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Handicap
Kinds of Handicap Terms modified by Handicap Selected AbstractsTETRAPLEGIA IN A PATIENT WITH HUGE HETEROTOPIC OSSIFICATION OF THE HIP JOINT AFTER TOTAL HIP ARTHROPLASTY: ADDITION OR REINFORCEMENT OF HANDICAPSJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2003Satoshi Ishikawa MD No abstract is available for this article. [source] Voice profile after type I or II laser chordectomies for T1a glottic carcinomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 11 2009Elisabeth V. Sjögren MD Abstract Background Can a "typical" voice in terms of auditory perception be defined after type I or II chordectomy? Do other parameters in a multidimensional voice protocol correlate to this perceptual profile? Methods Voice evaluation using a multidimensional voice protocol including perceptual (GRBAS; grade, roughness, breathiness, asthenia, strain scale), acoustic, aerodynamic, stroboscopic analyses, and self-assessment (Voice Handicap Index [VHI]) in a cohort of 37 consecutive patients with T1a midcord glottic carcinoma. Results Sixty-five percent of patients had dysphonia, dominated by mild breathiness (mean grade 1.4). Voice Handicap was minimal (mean VHI 19). Acoustic and aerodynamic parameters were only mildly deviant. The correlations between perceptual analysis and the other parameters were weak. Conclusion The typical laser treated voice (type I or II resections) is characterized by mild breathiness in perceptual analysis. Correlations with other parameters, including patients' self assessment, are weak. Therefore, these outcomes do not form 1 integrated voice profile. This may have consequences for clinical decision-making. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Wittgenstein and the Aesthetic Robot's HandicapPHILOSOPHICAL INVESTIGATIONS, Issue 2 2005Julian Friedland Ask most any cognitive scientist working today if a digital computational system could develop aesthetic sensibility and you will likely receive the optimistic reply that this remains an open empirical question. However, I attempt to show, while drawing upon the later Wittgenstein, that the correct answer is in fact available. And it is a negative a priori. It would seem, for example, that recent computational successes in textual attribution, most notably those of Donald Foster (famed finder of Ted Kazinski a.k.a. "the Unibomber") speak favorably of the digital model's capacity to overcome the "aspect blindness" handicap in this domain. I argue however that such results are only achievable when rigid input-to-output parameters are given, and that this element is precisely what is absent in standard examples of aesthetic judgment. I thus conclude that while the connectionist model anticipated by Turing may provide the best approach for the AI project, its capacity for meeting its own sufficiency requirements is necessarily crippled by its inability to share in what can be generally referred to as the collective engagements of human solidarity. [source] Head-shaking Nystagmus Predicts Greater Dizziness HandicapTHE LARYNGOSCOPE, Issue S3 2010Simon Angeli MD No abstract is available for this article. [source] Relation between change of hearing and (modified) Amsterdam Inventory for Auditory Disability and Handicap ScoreCLINICAL OTOLARYNGOLOGY, Issue 6 2004A.G.W. Meijer This study investigates the test,retest distributions and the interval for true score change of the (modified) Amsterdam Inventory for Auditory Disability and Handicap [(m)AIAD], when the latter is used to measure the effect of an intervention. In a previous study the reliability and validity of the (m)AIAD in a cohort of hearing impaired patients were found to have satisfactory high values. In this prospective study, 66 patients underwent a tympanoplasty operation. Preoperatively and postoperatively pure tone audiometry was performed, and at the same time the subjective hearing ability was established by means of the (m)AIAD. The correlation between threshold change and score change was 0.35 (Pearson's r). Scores on the (m)AIAD had to change by at least 16 to be qualified as a true change. For only nine of 66 subjects this criterion was fulfilled. No clear relation exists, except for these nine subjects, between threshold change and score change in this patient population. The study also shows that disability questionnaires have their limitations, when using them to measure the result of a medical intervention in an individual patient. [source] Oral health-related quality of life and its relationship with health locus of control among Indian dental university studentsEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 4 2008S. Acharya Abstract Objectives:, The objectives of this study were to assess the relationship between Oral Health-Related Quality of Life (OHRQoL) and Health Locus of Control (HLC) among students in an Indian dental school. Materials and methods:, A cross sectional study design was used. Three hundred and twenty-five dental students returned completed forms containing the 14 item Oral Health Impact Profile (OHIP-14) and the 18 item Multidimensional Health Locus of Control Scale (MHLC). Results:, The results showed that the perceived OHRQoL differed among students studying in different stages of the dental course. The OHRQoL dimensions of ,Social Handicap' and ,Handicap' were significantly (P < 0.01) lower among the later years of the course than the freshman year students. There was a sharp increase in Self-reported dental problems, in particular, Malocclusion, Tooth decay, Calculus among the third year and final year students respectively. The OHIP-14 scores were significantly higher among those with self-reported oral problems. Correlation analysis between the OHIP-14 and the MHLC scores also showed a statistically significant (P < 0.01) correlation between the ,Chance' dimension of the MHLC and OHIP-14 scores. Conclusions:, The results of this study underscored the relationship between the OHRQoL and HLC and of importance of assessing health attitudes and their impact on OHRQoL among the dental student community. [source] Handicaps and the development of skills between childhood and early adolescence in young people with severe intellectual disabilitiesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 12 2005O. Chadwick Abstract Background While a number of studies have examined the development of skills in children with intellectual disabilities (ID), most have been cross-sectional, most have been concerned with particular syndromes such as Down's syndrome or autism and few have attempted to identify factors associated with improvements in skills. Methods From a sample of 111 children with severe ID who had been identified from the registers of six special schools at 4,11 years of age, 82 were traced and reassessed 5 years later at the age of 11,17 years. On both occasions, information on the children's handicaps and skills was collected by interviewing their main carers using a shortened version of the Vineland Adaptive Behaviour Scales and the Disability Assessment Schedule. Results and conclusions There were small but statistically significant improvements in Vineland age-equivalent communication and daily living skills scores, but not in Vineland Socialization scores, over the 5-year period of follow-up. This pattern of improvement was observed in most aetiological subgroups. Improvement in skills was greatest in younger children, and was associated with reductions in behaviour problems and in levels of parental stress. In spite of the improvements in age-equivalent scores, Vineland standard scores showed significant declines over the same period of time, indicating that the improvements observed were smaller than would be expected in a general population sample of children of the same age. The dangers of using standard scores or quotients to quantify the level of functioning of children with severe ID are highlighted. [source] Changes in skills for people with intellectual disability: a follow-up of the Camberwell CohortJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 1 2000J. Beadle-Brown The skills of a total population of children with severe intellectual disability and/or autism from Camberwell, South London, UK, and the initial follow-up data, taken when the subjects were adolescents and young adults ( Shah 1986), are described in the present study. Changes in skills over time are presented within the categories of communication, self-care, and educational and cognitive skills, as assessed by the Handicaps, Behaviours and Skills schedule. The results indicated that skills had improved in many areas between times 1 and 2, but that this improvement was more noticeable for the children who had been youngest at time 1. The implications of these results and predictions for a further follow-up study are discussed. [source] Living with a child with a severe orofacial handicap: experiences from the perspectives of parentsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2003Ulrika Trulsson Orofacial functions include competences/abilities such as eating, breathing, speech/language, mimicry, as well as oral health, and disturbances are common in children with rare disorders. To describe parental experiences of orofacial function and needs in children with rare disorders, in-depth interviews focusing on orofacial function were carried out with 14 parents. Interviews were transcribed verbatim and analysed in open, axial (theoretical) and selective coding processes according to Grounded Theory. Two core categories emerged from data in the analysis: ,the vulnerable family' and ,support perceived from others'. The data indicated the importance of a balance between these two core categories: the strain caused by living in a family with a child with a severe disability/handicap, and the availability of perceived support from caregivers and significant others. This balance was necessary for the parents in developing self-reliance and in reconciling themselves to their life situations. Parents described orofacial dysfunction in terms of feeding and communication problems, needs for orthodontic treatment to reduce risk of trauma or improve chewing, and drooling. Oral health issues such as dental caries and gingivitis were not mentioned. Five aspects of good professional attitude were recognized: respect, involvement, continuity, knowledge, and availability. [source] Ethical investment and the incentives for corporate environmental protection and social responsibilityCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 4 2003Iulie Aslaksen This paper addresses some interrelated questions regarding ethical investments: does ethical screening provide any incentives for improved social