book of life

            Visual impairments include people who never had any visual function, those who had normal vision for a time before becoming gradually/ suddenly partially or totally blind, those with disabilities in addition with the visual loss, those with impairments of parts of the visual field, and those with a general degradation of acuity across the visual field. Persons who have visual impairments have a best corrected acuity of 20/70 or less in their better eye, or may experience difficulty with optic muscle control.
Characteristics
1. Low vision
            -limited ability to visually absorb their “out of arm’s reach” environment
            -Field of vision or muscles may be affected
            -Possible color blindness
            -Migraines headaches and/or debilitating fatigue after long periods of reading
2. Legally Blind
            A person who had visual acuity of 20/200 or less in the better eye even with correction or has a field of vision so narrow that its widest diameter subtends an angular distance no greater than 20 degrees. May not “appear” to have a visual disability, but will need accommodations in order to read printed materials and/or function within an unfamiliar environment.
3. Blindness

            Persons who are blind experience a complete lack of vision, though they may have some perception of light and colors. They often depend on their senses, such as hearing and touch, to gather information. Individuals who are blind do not always have the experience of sight from their past to assist in the recollection of data, so it is not appropriate to assume that someone who is blind is familiar with objects in the class room or in a new environment. They may use canes and/or seeing-eye dogs in order to navigate their environment.

Definition
            A sponge bath given to a person with fever.
Effects:
            1. Reduces fever or lowers body temperature.
            2. Sedative effects.
Things needed:
            1. Basin of water-temperature as indicated.
            2. Sheet or blanket to cover patient.
            3. Two bath towels.
            4. One face towel or washcloth.
            5. Ice cubes as indicated
            6. Alcohol.
> Hot sponge is given to the patients with very high fever but those skins of the legs and arms are cold. Water for hot sponge bath should be as hot as can be tolerated. The sponge bath should be done fast and with friction to encourage blood to the surface. The sponge may be repeated after 1 or 2 hours if the fever persists.
>Cold sponge bath is used in cases where the skin is dry and hot. Cold water is used for sponge bath but in case where skin is burning hot, ice cubes may be put in the water. Avoid chilling the patient. A cold compress on the forehead or armpits may be placed while the sponge is being done. Chilling with shivering will cause the temperature to rise. Sponge may be repeated or prolonged until the desired effects are obtained, or until the fever goes own.
> Tepid Sponge bath is given to restless and very tense patient with fever. It has a sedative effect, relaxing the patient. Water temperature is 94-98ºF, or comfortably warm if tested with the elbow. This time, there should be no friction or rubbing on the skin. Sponge and dry skin very gently with every little rubbing. Prolong the treatment for relaxing effect and to allow more evaporation.
> Saline sponge bath is given to patient who is inactive and sleeps most of the time. Saline salt bath has a mild tonic or stimulating effects. It makes the patient active.

About 14, 000 times a walking day, your eyes blink and you are totally blind during the blinks. However, the world doesn’t disappear during the eye blinks because of a special sensory memory, which is called iconic memory.
    Iconic memory is a form of sensory memory that automatically holds visual information for about a quarter of a second or more; as soon as you shift you attention, the information disappears.
    You don’t go blind when both eyes closed completely during a blink which is about one-third of a second because the visual scene is briefly held in iconic memory. When your eyes reopen, you don’t realized that your eyes were completely closed that was briefly stored in iconic memory. With out iconic memory, your world would disappear into darkness during eye blink.

Memory is the ability to retain information over time through the three processes: encoding (forming), storing, and retrieving. Memories are not copies but representation of the world that in accuracy and are subject to error and bias.
1. Encoding – refers to making mental representations of information so that it can be placed into our memories.
2. Storing – is the process of placing encoded information into relatively permanent mental storage for later recall. New information that is stored by making associations with old or familiar information’s is much easier to remember or retrieve.
3. Retrieving – is the process of getting or recalling information that has been placed into short-term or long-term storage.

