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PubMedDate not supplied

Malocclusions and traumatic injuries in disabled schoolchildren and adolescents in Kuwait.

The present study was carried out to determine the prevalence of malocclusion and traumatic injuries in disabled children and adolescents attending the special-needs schools in Kuwait. Included in the study were 818 children (438 males and 380 females), in the age groups of 3-20 years, who have visual impairment, hearing impairment, physical handicaps, or developmental disorders. The mean age of participants was 11.9 years. The survey was carried out according to the methods of WHO. The prevalence of severe malocclusion was 23.6%, and that of slight malocclusion was 37.0%. Children with Down syndrome (OR = 2.3; 95% CI = 1.51-3.52), those of increasing age (OR = 1.1; 95% CI = 1.01-1.10), and males (OR = 1.5; 95% CI = 1.05-2.07) had higher risk for the occurrence of severe malocclusion. Less than one-fifth of the subjects (16.9%) had traumatized anterior teeth. Severe malocclusion (OR = 1.8; 95% CI = 1.17-2.77) and increasing age (OR = 1.2; 95% CI = 1.13-1.26) were significant risk factors for the occurrence of traumatic injuries. We concluded that malocclusion and traumatic injuries are more prevalent among these subjects with disabilities than among the healthy population in Kuwait.

Adolescent↗
PubMed2003

Traumatised permanent teeth in 11-16-year-old Saudi Arabian children with a sensory impairment attending special schools.

- The aim of this study was to determine the prevalence of traumatised permanent teeth among sensory (visual (VI) and hearing (HI)) impaired children attending special schools in Riyadh, Saudi Arabia. All the dental injuries involved incisor teeth, and trauma was noted in 33 (6.7%) children attending government schools (control group) compared to 7 (9%) VI children and 24 (11.4%) HI children. Differences in the dental trauma only reached statistical significance between the HI and control group (P < 0.05). Gender differences were only apparent in the HI group, with males having higher levels of traumatised teeth. In addition, HI children aged 11-12 years were more prone to trauma than children in the control group of the same age (P < 0.05). In conclusion, sensory impaired children do have a tendency for more dental trauma. However, this was only statistically significant for HI children. Whereas a gender difference was most noticeable for the HI group, with males having higher levels of trauma, this was noticeable by its absence among VI children.

Adolescent↗
PubMedDate not supplied

Dentists' attitudes and practices toward provision of orthodontic treatment for children with visual and hearing impairments.

The objective of this study was to determine differences in behavior and attitudes of dentists in Riyadh, Saudi Arabia, in providing orthodontic care for children who are sensory impaired. A self-administered questionnaire was sent to all dentists working in Riyadh to assess the following domains: personal characteristics of the dentists and their practices, provision of dental care for children who are visually-impaired (Vl) and/or hearing-impaired (HI), and their attitude toward providing orthodontic care for these children. Attitudes were measured on two scales and the overall score of these two scales represented each respondent's attitude. Thirty percent of the dentists provided dental care for children with VI and 45.3 percent did for children with HI. The provision of orthodontic care was significantly affected by the country in which the dentists had received their dental training, both for children with VI and HI (p < 0.01), and by number of years they had been in practice for children with VI (p < 0.05). Regression analysis showed that only the country of dental training significantly affected the dentist's attitude score. There were also significant variations in attitudes toward the provision of orthodontic treatment for children with sensory impairment (SI), influenced by dental training and experience. In practical terms, this means that improvement in attitudes needs to be initiated at the dental undergraduate level. Establishing global guidelines for the provision of orthodontic treatment for patients with sensory impairment is likely to assist both professionals and patients.

Adult↗
PubMed2001

Dental caries experience of disabled children and young adults in Kuwait.