responsibility within firms? Are ethical screened portfolios competitive compared with conventional funds with respect to risk-adjusted return? Does the risk-adjusted return of a screened portfolio depend on the screening strategy applied? Considering ethical screening as a kind of segmentation of the equity market, it is shown that screening might create incentives for changes in firms' behaviour. The strength of this incentive depends on the relative share of screened portfolios, which in turn partially depends on the financial performance of the screened portfolios. While some theoretical arguments suggest that screening imposes a handicap compared with conventional portfolios, the empirical evidence does not suggest that screened portfolios systematically under-perform conventional portfolios. Copyright © 2003 John Wiley & Sons, Ltd and ERP Environment. [source] Epilepsy Can Be Diagnosed When the First Two Seizures Occur on the Same DayEPILEPSIA, Issue 9 2000Peter Camfield Summary: Purpose: Experts have suggested that when the first two (or more) unprovoked seizures occur on the same day, they should be considered as a single event and the diagnosis of epilepsy await a further seizure. We have studied the subsequent clinical course of children with their first two seizures on the same day ("same day" group) compared with children with their first two seizures separated by more than one day ("different day" group). Method: The Nova Scotia childhood epilepsy database documented all newly diagnosed children with epilepsy from 1977 to 1985 with follow-up in 1990 and 1991. Epilepsy was defined as two or more unprovoked seizures regardless of the interval between seizures provided that consciousness fully returned between seizures. All patients had their first seizure between the ages of 1 month and 16 years. Seizure types were restricted to partial, generalized tonic-clonic, and partial with secondary generalization. Results: Of the 490 children with partial or generalized tonic-clonic seizures and follow-up of more than 2 years, 70 had their first two or more seizures on the same day and 420 had their first two seizures on different days. Eighty percent (56 of 70) of the "same day" group subsequently had one or more further seizures with (n = 14) or without (n = 42) medication; 80.9% (340 of 420) of the "different day" group had one or more further seizures with (n = 115) or without (n = 225) medication. Seizure types were nearly identical. Cause was the same (except for fewer idiopathic "genetic" cases in the "same day" group: 1 of 70 vs. 42 of 420; p = 0.02). Rates of mental handicap and previous febrile seizures were the same. Children in the "same day" group were younger on average (60 vs. 84 months; p = 0.001) and were somewhat more likely to have neurological impairment. Outcome after 7 years average follow-up was the same: 58% of the "same day" group and 56% of the "different day" group were in remission. Conclusion: If two or more unprovoked seizures (with normal consciousness between) occur on the same day, the child appears to have epilepsy and will have a clinical course identical to that of the child with a longer time interval between the first two seizures. [source] Living with a child with a severe orofacial handicap: experiences from the perspectives of parentsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2003Ulrika Trulsson Orofacial functions include competences/abilities such as eating, breathing, speech/language, mimicry, as well as oral health, and disturbances are common in children with rare disorders. To describe parental experiences of orofacial function and needs in children with rare disorders, in-depth interviews focusing on orofacial function were carried out with 14 parents. Interviews were transcribed verbatim and analysed in open, axial (theoretical) and selective coding processes according to Grounded Theory. Two core categories emerged from data in the analysis: ,the vulnerable family' and ,support perceived from others'. The data indicated the importance of a balance between these two core categories: the strain caused by living in a family with a child with a severe disability/handicap, and the availability of perceived support from caregivers and significant others. This balance was necessary for the parents in developing self-reliance and in reconciling themselves to their life situations. Parents described orofacial dysfunction in terms of feeding and communication problems, needs for orthodontic treatment to reduce risk of trauma or improve chewing, and drooling. Oral health issues such as dental caries and gingivitis were not mentioned. Five aspects of good professional attitude were recognized: respect, involvement, continuity, knowledge, and availability. [source] A functional approach to sexual selectionFUNCTIONAL ECOLOGY, Issue 4 2007DUNCAN J. IRSCHICK Summary 1Sexual selection theory is a robust and dynamic field within evolutionary biology, yet despite decades of research, remarkably little is known of the mechanistic bases of mate choice and male competition. 2Because many aspects of sexual selection involve dynamic movements, and are physically challenging, the limits of sexual selection may be defined by key functional and physiological variables (i.e. the ,functional approach'). 