Availability of specialized healthcare facilities for deaf and hard of hearing individuals.

Context: To allow a medical consultation to proceed successfully, it is essential that physicians are aware of the linguistic and cultural backgrounds of deaf and hard of hearing individuals (DHH) and related communication aspects. Some specialised healthcare facilities have emerged to respond to the specific needs of people who are DHH. Objective: This study aims to provide insight into the various types of general healthcare facilities available for DHH individuals. By sharing and comparing experiences and results improvements can be made. Design, Data Sources and Study selection: A systematic review of the literature on specialised healthcare for DHH people was performed. The following databases were searched: PubMed, Web of Science, PsycINFO, Academic Search Premier, CINAHL and Embase. After independent extraction per article by two readers, fifteen articles were included in the systematic review. As it appeared that not all existing locations of facilities of which we were aware were described in the literature, we expanded the data collection with internet searches, specific literature searches and unstructured interviews. Results: Some countries have developed facilities to meet the needs DHH people Experts and patients’ groups report that the perceived quality of healthcare and health education in specialised healthcare settings is higher compared to regular healthcare settings. Two projects undertaken to improve the health related knowledge level of DHH people, proved to be effective. Conclusion: Some facilities or combinations of facilities are used in different countries to attempt to meet the needs of DHH patients. These facilities are rarely described in the scientific literature. Further development of specialised healthcare facilities for DHH patients, which should include high quality studies on their effectiveness, is imperative to comply with medical ethical standards and respect the human rights of DHH people

Prevalence of overweight in Dutch children with Down syndrome

OBJECTIVE Prevalence of overweight in children is increasing, causing various health problems. This study aims to establish growth references for weight and to assess the prevalence rates of overweight and obesity in a nationwide sample of Dutch children with Down syndrome (DS), taking into account the influence of comorbidity. METHODS In 2009, longitudinal growth data from Dutch children with trisomy 21 who were born after 1982 were retrospectively collected from medical records of 25 Dutch regional specialized DS centers. "Healthy" was defined as not having concomitant disorders or having only a mild congenital heart defect. Weight and BMI references were calculated by using the LMS method, and prevalence rates of overweight and obesity by using cutoff values for BMI as defined by the International Obesity Task Force. Differences in prevalence rates were tested by multilevel logistic regression analyses to adjust for gender and age. RESULTS Growth data of 1596 children with DS were analyzed. Compared with the general Dutch population, healthy children with DS were more often overweight (25.5% vs 13.3% in boys, and 32.0% vs 14.9% in girls) and obese (4.2% vs 1.8%, and 5.1% vs 2.2%, respectively). Prevalence rates of overweight between DS children with or without concomitant disorders did not vary significantly. CONCLUSIONS Dutch children with DS have alarmingly high prevalence rates of overweight and obesity during childhood and adolescence. Health care professionals should be aware of the risk of overweight and obesity in children with DS to prevent complications.Prevention, Population and Disease management (PrePoD

Quality of life of children with hearing loss in special and mainstream education: a longitudinal study

Objectives: To compare the quality of life (QoL) of children with hearing loss (HL) and children with normal hearing (NH) and to examine how the QoL of children with HL changes over time, considering language skills, type of hearing device, degree of HL, and type of education.Methods and materials: This longitudinal study included 62 children with HL and their parents. Developmental outcome data were collected at two time points, when the mean ages of the children were 4 and 11 years. The Pediatric Quality of Life (PedsQL (TM)) questionnaire, which includes assessments of Physical, Emotional, Social, and School functioning, was completed by parents at both time points and by the children with HL at the second time point. Receptive and expressive language skills at 4 years were assessed by the Reynell Developmental Language Scale. Results were compared with a Dutch normative sample.Results: The QoL of children with HL was similar to that of children with NH at both time points on two of the four QoL scales, Emotional and Physical functioning. On the other two scales, Social and School functioning, children with HL who attended special education and children who switched to mainstream education showed lower scores than children with HL who were consistently in mainstream education and lower scores than children with NH. The School QoL of children with HL decreased over time, as did the School QoL of children with NH. Social QoL of children with cochlear implants decreased over time, but this was not the case in children with hearing aids. Language skills and the degree of HL did not clinically improve the QoL over time of preschool children with HL.Conclusions: The QoL of children with HL in mainstream education and the Physical and Emotional QoL of all children with HL were satisfactory. It is essential to develop specific guidance regarding school activities for children with HL in special education and for children with HL who switch to mainstream education in order to increase their social QoL.Pathways through Adolescenc