The epistemological model of disability, and its role in understanding passive exclusion in eighteenth and nineteenth century protestant educational asylums

This article examines how the process of constructing knowledge on impairment has affected the institutional construction of an ethic of disability. Its primary finding is that the process of creating knowledge in a number of historical contexts was influenced more by traditions and the biases of philosophers and educators in order to signify moral and intellectual superiority, than by a desire to improve the lives of disabled people through education. The article illustrates this epistemological process in a case study of the development of Protestant asylums in the latter years of the nineteenth century

Parents' views on care of their very premature babies in neonatal intensive care units: a qualitative study

Background The admission of a very premature infant to the neonatal intensive care unit (NICU) is often a difficult time for parents. This paper explores parents’ views and experiences of the care for their very premature baby on NICU. Methods Parents were eligible if they had a baby born before 32 weeks gestation and cared for in a NICU, and spoke English well. 32 mothers and 7 fathers were interviewed to explore their experiences of preterm birth. Although parents’ evaluation of care in the NICU was not the aim of these interviews, all parents spoke spontaneously and at length on this topic. Results were analysed using thematic analysis. Results Overall, parents were satisfied with the care on the neonatal unit. Three major themes determining satisfaction with neonatal care emerged: 1) parents’ involvement; including looking after their own baby, the challenges of expressing breast milk, and easy access to their baby; 2) staff competence and efficiency; including communication, experience and confidence, information and explanation; and 3) interpersonal relationships with staff; including sensitive and emotional support, reassurance and encouragement, feeling like an individual. Conclusions Determinants of positive experiences of care were generally consistent with previous research. Specifically, provision of information, support for parents and increasing their involvement in the care of their baby were highlighted by parents as important in their experience of care

The HELLP syndrome: Clinical issues and management. A Review

<p>Abstract</p> <p>Background</p> <p>The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia. The present review highlights occurrence, diagnosis, complications, surveillance, corticosteroid treatment, mode of delivery and risk of recurrence.</p> <p>Methods</p> <p>Clinical reports and reviews published between 2000 and 2008 were screened using Pub Med and Cochrane databases.</p> <p>Results and conclusion</p> <p>About 70% of the cases develop before delivery, the majority between the 27th and 37th gestational weeks; the remainder within 48 hours after delivery. The HELLP syndrome may be complete or incomplete. In the Tennessee Classification System diagnostic criteria for HELLP are haemolysis with increased LDH (> 600 U/L), AST (≥ 70 U/L), and platelets < 100·10⁹/L. The Mississippi Triple-class HELLP System further classifies the disorder by the nadir platelet counts. The syndrome is a progressive condition and serious complications are frequent. Conservative treatment (≥ 48 hours) is controversial but may be considered in selected cases < 34 weeks' gestation. Delivery is indicated if the HELLP syndrome occurs after the 34th gestational week or the foetal and/or maternal conditions deteriorate. Vaginal delivery is preferable. If the cervix is unfavourable, it is reasonable to induce cervical ripening and then labour. In gestational ages between 24 and 34 weeks most authors prefer a single course of corticosteroid therapy for foetal lung maturation, either 2 doses of 12 mg betamethasone 24 hours apart or 6 mg or dexamethasone 12 hours apart before delivery. Standard corticosteroid treatment is, however, of uncertain clinical value in the maternal HELLP syndrome. High-dose treatment and repeated doses should be avoided for fear of long-term adverse effects on the foetal brain. Before 34 weeks' gestation, delivery should be performed if the maternal condition worsens or signs of intrauterine foetal distress occur. Blood pressure should be kept below 155/105 mmHg. Close surveillance of the mother should be continued for at least 48 hours after delivery.</p

Language as a multimodal phenomenon: implications for language learning, processing and evolution

Our understanding of the cognitive and neural underpinnings of language has traditionally been firmly based on spoken Indo-European languages and on language studied as speech or text. However, in face-to-face communication, language is multimodal: speech signals are invariably accompanied by visual information on the face and in manual gestures, and sign languages deploy multiple channels (hands, face and body) in utterance construction. Moreover, the narrow focus on spoken Indo-European languages has entrenched the assumption that language is comprised wholly by an arbitrary system of symbols and rules. However, iconicity (i.e. resemblance between aspects of communicative form and meaning) is also present: speakers use iconic gestures when they speak; many non-Indo-European spoken languages exhibit a substantial amount of iconicity in word forms and, finally, iconicity is the norm, rather than the exception in sign languages. This introduction provides the motivation for taking a multimodal approach to the study of language learning, processing and evolution, and discusses the broad implications of shifting our current dominant approaches and assumptions to encompass multimodal expression in both signed and spoken languages