Marzo 2001 - Volume XX - numero 3
Focus
Habilitation counsellor, Azienda Ospedaliera, Istituti Clinici di Perfezionamento, Milano
Key words: Disability, Parental training, Rehabilitation
Little attention has been paid to the re-habilitation of the parents as an essential component of an effective rehabilitation programme. A very severe neurological prognosis as well as the pathological manifestations of disease are very difficult to accept and may prompt inappropriate responses and initiate vicious cycles. Early parental support, starting from full recognition and comprehension of the profound grief and difficulties experienced by parents, and early parental training can be beneficial to babies affected by severe neurological diseases infants and to parents themselves. Training in the daily care of their baby including nutrition, massage, bathing, verbal communication can make parents more confident in their abilities, improve child wellbeing and parent-infant communication.
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Focus
Divisione di Pediatria e Neonatologia, Ospedale di Matera
Key words: Disability, Legislation, Children, Networking
In 1992 a new law established policies and interventions to improve the care of disabled people. The implementation of the law was hampered by the scarcity of resources, the excess of discretionary role attributed to local authorities, burocracy and lack of flexibility in the provision of services. Health professionals, including practicing paediatricians, must play a proactive role in ensuring the application of the principles of the law. They should provide information to patients and their families and promote, even on a single-case basis, effective networking among the various professionals involved.
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Focus
Divisione di Pediatria degli Ospedali Riuniti di Reggio Calabria
Key words: Nutrition, Disability, Oropharyngeal function, Enteral nutrition (EN), Gastroesophageal reflux (GER), Gastrostomy
As many as 90% of severely disabled children suffer from nutritional problems. Deglutition problems and gastroesophageal reflux hamper nutrition and cause frequent lower respiratory infections. Malnutrition follows in many cases. Appropriate management is based on early assessment of oropharyngeal function, GER and nutritional status. Nutritional status can be improved by appropriate feeding techniques and enteral nutrition (EN). EN is indicated when severe feeding problems or severe GER are present. The article also discusses the indications for gastrostomy or jejunostomy are discussed and provides recommendations for minimizing the risk of aspiration, bacterial contamination and ostruction of the EN tube.
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Focus
1Unità Operativa di Ortopedia Pediatrica; Ospedale dei Bambini “Vittore Buzzi”, Milano
2Laboratorio di Analisi della postura e del movimento ”Luigi Divieti”, Dipartimento di Bioingegneria, Politecnico di Milano
Key words: Cerebral palsy, Orthopedics, Gait analysis, Rehabilitation
Gross motor impairment and functional disability is a constant component of cerebral palsy. Over time, hypertonia or hypotonia may cause bone deformities and joint dislocations, which cause further impairment and functional problems. Quantitative functional assessment through gait analysis is a new technique which provides useful guidance for functional rehabilitation programmes and allows a precise evaluation of orthotic, surgical or pharmacological treatments.
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