3We advocate the functional approach for providing mechanistic resolution on the adaptive basis of sexual structures and signals, the nature of mate choice and how males compete, among other issues. 4An overview of recent work, highlighted in this special issue, shows that many features of sexual selection, including the outcome of male fights, the morphology and design of sexual signals, and the nature of mate choice, all appear to be dictated in large part by functional and physiological parameters. 5We argue that the functional approach provides a potent tool for resolving several unresolved issues in sexual selection theory, particularly the nature of male quality, the handicap and indicator models of sexual selection, and the basis of mate choice. [source] An emerging role for interferon in haemophiliacs with chronic hepatitis C?HAEMOPHILIA, Issue 1 2001C. Aguilar The combination of interferon (IFN) and ribavirin is the current gold standard for treatment of chronic hepatitis C virus (HCV) infection with sustained remission rates of 35,40% being achieved in haemophilic patients. A similar beneficial effect of this combined therapy has been suggested even for patients with compensated liver cirrhosis and some authors have reported a possible role for IFN and ribavirin in the prevention or delay in the development of hepatocellular carcinoma (HCC), a well known complication of HCV infection in haemophiliacs. The absence, due to design difficulties, of definite randomized controlled clinical trials remains a handicap for the routine use of specific therapy of HCV infected patients with the aim of preventing HCC. A discussion of these important issues has been performed in this paper. [source] Formal support of stroke survivors and their informal carers in the community: a cohort studyHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2008Chantal Simon PhD MSc MRCGP Abstract This cohort study, aims to explore formal care provision to stroke survivors and their informal carers in the community in the UK. An initial cohort of 105 cohabitant carers of first-time stroke patients was recruited while the stroke patient was in hospital. Structured face-to-face interviews were carried out with carers prior to discharge of the stroke patient home, at 6 weeks after discharge, and 15 months after stroke. Questionnaires included measures of psychological health (CIS-R), physical health (self-rated health), social well-being (relationship quality and Sarason's social support questionnaire), handicap of the stroke survivor (Oxford Handicap Scale) and formal community support (amount of formal support and carer satisfaction). Multiple services were involved with most survivor,carer pairs (mean 5.4; range 2,9; SD = 1.7), and 74% of carers were satisfied with formal support provided. Number of services decreased with time (5.5 versus 4.1, t = 4.201, d.f. = 52, P < 0.001, 95% confidence interval: 0.71,2.01) but not time allocated. Using stepwise linear regression, service provision early after discharge was predicted by: level of handicap, recruitment centre, carer self-rated health, number of informal supporters and other care commitments. Satisfaction was predicted by quality of informal support and activity restriction. Fifteen months after stroke, predictors of formal care were: level of handicap, quality of informal support and previous caring experience. Predictors of satisfaction were: quality of the relationship between the stroke survivor and carer, age and mood. Quality of services was good, but carers lacked information, had insufficient help and were not consulted enough. Carer distress is common, yet not currently a factor influencing support provision. Formal care provided adapts with time reflecting the importance of quality of support from friends and family rather than quantity of informal supporters. These factors should be taken into consideration when planning and providing formal support for stroke survivors and their carers. [source] Theoretical analysis of iterative signal reconstruction for impulsive noise mitigation in OFDM systemsINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 3 2010Nikola Rozic Abstract In this paper a theoretical analysis of the iterative signal reconstruction algorithm for impulsive noise mitigation in orthogonal frequency-division multiplexing (OFDM) systems is developed. The following main results are developed: first, analytical model for the total noise in the frequency domain, and second the model for the total noise probability density function (pdf) in the frequency domain, both defined for each step of the iterative reconstruction process. Finally, based on the pdf of the total noise, explicit expressions for BER in kth iteration are defined as well. The main intention of the paper is to present the approach to theoretical analysis of the iterative impulsive noise mitigation algorithm that has not yet been appeared in the literature, because the theoretical analysis of the noise pdf during iterations has been considered as too complex a problem. Analyses and analytical results presented in the paper are given for scenario with a fixed number of noise impulses per frame. However, this is not a handicap of the proposed approach, since all presented models can be used as building blocks for scenarios with other impulsive noise distributions including Bernoulli,Gaussian and Middleton's Class A. Copyright © 2009 John Wiley & Sons, Ltd. [source] Effect