OBJECTIVE: The aim of the study was to assess the caries experience of disabled children and young adults in Kuwait, to set baseline data, and to determine their treatment need. METHOD: Dental caries was scored by surface in accordance with WHO criteria. The study population comprised 832 disabled children and young adults (3-29 years; mean age 12.1 years) who were visually impaired, hearing impaired, had physical handicaps or developmental disorders, attending special needs schools. RESULTS: The proportion of caries free subjects in the primary dentition (3-12-year-old children) was 11.2%. The mean dmft was 5.4, and dmfs 15.2, being highest in the Down's syndrome and lowest in the blind. The proportion of caries-free subjects in permanent dentition, over 5 years of age was 24.2%. The smallest percentage of caries-free subjects was found in the hearing impaired (16.4%) and highest percentage in the blind (35.5%). The mean DMFT was 4.5 and the DMFS 8.7, being highest in the Down's syndrome and lowest in the blind. Prevalence of untreated decay was highest in hearing impaired (86%). The caries experience of first permanent molars represented the largest proportion of the DMFT score (53.6%). In the permanent dentition increasing age, impaired hearing, and poor oral hygiene were significantly associated with caries risk. CONCLUSIONS: Caries experience among this disabled population was clearly higher than among the respective age groups in a previous national population survey. The study confirmed the need for strengthening organised preventive and restorative care for this population in Kuwait.

Adolescent↗
PubMed2005

Prevalence and burden of self-reported blindness, low vision, and visual impairment in the French community: a nationwide survey.

OBJECTIVE: To estimate the prevalence of self-reported visual impairment and its association with disabilities, handicaps, and socioeconomic consequences. METHODS: A national survey was conducted on a random stratified sample of 359 010 French citizens living in the community; 21 760 subjects were selected at random and 16 945 persons (78%) agreed to further questioning. Four thousand ninety-one randomly selected caregivers were interviewed. Four subgroups of subjects were defined (blind or light perception only, low vision or still have form perception, other visual problems, and no visual problems). These were compared after adjustment for age, comorbidity, and household size differences. RESULTS: The prevalence of blindness was 0.10% and of low vision, 1.94%. Subjects with blindness needed assistance with daily activities more often than subjects with no visual problems; they also needed more house modifications. Many subjects with blindness (46.8%) and subjects with low vision (29.0%) were registered for social allowances. Subjects with blindness had fewer paid activities (4.5%) than subjects with no visual problems (20.7%). Social allowances increased considerably (by 277) between those with low vision and those with blindness. Monthly household incomes were lower (P<.001) for subjects with low vision (1255) and blindness (1587) than for subjects with no visual problems (1851). MAIN OUTCOME MEASURES: Collected data included social demography, home description, household income, handicaps, disabilities, social allowances, and daily activities. CONCLUSION: The results demonstrate associations between self-reported visual impairment and daily living.

Activities of Daily Living↗
PubMedDate not supplied

Evidence-based guidelines on the referral of visually impaired persons to low vision services.

PURPOSE: One to two percent of the population in the Western world is visually impaired or blind. For most of these people there is no curative therapy. Therefore, the Dutch Ophthalmic Society has taken the initiative to develop an evidence-based guideline for the referral of visually impaired persons to low vision services. METHODS: A systematic literature search was performed in the Embase (1991-2001) and Medline (1966-2003) databases. Literature was searched for definitions of visual impairment, for physician-patient communication, and for outcome of interventions for visually impaired persons. Results of the articles that were selected were summarized and rated according to the level of evidence. Other considerations such as the current organization of rehabilitation for visually impaired persons in the Netherlands were also taken into account. RESULTS: The World Health Organization criteria were slightly adapted in order to include all people who experience problems with reading and other daily life activities due to visual impairment. A large number of recommendations were devised. Among these is that the complete diagnosis should be communicated to the patient and that a second appointment should be offered in which the diagnosis and potential treatment options are discussed again. Another recommendation is that in general visually impaired adults eligible for referral should be referred for the provision of low vision aids and that patients with complex problems or extensive rehabilitative demand should be referred to a rehabilitation center. CONCLUSIONS: This article presents a summary of the first European evidence-based guideline for the referral of visually impaired persons.

Adult↗
PubMed2005

Clinical report: use of the Canadian Occupational Performance Measure in vision technology.