Smoking is very closely related to Buerger’s disease and smoking history is one of the criterion for diagnosing the disease. In general if the patient absolutely abandons smoking the course of the disease will be invariably benign, but if smoking continues any treatment will ultimately be futile. Though "passive smoking" has adverse effect on cardiovascular system, non smokers should never develop the disease. Active smokers can be indentified by measuring levels of continine, the major metabolite of nicotine in urine. Since all smokers do not develop the disease an immunopathogenesis is considered probable. It has been proposed in Japanese that presence of a gene linked to some HLA antigens might control the susceptibility to the disease.

Socioeconomic conditions, work environment may also play in etiology as the disease is seen more in out door and manual workers. Hypercoagulable state has been observed in association with the disease. Hepatitis B Virus and rickettssiosis may contribute to pathogenesis, but this role is uncertain.

Buergers disease is an inflammatry occlusive disease which involves all layers of medium sized and small arteries of the extremitiles. Involved superficial veins bear a close resemblance to those in the affected artery. Majority of the patients develop critical limb ischemia with trophic lesions are distal to ankle, the anklebrachial doppler index could be normal in early stage. Toe pressures can be measured and if it is less than 30 mm Hg, the healing of ulcers is unlikely. The disease though commences peripherally, may gradually extend proximately occluding the larger arteries.

VASCULAR ASSOCIATES OF BANGALORE NEWSLETTER

    A mood disorder is a prolonged and disturbed emotional state that affects almost all of the person’s thoughts, feelings, and behaviors. Most of us experienced a continuum of moods, with depression on one end and elation on the other. However, think of the depression or blues that most of us feel as having a paper cut on our finger. Then major depression is most like having to undergo open heart surgery. It’s some of the worst news that you can get.
1. Major depressive disorder – is marked by at least two weeks of continually being in a bad mood, having no interest in anything, and getting no pleasure from activities. In addition, problems with eating, sleeping, thinking, concentrating, or making decisions, lacking energy, thinking about suicide and feeling worthless or guilty.
2. Bipolar disorder – is marked by fluctuations between episodes of depression and mania. A manic episode goes on for at least for a week, during which a person is unusually euphoric, cheerful, and high and has at least three the following symptoms: has great self esteem, has little need for sleep, speak rapidly and frequently, has racing thoughts, is easily distracted, and pursues pleasurable activities.  
3. Dysthymic disorder – is characterized by being chronically but not continuously depressed for a period of two years. While depressed, a person experiences at least two of the following symptoms: poor appetite, insomnia, fatigue, low self-esteem, poor concentration, and feeling of hopeless.

One use of IQ scores has been helps identify individuals with metal retardation. Mental retardation refers to a substantial limitation in present functioning that is characterized by significantly sub average intellectual functioning, along with related limitations in two of ten areas, including communications, self care, home living, social skills and safety.
    Psychologist caution against using IQ scores as a sole test of mental retardation. IQ test are usually used in combination with observation of adaptive skills, which include social, home living and communication skills. On the basis of IQ scores and adaptive skills, three levels of retardation have been identified.
1. Borderline Mentally Retarded – these individuals have IQ that range from 50 to 75. With special training and education opportunities, they can learn to read and write, gain social competency, master simple occupational skills, and become self-supporting members of society. About 70% of individuals with retardation are in this category.
2. Mildly/moderately mentally retarded – These individuals have IQs that range from 35 to 50. With special training and education opportunities, they can learn to become partially independent in their everyday lives, provided they are in the family or self-help setting.
3. Severely/profoundly mentally retarded – these individuals have IQs range from 20-40. With special training and education opportunities, they can acquire limited skills in taking care of their personal needs. However, because of retarded motor and verbal abilities, they require considerable supervision their entire lives

Individuals with emotional and behavioural disorders have been referred to with a variety of terms:

·         Emotionally disturbed                                                
·         Socially maladjusted
·         Psychologically disordered
·         Emotionally handicapped
·         Psychotic
·         Seriously emotionally disturbed

The term behavioural disorder is currently and more frequently being used by many professional and parents for the ff. Reasons:

> It has greater utility for education than does the term seriously emotionally disturbed.
> It is not associated exclusively with any particular theory of causation and therefore with any particular set of intervention techniques.
> It affords  a more comprehensive assessment of the population
> It is less stigmatizing than the term serious emotional disturbance
>It is more representative of the students who are disabled by their behaviour and currently served under IDEA.

