to prohibition, and finally presents and analyses three...

  14. Jordanian Parents' Beliefs about the Causes of Disability and the Progress of Their Children with Disabilities: Insights on Mainstream Schools and Segregated Centres (United States)

    Al-Dababneh, Kholoud Adeeb; Al-Zboon, Eman K.; Baibers, Haitham


    This study aims to identify the beliefs of Jordanian parents of children with disabilities (CWD), including intellectual disabilities, specific learning disorders and Autism Spectrum Disorder: both in terms of the causes of these disabilities, and the ability of their children to make progress. A qualitative interpretive methodology was employed.…

  15. A Preliminary Examination of Identity Exploration and Commitment among Polish Adolescents with and without Motor Disability: Does Disability Constitute Diversity in Identity Development? (United States)

    Dominiak-Kochanek, Monika


    The aim of this study was to define whether, and to what extent identity formation in late adolescence is disability specific. Ninety-eight adolescents participated in this study, including 43 students with motor disability and 55 students without disability. Identity exploration and commitment was measured by the Utrecht-Groningen Identity…

  16. [Value of laparoscopic surgery in the diagnosis of suspected gestational trophoblastic neoplasia cases with uterine mass]. (United States)

    Li, Xiaochuan; Feng, Fengzhi; Xiang, Yang; Wan, Xirun; Ren, Tong; Yang, Junjun


    To evaluate the value of laparoscopic surgery in the diagnosis of suspected gestational trophoblastic neoplasia (GTN) cases with uterine mass. The clinical characteristics of patients underwent laparoscopic surgery for a suspected diagnosis of GTN with uterine mass in Peking Union Medical College Hospital from November 2009 to November 2014 were retrospectively reviewed and analyzed. GTN and other pregnant-related disease were definitely diagnosed by pathological findings. The prognoses of the GTN cases were also investigated. Sixty-two patients with a suspected diagnosis of GTN with uterine mass were studied. Among them, 17 cases were definitely diagnosed as GTN, including 8 choriocarcinoma, 5 invasive mole and 4 placental site trophoblastic tumor (PSTT). The other 45 cases were diagnosed as benign pregnancy-related diseases, including 29 cornual pregnancy, 6 cesarean scar pregnancy, 5 placenta accreta, 4 intramural uterine pregnancy and 1 exaggerated placental site. There were no significantly differences between the two groups in average age, preoperative value or tendency of β-hCG, and location or size of lesions (P>0.05). More GTN patients showed a history of hydatidiform mole [5/17 vs 4% (2/45) , P>0.05], and more patients with benign pregnancy-related disease showed a history of cesarean section [38% (17/45) vs 1/17, P>0.05]. No serious perioperative complication was found in these patients received laparoscopic surgery. All GTN patients achieved complete remission by chemotherapy later. Except for 1 case loss, no recurrence was found in 11 low-risk stage I cases with an average follow-up period of 11- 66 months, 1 high-risk stage I case with a follow-up period of 61 months and 4 cases PSTT with a follow-up period of 13-66 months. There were some atypical GTN cases with uterine mass, which were difficult to be differentiated from benign pregnancy-related diseases according to the clinical characteristics. Laparoscopic surgery with a pathologic diagnosis

  17. Representations of disability in nursing and healthcare literature: an integrative review. (United States)

    Boyles, Christina McMillan; Bailey, Patricia H; Mossey, Sharolyn


    This paper is a report of an integrative review to explore the way in which disability has been considered in the multidisciplinary health and nursing literature. In the multidisciplinary health and nursing literature, two ways are presented in which disability can be understood: the traditional, functional perspective and a more contemporary, social perspective. Computerized databases of the CINAHL, Proquest Nursing and Allied Health Sources, EBSCO and Evidence Based Medicine Reviews Multifile and Cochrane databases were conducted for papers published in English in the period 1963-2007 using the keywords 'models of disability', 'disability and nursing research' and 'theories of disability'. An integrative review was performed and, of the 11,578 papers identified, 65 were included. The concept of functional disability refers to an individual who is physically 'disabled' and unable to perform expected roles. The concepts of social stigmatization and normalcy are associated with functional disability. In contrast, social disability concerns functional limitations within an individual's experience of living with disability, examining how socially constructed barriers actually 'disable' people. Conventionally, disability research has been conducted from an etic perspective. Researchers contend that a shift towards an understanding from the emic perspective is needed for disability research to be emancipatory. Adoption of a social perspective is necessary to inform an understanding of disability that addresses stigmatization and oppression. Research-informed nursing practice, complemented by supportive health and social policies, could transform the experience of living with disability.

  18. Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes: a retrospective analysis of 137 patients

    Energy Technology Data Exchange (ETDEWEB)

    Bjoern Kristensen, Stine; Hess, Soeren; Petersen, Henrik; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)


    Paraneoplastic syndromes (PNS) are relatively infrequent manifestations appearing before or after a cancer declares itself. Autoimmune mechanisms may be involved, but their cause and pathogenesis are often unknown. Due to disparity of symptoms, PNS remain a major diagnostic challenge. We examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures, and final clinical diagnosis. Conclusions of the scan reports were compared to the final follow-up outcome as determined during an average follow-up of 31 months (range 6-51.5) in patients who were not diagnosed with cancer in immediate continuation of a positive PET/CT scan. A total of 137 patients were included. Main causes for referral were neurological (n = 67), rheumatological (n = 25), dermatological (n = 18), nephrological (n = 6), haematological (n = 2), abnormal biochemistry (n = 11), and others (n = 8). The cancer prevalence was 8.8 %. The FDG-PET/CT results were as follows: nine true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. FDG-PET/CT has in patients with suspected PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients with suspected PNS. (orig.)

  19. Highly sensitive troponin and coronary computed tomography angiography in the evaluation of suspected acute coronary syndrome in the emergency department. (United States)

    Ferencik, Maros; Hoffmann, Udo; Bamberg, Fabian; Januzzi, James L


    The evaluation of patients presenting to the emergency department with suspected acute coronary syndrome (ACS) remains a clinical challenge. The traditional assessment includes clinical risk assessment based on cardiovascular risk factors with serial electrocardiograms and cardiac troponin measurements, often followed by advanced cardiac testing as inpatient or outpatient (i.e. stress testing, imaging). Despite this costly and lengthy work-up, there is a non-negligible rate of missed ACS with an increased risk of death. There is a clinical need for diagnostic strategies that will lead to rapid and reliable triage of patients with suspected ACS. We provide an overview of the evidence for the role of highly sensitive troponin (hsTn) in the rapid and efficient evaluation of suspected ACS. Results of recent research studies have led to the introduction of hsTn with rapid rule-in and rule-out protocols into the guidelines. Highly sensitive troponin increases the sensitivity for the detection of myocardial infarction and decreases time to diagnosis; however, it may decrease the specificity, especially when used as a dichotomous variable, rather than continuous variable as recommended by guidelines; this may increase clinician uncertainty. We summarize the evidence for the use of coronary computed tomography angiography (CTA) as the rapid diagnostic tool in this population when used with conventional troponin assays. Coronary CTA significantly decreases time to diagnosis and discharge in patients with suspected ACS, while being safe. However, it may lead to increase in invasive procedures and includes radiation exposure. Finally, we outline the opportunities for the combined use of hsTn and coronary CTA that may result in increased efficiency, decreased need for imaging, lower cost, and decreased radiation dose. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email:

  20. Stress Perfusion Coronary Flow Reserve Versus Cardiac Magnetic Resonance for Known or Suspected CAD. (United States)

    Kato, Shingo; Saito, Naka; Nakachi, Tatsuya; Fukui, Kazuki; Iwasawa, Tae; Taguri, Masataka; Kosuge, Masami; Kimura, Kazuo


    Phase-contrast (PC) cine magnetic resonance imaging (MRI) of the coronary sinus is a noninvasive method to quantify coronary flow reserve (CFR). This study sought to compare the prognostic value of CFR by cardiac magnetic resonance (CMR) and stress perfusion CMR to predict major adverse cardiac events (MACE). Participants included 276 patients with known coronary artery disease (CAD) and 400 with suspected CAD. CFR was calculated as myocardial blood flow during adenosine triphosphate infusion divided by myocardial blood flow at rest using PC cine MRI of the coronary sinus. During a median follow-up of 2.3 years, 47 patients (7%) experienced MACE. Impaired CFR (10% ischemia on stress perfusion CMR were significantly associated with MACE in patients with known CAD (hazard ratio [HR]: 5.17 and HR: 5.10, respectively) and suspected CAD (HR: 14.16 and HR: 6.50, respectively). The area under the curve for predicting MACE was 0.773 for CFR and 0.731 for stress perfusion CMR (p = 0.58) for patients with known CAD, and 0.885 for CFR and 0.776 for stress perfusion CMR (p = 0.059) in the group with suspected CAD. In patients with known CAD, sensitivity, specificity, and positive and negative predictive values to predict MACE were 64%, 91%, 38%, and 97%, respectively, for CFR, and 82%, 59%, 15%, and 97%, respectively, for stress perfusion CMR. In the suspected CAD group, these values were 65%, 99%, 80%, and 97%, respectively, for CFR, and 72%, 83%, 22%, and 98%, respectively, for stress perfusion CMR. The predictive values of CFR and stress perfusion CMR for MACE were comparable in patients with known CAD. In patients with suspected CAD, CFR showed higher HRs and areas under the curve than stress perfusion CMR, suggesting that CFR assessment by PC cine MRI might provide better risk stratification for patients with suspected CAD. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    P. Thomas


    Full Text Available The focus of this review are allergic complications following insertion of metallic orthopedic implants. Such potential allergic reactions encompass eczema, impaired wound and fracture healing, infection-mimicking reactions, effusions, pain and loosening. Nickel, cobalt and chromium seem to be the predominant eliciting allergens. Allergy might be considered prior to planned orthopaedic surgery or in patients with complications following arthroplasty We recommend, that differential diagnoses - in particular infection -should always be excluded in cooperation with surgery collegues. The clinical work up of a patient suspected of suffering from metal implant allergy should include a combined evaluation of medical history, clinical findings, patch testing and histology In vitro testing, namely the lymphocyte transformation test (LTT, can indicate metal sensitization, but needs careful interpretation.

  2. Prediction of the academic success of children with suspected neurological impairments. (United States)

    Gold, P; Berk, R A


    Explored a multivariate approach to the prediction of 8-year academic achievement. Ss were black, of low socioeconomic status, and had been diagnosed as suspect neurologically impaired at age 7. A serial array of early predictors that included maternal education, sex, birth weight, 8-month and 4-year intelligence, and 3-year speech, hearing, and language were entered into multiple regression analyses to determine their value in predicting 8-year academic achievement in word recognition, arithmetic, spelling, and oral reading. The 4-year intelligence measure was the best overall predictor, although maternal education, sex, and birth weight contributed slightly to the predictions. The resulting equations, however, could not be used to predict accurately 8-year academic achievement.

  3. Sporotrichosis in Iran: A mini review of reported cases in patients suspected to cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    shahram mahmoudi


    Full Text Available Sporotrichosis is a chronic subcutaneous fungal infection with global distribution. It is a rare fungal infection with nine reported cases in Iran, including eight humans and one animal, within the past 30 years. Among the human cases, seven were of the fixed cutaneous type of sporotrichosis and one had sporotrichoid lymphocutaneous. The reported patients were within the age range of 23-60 years, and six of them were female. The most frequent sites of infection were forearms and hands, as well as the face and legs. In addition, the majority of the cases had previously been suspected of leishmaniasis and received treatment. Sporotrichosis is not a well-known condition in Iran and is often misdiagnosed and erroneously treated for other cutaneous parasitic or bacterial infections with similar clinical manifestations. Therefore, sporotrichosis should be taken into account in the differential diagnosis of nodular-ulcerative skin lesions.

