There is currently a unique opportunity to examine the experiences of young people who receive a second sequential cochlear implant (SCI), after only having had 1 cochlear implant (CI) for most of their lives. Eleven young people who had opted to receive an SCI were interviewed. Interpretative phenomenological analysis resulted in the identification of 6 master themes. Most participants enjoyed improved confidence and social well-being following their SCI and felt that 2 CIs were superior to 1. The majority identified themselves as hearing and deaf, but not culturally Deaf, as they strived to live in the hearing world. However, this was not without challenges and many young people experienced feelings of difference in the hearing world. These findings have clinical implications in terms of the role of clinical psychologists and other mental health professionals in CI clinics and in providing information to families making decisions about CIs. These findings add to the emergent deaf identity development literature in young people with CIs.
Background: Two simples scoring systems for a self-completed postal respiratory questionnaire were developed to identify adults who may have obstructive airways disease. The objective of this study was to validate these scoring systems.
Respiratory illness and healthcare utilization in children: the primary and secondary care interface. J.A. Cropper, T.L. Frank, P.I. Frank, M.L. Laybourn, P.C. Hannaford. #ERS Journals Ltd 2001. ABSTRACT: The aim of the present study was to quantify the healthcare utilization of a child population according to level of respiratory illness.A stratified random sample of 713 children was selected from respondents to a postal respiratory questionnaire, carried out in two general practice populations in 1993. Children were stratified into four groups according to the number of positive responses to five key questions. These groups were used as indicators of likelihood of asthma diagnosis. A search was made of these childrens9 practice records covering a 2-yr period, to include both primary and secondary healthcare.There was a significant increase across positive response groups in the proportion of children having primary and secondary care based consultations, particularly for respiratory conditions (p~0.001). There was also a significant increase in prescribing. Of those children considered to be "likely asthmatics" from their questionnaire responses, 8.1% (n~31) did not receive any primary or secondary care for a respiratory problem over the 2-yr period.As the likelihood of respiratory illness increased in this population, more demand was made upon resources for the treatment of respiratory illness. Quantification of this demand enables evidence based resource allocation decisions to be made. This method of quantification could be applied in other populations.
Aim:To examine the relationship between responses to a respiratory questionnaire and primary healthcare utilisation in children. Method: A stratified random sample of 713 children was selected from respondents to a postal respiratory questionnaire carried out in two general practice populations in 1993. Children were stratified into four groups according to the number of positive responses to five key questions. These groups were used as indicators of likelihood of asthma diagnosis. A search was made of the children's records covering a two-year period which included home visits, surgery consultations and prescribed medications.
To examine healthcare utilisation and the direct financial costs in providing medical care to a population of children aged 5-15 years with respiratory complaints. Secondarily, to assess whether these costs depended upon having specific asthma diagnosis or not.Method: A postal respiratory questionnaire was sent to the parents or guardians of all children registered with two general practices. A search of the general practice medical records over a 2-year reference period was made for a stratified random sample and results are presented for 488 children aged 5-15 years.Results: The cost of primary care lower respiratory tract consultations in children with 4-5 symptoms/risk factors was d17.02 per patient per year for those with a previous diagnosis of asthma compared with d6.08 per patient per year for those with the same number of symptoms but no diagnosis (t ¼ À4:446; Po0:001). The cost of primary care lower respiratory consultations in those with no GP diagnosis of asthma and no symptoms/risk factors was d2.25 per patient per year.Conclusions: Studies, which fail to include the costs associated with treating children with respiratory symptoms but without a formal diagnosis, will seriously underestimate the costs of treating asthmatic children.
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