The purpose of this historical inquiry research was to explore (a) the relationship of nursing and foundations focusing on polio from 1930 to 1959; (b) the employment and educational opportunities arising from the polio epidemics for white and black nurses, as well as the obstacles encountered; (c) the role of nursing leaders in the care of the crippled child; and (d) the effects of the resolution of the polio epidemics resulting from the polio vaccine on public attitude and on the philanthropic organizations. Relevant journals, primary and secondary sources, and personal interviews were the methods used for data collection. Because of the extraordinary community support for work related to polio, nurses were able to obtain support from foundations. This support resulted in employment and educational opportunities for bedside nursing, primarily for white nurses. Middle and upper class fear of polio enabled the development of powerful and successful private organizations to supplement the available governmental services. This research illustrates the advances that nursing has made and reminds nurses to develop and maintain strong praxis relationships, alliances with philanthropies, referrals for clients with local organizations, and a strong voice in the planning arena. 相似文献
OBJECTIVE: To evaluate whether persons with a history of poliomyelitis are at an increased risk of developing multiple sclerosis (MS). MATERIAL AND METHODS: All patients diagnosed with acute poliomyelitis in the greater capital area of Copenhagen, Denmark, between 1919 and 1954 were identified and followed with respect to MS. Information on vital status and diagnosis of sclerosis was obtained through linkage with the Danish Civil Registration System and The Danish Multiple Sclerosis Registry, respectively. Follow-up started on the date of the establishment of the Danish Civil Registration System (April 1, 1968) until death, emigration or December 31, 1996, whichever came first. The observed incidence of MS among polio patients was compared with the expected incidence calculated according to national gender, age and period specific rates of MS. RESULTS: During 149,364 years of follow-up, 19 cases of multiple sclerosis were observed among 5652 polio patients compared with 11.0 expected (SIR = 1.73 (1.04-2.74)). The increased risk of MS was most pronounced in polio patients hospitalized during adolescence. Neither gender nor the acute severity of poliomyelitis modified the risk of MS. CONCLUSION: Our results are based on small numbers of events, however the findings suggest that the polio patients might be at an increased risk of MS. 相似文献
BACKGROUND: The three major signs of hemolytic uremic syndrome (HUS) are hemolytic anemia, thrombopenia and acute renal failure. HUS is classified into Shiga toxin-mediated HUS (Stx-HUS) and non-Shiga toxin-mediated HUS (nStx-HUS). The prognosis of nStx-HUS is reported to be less favorable than that of Stx-HUS. Although the association between the prognosis and pathological characteristics of HUS have been reported such that the prognosis was considered to be poor for thrombotic microangiopathy (TMA) with predominant arterial involvement (arterial TMA), good for TMA with predominant glomerular involvement (glomerular TMA) and dependent on the extent of necrosis in cases of renal cortical necrosis, it is not yet clear whether pathological findings are also related to the renal prognosis of nStx-HUS cases. Therefore the purpose of the present paper was to analyze renal biopsy findings and prognosis for five children with nStx-HUS. METHODS: Clinical records of five cases of nStx-HUS among 74 cases of diagnosed HUS were reviewed, and information and data were summarized. RESULTS: Histological examination of the kidney led to the diagnosis of arterial TMA in three cases, and glomerular TMA and severe renal cortical necrosis in one case each. Analysis of the relationship between renal histological findings and the prognosis found that three patients with arterial TMA and one patient with severe renal cortical necrosis later developed end-stage renal failure while one patient with glomerular TMA has continued to show normal renal function. CONCLUSIONS: These findings indicate that pathological findings are closely related to the prognosis in cases of nStx-HUS. 相似文献
The role of a critical care unit in life-threatening situations is well established. The management of 52 children with acute gastroenteritis and 22 children with acute paralytic poliomyelitis as part of recent epidemics is described. The solutions to the problems in the critical care management of these 74 victims (out of a total of 6197 patients admitted during the epidemics) are discussed. 相似文献
Background: Knee-ankle-foot orthoses (KAFOs) are used by people with poliomyelitis to ambulate. Whist advances in orthotic knee joint designs for use in KAFOs such the provision of stance control capability have proven efficacy, little attention has been paid to shoe adaptations which may also improve gait.Aim: The aim of this study was to evaluate the alteration to the kinematics and temporal-spatial parameters of gait caused by the use of heel-to-toe rocker-soled footwear when ambulating with KAFOs.Method: Nine adults with a history of poliomyelitis who routinely wore KAFOs participated in the study. A heel-to-toe rocker sole was added to footwear and worn on the affected side. A three-dimensional motion capture system was used to quantify the resulting alteration to specific gait parameters.Results: Maximum hip joint extension was significantly increased (p?=?0.011), and hip abduction and adduction were both significantly reduced (p?=?0.011 and p?=?0.007, respectively) when walking with the rocker sole. A significant increase in stride length (p?=?0.035) was demonstrated but there were no significant increases in either walking speed or cadence.Conclusions: A heel-to-toe rocker sole adaptation may be useful for walking in patients with poliomyelitis who use KAFOs.
Implications for Rehabilitation
The poor functionality and difficulty in walking when using an orthotic device such as a KAFO which keeps the knee locked during ambulation, plus the significant energy required to walk, are complications of orthoses using.
Little evidence exists regarding the biomechanical effect of walking with a KAFO incorporating fixed knee joints, in conjunction with rocker-soled footwear.
The main aim of walking with a heel-to-toe rocker sole is to facilitate forward progression of the tibia when used with an AFO or KAFO or to provide easier walking for patients who have undergone an ankle arthrodesis.
In this study, a rocker sole profile adaptation produced no significant alteration to hip joint flexion, but hip joint maximum extension was significantly increased in subjects suffering from poliomyelitis, and maximum hip adduction and abduction were both significantly reduced.
The most significant alterations were seen in stride length, and although there was a significant increase in this parameter, there was no statistically significant increase in walking velocity or cadence.