  4. A suspected case of intermediate syndrome in a dog with carbamate toxicosis. (United States)

    Tinson, E; Boller, E; Davis, M


    A 7-year-old female spayed Labrador Retriever was managed for suspected carbamate toxicosis after confirmed ingestion of a large amount of methiocarb. Therapy included decontamination, supportive care and management for aspiration pneumonia. On the third day of hospitalisation, after an initial clinical improvement, the dog developed respiratory muscle weakness, inspiratory dyspnoea and pronounced cervical muscle weakness. These delayed clinical signs were consistent with the 'intermediate syndrome' described in some cases of organophosphate and carbamate toxicoses in humans and also described in one case of organophosphate toxicosis in the dog. Intermediate syndrome has not been reported in carbamate toxicosis in the dog. This case report highlights the necessity for veterinarians to monitor for additional complications not commonly considered in acute carbamate toxicoses. © 2017 Australian Veterinary Association.

  5. Differential diagnosis of Mendelian and mitochondrial disorders in patients with suspected multiple sclerosis (United States)

    Katz Sand, Ilana B.; Honce, Justin M.; Lublin, Fred D.


    Several single gene disorders share clinical and radiologic characteristics with multiple sclerosis and have the potential to be overlooked in the differential diagnostic evaluation of both adult and paediatric patients with multiple sclerosis. This group includes lysosomal storage disorders, various mitochondrial diseases, other neurometabolic disorders, and several other miscellaneous disorders. Recognition of a single-gene disorder as causal for a patient’s ‘multiple sclerosis-like’ phenotype is critically important for accurate direction of patient management, and evokes broader genetic counselling implications for affected families. Here we review single gene disorders that have the potential to mimic multiple sclerosis, provide an overview of clinical and investigational characteristics of each disorder, and present guidelines for when clinicians should suspect an underlying heritable disorder that requires diagnostic confirmation in a patient with a definite or probable diagnosis of multiple sclerosis. PMID:25636970

  6. Aiming for Inclusive Sport: the Legal and Practical Implications of the United Nation’s Disability Convention for Sport, Recreation and Leisure for People with Disabilities


    Conroy, Elise C.


    Although sport and disability are not new subjects to the United Nations, the Convention on the rights of Persons with Disabilities serves as the first legally binding instrument for protecting those with disabilities in the sporting realm. Article 30.5 is specifically devoted to addressing the rights of people with disabilities in the sport, recreation, play and leisure realms. The Convention requires all countries ratifying it to take proactive measures, including changes and/or additions t...

  7. [Suspected pathogenic mutation identified in two cases with oculocutaneous albinism]. (United States)

    He, Jiangmei; Zheng, Meiling; Zhang, Guilin; Hua, Ailing


    To detect potential mutations in genes related with non-syndromic oculocutaneous albinism I-IV and ocular albinism type I in two couples who had given births to children with albinism. All exons of the non-syndromic albinism related genes TYR, OCA2, TYRP-1, MITF, SLC45A2 and GPR143 were subjected to deep sequencing. The results were verified with Sanger sequencing. For the two female carriers, the coding region of the TYR gene was found to harbor a frameshift mutation c.925_926insC, which was also suspected to have been pathogenic. In one of the male partners, a nonsense mutations c.832C>T was found, which was also known to be pathogenic. Another male partner was found to harbor a TYR gene mutation c.346C>T, which was also known to be a pathogenic nonsense mutation. The coding region of the TYR gene c.925_926insC (p.Thr309ThrfsX9) probably underlies the OCA1 disease phenotype.

  8. Acute aortic dissection in patient with suspected pheochromocytoma

    Directory of Open Access Journals (Sweden)

    Lešanović Jelena


    Full Text Available Introduction: Aortic dissection is one of the most fatal vascular emergencies. Almost 40% of the patients do not reach hospital in time while more than quarter die in the first 24 hours after the dissection begins. Case Report: A 37-year old man was admitted to our hospital with severe anterior chest pain which had lasted for over a week. Suspected aortic dissection was rapidly confirmed using imaging modalities - MDCT chest scan and TTE, followed by an urgent surgical management - Bentall procedure. MDCT chest scan also discovered adrenal incidentaloma defined as malignant, pheochromocytoma like mass. Due to the critical state of the patient, there was not enough time for further endocrinologic testing. Discussion and conclusion: When treating patients with pheochromocytoma and acute aortic disection, it is crucial to obtain a stable hemodynamic state before the surgery, since they can trigger a severe hypertensive crisis due to high levels of cathecholamines induced chronic vasoconctriction. The most vulnerable periods are the induction of anesthesia and perioperative hemodynamic oscillations, so treating patients with short acting alpha- 1 adrenergic blocking agents preoperatively has proven to be helpful - Phentolamine. Both dissection of aorta and pheochromocytoma present challenges for anesthesiologists and early recognition of symptoms is essential in establishing the diagnosis and reducing the mortality rate.

  9. [Predictive value of procalcitonin in children with suspected sepsis]. (United States)

    Bustos B, Raúl; Padilla P, Oslando


    The use of biomarkers could be a tool for diagnosis, prognosis and stratifying children with sepsis. Our main goal was to analyze the value of procalcitonin (PCT), C reactive protein (CRP) and lactate in predicting mortality, septic shock and the stratification in children with suspected sepsis Prospective study in 81 patients. Plasma levels of PCT, CRP and lactate were measured at admission in the pediatric intensive care unit. Patients were categorized into systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock. Concentrations of PCT (ng/mL) increased significantly according to the severity of sepsis: 0.36 (0-1.2) for systemic inflammatory response syndrome; 1.96 (0.4-3.5) for sepsis; 7.5 (3.9-11.1) for severe sepsis; and 58.9 (35.1-82.7) for septic shock (P<.001). Compared to CRP and lactate, the area under the ROC curve revealed a good discriminative power of PCT to predict septic shock and mortality, 0.91 (95% CI: 0.83-0.97) and 0.80 (95% CI: 0.69-0.88), respectively. In contrast to CRP and lactate, the determination of PCT in pediatric intensive care unit admission is a good predictor of mortality and septic shock and can stratify patients according to severity of sepsis. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Mapping disability policies in Europe: Introducing the disability online tool of the commission (DOTCOM)


    Priestley, M; Lawson, A


    The United Nations Convention on the Rights of Persons with Disabilities was adopted in 2006 and came into force in 2008. It establishes a comprehensive framework for the protection and promotion of rights for disabled people and includes 50 Articles, which require parties to adopt its general principles, to take specific actions in relation to specific Articles, and to put in place arrangements for monitoring and reporting on their progress. Both the European Union and its Member States sign...

  11. The association of mobility disability and weight status with risk of disability pension: A prospective cohort study. (United States)

    Norrbäck, Mattias; de Munter, Jeroen; Tynelius, Per; Ahlström, Gerd; Rasmussen, Finn


    Mobility disability (MD) and obesity are conditions which have been associated with weaker labour market attachment. This study investigates whether the combined burden of MD and obesity increase the risk of disability pension compared with having only one of these conditions (the reference group). A nationwide cohort study, based on national surveys made between 1996 and 2011, was conducted including 50,015 individuals aged 19-64 years who were followed-up in a large database in terms of attainment of disability pension until 31 December 2012 (at the latest). Proportional hazards regression models were used to analyse the risk of all-cause and diagnosis-specific disability pension with six exposure groups, established by mobility and weight status (BMI) obtained through self-reports. A total of 2296 participants had received disability pension after a mean follow-up period of 7.2 years (SD 4.6). People with MD, regardless of weight, had 4-8 times higher risk of disability pension (for any reason) compared with the reference group (individuals with normal weight and no MD). No evidence of a double burden of MD and obesity with disability pension was observed in this study. MD seemed to contribute more to the risk of disability pension than weight status. In a long-term perspective, society and also people at risk of these disabling conditions would benefit from reallocation of resources from disability pensions to health-promoting and preventive policies, not least targeting MD.

  12. The association between children's contact with people with disabilities and their attitudes towards disability: a systematic review. (United States)

    MacMillan, Megan; Tarrant, Mark; Abraham, Charles; Morris, Christopher


    The aim of this review was to systematically review and synthesize observational evidence of associations between children's naturally varying contact with people with disabilities and their attitudes towards disability. A comprehensive search was conducted across multiple databases. Studies were included if they measured children's contact with people with disabilities and their attitudes towards disability. Qualitative research and studies that experimentally varied the amount of contact children had were excluded. Data were synthesized in a narrative review. There were 35 studies that met the inclusion criteria: 22 of these reported a statistically significant association between contact with people with disabilities and more positive attitudes towards disability; two studies reported a negative association between contact and attitudes; and 11 studies reported no association. Incomplete reporting of the methods and results across studies limited the conclusions that could be drawn. Studies identified in this review generally indicate that children's contact with people with disabilities is associated with more positive attitudes towards disability. There is a need for more rigorous research to examine the effect of children's contact with people with disabilities on their attitudes towards disability. © 2013 Mac Keith Press.

  13. Cripping safe sex : Life Goes On's queer/disabled alliances. (United States)

    Elman, Julie Passanante


    Life Goes On (1989-1993) was the first television series in U.S. history not only to introduce a recurring teenaged HIV-positive character but also to feature an actor with Down syndrome in a leading role. Drawing new connections among disability studies, queer theory, and bioethics, I argue that Life responded to American disability rights activism and the AIDS epidemic of the early 1990s by depicting sex education as disability activism. By portraying fulfilling sexual relationships for its disabled protagonists, Life challenged heteronormative and ableist underpinnings of marriage, sexuality, reproduction, and sex education and imagined transgressive queer/disabled alliances that often surpassed those of activists of its cultural moment. By representing homophobia, AIDS-phobia, and ableism as intertwined oppressions, the series conjured an expansive vision of sexual justice and pleasure, one that included and united teenagers, intellectually disabled people, and seropositive people-populations whose sexualities have generally been regarded as pathological or nonexistent.

  14. Conferences and convention centres' accessibility to people with disabilities. (United States)

    Doshi, Jasmine Khandhar; Furlan, Andréa Dompieri; Lopes, Luis Carlos; DeLisa, Joel; Battistella, Linamara Rizzo


    The purposes of this manuscript are to create awareness of problems of accessibility at meetings and conferences for people with disabilities, and to provide a checklist for organizers of conferences to make the event more accessible to people with disabilities. We conducted a search of the grey literature for conference centres and venues that had recommendations for making the event more accessible. The types of disability included in this manuscript are those as a consequence of visual, hearing and mobility impairments. We provide a checklist to make meetings accessible to people with disabilities. The checklist is divided into sections related to event planning, venue accessibility, venue staff, invitations/registrations, greeting people with a disability, actions during the event, and suggestions for effective presenters. The checklist can be used by prospective organizers of conferences to plan an event and to ensure inclusion and participation of people with disabilities.

  15. Stigma and Developmental Disabilities in Nursing Practice and Education. (United States)

    Whiteley, Annette D; Kurtz, Donna L M; Cash, Penelope A


    Individuals with developmental disabilities (DD) experience stigma, discrimination, and barriers, including access to appropriate health care, that restrict their ability to be equal participants in society. In this study, underlying contexts, assumptions, and ways of acting are investigated that perpetuate inequalities and pejorative treatment toward those with disabilities. Several nurse researchers and educators suggest specific content for, or approaches to, education about DD. Critical pedagogy that employs cultural competency and a disability studies' framework to guide curriculum and course development will allow assumptions underlying common health care practices that oppress and "other" people with disabilities to be exposed and changed.

  16. Disability, Procreation, and Justice in the United States

    Directory of Open Access Journals (Sweden)

    Kimberly Mutcherson


    Full Text Available Parenting and procreation have long been contested legal terrain in the United States as exemplified by a history of abuses against marginalized populations including people with disabilities. While some of the most egregious abuses, such as state sponsored sterilization programs, are relics of the past, it remains true that people with disabilities face distinct and at times insurmountable roadblocks to procreation and parenting. This article details ongoing forms of procreative discrimination against people with disabilities, rejects common justifications for that discrimination, and offers proposals for better protecting the rights to procreate and parent for disabled people.

