It has been recognised for many years that the amount of health care received by physically handi... more It has been recognised for many years that the amount of health care received by physically handicapped young adults rapidly declines after they leave the paediatric services. However, little is known about their specific health needs at that stage of their lives, or how these needs may be best met by the statutory services. The results of this study indicate a considerable degree of unmet need and point to a failure by the Health Service to maintain a continuity of health care for young adults with physical handicaps. A policy is called for to set up multidisciplinary Handicapped Adult Teams, at District level, to provide a clinical service for all physically and multiply handicapped adults.
Developmental Medicine & Child Neurology, Feb 13, 2007
ABSTRACT The aims of the study were to describe the functional ability, health status, and health... more ABSTRACT The aims of the study were to describe the functional ability, health status, and health-related quality of life (HRQL) of young children with a vision impairment or blindness (VI/BL) and to examine the effect of different types of ophthalmic condition and the presence of other impairments or systemic disorders. A cross-sectional community survey of children aged 3 to 8 years with VI/BL was conducted in four areas of England using the Health Utilities Index Mark 3 system. Seventy-nine children (47 males, 32 females; mean age 6y 2mo [SD 1y 6mo]) met the selection criteria: 43% had a visual pathway condition, 38% a condition of the eye, and 19% nystagmus alone; and 61% had additional impairments/disorders. Eighty per cent had functional limitations on at least two of the following attributes: vision, hearing, speech, cognition, ambulation, dexterity, emotion, and pain. Forty-four per cent had functional limitations on four or more attributes. Children with nystagmus alone had significantly higher mean HRQL utility scores (0.80 [SD 0.26]) than children with a condition of the eye (0.45 [SD 0.33]), who, in turn, had higher scores than children with a visual pathway condition (0.05 [SD 0.33], p= 0.002). Children with an isolated VI/BL had significantly higher mean scores (0.73 [SD 0.21]) than those with additional impairments/disorders (0.09 [SD 0.34], p < 0.001). These findings underline the need for a broad assessment of each child with VI/BL and a multidisciplinary approach to care.
LONG CONTENTS: See full list and Contributors list. Contributors' list, cont... Dodge, John A... more LONG CONTENTS: See full list and Contributors list. Contributors' list, cont... Dodge, John A MD, FRCP, DCH Drake, Chris LBISt, Dip OTC Dreifuss, Fritz E MB, FRCP, FRACP Edwards, Bridget. Elkan, Judith BA, MACP Elston, John S BSc, FRCS Emond, Alan MA, MB, BChirMD, MRCP Fletcher, Patrick BSc, MSc Garralda ME MD, MPhil[Psych], FRCPsych.DPM Gillon, Raanan BA, MB, BS, FRCP, Hon RCM Goodyear, Helen M MB, ChB, MRCP Golding, Jean, Professor. Green, Stuart H MA, FRCP Harper, John I MD, MBBS, MRCP Hackmatt, John Z. Harvey, David FRCP, MD, DCH Hobbs, Chris BS, MRCP, DobstRCOG Hogan, James I. Hunt, David M FRCS Jenkins, Sue MRCP, DCH Kingsley, Mary PL MA[Lond], BSc[Lond], Dip VH Kuerndal, (nee Keating), Diana MCSP Kurtz, Zarrina MSc, MFCM Lansdown, Richard PhD, FBPsS, CPsychol Lenton, Simon. Lessing, Daniel MB, ChB, MRCP, DCH, DobstRCOG, SCMO Lethem, Jane BA, MPsychol, AFBPS Levinge, Alison Cert Ed., MPhil Ed., LGSM (MT) Logan, Stuart MB, ChB, MSc, MRCP Macfarlane, Aidan. McKinlay, Ian. Ma...
Juvenile Krabbe's disease, a neurometabolic disorder, presented as an acute demyelinating episode... more Juvenile Krabbe's disease, a neurometabolic disorder, presented as an acute demyelinating episode characterised by an abnormal gait. The neurological presentation was preceded by influenza A infection.
