174例聋幼儿助听效果动态观察

为评价聋幼儿配戴助听器后语言分辨能力,使用全国聋儿听觉言语康复评估题库中听觉评估内容评估助听效果。经3个学期跟踪观察,声场下助听音频测试助听补偿范围无明显差异(P>0.05);最大言语识别率有显著性差异(P<0.01)。结论:1)聋幼儿配戴助听器后必须经过听觉言语训练,才能逐步建立起助听后阈上听觉功能。2)言语测听为听觉言语康复训练提供最直接最重要的评价指标。     

Low vision services in South Devon: a multi-agency, multi-disciplinary approach.

Since 1994, the Low Vision Service in South Devon has been provided by a multi-agency, multi-disciplinary team. The team comprises of staff from Devon Social Services Sensory Team, Optima Low Vision Services Ltd, Royal National Institute for the Blind (RNIB) Manor House, Devon and Torbay Special Education Services and South Devon Healthcare Trust. In the 9 years of operation this service has been independently audited twice for patient satisfaction levels and compliance level in the use of low vision aids (LVAs). The results of the most recent service audit questionnaire reveal a high and constant patient satisfaction level with 92% of patients who answered the question reporting that the service was sufficient to meet their needs. The number of patients who used LVAs at least weekly was 88% of those answering the question. Plans for the future expansion of the service include the further development of interdisciplinary working.     

Managing drug reactions to sulfonamides and other drug in hiv infection: Desensitization rather than rechallenge

Drug reactions in patients with hiv infection, e.g. fever or rash, are a frequently occurring clinical problem. These side effects particularly are observed with sulfonamides; however, many other drugs have also shown to induce allergic reactions when given to patients with hiv infection. The production of hydroxylamines has been put forward as one of the explanations for these high incidence of reactions on drugs. Since sulfonamides are the first choice of therapy for the treatment and prophylaxis of Pneumocystis carinii pneumonia, several strategies have been developed to circumvent drug reactions. In general rechallenge or desensitization are recommended in literature. This article discusses the results and risks of rechallenge and desensitization with sulfonamides or other drugs, as mentioned in the literature. Furthermore preliminary results of rechallenge with a sulfonamide, which is not metabolized into hydroxylamines, are presented. From the data in the literature it is concluded that desensitization should be preferred to rechallenge.     

Cost-Effectiveness of Smoking Cessation Modalities: Comparing Apples with Oranges?

Background.Although the results of self-help and group treatments for smoking cessation are known, the cost effectiveness and participants' characteristics of these treatments remain mostly undetermined.Methods.Consecutive samples of 84 self-help manual requesters and 83 group participants in a Dutch community-based smoking cessation program were subjected to telephone interviews before treatment and after a 6-month follow-up. Participants' baseline characteristics were compared and contrasted with a random sample of nonparticipating smokers (N= 924). Cost effectiveness rates were computed from the perspectives of the society, the steering group, and the participants.Results.Participants appeared to be more “hardcore smokers” than nonparticipants. Self-help manual requesters seemed easier quitters than group participants. Self-help was at least three times as cost effective as group treatment from the perspective of the program provider and over four times as cost effective from the viewpoint of the participants. When taking savings through not smoking into account, return on the social investment was positive.Conclusions.From a social perspective, the project seemed cost effective, compared with medical interventions. Since both modalities attracted different groups of smokers, cost effectiveness comparisons may incorporate the comparison of apples with oranges, and referral to either modality should be based on smokers' characteristics and the societal value placed on health as well.     

A selective look at self-help groups in the United States

Government health policies in the United States have emphasized private business and professional solutions, benignly neglecting self-help mutual aid. This paper presents a selective overview of the development and current situation of self-help groups (SHGs) and resource centres in the United States based on a literature review, recent interviews and the author's observations. The development of contemporary self-help groups is linked with the 1935 founding of Alcoholics Anonymous (AA). AA is a model for 100 or more other SHGs which are non-hierarchical direct democracies that avoid advocacy. The major growth of groups occurred in tandem with the civil rights and women's movements especially during and after the 1970s; both challenged bureaucracies and traditional authority. Self-help groups are often criticized for focusing on emotional support. However, major changes occurred stemming from separate self-help advocacy movements for persons with cancer, AIDS, mental illness, disabilities, alcohol problems and women's conditions. Currently, self-help resource centres which provide information and referral, among other services, are viewed as important linking organizations. The social demographic composition of self-help group members has been estimated to be disproportionately white middle class females. An active interdisciplinary network of over 200 researchers, most from academia, studies self-help mutual aid. The future of resource centres is less certain than for groups since centres have little legitimacy while requiring substantial resources. The impact of current changes in health care (e.g. managed care) on self-help mutual aid is unknown.     

The “Koach” project for treatment of combat-related PTSD: Rationale,aims, and methodology

The Koach project was designed and implemented by the Mental Health Department of the IDF (Israel Defense Forces) Medical Corps as a treatment program for chronic PTSD veterans, aimed at reducing the prevalence and severity of PTSD and accompanying psychiatric symptomatology and improving functioning in the military, the family, and the community. It was comprised of a 1-month residential phase on an army base, followed by mutual self-help groups in the veterans' communities. The project combined behavioral, cognitive, and group approaches into an integrated therapeutic program. This article presents the rationale behind the project and describes the treatment approaches that were utilized.     

Coping and adjustment to genital herpes: The effects of time and social support

The current study investigated the relationship of the passage of time and membership in a self-help group with coping behaviors and distress among people with genital herpes. A comparison between 116 people in herpes support groups and 36 community volunteers on the use of coping and level of emotional adjustment was undertaken. Results of the study indicated that people employed fewer coping strategies with increasing time since the onset of the Stressor. This pattern was particularly clear in non-support-group subjects. In comparison, support-group members did not exhibit as significant a decrease in the use of coping strategies or as great an improvement in the level of depression and degree bothered by herpes over time. Selection factors and effects of self-help group membership are discussed as alternative explanations for these differences. Future research in the area of group membership as well as helpful and nonhelpful processes in these groups is suggested.     

Near Vision Aids In Geriatric Patients With Reduced Visual Acuity

ABSTRACT The usefulness of near vision aids was studied in one hundred and forty-one patients in a geriatric hospital. The patients were over 65 years of age and had reduced vision. Where lens power exceeded +10DS spectacle lenses seldom worked well. Aspheric stand magnifiers were the most useful device in cases where greater magnification was needed. Elderly patients had difficulty in adapting to optical aids over 5X. Impaired cerebral function was the main reason for failure of the low vision aids of lower magnification.