      

CHARACTERISTICS OF STUDENTS WITH BEHAVIOR DISORDER

 Intelligence and achievement

     -Academic deficits in basic academic skills and educational achievement. Typically, the student performs below expected grade level.

Intelligence and achievement·        

SOCIAL SKILLS AND INTERPERSONAL RELATIONSHIPS

                        The ability to develop and maintain interpersonal relationships during childhood and adolescence is an important predictor of present and future adjustment. Many students with emotional and behavioural disorders often experience great difficulty in making and keeping friends.

ANTISOCIAL BEHAVOUR
-                       The most common pattern of behaviour consists of antisocial behaviour, sometimes called externalizing behavioural disorder (eg. Out of seat runs around the room, disturbs peers, hits or fights, ignores the teacher, complains  excessively, steals, destroys property, argues, distorts the truth, and so forth.)

WITHDRAWN BEHAVIOUR
-          Some children are anything but aggressive. Their problem is just the opposite, too little social interaction with others. They are said to have internalizing behavioural disorders.
-          Fearful of things without reason, frequently complain of being inside or hurt and go into deep bouts of depression.
-          They are less disturbing to teachers than antisocial students, but these students is endanger of not being identified or helped.

                             

IRRESPONSIBILITY
                        Is common students will deny they did anything wrong and then confronted with evidence they blame other students.

According to Freud, every child goes through certain situations, such as nursing, bottle feeding, and toilet training, that contains potential conflicts between the child’s desire for instant satisfaction or gratification and the parent’s wishes, which may involve delaying the child’s satisfaction. How these conflicts resolve and whether the child becomes fixated at one stage because of too much or little satisfaction greatly influenced development of personality ad onset future problems.
1. Oral Stage – Time. Early infancy: first 18 months of life.
Potential conflict. The oral stage lasts for the first 18 months of life and is a time when infat’s pleasure seeking is centered on the mouth.
2. Anal Stage – Time. Early infancy: 1 ½ to 3 years.
Potential conflict. The anal stage lasts from the age of about 1 ½ to 3 and is a time when the infant’s pleasure seeking on the centered on the anus and its functions of elimination.
3. Phallic Stage – Time. Early childhood: 3-6 years.
Potential conflict. The Phallic stage lasts from the age of about 3 to 6 and is a time when the infant’s pleasure seeking on the centered on the genitals. Freud theorized that the phallic stage is particularly important for personality development because of the occurrence of the Oedipus complex which means the process in which a child completes with a parent of the same sex for the affections and pleasure of the parent of the opposite sex.
4. Latency Stage – Time. Middle and late childhood: 6-puberty.
Potential conflict. The Latency stage lasts from the age of about 6 to puberty and is a time when the child represses sexual thoughts and engages in nonsexual activities, such as developing social and intellectual skills. At puberty, sexually reappears and marks the beginning of new stage, called genital stage.
5. Genital Stage – Time. Puberty to adulthood.
Potential conflict. The Genital stage lasts from puberty to adulthood and is a time when the individual has renewed sexual desires that he or she seeks to fulfill through relationships with other people. How a person meets the conflicts of genital stage depends on how conflicts in the first three stages were developed.

1. Biological factors
          -genetic, neurological or biochemical factors, single or in combination

2. Environmental factors
          -Environmental factors are considered important in the development of emotional and behavioural disorders in all conceptual models, however professional and researchers view what behaviour is important and how it is analyzed differently.

DODGE (1993) HAS IDENTIFIED 3 PRIMARY CAUSAL FACTORS THAT CONTRIBUTE TO THE DEVELOPMENT OF CONDUCT DISORDER AND ANTISOCIAL BEHAVIOUR:             

a.      An adverse early rearing environment.
b.      An aggressive pattern of behaviour displayed on entering school.
c.       Social rejection of peers.             

1. Family/home
-          The relationship children have with their parents, particularly during the early years is critical to the way they learn to act.           

2. School
-          School is where the children spend the largest portion of their time outside the home. Teacher expectations and actions greatly affects the students life and behaviour.          

3. Society
-          Societal problems can impact on a student’s emotional and behavioural status. An impoverished environment, including poor nutrition, a disrupted family, and a sense of frustration and hopelessness may lead to aggressive, acting-out behaviour.