  17. ICT Learning Technologies for Disabled People: Recommendations for Good Practice. (United States)

    Hersh, Marion


    The use of ICT in education is becoming increasingly important and has potential advantages to disabled learners if the technologies are appropriately designed, including for accessibility and usability, and used. This paper presents the first sets of recommendations for learning technologies for disabled people aimed at disabled learners, teachers, developers and educational institutions respectively. They were developed as part of the work of the Enable Network for ICT Learning for Disabled People and involved input from both experts and end-users. The concise format facilitates production in a variety of formats and languages for accessibility and wide distribution. The paper discusses the recommendations and their relationship to existing guidelines.

  18. Herbal medicine use and linked suspected adverse drug reactions in a prospective cohort of Ugandan inpatients. (United States)

    Kiguba, Ronald; Ononge, Sam; Karamagi, Charles; Bird, Sheila M


    Clinical history-taking can be employed as a standardized approach to elucidate the use of herbal medicines and their linked suspected adverse drug reactions (ADRs) among hospitalized patients. We sought to identify herbal medicines nominated by Ugandan inpatients; compare nomination rates by ward and gender; confirm the herbs' known pharmacological properties from published literature; and identify ADRs linked to pre-admission use of herbal medicines. Prospective cohort of consented adult inpatients designed to assess medication use and ADRs on one gynaecological and three medical wards of 1790-bed Mulago National Referral Hospital. Baseline and follow-up data were obtained on patients' characteristics, including pre-admission use of herbal medicines. Fourteen percent (26/191) of females in Gynaecology nominated at least one specific herbal medicine compared with 20 % (114/571) of inpatients on medical wards [20 % (69/343) of females; 20 % (45/228) of males]. Frequent nominations were Persea americana (30), Mumbwa/multiple-herb clay rods (23), Aloe barbadensis (22), Beta vulgaris (12), Vernonia amygdalina (11), Commelina africana (7), Bidens pilosa (7), Hoslundia opposita (6), Mangifera indica (4), and Dicliptera laxata (4). Four inpatients experienced 10 suspected ADRs linked to pre-admission herbal medicine use including Commelina africana (4), multiple-herb-mumbwa (1), or unspecified local-herbs (5): three ADR-cases were abortion-related and one kidney-related. The named herbal medicines and their nomination rates generally differed by specialized ward, probably guided by local folklore knowledge of their use. Clinical elicitation from inpatients can generate valuable safety data on herbal medicine use. However, larger routine studies might increase the utility of our method to assess herbal medicine use and detect herb-linked ADRs. Future studies should take testable samples of ADR-implicated herbal medicines for further analysis.

  19. Impact of transesophageal echocardiography on management in patients with suspected cardioembolic stroke. (United States)

    Khariton, Yevgeniy; House, John A; Comer, Lynn; Coggins, Tina R; Magalski, Anthony; Skolnick, David G; Good, Thomas H; Main, Michael L


    Transesophageal echocardiography (TEE) is frequently performed in patients with acute ischemic cerebrovascular events to exclude a cardioembolic source. We aimed to determine the clinical impact of TEE on management. This is a retrospective single-center study of 1,458 consecutive patients hospitalized with acute ischemic stroke or transient ischemic attack who underwent TEE for evaluation of a suspected cardioembolic cause. Significant TEE findings were determined for each patient as recorded on the TEE report. The medical record was reviewed for baseline, clinical, and demographic variables and to determine whether significant management changes occurred as a result of the TEE findings. Potential significant changes in management included initiation of anticoagulation, placement of a patent foramen ovale (PFO) closure device, initiation of antibiotic therapy for endocarditis, surgical PFO closure, other cardiac surgery, and coil embolization of a pulmonary arteriovenous malformation. A significant change in management occurred in 243 patients (16.7%); 173 (71%) underwent treatment for PFO with a percutaneous PFO closure device (n = 100), initiation of chronic systemic anticoagulation (n = 68), or surgical PFO closure (n = 5). Additional findings leading to a change in management included endocarditis (n = 20), aortic arch atheroma (n = 14), intracardiac thrombus (n = 13), pulmonary arteriovenous malformation (n = 2), aortic valve fibroelastoma (n = 2), other valve masses (n = 4), and miscellaneous causes (n = 15). In conclusion, in patients with suspected cardioembolic stroke, TEE findings led to a change in management in 16.7% of patients. Of these, most (71%) were directed at prevention of subsequent paradoxical emboli in patients with PFO. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Comprehensive Cardiac Magnetic Resonance Imaging in Patients With Suspected Myocarditis: The MyoRacer-Trial. (United States)

    Lurz, Philipp; Luecke, Christian; Eitel, Ingo; Föhrenbach, Felix; Frank, Clara; Grothoff, Matthias; de Waha, Suzanne; Rommel, Karl-Philipp; Lurz, Julia Anna; Klingel, Karin; Kandolf, Reinhard; Schuler, Gerhard; Thiele, Holger; Gutberlet, Matthias


    Data suggest that T1 and T2 mapping have excellent diagnostic accuracy in patients with suspected myocarditis. However, the true diagnostic performance of comprehensive cardiac magnetic resonance (CMR) mapping versus endomyocardial biopsy (EMB) has not been determined. This study assessed the performance of CMR imaging, including T1 and T2 mapping, compared with EMB in an unselected, consecutive patient cohort with suspected myocarditis. It also examined the potential role of CMR field strength by comparing 1.5-T versus 3.0-T imaging. Patients underwent biventricular EMB, cardiac catheterization (for exclusion of coronary artery disease), and CMR imaging on 1.5- and 3-T scanners. The CMR protocol included current standard Lake Louise criteria (LLC) for myocarditis as well as native T1, calculation of extracellular volume fraction (ECV), and T2 mapping (only on 1.5-T). Patients were divided into 2 groups according to symptom duration (acute: ≤14 days vs. chronic: >14 days). A total of 129 patients underwent 1.5-T imaging. In patients with acute symptoms, native T1 yielded the best diagnostic performance as defined by the area under the curve (AUC) of receiver-operating curves (0.82) followed by T2 (0.81), ECV (0.75), and LLC (0.56). In patients with chronic symptoms, only T2 mapping yielded an acceptable AUC (0.77). On 3.0-T, AUCs of native T1, ECV, and LLC were comparable to 1.5-T with no significant differences. In patients with acute symptoms, mapping techniques provide a useful tool for confirming or rejecting the diagnosis of myocarditis and are superior to the LLC. However, only T2 mapping has acceptable diagnostic performance in patients with chronic symptoms. (Magnetic Resonance Imaging in Myocarditis [MyoRacer]; NCT02177630). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Detection of suspected placental invasion by MRI: Do the results depend on observer’ experience?

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    Alamo, Leonor, E-mail: [Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Anaye, Anass; Rey, Jannick; Denys, Alban [Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Bongartz, Georg [Universitätsspital Basel (Switzerland); Terraz, Sylvain [Hôpitaux Universitaires Genève (Switzerland); Artemisia, Simona; Meuli, Reto; Schmidt, Sabine [Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)


    Purpose: To evaluate the diagnostic value of previously described MR features used for detecting suspected placental invasion according to observers’ experience. Materials and methods: Our population included 25 pregnant women (mean age 35.16) investigated by prenatal MRI (1.5 T, T1- and T2-weighted MR-sequences without i.v. contrast), among them 12 with histopathologically proven placental invasion and 13 women (52%) without placental invasion used as control group. Two senior and two junior radiologists blindly and independently reviewed MR-examinations in view of 6 previously defined MR-features indicating presence and degree of placental invasion (placenta increta, accreta or percreta). For each reader the sensibility, specificity, and receiver operating curve (ROC) were calculated. Interobserver agreements between senior and junior readers were determined. Stepwise logistic regression was performed including the 6 MR-features predictive of placental invasion. Results: Demographics between both groups were statistically equivalent. Overall sensitivity and specificity for placental invasion was 90.9% and 75.0% for seniors and 81.8% and 61.8% for juniors, respectively. The best single MR-feature indicating placental invasion was T2-hypointense placental bands (r{sup 2} = 0.28), followed by focally interrupted myometrial border, infiltration of pelvic organs and tenting of the bladder (r{sup 2} = 0.36). Interobserver agreement for detecting placental invasion was 0.64 for seniors and 0.41 for juniors, thus substantial and moderate, respectively. Seniors detected placental invasion and depth of infiltration with significantly higher diagnostic certitude than juniors (p = 0.0002 and p = 0.0282, respectively). Conclusion: MRI can be a reliable and reproducible tool for the detection of suspected placental invasion, but the diagnostic value significantly depends on observers’ experience.

  2. Outcomes associated to serum phosphate levels in patients with suspected acute coronary syndrome. (United States)

    Xu, Hong; Evans, Marie; Gasparini, Alessandro; Szummer, Karolina; Spaak, Jonas; Ärnlöv, Johan; Lindholm, Bengt; Jernberg, Tomas; Carrero, Juan Jesús


    We investigated the association between phosphate and the risk of adverse clinical outcomes in patients with manifest cardiovascular disease (CVD). Observational study of patients hospitalized during 2006-2011 in Stockholm, Sweden, because of suspected acute coronary syndrome (ACS). The exposure was serum phosphate during the hospitalization. We modeled the association between phosphate and in-hospital death or in-hospital events (composite of myocardial infarction, cardiogenic shock, resuscitated cardiac arrest, atrial fibrillation, or atrioventricular block) as well as the one-year post-discharge risk of death or cardiovascular event (composite of myocardial re-infarction, heart failure and stroke). Confounders included demographics, comorbidities, kidney function, diagnoses, in-hospital procedures and therapies. Included were 2547 patients (68% men, mean age 67±14years) with median phosphate of 1.10 (range 0.14-4.20) mmol/L. During hospitalization, 198 patients died and 328 suffered an adverse event. Within one year post-discharge, further 381 deaths and 632 CVD events occurred. The associations of phosphate with mortality and CVD were J-shaped, with highest risk magnitudes at higher phosphate levels. For instance, compared to patients in the 50th percentile of phosphate distribution, those above the 75th percentile (1.3mmol/L, normal range) had significantly higher odds for in-hospital death [odds ratio 1.36, 95% confidence interval (CI) (1.08-1.71)] and of CVD post-discharge [sub-hazard ratios 1.17 (1.03-1.33)]. In patients with suspected ACS, both higher and lower phosphate levels associated with increased risk of adverse outcomes during the index hospitalization and within one year post-discharge. The risk association was present already within normal-range serum phosphate values. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  3. Trajectories of Work Disability and Economic Insecurity Approaching Retirement. (United States)

    Shuey, Kim M; Willson, Andrea E


    In this article, we examine the connection between trajectories of work disability and economic precarity in late midlife. We conceptualize work disability as a possible mechanism linking early and later life economic disadvantage. We model trajectories of work disability characterized by timing and stability for a cohort of Baby Boomers (22-32 in 1981) using 32 years of data from the Panel Study of Income Dynamics and latent class analysis. Measures of childhood disadvantage are included as predictors of work disability trajectories, which are subsequently included in logistic regression models predicting four economic outcomes (poverty, asset poverty, home ownership, and pension ownership) at ages 54-64. Childhood disadvantage selected individuals into five distinct classes of work disability that differed in timing and stability. All of the disability trajectories were associated with an increased risk of economic insecurity in late midlife compared to the never work disabled. This study contributes to the aging literature through its incorporation of the early life origins of pathways of disability and their links to economic outcomes approaching retirement. Findings suggest work disability is anchored in early life disadvantage and is associated with economic insecurity later in life.