of oral hygiene instruction and scaling on oral malodour in a population of Turkish children with gingival inflammationINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2006C. KARA Summary. Aim., Oral malodour affects a large proportion of the population, and may cause a significant social or psychological handicap to those suffering from it. The condition has a positive correlation with the accumulation of bacterial plaque in the oral cavity. The aim of the present study was twofold: first, to determine whether oral malodour and periodontal disease parameters are associated with one another in 150 Turkish subjects (mean age ± SD = 9·1 ± 2·7 years; age range = 7,12 years); and secondly, to investigate the impact of oral hygiene instruction and scaling on oral malodour. Design., The parameters measured included whole-mouth odour judge scoring, halimeter measurements, saliva pH scores, gingival index, plaque index, and probing depth before and after the treatment procedures. Results., Odour judge scores were significantly associated with halimeter findings. However, gingival index, plaque index and probing depth were significantly associated with odour judge scores and halimeter scores. The statistical analysis revealed that periodontal treatments caused a significant reduction (P < 0·001) in volatile sulphur compound formation. Conclusion., These results suggest that, in the population studied, periodontal health and oral malodour are associated with one another. Oral malodour levels were significantly reduced after treating gingival inflammation. Thus, in order to avoid oral malodour in children, oral care should not be neglected. [source] Long-Term Effectiveness of Screening for Hearing Loss: The Screening for Auditory Impairment,Which Hearing Assessment Test (SAI-WHAT) Randomized TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010Bevan Yueh MD OBJECTIVES: To evaluate the effect of hearing screening on long-term hearing outcomes in a general population of older veterans. DESIGN: Hearing loss in the elderly is underdetected and undertreated. Routine hearing screening has been proposed, but it is not clear whether screening identifies patients who are sufficiently motivated to adhere to treatment. A four-arm randomized clinical trial was conducted to compare three screening strategies with no screening in 2,305 older veterans seeking general medical care. SETTING: Veterans Affairs Puget Sound Health Care System. INTERVENTIONS: The screening strategies were a tone-emitting otoscope, a widely used questionnaire about hearing handicap, and a combination of both tools. MEASUREMENTS: Hearing aid use 1 year after screening. RESULTS: Of participants who underwent screening with the tone-emitting otoscope, questionnaire, and combined testing, 18.6%, 59.2%, and 63.6%, respectively, screened positive for hearing loss (P<.01 for test of equality across three arms). Patients proceeded to formal audiology evaluation 14.7%, 23.0%, and 26.6% of the time in the same screening arms, compared with 10.8% in the control arm (P<.01 for test of equality across four arms). Hearing aid use 1 year after screening was 6.3%, 4.1%, and 7.4% in the same arms, compared with 3.3% in the control arm (P<.01). Hearing aid users experienced significant improvements in hearing-related function and communication ability. CONCLUSION: In older veterans, screening for hearing loss led to significantly more hearing aid use. Screening with the tone-emitting otoscope was more efficient. The results are most applicable to older populations with few cost barriers to hearing aids. [source] Singing as a handicap: the effects of food availability and weather on song output in the Australian reed warbler Acrocephalus australisJOURNAL OF AVIAN BIOLOGY, Issue 2 2005Mathew L. Berg Bird song is generally regarded as a sexually selected trait, and may represent a reliable handicap signal under at least certain conditions. Females may use the degree of male song production as a reliable cue to male condition or territory quality. We investigated the effect of supplementary feeding on song output in the migratory Australian reed warbler Acrocephalus australis. We experimentally increased the food availability on alternate days, and recorded several weather variables. We measured song rate and song length independently. Supplementary fed birds sang more on feeding days than on non-feeding days, while control birds did not show this effect. Song output was not significantly associated with any of the weather variables examined. Our results indicate that singing has the potential to serve as a reliable handicap signal to territorial food availability irrespective of the prevailing weather conditions. We discuss the role of energetic constraints and behavioural flexibility on the signaling function of song. [source] A randomized controlled trial of a community nurse-supported hospital discharge programme in older patients with chronic heart failureJOURNAL OF CLINICAL NURSING, Issue 1 2008Timothy Kwok MD Aims and objectives., To evaluate the effectiveness and cost-effectiveness of a community nurse-supported hospital discharge programme in preventing hospital re-admissions, improving functional status and handicap of older patients with chronic heart failure. Design., Randomized controlled trial; 105 hospitalized patients aged 60 years or over with chronic heart