BACKGROUND: The Canadian Occupational Performance Measure (COPM) has gained wide acceptance in general occupational therapy research and practice, however, the use of the COPM in assistive technology assessments and outcomes is not as well documented. PURPOSE: This clinical report discusses the utility of the COPM in assistive technology, as illustrated by the assessment and follow-up of clients requiring high technology vision aids. RESULTS: The COPM makes important contributions to the outcomes of providing vision aids. The COPM ensures a needs review that incorporates all areas of occupational performance, which in turn directs the clinician to match the technology to client needs. From a clinical perspective, the quantitative follow-up data are helpful to determine clients' improvement in occupational performance as well as their satisfaction with the assistive technology. For administrative purposes, the COPM results provides accountability to the funding agency. PRACTICE IMPLICATIONS: The COPM can be readily integrated into the assessment and follow-up of assistive technology service delivery and adds value to both components of the process.

Activities of Daily Living↗
PubMed2006

Concurrent visual and hearing impairment and risk of mortality: the National Health Interview Survey.

OBJECTIVE: To determine the association between reported concurrent visual and hearing impairment and risk of mortality. DESIGN, SETTING, AND PARTICIPANTS: Annual cross-sectional multistage area probability surveys of the US civilian noninstitutionalized population living at addressed dwellings were conducted by the National Center for Health Statistics, Hyattsville, Md. Mortality linkage with the National Death Index of participants from 1986 to 1994 was performed through 1997. Complete reported visual and hearing impairment data and survival status were available for 116 796 adults aged 18 years and older. A total of 3620 participants reported visual impairment only, 12 330 reported hearing impairment only, and 1461 reported concurrent visual and hearing impairment. MAIN OUTCOME MEASURE: Risk of mortality. RESULTS: Mortality linkage identified 8949 deaths with an average follow-up of 7.0 years. After controlling for survey design, age, marital status, educational level, self-rated health, and number of nonocular and nonauditory conditions, white participants and "other-race" participants, but not African American participants, reporting concurrent visual and hearing impairment had significantly increased risk of mortality in comparison with their counterparts reporting no impairment (white participants: hazard ratio [HR] = 1.23, 95% confidence interval [CI], 1.04-1.46 for men and HR = 1.63, 95% CI, 1.37-1.93 for women; African American participants: HR = 1.50, 95% CI, 0.94-2.40 for men and HR = 0.92, 95% CI, 0.51-1.63 for women; participants of other races: HR = 2.47, 95% CI, 1.33-4.57 for men and HR = 2.23, 95% CI, 1.01-4.90 for women). Risk of mortality was generally greater for participants reporting concurrent impairment as compared with that for participants reporting either visual impairment alone or hearing impairment alone. CONCLUSIONS: In the United States, white persons and those of other races, but not African American persons, reporting concurrent visual and hearing impairment have an increased risk of mortality. Reported concurrent impairment is an independent predictor of mortality among white persons and those of other races for both men and women.

Adolescent↗
PubMed1997

Screening for depression in low-vision elderly.

OBJECTIVE: To determine the sensitivity and specificity of the Geriatric Depression Scale (GDS) in older low-vision patients, and to compare GDS scores with the diagnosis of major depression in statistical models examining the interrelationships of vision, depression and disability. DESIGN: Cross-sectional survey. PARTICIPANTS: Community-residing older persons attending the low-vision clinic of Wills Eye Hospital, Philadelphia, PA, USA. MEASUREMENTS: Geriatric Depression Scale, DSM-III-R Checklist for Depression, Community Disability Scale and Snellen Visual Acuity. RESULTS: The sensitivity and specificity of the GDS (GDS = 11) were 63% and 77%, respectively. A receiver operating characteristic curve showed that the GDS's ability to discriminate patients with and without major depression was no better than chance. Although the GDS was limited as a screen for major depression, it was useful in statistical models examining the interrelationships of vision, depression and disability. CONCLUSION: Depressive symptoms are common among elderly patients with impaired vision attending a low-vision clinic. Although the GDS is unable to discriminate patients with and without major depression in this population, it is valuable as a continuous measure of depressive symptomatology to examine the interrelationships of vision, depression and disability.

Aged↗
PubMedDate not supplied

[Present-day positions of the clinical-and-social ophthalmology].