  4. Combat sports for persons with disabilities

    Directory of Open Access Journals (Sweden)

    Kasum Goran


    Full Text Available In literature, the term adapted sport indicates sports activities, modified and adapted to persons with disabilities. In spite of their highly prominent values, combat sports are underrepresented among persons with disabilities in Serbia. The benefits of combat sports practicing are numerous, and at some international hospitals, martial sports and arts already have an important role in the treatment of traumatized and disabled persons. Currently, the programme of Paralympic Games includes only two sports, these are fencing and judo, in male and female competition. Almost certainly, karate will also be included in the programme of Paralympic Games, and there are similar ambitions in the case of taekwondo as well. In addition to these sports, some martial arts, especially aikido, thai-chi-chuan and qigong, have obtained significant representation and interest among persons with disabilities. The reasons for weaker interest in other martial sports and arts, should be sought in the fact that they are underrepresented among this population, and that these persons are not offered the possibility of organized practice of such sports. Orientation towards a combat sport brings great refreshment and powerful emotional experience to each practitioner, and this fact has special significance to persons with disabilities. In Serbia, combat sports are not widely represented among persons with disabilities, and only the wrestlers with impaired hearing have achieved significant success on the international stage. On the other hand, the popularity of combat sports among persons with disabilities in the world is significantly growing. It is necessary to take concrete steps to make it so in Serbia as well.

  5. Human Rights and Neoliberalism in Australian Welfare to Work Policy: Experiences and Perceptions of People with Disabilities and Disability Stakeholders

    Directory of Open Access Journals (Sweden)

    Sarah Parker Harris


    Full Text Available Recent policy approaches in Australia, influenced by neoliberalism, have constrained the implementation of international disability rights at the national level. Within the neoliberal and human rights approaches to social policy, what is the lived experience of people with disabilities? In focus groups with people with disabilities and interviews with disability stakeholders in Australia, participants were asked about their experiences and perspectives of welfare to work programs. We analyzed the data by drawing on the United Nations Convention on the Rights of Persons with Disabilities as a framework. The analysis revealed tensions between the rights and responsibilities of citizens and the government, and a disconnection between policy discourse and policy practice. The results suggest that disability rights are jeopardized unless governments take responsibility to create the policy environment for rights-based policy to be implemented; including the equalization of opportunities, providing accessible information and communication about employment, and addressing the administration and process practices that employment service providers follow.

  6. Focused cardiac ultrasound (FOCUS) by emergency medicine residents in patients with suspected cardiovascular diseases. (United States)

    Farsi, Davood; Hajsadeghi, Skokoufeh; Hajighanbari, Mohammad Javad; Mofidi, Mani; Hafezimoghadam, Peyman; Rezai, Mahdi; Mahshidfar, Babak; Abiri, Samaneh; Abbasi, Saeed


    Few studies have assessed the value and accuracy of focused cardiac ultrasound (FOCUS) performed by emergency physicians. The aim of the present study was to evaluate the diagnostic accuracy of FOCUS performed by emergency medicine residents compared to echocardiography performed by a cardiologist in emergency department (ED) patients suspected of cardiovascular disease. The research involved a prospective observational cross-sectional study enrolling patients over 18-years old suspected of having cardiovascular disease who required an echocardiograph. For each patient, a FOCUS test was conducted by a trained emergency medicine resident. The diagnostic accuracy of ED performed FOCUS was compared to echocardiography performed by a cardiologist (gold standard) in the ED. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated for FOCUS. The agreement of EM residents and cardiologists on each finding was evaluated using Cohen's kappa coefficient with 95% CI. Two hundred and five patients, with a mean age of 61.0 ± 17 years (50% male), were included in this study. Agreement between FOCUS performed by an emergency medicine resident and echocardiography performed by a cardiologist in measuring ejection fraction of the left ventricle was 91% (κ = 0.85; 95% CI = 0.79-0.91). Reports of the two groups for identifying right ventricular enlargement showed 96% agreement (κ = 0.86; 95% CI = 0.82-0.90). The agreements for right ventricular pressure overload, wall motion abnormality and pericardial effusion were 100% (κ = 0.83; 95% CI = 0.77-0.89), 92% (κ = 0.83; 95% CI = 0.76-0.90), and 96% (κ = 0.83; 95% CI = 0.77-0.89), respectively. FOCUS performed by emergency medicine residents is comparable to echocardiography performed by cardiologists. Therefore, it could be a reliable tool and screening test for initial testing of patients suspected of cardiac abnormalities.

  7. Genotype MTBDR plus (Hain) test in suspected MDR-TB patients. (United States)

    Sangsayunh, Piamlarp; Chuchothawon, Chareon


    Incidence ofMDR-TB in Thailand is higher Diagnosis ofmulti-drug resistance (MDR-TB) is often delayed because of insufficient investigations. Therefore, there is a need to introduce an efficient testing method. Genotype MTBDR plus (Hain test) is a new technology of line probe assay (LPAs) In general practice, it had questionable benefit on negative and positive direct smear specimens. Evaluate the accuracy of the Hain test as compared to the conventional culture and drug susceptibility test (DST), and evaluate the judgment of the physician on starting MDR-TB treatment after receiving the result of the Hain test. An observational prospective study was done of 100 suspected MDR-TB patients who visited the Central Chest Institute of Thailand between September and December 2012. Ninety-four patients were included in the present study. They were assessed by direct sputum smear test, Hain test, sputum conventional culture, and drug-susceptibility test (DST) in the first visit. Followed-up treatment until cure/definite treatment were observed for definite diagnosis. Hain tests identified 65 (69%) MTB positives, 25 (26%) MTB negatives, andfour (4%) Non-tuberculous Mycobacteria (NTM), respectively. Fourteen of 17 negative direct smear but positive Hain test samples were culture negative. We followed these 14 patients. Four patients with TB treatment were cured. Six patients received MDR treatment and improved. Two patients were misdiagnosed CA. Two patients had old scar TB lesion. Sensitivity, specificity, and accuracy ofHain test for MDR-TB detection compared to standard conventional culture were 95%, 86%, and 88%, respectively. Twelve patients were NTMculture positive. Most of them (75%) were M abscessus. Sixty-three percent of chest physicians used the result of the Hain testfor extended treatment ofstandard regimen in non-IR resistance or changing ofTB regimen. There was correlation between judgments of starting MDR-TB treatment and results of Hain test (p = 0.001), no

  8. Prevalence and risk factors of suspected elder abuse subtypes in people aged 75 and older. (United States)

    Garre-Olmo, Josep; Planas-Pujol, Xènia; López-Pousa, Secundino; Juvinya, Dolors; Vilà, Antoni; Vilalta-Franch, Joan


    To assess the prevalence of suspected elder abuse subtypes and to identify related factors. Cross-sectional, population-based, descriptive study. Eight rural villages in Girona, Spain. Six hundred seventy-six inhabitants aged 75 and older. All participants were interviewed in their homes using the study protocol, which includes an abuse screen used in previous elder abuse studies and questions about demographic, social, physical, psychiatric, cognitive, and social services variables. The mean age of the participants was 81.7 +/- 4.8; 58.2% were female. Prevalence of suspected neglect abuse was 16.0% (95% confidence interval (CI)=13.2-18.9), prevalence of psychosocial abuse was 15.2% (95% CI=12.8-18.2), prevalence of financial abuse was 4.7% (95% CI=3.0-6.4) and prevalence of physical abuse was 0.1% (95% CI=0.004-0.8). Psychosocial abuse was positively associated with depressive symptoms (odds ratio (OR)=1.65, 95% CI=1.01-2.72), social isolation (OR=0.35, 95% CI=0.18-0.69), and frequent bladder incontinence (OR=2.44, 95% CI=1.23-4.86). Neglect abuse was positively associated with social isolation (OR=0.52, 95% CI=0.27-0.99), use of social services (OR=1.83, 95% CI=1.05-3.20), and living arrangements (OR=5.29, 95% CI=2.65-10.56). Financial abuse was associated with marital status (OR=0.15, 95% CI=0.04-0.59), age 85 and older, (OR=3.84, 95% CI=1.70-8.68), and Mini-Mental State Examination score (OR=0.85, 95% CI=0.78-0.94). After adjustment for confounding factors, each subtype of suspected elder abuse was associated with different variables. The results of this study suggest that elder abuse cannot be analyzed as a unitary concept and that risk factors must be assessed for each abuse subtype.

  9. Clinical characteristics, management and long-term outcome of suspected rapid eye movement sleep behaviour disorder in 14 dogs. (United States)

    Schubert, T A; Chidester, R M; Chrisman, C L


    To describe the clinical characteristics, management and long-term outcome in dogs with suspected rapid eye movement sleep behaviour disorder. Medical records and video recordings of 14 dogs with suspected rapid eye movement sleep behaviour disorder were reviewed and the owners were contacted via telephone or email for further information. Clinical signs included episodes of violent limb movements, howling, barking, growling, chewing, or biting during sleep. Episodes occurred at night and during daytime naps. The age at onset ranged from 8 weeks to 7·5 years with a median of 6 years but 64% of dogs were one year or less. There was no apparent sex or breed predisposition. Rapid eye movement sleep behaviour disorder events were reduced in severity and frequency in 78% of the dogs treated with 40 mg/kg/day oral potassium bromide. One dog was euthanized within 3 months of the onset of signs because of their severity. The duration of the disorder in the 13 surviving dogs ranged from 1·5 to 9 years. None of the dogs spontaneously recovered. Rapid eye movement sleep behaviour disorder is suspected to occur in dogs, as it does in human beings. It causes concern to the owners and disrupts the home environment. Unlike human beings, rapid eye movement sleep behaviour disorder of dogs often has a juvenile onset. © 2011 British Small Animal Veterinary Association.

  10. Neonatal BCG has no effect on allergic sensitization and suspected food allergy until 13 months. (United States)

    Thøstesen, Lisbeth Marianne; Kjaer, Henrik Fomsgaard; Pihl, Gitte Thybo; Nissen, Thomas Nørrelykke; Birk, Nina Marie; Kjaergaard, Jesper; Jensen, Aksel Karl Georg; Aaby, Peter; Olesen, Annette Wind; Stensballe, Lone Graff; Jeppesen, Dorthe Lisbeth; Benn, Christine Stabell; Kofoed, Poul-Erik


    Vaccination with Bacillus Calmette-Guérin (BCG) is used in many countries as protection against tuberculosis. Studies have suggested that BCG may also have non-specific effects, reducing non-tuberculosis mortality, morbidity, and atopic manifestations. In this study, we evaluated the effect of neonatal BCG vaccination on allergic sensitization and suspected food allergy at 13 months of age. The Danish Calmette Study was conducted from 2012 to 2015 at three Danish hospitals. Within 7 days of birth, the 4262 newborns of 4184 included mothers were randomized 1:1 to BCG or to a no-intervention control group. Exclusion criteria were gestational age BCG group and 6.1% (126/2061) of the control group suspected food allergy, resulting in a risk ratio comparing BCG-vaccinated children with control children of 0.91 (95% CI 0.71-1.16). Among 1370 blood samples, sensitization (Phadiatop Infant >0.35 kUA/L) was found in 55 of 743 (7.4%) children in the BCG group and 50 of 627 (8.0%) of the control group (risk ratio 0.94 [0.65-1.36]). In this randomized clinical trial, neonatal BCG had no significant effect on suspected food allergy or on sensitization at 13 months of age. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  11. The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

    Directory of Open Access Journals (Sweden)

    Nurettin Tunç


    Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

  12. Abdominal and pelvic CT in cases of suspected abuse: can clinical and laboratory findings guide its use?

    Energy Technology Data Exchange (ETDEWEB)

    Trout, Andrew T.; Strouse, Peter J. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Mohr, Bethany A. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics, Ann Arbor, MI (United States); Khalatbari, S.; Myles, Jamie D. [University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, MI (United States)


    Incomplete history and concern for occult injury in suspected child abuse occasionally results in CT screenings of the abdomen and pelvis. At our institution, we noted that these exams were infrequently positive. To identify clinical or laboratory criteria that may predict intra-abdominal injury and guide the use of abdominal and pelvic CT in this population. This retrospective review involved 68 children older than 36 months who had a CT of the abdomen/pelvis for suspected abuse. CT results and patient charts were reviewed for physical exam and historical and laboratory variables. CTs were positive in 16% of patients (11/68). Hypoactive/absent bowel sounds (P = 0.01, specificity = 94.7%) and AST and ALT values greater than twice normal (P = 0.004 and P = 0.003 respectively, NPV = 93.6%) were significantly associated with positive CTs. Multiple abnormal physical exam or laboratory findings were also significantly associated with positive CTs (P = 0.03 and P = 0.002 respectively, specificity = 91.3% and NPV = 93.6% respectively). CTs of the abdomen and pelvis are infrequently positive in cases of suspected abuse. To reduce radiation exposure, CTs should only be ordered if there are findings indicating that they may be positive. In our population, these findings include absent/hypoactive bowel sounds, LFTs greater than twice normal and {>=}2 abnormal labs or physical exam findings. (orig.)