Journal of the British Institute of Mental Handicap (APEX), 1988
ABSTRACT It has been recognised for many years that the amount of health care received by young a... more ABSTRACT It has been recognised for many years that the amount of health care received by young adults with physical and mental handicaps rapidly declines after they leave the paediatric services. However, little is known about their specific health needs, or how these needs may be best met by the statutory services. This study indicates a considerable degree of unmet need and points to a failure by the Health Service to maintain a continuity of health care for these young people. A formal policy is called for in which multidisciplinary Teams for Adults with Handicaps are set up at district level, to provide a clinical, support, and coordination service for all adults with disabilities.
This report describes the unusual syndrome of opsoclonus-myoclonus associated with group A strept... more This report describes the unusual syndrome of opsoclonus-myoclonus associated with group A streptococcal infection in a 9-year-old Nepalese boy.
similar to Zellweger syndrome with hepatic acatalasia and absence of peroxisomes, altered content... more similar to Zellweger syndrome with hepatic acatalasia and absence of peroxisomes, altered content and redox state of cytochromes and infantile cirrhosis with hemosiderosis. Eur. J. Pediatr., 124: 261 (1977). 40. The authors thank Ms. Angela Liu and Surinder K. Khangoora for their technical assistance.
The technique of quantitative electromyography suitable for babies and young children is reviewed... more The technique of quantitative electromyography suitable for babies and young children is reviewed. The findings in 22 children with myopathic disease and 21 with neurogenic disease have been compared with the results from 25 children with no evidence of neuromuscular disease (the Apparent control group). Children with primary muscle disease had low Mean Ratios of mean amplitude/turns per second whereas those with neurogenic lesions had high Mean Ratios. The most abnormal results were found in children with muscular dystrophies and anterior horn cell disease.
An 8-year-old boy developed tremor, unsteadiness, chorea, and eye movement abnormalities on start... more An 8-year-old boy developed tremor, unsteadiness, chorea, and eye movement abnormalities on starting lamotrigine for myoclonic jerks. Investigations for a neurodegenerative disorder were negative. Symptoms and signs resolved on stopping lamotrigine. He was well and asymptomatic on follow-up after 4 years. Another 7-year-old boy who started on lamotrigine for suspected absence seizures developed abnormalities of eye movement with associated cognitive decline, which also resolved on discontinuing the medication. Eye movement abnormalities, involuntary movements, and behavioral changes appear to be unusual side effects of lamotrigine therapy.
Little is known about the health needs of physicaily handicapped young adults after they become t... more Little is known about the health needs of physicaily handicapped young adults after they become too old for the paediatric service. To assess these needs 104 young people with physical handicaps were given a medical examination and interviewed. They had diverse physical handicaps, many of which were rare (41 subjects); 45 had cerebral palsy and 18 spina bifida. Mental handicap (42 subjects) and a need for special education (28) were also diagnosed. The state of health of ali subjects was generally poor. Sixty one subjects had contractures of the lower joints and almost a quarter contractures of the upper joints; 26 had deformed feet. Consequently, many subjects (41) could not walk; only 13 could walk without difficulty. Urinary and bowel incontinence were prevalent (58 and 55 subjects, respectively) and with contractures and pressure sores resulted in skin problems (35 subjects). Kyphoscoliosis was present in 30 subjects, particularly those with spina bifida (10 out of 18), of whom one third had respiratory problems and almost half cardiac problems. Thirty one subjects had epilepsy. Many subjects (49) had difficulty communicating or some visual defect (27). Although over half the subjects had health problems that were severe enough to warrant intervention, less than a third were receiving any form of regular hospital care; regular contact with physiotherapists, speech therapists, and dentists was also poor. Moreover, the original diagnoses and prescriptions had not been reviewed regularly. Teams for handicapped adults should be set up in all district health authorities to provide a clinical and coordination service for all adults with physical and mental handicaps.
Journal of The Neurological Sciences - J NEUROL SCI, 1982
The technique of quantitative electromyography suitable for babies and young children is reviewed... more The technique of quantitative electromyography suitable for babies and young children is reviewed. The findings in 22 children with myopathic disease and 21 with neurogenic disease have been compared with the results from 25 children with no evidence of neuromuscular disease (the Apparent control group). Children with primary muscle disease had low Mean Ratios of mean amplitude/turns per second whereas those with neurogenic lesions had high Mean Ratios. The most abnormal results were found in children with muscular dystrophies and anterior horn cell disease.