failure and history of hospital admission(s) in previous year were randomly assigned into intervention group (n = 49) and control group (n = 56) for six months. Intervention group subjects received community nurse visits before discharge, within seven days of discharge, weekly for four weeks, then monthly. Community nurse liaised closely with a designated specialist in hospital and were accessible to subjects during normal working hours. Control and intervention group subjects were followed up in the same specialist medical clinics. Primary outcome was the rate of unplanned re-admission at six months. Secondary outcomes were number of unplanned re-admissions, six-minute walking distance, London Handicap Scale and public health care and personal care costs. Results., At sixth months, the re-admission rates were not significantly different (46 vs. 57% in control subjects, p = 0·233, Chi-square test). But the median number of re-admissions tended to lower in the intervention group (0 vs. 1 in control group, p = 0·057, Mann Whitney test). Intervention group subjects had less handicap in independence (median change 0 vs. 0·5 in control subjects, p = 0·002, Mann Whitney test), but there was no difference in six-minute walking distance. There was no significant group difference in median total public health care and personal care costs. Conclusion., Community nurse-supported post-discharge programme was effective in preserving independence and was probably effective in reducing the number of unplanned re-admissions. The cost benefits to public health care were not significant. Relevance to clinical practice., Older chronic heart failure patients are likely to benefit from post-discharge community nurse intervention programmes. More comprehensive health economic evaluation needs to be undertaken. [source] Reframing applied disease stigma research: a multilevel analysis of diabetes stigma in GhanaJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 6 2006Ama de-Graft Aikins Abstract Research suggests that rural and urban Ghanaians living with uncontrolled diabetes,typified by extreme weight loss,experience HIV/AIDS-related stigma. This paper reports a multilevel analysis of this stigma within the broader context of diabetes handicap in two rural communities. Two key findings emerge. First, the content of stigma constitutes social representations of HIV/AIDS, and to internalized and projected collective attributions of protracted illness to witchcraft or sorcery. Thus the stigma experienced by people with uncontrolled diabetes is not specific to the disease category ,diabetes' and distant others affected by it. Second, extreme biophysical disruption, which precipitates misperceptions, stigma and/or discrimination, is both cause and consequence of financial destitution and psychosocial neglect. Both forms of handicap have deeper pre-stigma roots in poverty and the socio-psychological and cultural impact of long-term illness. Thus the actuality or threat of diabetes stigma has to be understood in terms of diabetes handicap, which in turn has to be understood as a product of shared responses to long-term illness in communities constantly negotiating financial, health and psychological insecurities. The scope for multifaceted/multilevel intervention is considered taking into account the biophysical and psychological impact of illness and the socio-psychological and structural realities of diabetes care in Ghana. Copyright © 2006 John Wiley & Sons, Ltd. [source] Whatever happened to biology?JOURNAL OF FAMILY THERAPY, Issue 2 2001Reconnecting family therapy with its evolutionary origins This article argues for a rapprochement between family therapy and biological science. In spite of the prevailing tendency nowadays to write biology out of the story of family therapy, it has played a central historical and conceptual role in the origin of our discipline. Family therapists may have done themselves and their patients a disservice by distancing themselves from the discipline of biology; ignorance of modern biological ideas may be a serious handicap in the practice of therapy. The gap between contemporary biology and the kind of postmodern thinking currently favoured by many therapists is not as great as it appears, and may be bridged. [source] Variation of reproductive behaviour and success of males adopting different tactics in Atlantic salmonJOURNAL OF FISH BIOLOGY, Issue 2003B. De Gaudemar Six males and five females anadromous Atlantic salmon were released in two sections of the Lapitxuri experimental stream (Southwest France), where they could reproduce naturally. Females had all the same size and age, contrary to males. We focussed our attention on the variation with time of spawning tactics and success of males. Two factors affected male spawning behaviour in the short term. An increase of the OSR increased the level of male competition around redds which resulted in a larger number of males adopting sneaking rather than fighting tactics. Changes in female activities also seemed to be detected by males, since male aggressiveness increased when females were close to oviposition. But whatever their activities, males preferentially courted the earlier spawning female when two females were active at the same time. Fighting in males was confirmed to be the most successful tactic at a given time. However, males adopting sneaking