By N. Gorok. Centre College, Danville Kentucky.
PROGNOSIS The prognosis of pediatric hydrocephalus is dependent more on the underlying brain morphology as well as other factors such as IVH buy cialis super active 20mg on line, ventriculitis 20mg cialis super active fast delivery, and perinatal ische- mia, than on the severity of the hydrocephalus and ventriculomegaly. The 5-year sur- vival rate of children with congenital hydrocephalus is approximately 90%. Normal intellect has been reported to range from 40% to 65%, but obviously varies widely with each speciﬁc etiology. Before the advent of the CT scan, several studies attempted to investigate the prognosis of shunted vs. In 1963, Foltz and Shurtleff performed a 5-year study of 113 hydrocephalic children of whom 65 were shunted early, and 48 were not operated on. They found that shunted children had a signiﬁcantly better survival and a higher percentage had an IQ of at least 75. In 1973, Young and colleagues performed an outcome analysis on a series of 147 shunted hydrocephalic children. They found a correlation between the width of the child’s cerebral mantle and IQ in that the IQ distribution approached a normal pattern when a cerebral mantle width of 2. Since the introduction of CT and MR imaging, there have been several studies investigating the outcomes of hydrocephalus secondary to speciﬁc etiologies. In 1985, Op Heij and colleagues followed children with congenital nonobstructive hydrocephalus and found that IQ was normal ( > 80) in 50% of cases and abnormal ( < 55) in 28%. There was no correlation with head circumference or degree of ventriculomegaly. They concluded that the degree of intellectual impairment had less to do with the severity of the hydrocephalus and more to do with the severity of underlying anomalies in the central nervous system and defects in the cytoarchitecture of the neocortex. Infants with PHH have a signiﬁcantly higher mortality rate when compared with low-birth-weight infants without PHH. The correlation between severity of PHH and neurological disabilities is less clear. Historically, the mortality for infants with Dandy–Walker malformation approached 20–30%. However, in 1990, Bindal and colleagues demonstrated a mor- tality rate of 14% in their series. Lower IQ and neurological developmental delay are seen in children with Dandy–Walker malformations, but they are thought to be related to the associated anomalies in the central nervous system.
It took us a whole hour to walk this circle in our neighborhood generic 20 mg cialis super active fast delivery, and it was wonderful generic cialis super active 20mg. Some interviewees don’t want to talk about their mo- bility problem, saying it’s “depressing,” “unhelpful,” “talking won’t make it go away,” “why bother,” “what’s the use? Research suggests that talking about disability generally improves family function, although discussing every detail of experiences and feelings is not always helpful (Olkin 1999, 124). Deciding what to say and when to say it, even within a marriage, is a balancing act. When Gerald Bernadine got his motorized scooter, he and his wife resumed their long walks and talks. Intimacy Sexual closeness remains just as important as before the mobility prob- lems, in some ways even more so. Misconceptions abound about technical sexual competence among peo- ple with mobility problems, perpetuating false stereotypes about whether people still “have sex,” even affecting physicians’ behavior (e. Erroneous assumptions are perhaps most pronounced for peo- ple with spinal cord injuries. The reporter John Hockenberry, married with children, recounted a conversation with an airline ﬂight attendant exem- plifying these prejudices. Having seen Hockenberry transfer effortlessly into his seat, the ﬂight attendant expressed admiration then added,“I guess you are the ﬁrst handicapped person I have ever seen up close.... Can you, I mean, can your body, I mean are you able to do it with a woman? Hockenberry’s simple answer would have been “yes,” but he was un- derstandably stumped by how to respond. Irving Zola, who had polio, observed, “There is the absence of a certain spontaneity in my court- ing.... There’s simply no sexy, subtle, or even fast way for me to remove my leg braces and get undressed” (1982, 149). Obesity also often accompa- nies mobility limitations—as a cause or effect. People’s body images can suffer, making them shy or embarrassed about physical closeness. My mate, Gerry, and I have been living together for thirty-three years, which is a long time, half my life.