  13. Predictive Analysis Between Topographic, Pachymetric and Wavefront Parameters in Keratoconus, Suspects and Normal Eyes: Creating Unified Equations to Evaluate Keratoconus. (United States)

    Prakash, Gaurav; Suhail, Muhammad; Srivastava, Dhruv


    To perform prediction analysis between topographic, pachymetric and wavefront parameters in keratoconus, suspects, and normal cases and to look at the possibility of a unified equation to evaluate keratoconus. This cross-sectional, observational study was done in cornea services of a specialty hospital. Fifty eyes of 50 candidates with a diagnosis of normal, keratoconus suspect, and keratoconus were included in each group (total 150 eyes). All eyes underwent detailed analysis on Scheimplug + Placido device (Sirius, CSO, Italy). Main parameters evaluated were topographic [maximum keratometry (Max Km), average keratometry and astigmatism at 3, 5, and 7 mm], pachymetric [central and minimum corneal thickness (MCT) and their difference, corneal volume] and corneal aberrations [higher order aberrations root-mean-square (HOARMS), coma, spherical, residual].Central tendency, predictive fits and regression models, were computed. The measured variables had a significant difference in mean between the three groups (Kruskal-Wallis, p keratoconus (R(2) from 0.75 to 0.33) compared to suspect/normal eyes (R(2) from 0.15 to 0.003). These three variables (Max Km, MCT and HOARMS) were used as representative variables to create the unified equations. The equation for the pooled data was (Kmax = 59.5 + 2.3 × HOARMS-0.03 × MCT; R(2)= 0.7, p keratoconus (MaxKm, MCT, HOARMS) can be linked by linear regression equations to predict the pathology's behavior.

  14. The accuracy of MRI in diagnosis of suspected deep vein thrombosis: systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sampson, Fiona C.; Goodacre, Steve W. [University of Sheffield, Health Services Research Section, ScHARR, Sheffield (United Kingdom); Thomas, Steven M. [Northern General Hospital, Academic Vascular Unit, The University of Sheffield, Coleridge House, Sheffield (United Kingdom); Beek, Edwin J.R. van [University of Iowa Hospitals and Clinics, Department of Radiology, Carver College of Medicine, Iowa (United States)


    Magnetic resonance imaging (MRI) may be used to diagnose deep vein thrombosis (DVT) in patients for whom ultrasound examination is inappropriate or unfeasible. We undertook a systematic review of the literature and meta-analysis to estimate the diagnostic accuracy of MRI for DVT. We searched databases of medical literature and citation lists of retrieved articles. We selected studies that compared MRI with a reference standard in patients with suspected DVT or suspected pulmonary embolus, or high-risk asymptomatic patients. Data were analysed by random effects meta-analysis. We included 14 articles in the meta-analysis. Most compared MRI with venography in patients with clinically suspected DVT. The pooled estimate of sensitivity was 91.5% (95% CI: 87.5-94.5%) and the pooled estimate of specificity was 94.8% (95% CI: 92.6-96.5%). Sensitivity for proximal DVT was higher than sensitivity for distal DVT (93.9% versus 62.1%). However, pooled estimates should be interpreted with caution as estimates of both sensitivity and specificity were subject to significant heterogeneity (P<0.001). Individual studies reported sensitivity ranging from zero to 100%, while specificity ranged from 43 to 100%. MRI has equivalent sensitivity and specificity to ultrasound for diagnosis of DVT, but has been evaluated in many fewer studies, using a variety of different techniques. (orig.)

  15. Prevalence of IgG autoantibody against F-actin in patients suspected of having autoimmune or acute viral hepatitis. (United States)

    Jaskowski, Troy D; Konnick, Eric Q; Ashwood, Edward R; Litwin, Christine M; Hill, Harry R


    Our objectives in this study were to compare results obtained by an enzyme immunoassay (EIA) for F-actin antibody (FAA) immunoglobulin G (IgG) to those determined by an indirect fluorescent antibody (IFA) assay for smooth muscle antibody (SMA) IgG, and to determine the prevalence of FAA in patient sera having serologic evidence of acute viral hepatitis. Sera from 415 patients suspected of having autoimmune hepatitis (AIH), 208 patients suspected of having acute viral hepatitis A, B, or C, and 100 healthy blood donors (HBD) were included in the study. Only one of 100 HBD showed low levels (20-30 Units) of F-actin IgG. In patients suspected of having AIH, the prevalence of FAA increased as SMA titers increased and all sera with SMA titers of >or=1:160 were FAA-positive. In contrast, there were many sera with negative (30 Units) of FAA; many exceeding 80 Units. Moreover, 51.4% of these sera were also positive for anti-nuclear antibody (ANA), which is also utilized in diagnosing type 1 AIH. FAA was detected in 25% of viral hepatitis antibody-positive sera, with the majority (59.3%) containing low levels, and all were ANA-negative. Copyright (c) 2007 Wiley-Liss, Inc.

  16. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Yalewayker Tegegne


    Full Text Available Introduction. Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method. Institutional based cross-sectional study was conducted at University of Gondar Hospital from March to May, 2017. Stool samples were taken from each participant and examined by direct microscopy and concentration technique. Descriptive statistics was performed and chi-square test was used to show the association between variables. P values of <0.05 were considered statistically significant. Results. Intestinal parasites were detected in 50 (19.6% among a total of 256 pulmonary tuberculosis suspected patients who were included in the study, whereas the prevalence of pulmonary tuberculosis was 16.8% (43/256. Pulmonary tuberculosis and intestinal parasite coinfection was detected in 5 (2.0% of the participants. The most prevalent intestinal parasites infection in this study was Ascaris lumbricoides, 15 (5.85%, followed by Entamoeba histolytica/dispar, 14 (5.46%, and Hookworm, 13 (5.1%. Conclusion. The prevalence of intestinal parasites and their coinfection rate with pulmonary tuberculosis among pulmonary tuberculosis suspected patients were considerable.

  17. Ultrasonographic findings and outcomes of dogs with suspected migrating intrathoracic grass awns: 43 cases (2010-2013). (United States)

    Caivano, Domenico; Birettoni, Francesco; Rishniw, Mark; Bufalari, Antonello; De Monte, Valentina; Proni, Alessia; Giorgi, Maria Elena; Porciello, Francesco


    To describe ultrasonographic findings and outcomes for dogs with suspected migrating intrathoracic grass awns. Retrospective case series. 43 client-owned dogs. Records for dogs with suspected migrating intrathoracic grass awns examined between 2010 and 2013 were reviewed. Ultrasonographic images and additional information such as signalment and pleural fluid analysis, radiographic, bronchoscopic, and CT findings were collected. Surgical treatments and outcomes were also reviewed. Transthoracic or transesophageal ultrasonography revealed grass awns in the pleural space (n = 13) or pulmonary parenchyma (10) of 23 dogs. Surgical removal of grass awns was successful on the first attempt in 21 of these 23 dogs (including 11/23 that had intraoperative ultrasonography performed to aid localization and removal of the awn). In the remaining 2 dogs, a second surgery was required. Twenty dogs with evidence of migrating intrathoracic grass awns had no foreign body identified on initial ultrasonographic evaluation and were treated medically; 16 developed draining fistulas, and awns identified ultrasonographically at follow-up visits were subsequently removed from the sublumbar region (n = 10) or thoracic wall (6). The remaining 4 dogs had no grass awn visualized. Clinical signs resolved in all dogs. Transthoracic, transesophageal, and intraoperative ultrasonography were useful for localization and removal of migrating intrathoracic grass awns. Ultrasonography may be considered a valuable and readily available diagnostic tool for monitoring dogs with suspected migrating intrathoracic grass awns.

  18. Experiences and perceptions of students with disabilities concerning ...

    African Journals Online (AJOL)

    South African universities share a common purpose to make sport and recreation accessible to students at higher education institutions, including students with disabilities.Therefore, integrating students with disabilities into the daily activities of any university institution is important as it may be beneficial for them to ...

  19. Intellectual disability, oncogenes and tumour suppressor genes: the ...

    Indian Academy of Sciences (India)

    disability, the presence of CNV including gene expressed in the brain or with specific brain function is a strong argument. In contrast, CNV affecting only genes involved in oncogen- esis are mostly ignored. However, links between some onco- genes or tumour suppressor genes and intellectual disability deserve attention.

  20. Physical Disabilities in the Land of Karma Theory. (United States)

    Singh, Delar K.

    This paper discusses the Person's with Disabilities Act (PDA) passed in 1995 in India and compares it with the United State's Individuals with Disabilities Education Act (IDEA) of 1997. The comparison indicates the PDA is more limited in its coverage, does not include due process procedures, and does not fund the education of individuals with…

  1. Applying Common Core Standards to Students with Disabilities in Music (United States)

    Darrow, Alice-Ann


    The following article includes general information on the Common Core State Standards, how the standards apply to the music and academic education of students with disabilities, and web resources that will helpful to music educators teaching students with and without disabilities.

  2. (dis)Ability and Postsecondary Education: One Woman's Experience (United States)

    Myers, Melissa; MacDonald, Judy E.; Jacquard, Sarah; Mcneil, Matthew


    The storied experiences of a (dis)Abled student negotiating postsecondary education in Canada are highlighted within this article, including advocacy strategies and a critique of related policies. Persons with (dis)Abilities are a particularly marginalized population, traditionally excluded from society, with modern day views of pity or heroics…

  3. Dimensions of Parenting in Families Having Children with Disabilities. (United States)

    Bradley, Robert H.; And Others


    This study examined relationships between parenting, severity of disability, and 5 aspects of family ecology for 83 preschool and 69 elementary school children with disabilities. Family ecology variables included socioeconomic status, coping styles, social support, stressful life events, and marital quality. Results showed positive correlations…

  4. Gifted Learning Disabilities: Is It Such a Bright Idea? (United States)

    Vaughn, Sharon


    Literature related to the definition, identification, characteristics, and intervention for gifted learning-disabled students is reviewed. Under-researched areas revealed include identification of characteristics and effectiveness of specific interventions. Issues in gifted/learning-disabled education and suggestions for future research are…

  5. Gifted and Learning Disabled Students: Practical Considerations for Teachers. (United States)

    Landrum, Timothy J.


    The article provides practical suggestions for teachers working with gifted learning-disabled students. It includes a discussion of whether students can be both gifted and learning disabled, and reviews service options, methods of identification, and programing for this population. (DB)

  6. Differentiating Instruction for Disabled Students in Inclusive Classrooms (United States)

    Broderick, Alicia; Mehta-Parekh, Heeral; Reid, D. Kim


    Differentiating instruction, a comprehensive approach to teaching, enables the successful inclusion of all students, including the disabled, in general-education classrooms. As inclusive educators, we argue that disability is an enacted, interactional process and not an empirical, stable fact or condition. We recommend planning responsive lessons…

  7. Large-Scale Assessment and English Language Learners with Disabilities (United States)

    Liu, Kristin K.; Ward, Jenna M.; Thurlow, Martha L.; Christensen, Laurene L.