tactic at the beginning of the spawning season could dramatically increase their reproductive success in the long-term. Fighting males invested much more energy in contests than secondary males, which may constitute a handicap in terms of longevity. They could quickly lose their status or strength with time which, although placed in a situation of high OSR, resulted in greater numbers of previously low-ranking males adopting satellite and fighting tactics during the period preceding oviposition. Age more than size affected male status and reproductive success. Females seemed to select their mate directly in relation to their physiological condition, since they only attacked dull coloured males showing obvious wound marks. They also could indirectly choose their mate by repeatedly leaving the redd during the period preceding oviposition in a situation of high OSR. This behaviour might incite male competition and also promoted, by incessant attempts of secondary males to rob the more successful status of primary males, their chance to spawn with fitter males. These results emphasized the importance of environment, physiological condition and energy expenditure in allocation tactics and variations in salmon reproductive success throughout the spawning season. This led us to hypothesize that the choice of sneaking through conditional strategies might provide greater average fitness in salmon alternative life histories. [source] The Human Genome Project , threat or promise?JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2003B. Carmichael Abstract This paper reflects on some of the arguments against screening from the perspective of a relative of individuals with Fragile X syndrome. It proposes to think about intellectual disability (ID) as including a wide range of limitations beyond that of only the mental handicap. It argues that these limitations impose conditions upon both people with disabilities and their parents, as well as upon their siblings, that in various ways amount to suffering. The claim that people with disabilities are enriching the lives of their relatives is rejected. Furthermore, it is argued that those who ascribe a high moral status to people with disabilities tend to neglect that society does not make much of an effort to offer the necessary support to materialize this status. The claim that screening negatively affects the moral status of persons with ID is rebutted on grounds of the freedom of choice. [source] Racial discrimination in the Brazilian labour market: wage, employment and segregation effectsJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 8 2004Jean-Louis Arcand The social science literature has done much to document pervasive racial discrimination in Brazil and there is little doubt that a very dark colour is a handicap to social advancement. Nevertheless, very few empirical economic studies have attempted to quantify the impact of ethnic discrimination in Brazil. Using data culled from the Pesquisa National por Amostra de Domicílios (PNAD), this paper fills this void by analysing ethnic wage and employment gaps, as well as occupational segregation in Brazil, using the Oaxaca decomposition methodology. Copyright © 2004 John Wiley & Sons, Ltd. [source] Medico-legal assessment of disability in narcolepsy: an interobserver reliability studyJOURNAL OF SLEEP RESEARCH, Issue 1 2008FRANCESCA INGRAVALLO Summary Impairment because of narcolepsy strongly limits job performance, but there are no standard criteria to assess disability in people with narcolepsy and a scale of disease severity is still lacking. We explored: (1) the interobserver reliability among Italian Medical Commissions making disability and handicap benefit decisions for people with narcolepsy, searching for correlations between the recognized disability degree and patients' features; (2) the willingness to report patients to the driving licence authority and (3) possible sources of variance in judgement. Fifteen narcoleptic patients were examined by four Medical Commissions in simulated sessions. Raw agreement and interobserver reliability among Commissions were calculated for disability and handicap benefit decisions and for driving licence decisions. Levels of judgement differed on percentage of disability (P < 0.001), severity of handicap (P = 0.0007) and the need to inform the driving licence authority (P = 0.032). Interobserver reliability ranged from Kappa = ,0.10 to 0.35 for disability benefit decision and from Kappa = ,0.26 to 0.36 for handicap benefit decision. The raw agreement on driving licence decision ranged from 73% to 100% (Kappa not calculable). Spearman's correlation between percentages of disability and patients' features showed correlations with age, daytime naps, sleepiness, cataplexy and quality of life. This first interobserver reliability study on social benefit decisions for narcolepsy shows the difficulty of reaching an agreement in this field, mainly because of variance in interpretation of the assessment criteria. The minimum set of indicators of disease severity correlating with patients' self assessments encourages a disability classification of narcolepsy. [source] Rehabilitation of surgical cancer patients at University of Texas M. D. Anderson Cancer CenterJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2007Rajesh Yadav MD Abstract With early detection and treatment, survival