You will find that the concluding comments often relate in some way to the introduction buy 20mg cialis super active with visa. The end of the article is also the place for details such as other sources of information purchase cialis super active 20 mg overnight delivery, advice or support. Include any contact addresses and tele phone numbers for associations, helplines or self-help groups. Presentation and submission of your article Always follow the publication’s guidelines for preparing and submitting your manuscript. ARTICLES FOR THE MEDIA 315 Summary Points ° Writing articles for the media can help to raise the profile of your profession as well as providing information for the general public. This will affect your choice of language and the type and amount of information you give. Audit Commission (1993) What Seems to be the Matter: Communication Between Hospitals and Patients. Audit Commission (1995) Setting the Records Straight: A Study of Medical Records. Citrenbaum Irresistible Communication: Creative Skills for the Health Professional. Department of Health (1995) ‘The Patient’s Charter’ and You (1995) London: HMSO. National Health Service Executive (1990) Consent to Treatment and Examination (Appendix B). National Health Service Executive (1996) The Protection and Use of Patient In formation. National Health Service Executive (1998) Preservation, Retention and Destruction of GP Medical Services Records Relating to Patients. National Health Service Executive (1999) For the Record: Managing Records in NHS Trusts and Health Authorities.
In chapter five I turn to an analysis of their model of alternative health 20mg cialis super active with mastercard. This model gives voice to the lay perspective order cialis super active 20mg otc, in contrast to existing models of alternative health which rely on physician and alternative practitioner beliefs. I extend my analysis of the potential implications for the individual of participation in alternative health care in chapter six by addressing the hitherto underdeveloped analysis of the relationship between alternative therapy use and the self. I discuss how some of the people who spoke with me used the ideology contained within this model of health to construct a healthy sense of self. In chapter seven I address the less positive impact of alternative healing ideology on identity through analysis of how these people manage the stigma associated with their participation in alternative therapies. My conclusion provides a summary of the major findings of this research, a discussion of the implications of these findings for health policy, and suggestions for future research in the growing field of the sociology of alternative forms of health and healing. I have also included an appendix of brief descriptions of the alternative therapies mentioned in this book. It is important to note that I provide these sketches solely for the benefit of those readers who may be unfamiliar with particular alternative healing techniques; in no way do I mean these descriptions to be read as definitive. Hence I have chosen the descriptions randomly from a selection of scholarly literature, popular sources, advertising pamphlets, and—in keeping with my focus on the user of alternative therapies—quotations from informant interviews. The interviews took place between 1993 and 1996 and the transcription was conducted between 1993 and 1998. The number of informants who participate in grounded theory research is in one sense irrelevant, as the unit of analysis in these cases is the concept rather than the individual (Corbin and Strauss 1990). All informants were asked to give their written consent prior to the interviews. They were informed of the purpose of the research, assured that their participation in the study was voluntary, told that they had the right to end the interview at any time and that they were not required to answer any questions they did not wish to. They were also made aware that if they decided to withdraw from the project at any time, their tapes and tran- scripts would be destroyed.
Well roles: An approach to reincorporate role theory into medical sociology safe cialis super active 20mg. Holistic physicians: Implications for the study of the medical profession cheap cialis super active 20 mg free shipping. Comparison of physician and patient perspectives on unconventional cancer therapies. International Journal of Alternative and Complementary Medicine; 10: 27–28. Perspectives on complementary and alternative health care: A collection of papers prepared for Health Canada. Industrialization and the practice of medicine: Movement and countermovement. Complementary and Alternative Medicine, Select Committee on Science and Technology [online]. There are more things in medicine and science than are dreamt of in our paradigm, practice and policy! Alternative Therapies: A report on an inquiry by the British Medical Association. Patients’ views on the factors which would influence the use of aromatherapy massage out-patient service. Use of complementary and alternative medicine among primary care patients. Belief in the efficacy of alternative medicine among general practitioners in the Netherlands. Use of alternative treatments in Denmark: Patterns of use and patients experience with treatment effects.