It has been recognised for many years that the amount of health care received by physically handi... more It has been recognised for many years that the amount of health care received by physically handicapped young adults rapidly declines after they leave the paediatric services. However, little is known about their specific health needs at that stage of their lives, or how these needs may be best met by the statutory services. The results of this study indicate a considerable degree of unmet need and point to a failure by the Health Service to maintain a continuity of health care for young adults with physical handicaps. A policy is called for to set up multidisciplinary Handicapped Adult Teams, at District level, to provide a clinical service for all physically and multiply handicapped adults.
Developmental Medicine & Child Neurology, Feb 13, 2007
ABSTRACT The aims of the study were to describe the functional ability, health status, and health... more ABSTRACT The aims of the study were to describe the functional ability, health status, and health-related quality of life (HRQL) of young children with a vision impairment or blindness (VI/BL) and to examine the effect of different types of ophthalmic condition and the presence of other impairments or systemic disorders. A cross-sectional community survey of children aged 3 to 8 years with VI/BL was conducted in four areas of England using the Health Utilities Index Mark 3 system. Seventy-nine children (47 males, 32 females; mean age 6y 2mo [SD 1y 6mo]) met the selection criteria: 43% had a visual pathway condition, 38% a condition of the eye, and 19% nystagmus alone; and 61% had additional impairments/disorders. Eighty per cent had functional limitations on at least two of the following attributes: vision, hearing, speech, cognition, ambulation, dexterity, emotion, and pain. Forty-four per cent had functional limitations on four or more attributes. Children with nystagmus alone had significantly higher mean HRQL utility scores (0.80 [SD 0.26]) than children with a condition of the eye (0.45 [SD 0.33]), who, in turn, had higher scores than children with a visual pathway condition (0.05 [SD 0.33], p= 0.002). Children with an isolated VI/BL had significantly higher mean scores (0.73 [SD 0.21]) than those with additional impairments/disorders (0.09 [SD 0.34], p < 0.001). These findings underline the need for a broad assessment of each child with VI/BL and a multidisciplinary approach to care.
LONG CONTENTS: See full list and Contributors list. Contributors' list, cont... Dodge, John A... more LONG CONTENTS: See full list and Contributors list. Contributors' list, cont... Dodge, John A MD, FRCP, DCH Drake, Chris LBISt, Dip OTC Dreifuss, Fritz E MB, FRCP, FRACP Edwards, Bridget. Elkan, Judith BA, MACP Elston, John S BSc, FRCS Emond, Alan MA, MB, BChirMD, MRCP Fletcher, Patrick BSc, MSc Garralda ME MD, MPhil[Psych], FRCPsych.DPM Gillon, Raanan BA, MB, BS, FRCP, Hon RCM Goodyear, Helen M MB, ChB, MRCP Golding, Jean, Professor. Green, Stuart H MA, FRCP Harper, John I MD, MBBS, MRCP Hackmatt, John Z. Harvey, David FRCP, MD, DCH Hobbs, Chris BS, MRCP, DobstRCOG Hogan, James I. Hunt, David M FRCS Jenkins, Sue MRCP, DCH Kingsley, Mary PL MA[Lond], BSc[Lond], Dip VH Kuerndal, (nee Keating), Diana MCSP Kurtz, Zarrina MSc, MFCM Lansdown, Richard PhD, FBPsS, CPsychol Lenton, Simon. Lessing, Daniel MB, ChB, MRCP, DCH, DobstRCOG, SCMO Lethem, Jane BA, MPsychol, AFBPS Levinge, Alison Cert Ed., MPhil Ed., LGSM (MT) Logan, Stuart MB, ChB, MSc, MRCP Macfarlane, Aidan. McKinlay, Ian. Ma...
Juvenile Krabbe's disease, a neurometabolic disorder, presented as an acute demyelinating episode... more Juvenile Krabbe's disease, a neurometabolic disorder, presented as an acute demyelinating episode characterised by an abnormal gait. The neurological presentation was preceded by influenza A infection.