rates for many types of cancer have improved. Long term survivors have number of issues, which can include functional deficits, pain, fatigue, lymphedema and altered bowel and bladder function. Simple activities such as mobility and the ability to perform self care can be limited. In addition, re-integration into society with activities such as driving, social interaction and return to work are often problematic. The goal of cancer rehabilitation is to improve quality of life by minimizing disability and handicap caused by cancer and associated treatments. Initial rehabilitation interventions usually occur in an inpatient setting as patients often experience a decline in functional status due to cancer progression and or surgical treatment. Rehabilitation interventions reduce the debility and functional deficits and add to the quality of life for cancer patients undergoing surgical treatments. The rehabilitation team can assist not only with acute decline in functional status but also with re-integration back in society. Both general and specific rehabilitation interventions based on diagnoses are reviewed. J. Surg. Oncol. 95:361,369. © 2007 Wiley-Liss, Inc. [source] Botulinum toxin a may be efficacious as treatment for jaw tremor in Parkinson's diseaseMOVEMENT DISORDERS, Issue 10 2006Susanne A. Schneider MD Abstract Jaw tremor in Parkinson's disease (PD) may not respond well to conventional treatment. It causes embarrassment and social handicap. We piloted the use of botulinum toxin (BTX) injections in three patients with PD jaw tremor. BTX A (Dysport; mean, 53 U; range, 30,100 U) was given into each masseter muscle. Outcome was assessed by subjective and clinical improvement and by video recording before and 4 to 9 weeks after injections. There was an excellent response in all without side effects. BTX injections into the masseter may effectively improve jaw tremor and be useful in PD and other conditions. © 2006 Movement Disorder Society [source] Measuring performance status in pediatric patients with brain tumors,experience of the HIT-GBM-C protocol,,PEDIATRIC BLOOD & CANCER, Issue 3 2010Johannes E. A. Wolff MD Abstract Background Measuring the quality of life or performance status in pediatric neurooncology has proven a challenge. Here, we report in a treatment protocol for pediatric patients with high-grade glioma and diffuse intrinsic pontine glioma. Procedure The Fertigkeitenskala Münster,Heidelberg (FMH) is a 56-item quantitative measure of health status. The number of yes answers is transformed to age-dependent percentiles. Physicians were also asked the patients' health status by their own judgment on a 1,5 scale: normal, mild handicap, age-normal activity severely reduced but patient not in bed, in bed, and in ICU. Results Assessments were available from 50 of 97 eligible patients. For 22 patients both questionnaire and the physicians score obtained. At the beginning of the treatment, only 5 patients scored over 40 FMH%, and 4 of these survived. Of 16 patients who initially scored less than 40 FMH%, 15 died. During later assessments, most FMH measures became gradually worse. FMH scores improved in three patients. The physician's judgment was documented at diagnosis and during treatment (n,=,50). Per physician, 22% of the patients were normal before chemotherapy, decreasing to 16% in the middle of the protocol. At diagnosis only 16% of patients had severely reduced activity, which increased to 30.6% in the middle of the protocol. The FMH% correlated well with the physicians' judgments (P,<,0.005). Conclusion The FMH scale is easily obtained and provides a valid assessment of health status. Patients with poor performance at diagnosis had a poorer prognosis. Pediatr Blood Cancer. 2010;55:520,524. © 2010 Wiley-Liss, Inc. [source] Pregnancy outcome in fetuses with increased nuchal translucency and normal karyotypePRENATAL DIAGNOSIS, Issue 5 2002M. V. Senat Abstract Objective This study was conducted to evaluate pregnancy outcome and mid- and long-term prognosis of cases with nuchal translucency ,4,mm and normal karyotype. Methods Retrospective analysis of 160 cases who presented with a nuchal translucency ,4,mm when the CRL was between 45 and 84,mm was undertaken. Cystic hygromas were excluded. When the karyotype was normal a detailed anomaly scan was performed at 20 to 24 weeks followed by serial ultrasound examination. Clinical examination of the neonates was performed by a paediatrician. Long-term follow-up was completed through a questionnaire filled in by parents, GPs and paediatricians. Results 160 fetuses had an NT ,4,mm. 44.3% had an abnormal karyotype. Of the 55.7% with normal karyotypes, 74 % did not show any abnormalities on follow-up ultrasound scan. Mid- and long-term outcome was known in 91% of the cases. 6.4% had a malformation diagnosed only at birth. Among the normal neonates, 11.1% are considered to have a significant neurological handicap or orthopaedic problems at 12 to 72 months of age. Conclusion In an unselected population, NT ,4,mm is associated with a high incidence of chromosomal and non chromosomal abnormalities. Even when the fetal karyotype and serial ultrasound examinations are considered to be normal, the risk of fetal malformation and developmental delay should not be underestimated. Copyright © 2002 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||||||||||||||||||||