    This article highlights a set of principles and guidelines, developed by a diverse group of specialists in the field, for appropriately including English language learners (ELLs) with disabilities in large-scale assessments. ELLs with disabilities make up roughly 9% of the rapidly increasing ELL population nationwide. In spite of the small overall…

  8. Water-Based Outdoor Recreation and Persons with Disabilities. (United States)

    Ross, Jo-Ellen

    People with disabilities have long been hindered from participating in outdoor recreation activities such as fishing and boating because of structural and social barriers. Within the past decade, significant progress has been made toward including people with disabilities in outdoor recreation programs and improving access to related facilities…

  9. A Manual on Food and Nutrition for the Disabled. (United States)

    Van-Lane, Deirdre, Comp.; MacDonald, Donna

    The manual considers nutritional issues in disability. Basic nutrition principles are offered in the first section along with a table of sources and functions of nutrients in food. Section 2 considers nutrition factors associated with disabilities, including causes and treatment of obesity and underweight. Implications of diet and feeding patterns…

  10. Intellectual Disability and Space: Critical Narratives of Exclusion (United States)

    Gabel, Susan L.; Cohen, Carie J.; Kotel, Kathleen; Pearson, Holly


    The language of intellectual disability is rife with spatial terms. Students labeled with intellectual disability are "placed in" special education where they may be "self-contained," "segregated," "excluded," or "included." Conversations ensue about where to seat them, "next" to whom, and at what distance "from" the teacher and other students. In…

  11. Gender differences in functional disability and self-care among seniors in Bangladesh. (United States)

    Tareque, Md Ismail; Tiedt, Andrew D; Islam, Towfiqua Mahfuza; Begum, Sharifa; Saito, Yasuhiko


    Disability among older adults is a public health concern. To date there are no in-depth and comprehensive analyses on older adults' disabilities in Bangladesh. This study investigated gender differences in the prevalence of disability and the socio-demographic factors associated with disability among older adults in Bangladesh. This research used a sample of 4176 elderly males and females aged 60 years and over from a nationally representative data set- Bangladesh's 2010 Household Income and Expenditure Survey. The study used both household level and individual level data and applied a wealth index, which was constructed based on household assets using principal component analysis. The Washington Group's short set of questions on disability were used to measure disability. Chi-square tests and ordinal logistic regression models were fit. Forty-two percent of older had some form of functional disability, including 5% of elderly with severe/extreme functional disability. Seven percent of older adults had a self-care disability, including 3% of elderly with a severe/extreme form of self-care disability. Elderly females suffered from all the studied disabilities, including functional and self-care disabilities in higher percentages, and had higher odds ratios of having both functional disability and self-care disability compared to elderly males. The study also identified some significant factors affecting functional disability and self-care disability, namely age, having a chronic condition, wealth status and place of residence, including divisional differences. Programs aimed at reducing functional disability among seniors, particularly elderly females, should be granted the highest priority in Bangladesh.

  12. "It's Like Piecing Together Small Pieces of a Puzzle". Difficulties in Reporting Abuse and Neglect of Disabled Children to the Social Services


    Mallén, Agneta


    According to Swedish law, the Child and Youth Habilitation Services are obliged to report abuse and neglect of disabled children to the Social Services. Only a small proportion of all children who are suspected of being victims of abuse or neglect are however reported to the Social Services. The aim of this study is to discuss why some cases of abuse and neglect of disabled children are considered difficult to report by the Child and Youth Habilitation Services. The qualitative data were coll...

  13. Cost-Effectiveness Analysis of Natriuretic Peptide Testing and Specialist Management in Patients with Suspected Acute Heart Failure. (United States)

    Griffin, Edward A; Wonderling, David; Ludman, Andrew J; Al-Mohammad, Abdallah; Cowie, Martin R; Hardman, Suzanna M C; McMurray, John J V; Kendall, Jason; Mitchell, Polly; Shote, Aminat; Dworzynski, Katharina; Mant, Jonathan


    To determine the cost-effectiveness of natriuretic peptide (NP) testing and specialist outreach in patients with acute heart failure (AHF) residing off the cardiology ward. We used a Markov model to estimate costs and quality-adjusted life-years (QALYs) for patients presenting to hospital with suspected AHF. We examined diagnostic workup with and without the NP test in suspected new cases, and we examined the impact of specialist heart failure outreach in all suspected cases. Inputs for the model were derived from systematic reviews, the UK national heart failure audit, randomized controlled trials, expert consensus from a National Institute for Health and Care Excellence guideline development group, and a national online survey. The main benefit from specialist care (cardiology ward and specialist outreach) was the increased likelihood of discharge on disease-modifying drugs for people with left ventricular systolic dysfunction, which improve mortality and reduce re-admissions due to worsened heart failure (associated with lower utility). Costs included diagnostic investigations, admissions, pharmacological therapy, and follow-up heart failure care. NP testing and specialist outreach are both higher cost, higher QALY, cost-effective strategies (incremental cost-effectiveness ratios of £11,656 and £2,883 per QALY gained, respectively). Combining NP and specialist outreach is the most cost-effective strategy. This result was robust to both univariate deterministic and probabilistic sensitivity analyses. NP testing for the diagnostic workup of new suspected AHF is cost-effective. The use of specialist heart failure outreach for inpatients with AHF residing off the cardiology ward is cost-effective. Both interventions will help improve outcomes for this high-risk group. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. [Genetic analysis of TPO, DUOX2 and DUOXA2 genes in children with permanent congenital hypothyroidism suspected dyshormonogenesis]. (United States)

    Huang, Y L; Tan, M Y; Jiang, X; Li, B; Chen, Q Y; Jia, X F; Tang, C F; Liu, J L; Liu, L


    Objective: To explore the TPO, DUOX2 and DUOXA2 genotypes and phenotypes of children with permanent congenital hypothyroidism(PCH) suspected dyshormonogenesis in Guangzhou, identified and treated at Guangzhou Newborn Screening Center. Six of them were born between 2011 and 2012. Method: Retrospectively analyzed the clinical data of 9 children with PCH suspected dyshormonogenesis. Genetic analysis of TPO, DUOX2 and DUOXA2 genes were performed with Sanger sequencing. Result: Of the 9 patients, four were identified variants in TPO gene including three cases with biallelic variants and one case with monoallelic variant. Novel c. 1784G>C( p. R595T) variant in TPO was predicted to be damaging by SIFT and PolyPhen-2. Four patients harbored monoallelic known variants in DUOX2 gene and the other one harbored heterozygous known mutation c. 738C>G(p.Y246X) in DUOXA2 gene.Two adolescent patients with biallelic variants in TPO gene showed classical PCH phenotypes with thyroid goiter or nodules. The six patients with monoallelic variant in TPO, DUOX2 or DUOXA2 presented variable phenotypes. Among the 433 578 newborns in the 2011-2012 cohort, there were 156 cases of CH. Six of these cases were PCH suspected dyshormonogenesis, among which 1 case was confirmed TPO biallelic variants and 5 cases were monoallelic variants of TPO, DUOX2, or DUOXA2 genes. Conclusion: TPO and DUOX2 variants are the common molecular pathogenesis in children with PCH suspected dyshormonogenesis. Monoallelic variants in TPO, DUOX2 or DUOXA2 are associated with PCH and showed wide variability in their phenotypes. The novel variant p. R595T in TPO is probably a pathologic variant. The prevalence of PCH caused by TPO gene defects is rare in Guangzhou.

  15. Prospective evaluation of the diagnostic value of sensitive KIT D816V mutation analysis of blood in adults with suspected systemic mastocytosis

    DEFF Research Database (Denmark)

    Kielsgaard Kristensen, Thomas; Vestergaard, H; Bindslev-Jensen, C


    BACKGROUND: Sensitive KIT D816V mutation analysis of blood has been proposed to guide bone marrow (BM) investigation in suspected systemic mastocytosis (SM). The aim of this prospective study was for the first time to compare the D816V status of the "screening blood sample" used to guide BM biopsy...... in suspected SM to the outcome of the subsequent BM investigation. METHODS: Fifty-eight adult patients with suspected SM were included. The outcome of sensitive KIT D816V analysis of blood was compared to the result of the BM investigation. RESULTS: Screening blood samples from 44 of 58 patients tested D816V......-positive. In 43 of these, SM was subsequently diagnosed in the BM investigation. One patient with a D816V-positive screening sample was diagnosed with monoclonal MC activation syndrome. Screening blood samples from 14 patients tested D816V-negative. SM was subsequently diagnosed in five of these, whereas nine...

  16. Disability prevalence and disability-related employment gaps in the UK 1998-2012: Different trends in different surveys? (United States)

    Baumberg, Ben; Jones, Melanie; Wass, Victoria


    The persistently low employment rate among disabled individuals has been an enduring concern of governments across developed countries and has been the subject of a succession of policy initiatives, including labour market activation programmes, equality laws and welfare reform. A key indicator of progress is the trend in the disability-related employment gap, the percentage point difference between the employment rate for disabled and non-disabled individuals. Confusingly for the UK, studies undertaken between 1998 and 2012 have simultaneously reported both a widening and a narrowing of the gap. The source of the discrepancy can be found in the choice of survey, the General Household Survey (GHS) or the Labour Force Survey (LFS), although both use a common conception of disability and collect self-reported information from a random sample of households. The literature has analysed these surveys separately from each other and ignored inter-survey differences in findings. The Health Survey for England (HSE), a third national household survey, replicates the GHS questions on disability but has had limited use in this context. This empirical study compares the trends in disability prevalence and the disability-related employment gap across the three surveys using a three-stage harmonisation process. The negative relationship between the prevalence of disability and the employment gap found in cross-section inter-survey comparisons prompts an initial focus on differences in the definition of disability as an explanation of the discrepancy. This is broadened to include differences in survey methods and sample composition. Differences in the trend in disability prevalence and the employment gap remain following harmonisation for definition, survey method and sample composition. It is the LFS, the main policy-influencing and policy-assessment survey, which generates outlying results. As such, we cannot be confident that the disability-related employment gap has narrowed

  17. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis

    NARCIS (Netherlands)

    Thieme, Mai E.; Leeuwenburgh, Marjolein M. N.; Valdehueza, Zaldy D.; Bouman, Donald E.; de Bruin, Ivar G. J. M.; Schreurs, W. Hermien; Houdijk, Alexander P. J.; Stoker, Jaap; Wiarda, Bart M.


    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h,

  18. 9 CFR 354.123 - Segregation of suspects on ante-mortem inspection. (United States)


    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Segregation of suspects on ante-mortem inspection. 354.123 Section 354.123 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... Inspection Procedures; Ante-Mortem Inspections § 354.123 Segregation of suspects on ante-mortem inspection...

  19. 9 CFR 381.72 - Segregation of suspects on ante mortem inspection. (United States)


    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Segregation of suspects on ante mortem inspection. 381.72 Section 381.72 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT... Inspection § 381.72 Segregation of suspects on ante mortem inspection. (a) All birds, except ratites, that on...

  20. D-dimer test in cancer patients with suspected acute pulmonary embolism

    NARCIS (Netherlands)

    Di Nisio, M.; Sohne, M.; Kamphuisen, P. W.; Büller, H. R.


    Background: The safety of a D-dimer (DD) measurement in cancer patients with clinically suspected pulmonary embolism (PE) is unclear. Objectives: The aim of this study was to assess the accuracy of the DD test in consecutive patients with clinically suspected PE with and without cancer. Methods: The

  1. D-Dimer test in cancer patients with suspected acute pulmonary embolism.

    NARCIS (Netherlands)

    Nisio, M. Di; Sohne, M.; Kamphuisen, P.W.; Buller, H.R.