Outlined in the paper are the basic trends and tasks of clinical-and-social ophthalmology--research and practice related with the medical-and-social consequences of disabling visual impairments as well as of blindness and disability due to vision. They comprise: 1) A study of the epidemiological, social-and-hygienic and clinical-and-ophthalmologic aspects of blindness and disability; 2) Scientific elaboration of methodological, clinical, social and managerial positions and criteria of ophthalmologic and of medical-and-social expertise; 3) A theoretical definition of the methodological principles for medical-and-social rehabilitation of the disabled due to vision. Data are presented of the rate of blindness and disability due to ophthalmic pathologies in the Russian Federation. The modern standpoints of ophthalmologic medical-and-social expertise and rehabilitation of persons with visual lesions are elucidated.

Adult↗
PubMed1999

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Persons with Disabilities↗
PubMedDate not supplied

Use of optical aids by visually impaired students: social and cultural factors.

PURPOSE: To identify conceptions, social and cultural factors regarding the use of optical aids by visually impaired students and to present information to health and educational professionals. METHODS: Qualitative research using spontaneous theater (interactive theater modality based on improvisation) as research instrument. To analyze data, an adapted form of the collective subject discourse technique - procedures for organization of verbal data - was applied. Scenes, gestures, expressions, silences and behaviors were added to the original proposal. The study population included all visually impaired students from elementary public schools, aged 10 to 14 years who attended a resource room in a São Paulo state city. The students were examined at a university low vision service. RESULTS: Little knowledge about the impairment and difficult adaptation to use of optical aids were identified. The students' behavior showed denial of own problems, discomfort on public use of aids and lack of participation in own health decisions. CONCLUSION: Analysis through spontaneous theater session allows the professional to gather information which is not possible to acquire in the health assistance atmosphere. Needs, difficulties and barriers the users found before the prescribed treatment were identified.

Adolescent↗
PubMed2004

Disability and 6-year mortality in elderly population. Role of visual impairment.

BACKGROUND AND AIMS: We investigated the prevalence of visual impairment (VI), its determinants and its association with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Gross Mobility (GM) and 6-year mortality in elderly subjects. A cross-sectional survey in a large population randomly selected in 1992 with a 6-year mortality evaluation in Campania, a region in southern Italy. METHODS: A random sample of 1332 elderly subjects aged 65 to 95 years (mean age 74.2 +/- 6.4), selected from the electoral rolls, was interviewed by trained physicians. Self-reported visual function, socio-demographic and clinical characteristics were recorded. Disability was assessed by measuring ability in ADL, IADL and GM. RESULTS: VI was found to affect 34% of this population, with an age-related increase of mild and severe VI. VI affects ADL, IADL and GM disability. Age, diabetes and low educational level, but not comorbidity or hypertension, proved to be predictors of VI. Mortality increased with severity of VI in 38.1% of subjects with severe functional impairment (p < 0.001). The presence of VI was seen to increase the risk of mortality by 1.40 (95% CI 1.07-1.84), independently of age, sex, comorbidity, diabetes, hypertension or disability. CONCLUSIONS: This study demonstrates an association between visual impairment and disability in an elderly population, and the predictive effect of visual impairment on mortality independently of comorbidity. These results illustrate the need to eradicate avoidable blindness, in order to improve the quality of life and to prolong survival of the elderly.

Activities of Daily Living↗
PubMedDate not supplied

[Functional outcome of visually handicapped children cared for at the Department of Visual Stimulation--"Fundação Altino Ventura"].

PURPOSE: To analyze the functional outcome of visually handicapped children. METHODS: Twenty-seven children were evaluated using the standard functional PEDI test. Seventeen who attended school at "Escola Municipal Alto do Maracanã", Recife - Pernambuco, Brazil, had normal visual acuity and the other ten had visual handicap, and were cared for at Stimulation Visual Department - "Fundação Altino Ventura", in the same city. RESULTS: The children who had visual handicap showed significantly worse performance in self-care and mobility than normal children. CONCLUSION: Visual handicap may have limited the performance regarding self-care, mobility, understanding, communication, home works, in the studied group.

Activities of Daily Living↗