Journal of the British Institute of Mental Handicap (APEX), 1988
ABSTRACT It has been recognised for many years that the amount of health care received by young a... more ABSTRACT It has been recognised for many years that the amount of health care received by young adults with physical and mental handicaps rapidly declines after they leave the paediatric services. However, little is known about their specific health needs, or how these needs may be best met by the statutory services. This study indicates a considerable degree of unmet need and points to a failure by the Health Service to maintain a continuity of health care for these young people. A formal policy is called for in which multidisciplinary Teams for Adults with Handicaps are set up at district level, to provide a clinical, support, and coordination service for all adults with disabilities.
This report describes the unusual syndrome of opsoclonus-myoclonus associated with group A strept... more This report describes the unusual syndrome of opsoclonus-myoclonus associated with group A streptococcal infection in a 9-year-old Nepalese boy.
similar to Zellweger syndrome with hepatic acatalasia and absence of peroxisomes, altered content... more similar to Zellweger syndrome with hepatic acatalasia and absence of peroxisomes, altered content and redox state of cytochromes and infantile cirrhosis with hemosiderosis. Eur. J. Pediatr., 124: 261 (1977). 40. The authors thank Ms. Angela Liu and Surinder K. Khangoora for their technical assistance.
The technique of quantitative electromyography suitable for babies and young children is reviewed... more The technique of quantitative electromyography suitable for babies and young children is reviewed. The findings in 22 children with myopathic disease and 21 with neurogenic disease have been compared with the results from 25 children with no evidence of neuromuscular disease (the Apparent control group). Children with primary muscle disease had low Mean Ratios of mean amplitude/turns per second whereas those with neurogenic lesions had high Mean Ratios. The most abnormal results were found in children with muscular dystrophies and anterior horn cell disease.
An 8-year-old boy developed tremor, unsteadiness, chorea, and eye movement abnormalities on start... more An 8-year-old boy developed tremor, unsteadiness, chorea, and eye movement abnormalities on starting lamotrigine for myoclonic jerks. Investigations for a neurodegenerative disorder were negative. Symptoms and signs resolved on stopping lamotrigine. He was well and asymptomatic on follow-up after 4 years. Another 7-year-old boy who started on lamotrigine for suspected absence seizures developed abnormalities of eye movement with associated cognitive decline, which also resolved on discontinuing the medication. Eye movement abnormalities, involuntary movements, and behavioral changes appear to be unusual side effects of lamotrigine therapy.
Little is known about the health needs of physicaily handicapped young adults after they become t... more Little is known about the health needs of physicaily handicapped young adults after they become too old for the paediatric service. To assess these needs 104 young people with physical handicaps were given a medical examination and interviewed. They had diverse physical handicaps, many of which were rare (41 subjects); 45 had cerebral palsy and 18 spina bifida. Mental handicap (42 subjects) and a need for special education (28) were also diagnosed. The state of health of ali subjects was generally poor. Sixty one subjects had contractures of the lower joints and almost a quarter contractures of the upper joints; 26 had deformed feet. Consequently, many subjects (41) could not walk; only 13 could walk without difficulty. Urinary and bowel incontinence were prevalent (58 and 55 subjects, respectively) and with contractures and pressure sores resulted in skin problems (35 subjects). Kyphoscoliosis was present in 30 subjects, particularly those with spina bifida (10 out of 18), of whom one third had respiratory problems and almost half cardiac problems. Thirty one subjects had epilepsy. Many subjects (49) had difficulty communicating or some visual defect (27). Although over half the subjects had health problems that were severe enough to warrant intervention, less than a third were receiving any form of regular hospital care; regular contact with physiotherapists, speech therapists, and dentists was also poor. Moreover, the original diagnoses and prescriptions had not been reviewed regularly. Teams for handicapped adults should be set up in all district health authorities to provide a clinical and coordination service for all adults with physical and mental handicaps.
Journal of The Neurological Sciences - J NEUROL SCI, 1982
The technique of quantitative electromyography suitable for babies and young children is reviewed... more The technique of quantitative electromyography suitable for babies and young children is reviewed. The findings in 22 children with myopathic disease and 21 with neurogenic disease have been compared with the results from 25 children with no evidence of neuromuscular disease (the Apparent control group). Children with primary muscle disease had low Mean Ratios of mean amplitude/turns per second whereas those with neurogenic lesions had high Mean Ratios. The most abnormal results were found in children with muscular dystrophies and anterior horn cell disease.
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