Self-Help Devices: Communication and Vocations

Increased understanding of the pathogenesis of acute gout has developed in the past few years. Investigators have indicated that an attack is precipitated by (1) deposition of sodium urate crystals, (2) development of an inflammatory reaction against these crystals, and (3) propagation of the inflammatory response by addition of more crystals to inflamed area.

The nature of the inborn metabolic errors of primary gout is still obscure. Studies point to a dual cause of the hyperuricemia. Until more evidence is accumulated, it seems useful to separate patients into two categories: those with overproduction and those with normal production of uric acid.     

Self-Help Devices: Communication and Vocations

The changes noted in right ventricular hypertrophy are not diagnostically specific. A general classification of the patterns can be made, but the overlap is great. The P loop and P waves are especially important, often providing clues to the presence of mitral stenosis or atrial enlargement.     

Self-Help Devices: Communication and Vocations: Stationary Work Surfaces for Wheel-Chair Patients

Mercury strain-gauge plethysmography is a simple, reliable and relatively inexpensive technic for office diagnosis and evaluation of patients with peripheral arterial disease. This method also can be applied to study of smaller arteries and sympathetic nervous system activity and evaluation of diabetic patients with peripheral neuropathy.     

Self-Help Devices

Psoriasis may affect only the nails and may be associated with arthropathy. Circulatory impairment causes many nail deformities, even total loss. The yellow nail syndrome, often accompanied by lymphedema, produces distinctive changes. Leukonychia should not be attributed to previous ill health. Beau's lines, however, do signify recent illness. Subcuticular hemorrhages probably are traumatic in most instances. Changes close to the nails may give useful evidence in diagnosis of disseminated lupus erythematosus or dermatomyositis.     

Self-Help Devices: Crutch Prescriptions: Modifications

In estimating physical impairment, accurate measurement of range of motion is essential, but other factors also must be considered. In the method of calculation described, the percentage of impairment due to limited motion is determined first, and if they are important, estimations of impairment due to pain, weakness, instability, sensory loss, or shortened extremities are added.     

Self-Help Devices: Crutch Prescriptions: Measurement

Revascularization of the ischemic heart is feasible in selected cases of coronary artery disease by implantation of the internal mammary artery into the myocardium. Of the first 78 patients undergoing Vineberg's operation at the Cleveland Clinic Hospital, 75 are alive. In 80 per cent a patent implant has been demonstrated. Direct communication between the implant and the coronary artery distal to the original obstruction is demonstrable by internal mammary arteriography.     

State of the Science: Pacemaker and Defibrillator Interference from Wireless Communication Devices

The use of wireless communication devices has increased rapidly, with current industry estimates of 50,000,000 subscribers of cellular telephone services, a number that is expected to double by the year 2000. Because wireless communication devices emit RF signals, they have the potential to interfere with implantable devices. The mechanisms of interference and the magnitude of interference must be considered in terms of the type of wireless communication device being used and the characteristics of the individual implantable device that is exposed to the RF emission of the cellular phone. This article reviews the potential effects of wireless communication devices on implantable devices and makes initial recommendations for patients with implantable devices.     

A test of the Self-Help Model: learned response to chronic illness experience

The purpose of this study was to increase understanding of the essential dynamics of learned response to chronic illness experience. A Self-Help Model was tested with 396 subjects with diagnoses of rheumatoid arthritis or arthritis-related conditions. Self-Help Model variables include disease characteristics, background inputs, monitoring, severity of illness, dependency, uncertainty, enabling skill, self-help, and life quality. Severity of illness, disease characteristics, background inputs, and monitoring explained 24% of the variance in dependency and 40% of the variance in uncertainty. Monitoring was the strongest contributor to explanation of enabling skill; however, only a small amount of the variance in enabling skill was explained, adjusted R2 = .15. Enabling skill was the strongest predictor of self-help, beta = .42, minimizing the influence of uncertainty, beta = -.23 and dependency, beta = -.10, on self-help, R2 = .55. Self-help was strongly related to life quality, beta = .62. Self-help and uncertainty explained 49% of the variance in life quality. Results suggest a basis for interventions that reduce dependency and uncertainty and enhance enabling skill.     

The Use of Computers and Augmentative and Alternative Communication Devices by Children and Young With Cerebral Palsy

The purpose of the study was to determine the use of computers and assistive devices amongst children with cerebral palsy (CP) and establish the satisfaction level of both users and educational staff. The study was carried out with 30 children with cerebral palsy. A questionnaire was designed to characterize the use of new technologies and assistive devices. Some of the questions were reserved for the teachers. Even though 29 users show some type of communication difficulty, only 4 users dispose of a computer-aided communication device, with the static symbolic board being the most widely used device (4). More than half of the participants (17) regularly use a computer, 16 of them requiring some type of assistive device. The perception of the teachers with regard to the use of Information and Communications Technologies (ICTs) in the classrooms is positive in 5 out of 6 cases. ICTs only provide assistance if their application is accompanied by the involvement of professionals and the child's social environment. The low use of Augmentative and Alternative Communication techniques along with the absence of communication codes reveal the need to establish training protocols. The inclusion of social, physical, and personal factors is considered essential in order to evaluate the needs for assistive technology.