    BACKGROUND: The safety of a D-dimer (DD) measurement in cancer patients with clinically suspected pulmonary embolism (PE) is unclear. OBJECTIVES: The aim of this study was to assess the accuracy of the DD test in consecutive patients with clinically suspected PE with and without cancer. METHODS: The

  2. The Lawyer in the Dutch Interrogation Room: Influence on Police and Suspect

    NARCIS (Netherlands)

    W-J. Verhoeven (Willem-Jan); L. Stevens (Lonneke)


    textabstractIn many European countries, providing a suspect in custody with legal aid before the first police interrogation is a heavily debated issue. In this paper, we report on an exploratory study on the use of coercion by the police and the use of the right to silence by suspects in 70 Dutch

  3. Occurrence of antibodies to Anaplasma phagocytophilum in patients with suspected tick-borne encephalitis

    Directory of Open Access Journals (Sweden)

    Zuzana Kalinová


    None of the examined patients with suspected TBE had the disease confirmed. Hoever, as shown by the results, the relative risk of occurrence of anaplasmosis is higher in people examined for some another vector-borne disease (in this case TBE. Therefore, the performance of screening examinations in patients suspected of having any tick-borne disease is very important.

  4. Disability in post-earthquake Haiti: prevalence and inequality in access to services. (United States)

    Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah


    To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with

  5. Screening for keratoconus suspects among candidates for refractive surgery. (United States)

    McMonnies, Charles W


    This review examines methods for estimating the risk of post-surgical ectasia in candidates for refractive surgery by establishing a diagnosis of keratoconus suspect as a contraindication for proceeding with surgery. Notwithstanding the desirability of achieving 100 per cent sensitivity, any associated reduction in specificity and increased numbers of false positives might deny some candidates the opportunity to proceed with refractive surgery. The introduction of a model for the risk of ectasia involving both pre- and post-surgical findings has been followed by a plethora of attempts to achieve the same purpose based on topographic and/or tomographic evaluation before surgery. The desirability of being able to depend on objective assessment using one type of instrument needs to be weighed against the possibility that subjective assessments may contribute significantly to screening success. For example, consideration of ethnicity, family history of keratoconus, a history of atopy or ocular allergies in particular, a history of significant exposure to corneal trauma associated with abnormal rubbing habits or with vocational, leisure or geographically increased exposure to ultraviolet radiation or with contact lens wear trauma or a history of significant exposure to activities which elevate intraocular pressure may improve screening success. To the extent that these factors could contribute to increased risk of the development of keratoconus, they may be useful in estimating the risk of post-surgical ectasia. If any combination of these factors helps to explain the development of keratoconus in normal or even thicker than normal corneas, they may have more significance for those corneas, which have been thinned surgically. © 2014 The Author. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

  6. Suspected dog bite associated HIV horizontal transmission in Swaziland

    Directory of Open Access Journals (Sweden)

    Ganizani Mlawanda


    Full Text Available Background: Dog bites may lead to transmission of bacteria and viruses over and above tetanus and rabies. Theoretically human immunodeficiency virus (HIV, Hepatitis B and Hepatitis C may be transmitted after dog bites where transfer of blood from one victim to another occur in clinical practice HIV, Hepatitis B and Hepatitis C are not considered when making treatment decisions, nor adequate patient history taken to consider all potential risks after dog bites in succession.Objective: To present case of suspected HIV transmission after dog bites in close succession involving two HIV sero-discordant victims.Management and outcome: HIV rapid test and/or HIV Ribonucleic acid (RNA polymerasechain reaction (PCR results for the victim(s at presentation and a month later.Results: Two night patrol guards presented to casualty after dog bites in close succession by the same dog. They were managed according to the dog bite protocol. Thinking out of the box, the first victim was found to be HIV positive by rapid test whilst the second victim was negative based on both HIV rapid test and HIV RNA PCR. One month after the dogbites, a case of HIV sero-conversion was confirmed in the second victim despite post-exposure prophylaxis (PEP.Discussion: Although an isolated case, shouldn’t clinicians re-think the significance of HIV transmission after animal bites where there is repeated blood exposure in several people insuccession?Conclusion: Clinicians should be aware of the potential of HIV, Hepatitis B and C transmission, when faced with dog bites in succession. 

  7. Disability in multiple sclerosis (United States)

    Chamot, Eric; Salter, Amber R.; Cutter, Gary R.; Bacon, Tamar E.; Herbert, Joseph


    Objective: To create a reference table of disability outcomes in multiple sclerosis (MS) that would enable patients to rank their disability relative to others' with similar disease duration and to develop a cost-effective research tool for comparing MS severity across patient populations and time periods. Methods: The North American Research Committee on Multiple Sclerosis (NARCOMS) Registry collects disability data from patients with MS on a validated, 9-point Patient-Determined Disease Steps (PDDS) scale. We compiled the Disability Expectancy Table, which displays cumulative frequencies of PDDS scores for each year of disease duration, from 0 to 45 years. We also tabulated disease duration–adjusted mean ranks of PDDS scores, referred to as Patient-derived MS Severity Scores (P-MSSS). Results: The cohort consisted of 27,918 NARCOMS enrollees, 72.7% of whom were female and 90.1% of whom were white. Mean age at symptom onset was 30.1 ± 10.1 years, and age at enrollment was 47.1 ± 11.0 years. The Disability Expectancy Table and P-MSSS afford a detailed overview of disability outcomes in a large MS cohort over a 45-year period. In the first year of disease, 15% of patients reported need of ambulatory aid, and 4% needed bilateral assistance or worse; after 45 years of disease, 76% of patients required ambulatory aid, and 52% bilateral assistance or worse. Proportion of patients who reported minimal or no interference in daily activities (PDDS ≤ 1) declined from 63% in the first year to 8% after 45 years of disease. Conclusion: The Disability Expectancy Table allows individual patients to determine how their disability ranks relative to NARCOMS enrollees with the same disease duration. P-MSSS may be used to compare disability across patient populations and to track disease progression in patient cohorts. P-MSSS does not require a formal neurologic examination and may therefore find wide applicability as a practical and cost-effective outcome measure in

  8. Dairy cow disability weights. (United States)

    McConnel, Craig S; McNeil, Ashleigh A; Hadrich, Joleen C; Lombard, Jason E; Garry, Franklyn B; Heller, Jane


    Over the past 175 years, data related to human disease and death have progressed to a summary measure of population health, the Disability-Adjusted Life Year (DALY). As dairies have intensified there has been no equivalent measure of the impact of disease on the productive life and well-being of animals. The development of a disease-adjusted metric requires a consistent set of disability weights that reflect the relative severity of important diseases. The objective of this study was to use an international survey of dairy authorities to derive disability weights for primary disease categories recorded on dairies. National and international dairy health and management authorities were contacted through professional organizations, dairy industry publications and conferences, and industry contacts. Estimates of minimum, most likely, and maximum disability weights were derived for 12 common dairy cow diseases. Survey participants were asked to estimate the impact of each disease on overall health and milk production. Diseases were classified from 1 (minimal adverse effects) to 10 (death). The data was modelled using BetaPERT distributions to demonstrate the variation in these dynamic disease processes, and to identify the most likely aggregated disability weights for each disease classification. A single disability weight was assigned to each disease using the average of the combined medians for the minimum, most likely, and maximum severity scores. A total of 96 respondents provided estimates of disability weights. The final disability weight values resulted in the following order from least to most severe: retained placenta, diarrhea, ketosis, metritis, mastitis, milk fever, lame (hoof only), calving trauma, left displaced abomasum, pneumonia, musculoskeletal injury (leg, hip, back), and right displaced abomasum. The peaks of the probability density functions indicated that for certain disease states such as retained placenta there was a relatively narrow range of

  9. Added diagnostic value of magnetoencephalography (MEG) in patients suspected for epilepsy, where previous, extensive EEG workup was unrevealing

    DEFF Research Database (Denmark)

    Duez, Lene; Beniczky, Sándor; Tankisi, Hatice


    normal EEGs, including sleep-EEG, were prospectively analyzed. The reference standard was inferred from the diagnosis obtained from the medical charts, after at least one-year follow-up. MEG (306-channel, whole-head) and simultaneous EEG (MEG-EEG) was recorded for one hour. The added sensitivity of MEG......OBJECTIVE: To elucidate the possible additional diagnostic yield of MEG in the workup of patients with suspected epilepsy, where repeated EEGs, including sleep-recordings failed to identify abnormalities. METHODS: Fifty-two consecutive patients with clinical suspicion of epilepsy and at least three...

  10. Lack of uniformity in the investigation and management of suspected β-lactam allergy in children. (United States)

    Foong, Ru-Xin Melanie; Logan, Kirsty; Perkin, Michael Richard; du Toit, George


    Beta-lactam allergy is commonly suspected in childhood with health implications for the individual and wider public. Diagnostic modalities include skin prick tests (SPT), specific immunoglobulin-E (sp-IgE) tests, intradermal tests (IDT) and drug provocation challenges (DPC). The aim of this research was to establish whether variation exists around the world in the investigation and management of beta-lactam allergy. Anonymized electronic questionnaire surveys were distributed over 3 months through International Allergy Societies for completion by clinicians who investigate drug allergy in children. Eighty-one clinicians, practising in 16 countries, completed the questionnaire. There is variability in the selection of diagnostic tests used by clinicians around the world and poor agreement on positive cut-off values (sp-IgE, SPT and IDT) and practical techniques used to measure SPT or IDT wheal diameters. DPC were considered the gold standard investigation with 94% of respondents undertaking DPC over the last 12 months; 64% of respondents considered DPC extremely useful for both exclusion and confirmation of beta-lactam allergy. However, there is a lack of consensus on when and how DPC should be performed. Overall, DPC are safe - only 3% of our respondents had patients who required intramuscular adrenaline and none had patients requiring admission to intensive care. There is lack of consistency amongst clinicians in different countries in the diagnosis and management of suspected beta-lactam allergy. The development of a standardized approach is a priority. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Clinical value of somatostatin receptor imaging in patients with suspected head and neck paragangliomas

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Matthias; Dietlein, Markus; Weber, Kerstin; Moka, Detlef; Schicha, Harald [Klinik und Poliklinik fuer Nuklearmedizin, Universitaet zu Koeln, Joseph-Stelzmann-Strasse 9, 50924 Koeln (Germany); Fischer, Eva; Michel, Olaf; Stennert, Eberhard [Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde, Universitaet zu Koeln, Koeln (Germany)


    Paragangliomas or glomus tumours of the head and neck region are rare somatostatin receptor-expressing neuroendocrine tumours. Precise preoperative diagnosis is of special importance in order to adequately weigh the potential benefit of the operation against the inherent risks of the procedure. In this study, the clinical value of somatostatin receptor imaging was assessed in 19 patients who underwent somatostatin receptor scintigraphy because of known or suspected paraganglioma of the head and neck region. The results were compared with the results of computed tomography and/or magnetic resonance imaging, histology and clinical follow-up. [{sup 111}In-DTPA-D-Phe{sup 1}]-octreotide scintigraphy was performed 4-6 and 24 h after i.v. injection of 140-220 MBq {sup 111}In-octreotide. Whole-body and planar images as well as single-photon emission tomography images were acquired and lesions were graded according to qualitative tracer uptake. Somatostatin receptor imaging was positive in nine patients, identifying paragangliomas for the first time in three patients and recurrent disease in six patients. In one patient, a second, previously unknown paraganglioma site was identified. Negative results were obtained in ten patients. These patients included one suffering from chronic hyperplastic otitis externa, one with granuloma tissue and an organised haematoma, one with an acoustic neuroma, one with an asymmetric internal carotid artery, two with ectasia of the bulbus venae jugularis and one with a jugular vein thrombosis. In two patients with a strong family history of paraganglioma, individual involvement could be excluded. In only one patient did somatostatin receptor imaging and magnetic resonance imaging yield false negative results in respect of recurrent paraganglioma tissue. It is concluded that somatostatin receptor scintigraphy provides important information in patients with suspected paragangliomas of the head and neck region and has a strong impact on further

  12. [CT strategy for patients with suspected acute appendicitis; comparison of conditional and immediate CT]. (United States)

    Atema, Jasper J; Gans, Sarah L; van Randen, Adrienne; Laméris, Wytze; van Es, H W Wouter; van Heesewijk, Johannes P M; van Ramshorst, Bert; Bouma, Wim H; ten Hove, Wim; van Keulen, Esteban M; Dijkgraaf, Marcel G W; Bossuyt, Patrick M M; Stoker, Jaap; Boermeester, Marja A


    To compare the diagnostic accuracy of conditional CT strategy, i.e. CT if ultrasound findings are negative or inconclusive, with immediate CT strategy for patients with suspected appendicitis. Subanalysis of a prospective multicenter diagnostic accuracy study. Only data of patients with signs of appendicitis based on medical history, physical examination, and laboratory tests were analyzed. All patients underwent both ultrasound and CT. Images of each were read by different observers who were blinded to the results of the other imaging modality. The observer then selected the most likely diagnosis. These diagnoses were compared with the reference standard, i.e. final diagnoses as assigned by an expert panel based on all available data and at least 6 months of follow-up. A total of 422 patients with suspected appendicitis were included. In 251 patients the final diagnosis was acute appendicitis (59%). In 199 patients (47%), ultrasound findings were inconclusive or negative. Use of conditional CT strategy resulted in correctly identified number of correctly identified patients with appendicitis, i.e. 96% (95% CI 93-98), versus 95% identified by immediate CT (95% CI 91-97). However, conditional CT strategy resulted in more false positive diagnoses compared with immediate CT (39 versus 22), had an accompanying lower specificity of 77% (95% CI 70-83) versus 87% (95% CI 81-91), and a lower positive predictive value of 86% (95% CI 81-90) versus 92% (95% CI 87-95). Use of a conditional CT strategy results in exactly the same number of patients with correctly identified acute appendicitis while halving the number of CTs needed. However, conditional strategy results in more false positive diagnoses.

  13. Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection

    Directory of Open Access Journals (Sweden)

    Diogo Diniz Gomes Bugano


    Full Text Available Objective: To compare efficacy and safety of vancomycin versusteicoplanin in patients with proven or suspected infection.Methods: Data Sources: Cochrane Renal Group’s SpecializedRegister, CENTRAL, MEDLINE, EMBASE, nephrology textbooksand review articles. Inclusion criteria: Randomized controlled trialsin any language comparing teicoplanin to vancomycin for patientswith proven or suspected infection. Data extraction: Two authorsindependently evaluated methodological quality and extracted data.Study investigators were contacted for unpublished information. Arandom effect model was used to estimate the pooled risk ratio (RRwith 95% confidence interval (CI. Results: A total of 24 studies (2,610patients were included. The drugs had similar rates of clinical cure(RR: 1.03; 95%CI: 0.98-1.08, microbiological cure (RR: 0.98; 95%CI:0.93-1.03 and mortality (RR: 1.02; 95%CI: 0.79-1.30. Teicoplaninhad lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92, red mansyndrome (RR: 0.21; 95%CI: 0.08-0.59 and total adverse events (RR:0.73; 95%CI: 0.53-1.00. Teicoplanin reduced the risk of nephrotoxicity(RR: 0.66; 95%CI: 0.48-0.90. This effect was consistent for patientsreceiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88 or havingvancomycin doses corrected by serum levels (RR: 0.22; 95%CI:0.10-0.52. There were no cases of acute kidney injury needingdialysis. Limitations: Studies lacked a standardized definition fornephrotoxicity. Conclusions: Teicoplanin and vancomycin are equallyeffective; however the incidence of nephrotoxicity and other adverseevents was lower with teicoplanin. It may be reasonable to considerteicoplanin for patients at higher risk for acute kidney injury.

  14. Emergency physician performed tricuspid annular plane systolic excursion in the evaluation of suspected pulmonary embolism. (United States)

    Daley, James; Grotberg, John; Pare, Joseph; Medoro, Amanda; Liu, Rachel; Hall, Michael Kennedy; Taylor, Andrew; Moore, Christopher L


    The primary objectives were to describe the diagnostic characteristics tricuspid annular plane systolic excursion (TAPSE) for pulmonary embolism (PE) and to optimize the measurement cutoff of TAPSE for the diagnosis of PE. Secondary objectives included assessment of interrater reliability and the quantitative visual estimation of TAPSE. This is a prospective observational cohort study involving a convenience sample of patients at an urban academic emergency department. Patients underwent focused right heart echocardiogram (FOCUS) before computed tomographic angiography (CTA) for suspected PE. A total of 150 patients were enrolled, 32 of whom (21.3%) were diagnosed as having a PE. A receiver operating characteristic curve analysis yielded 2.0 cm as the optimal cutoff for TAPSE in the diagnosis of PE, with a sensitivity of 72% (95% confidence interval [CI], 53-86), a specificity of 66% (95% CI, 57-75), and an area under the curve of 0.73 (95% CI, 0.65-0.83). In patients with tachycardia or hypotension, post hoc analysis demonstrated that FOCUS is 100% (95% CI, 80-100) sensitive for PE, whereas TAPSE is 94% (95% CI, 71-99) sensitive for PE. The intraclass correlation coefficient was 0.87 (95% CI, 0.79-0.93). Emergency physicians with training in echocardiography accurately visually estimated TAPSE, with a κ statistic of 0.94 (95% CI, 0.87-0.98). Emergency physicians with training in echocardiography can reliably measure TAPSE and are able to accurately visually estimate TAPSE as either normal or abnormal. When using an abnormal cutoff of less than 2.0 cm, TAPSE has moderate diagnostic value in patients with suspected PE. On post hoc analysis, TAPSE and FOCUS appear to be highly sensitive for PE in patients with tachycardia or hypotension. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Exogenous pigment in Peyer patches of children suspected of having IBD. (United States)

    Hummel, Thalia Z; Kindermann, Angelika; Stokkers, Pieter C F; Benninga, Marc A; ten Kate, Fiebo J W


    The base of human Peyer patches of the terminal ileum has been noted to contain black granular pigment deposits, composed of titanium dioxide and aluminosilicate, which are food additives typically present in a Western diet, and pharmaceuticals. In the present study, we investigated the distribution of exogenous pigment throughout the gastrointestinal tract of children suspected of having inflammatory bowel disease (IBD), the correlation between their age and the presence and amount of pigment in Peyer patches, and its relation to pediatric IBD. Biopsies (upper and lower gastrointestinal tract) from children suspected of having IBD who underwent endoscopy, were reassessed by a blinded, expert pathologist. The amount of pigment in biopsies was scored using a semiquantitative scale (range 0 to +++). A total of 151 children were included: 62 with Crohn disease (CD), 26 with ulcerative colitis, and 63 with non-IBD. In 63 children (42%), deposits of black pigment were found only in biopsies from the terminal ileum, located in Peyer patches. A significant correlation was found between increasing age and the amount of pigment (P = 0.004). Pigment deposits were found significantly less in the patients with CD compared with those in patients with ulcerative colitis and those with non-IBD (26% vs 62% and 49%, P = 0.002). These results provide support for the hypothesis that the amount of pigment, only present in Peyer patches in the terminal ileum, becomes denser with increasing age. Absence of pigment in Peyer patches in a higher number of patients with CD suggests that microparticles may have become involved in the inflammatory process, possibly because of disrupted autophagy.

  16. The prevalence of marijuana in suspected impaired driving cases in Washington state. (United States)

    Couper, Fiona J; Peterson, Brianna L


    In December 2012, the possession and private use of limited quantities of marijuana and marijuana products became legal in the state of Washington. At the same time, the state's driving under the influence statutes were amended to include a per se level of 5 ng/mL delta(9)-tetrahydrocannabinol (THC) in whole blood for drivers aged 21 years and older. The aim of this study was to assess the effect of marijuana legalization on the prevalence of marijuana in suspected impaired driving cases. The prevalence of both active THC and its metabolite carboxy-THC detected in such cases pre-legalization was compared with the prevalence post-legalization. In 2009-2012, the average yearly percentage of cases positive for THC and carboxy-THC was 19.1% (range: 18.2-20.2%) and 27.9% (range: 26.3-28.6%), respectively. In 2013, the percentages had significantly increased to 24.9 and 40.0%, respectively (P 5 ng/mL over the 5-year period. The prevalence of alcohol and the majority of other drugs in this same population of suspected impaired drivers submitted for testing did not change during this same 5-year period-marijuana was the only drug to show such an increase in frequency. Further, this observed increase remained after the data had been normalized to account for changes in laboratory testing procedures that occurred during this time period. Future studies need be conducted to ascertain whether the observed increase has had any effect on the incidence of crashes, serious injuries and/or traffic fatalities. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  17. Disability and the Services for the Disabled in Turkey

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    Seval Cambaz Ulas


    Full Text Available In Turkey there are approximately 8.5 million (% 12.3 disabled people. While the ratio of orthopedic, visual, auditory, speech, and talking disabilities and mental disability is 2.6%, the ratio of the people who have chronic diseases is 9.7% In our country, by the beginning of 1982 Constitution, there have been a lot of legal regulations. If the services for disabled persons considered as social security-related legislation for care, healthcare, education, employment and practices; the legal regulation on the year 2005 (The Disability Law no. 5378 has covered many blankness and also evolved the services to the disabled people. However, despite these recent legal regulation it is questionable that if the services for the disabled are adequate or not. In this review, the services, which offered to the disabled people, are evaluated as the topics mentioned above. [TAF Prev Med Bull 2012; 11(4.000: 483-488

  18. Rethinking disability: the social model of disability and chronic disease

    National Research Council Canada - National Science Library

    Goering, Sara


    .... The social model of disability, by contrast, distinguishes between impairment and disability, identifying the latter as a disadvantage that stems from a lack of fit between a body and its social environment...

  19. Exploration of the academic lives of students with disabilities at South African universities: Lecturers’ perspectives

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    Oliver Mutanga


    Full Text Available Background: A decade has passed since South Africa signed and ratified the Convention on the Rights of Persons with Disabilities, a human rights treaty that protects the rights and dignity of people with disabilities. However, not much have changed for students with disabilities. Objectives: The aim of this study was to explore lecturers’ experiences with, and perspectives on, disability as well as with students with disabilities. It was hoped that this would contribute to the ongoing policy debates about diversity, inclusion and support for students with disabilities at universities.Methods: In an effort to understand the lives of students with disabilities better, a study which included students with disabilities, lecturers and disability supporting staff was conducted at two South African universities – University of the Free State and University of Venda. The paper takes a snapshot view of four lecturers and their perceptions of the lives of students with disabilities at their respective universities. Results and Conclusion: Although most disability literature report students with disabilities blaming lecturers for their failure to advance their needs, this paper highlights that the education system needs to be supportive to lecturers for the inclusive agenda to be realised. An argument is made for a more comprehensive approach towards a national disability policy in higher education involving many stakeholders. Without a broader understanding of disability, it will be difficult to engage with the complex ways in which inequalities emerge and are sustained.

  20. Service needs and service gaps among refugees with disabilities resettled in the United States. (United States)

    Mirza, Mansha; Heinemann, Allen W


    To examine the adequacy of existing service systems in addressing the needs of refugees with disabilities resettled in the U.S.A. A cross-disability group of eight Cambodian and seven Somali refugees were purposively selected to participate in a 2-year qualitative study in the Midwestern U.S.A. Ten disability/refugee service providers and key experts on refugee resettlement were also recruited to participate. Data sources included in-depth interviews, focus groups, participant observations and social network surveys with disabled refugees. Participant observations and semi-structured interviews were also conducted with service providers and key experts. Data were analyzed using coding procedures based on a grounded theory approach. Disabled refugee participants experienced several unmet disability-related needs and limited access to resettlement resources on account of their disability. These findings were associated with refugee service providers having limited awareness of disability rights and resources and a narrow biomedical perspective of disability. Additionally there was a disconnection between refugee and disability service systems resulting from resource limitations within agencies, mistrust between the different service entities, and a lack of cross-cultural nuance among disability service organizations. These findings contribute important insights to the literature on disability disparities. Disabled refugees resettled in the U.S.A. have many unmet needs associated with gaps in-service delivery stemming from disconnections between refugee and disability service systems.