Fibroids affect at least 20% of all women at sometime during their life. Women aged between 30 and 50 are the most likely to develop fibroids. Overweight and obese women are at significantly higher risk of developing fibroids, compared to women of normal weight. Malignant (cancerous) growths on the smooth muscles inside the womb can develop, called leiomyosarcoma of the womb. However, this is extremely rare.
What is a Fibroid?
Fibroid is a non-cancerous (benign) tumors that grow from the muscle layers of the uterus (womb). They are also known as uterine fibroids, myomas, or fibromyomas. The singular of uterine fibroids is Uterine Fibroma. Fibroids are growths of smooth muscle and fibrous tissue. Fibroids can vary in size, from that of a bean to as large as a melon.
Types of Fibroid
There are four types of Fibroid:
Intramural: These are located in the wall of the uterus. These are the most common types of fibroids.
Subserosal fibroids: These are located outside the wall of the uterus. They can develop into pedunculated fibroids (stalks). Subserosal fibroids can become quite large.
Submucosal fibroids: These are located in the muscle beneath the lining of the uterus wall.
Cervical fibroids: These are located in the neck of the womb (the cervix).
Causes of Fibroid
A fibroid starts as a single muscle cell in the uterus. For reasons that are not known, this cell changes into a fibroid tumor cell and starts to grow and multiply. Heredity may be a factor. It is thought that a muscle cell in the uterus may be "programmed" from birth to develop into a fibroid sometime perhaps many years after puberty (the start of menstrual periods). After puberty, the ovaries produce more hormones, especially estrogen. Higher levels of these hormones may help fibroids to grow, although exactly how this might happen is not understood.
Symptoms of Fibroid
The symptoms of fibroids may include:
Heavy Vaginal Bleeding: Excessively heavy or prolonged menstrual bleeding is a common symptom. Women describe soaking through sanitary protection in less than an hour, passing blood clots and being unable to leave the house during the heaviest day of flow.
Pelvic Discomfort: Women with large fibroids may feel heaviness or pressure in their lower abdomen or pelvis. Often this is described as a vague discomfort rather than a sharp pain. Sometimes, the enlarged uterus makes it difficult to lie face down, bend over or exercise without discomfort.
Pelvic Pain: A less common symptom is acute, severe pain. This occurs when a fibroid goes through a process called degeneration. Usually, the pain is localized to a specific spot and improves on its own within two to four weeks. Using a pain reliever, such as ibuprofen, can decrease the pain significantly.
Bladder Problems: The most common bladder symptom needs to urinate frequently. A woman may wake up several times during the night to empty her bladder. Occasionally, women are unable to urinate despite a full bladder.
Low Back Pain: Rarely, fibroids press against the muscles and nerves of the lower back and cause back pain. A large fibroid on the back surface of the uterus is more likely to cause back pain than a small fibroid within the uterine wall. Because back pain is so common, it is important to look for other causes of the pain before attributing it to fibroids.
Rectal Pressure: Fibroids also can press against the rectum and cause a sensation of rectal fullness, difficulty having a bowel movement or pain with bowel movements. Sometimes, fibroids can lead to the development of a hemorrhoid.
Discomfort or Pain with Sexual Intercourse: Fibroids can make sexual intercourse painful or uncomfortable. The pain may occur only in specific positions or during certain times of the menstrual cycle. Discomfort during intercourse is a significant issue. If your doctor doesn't ask you about this symptom, make sure you mention it.
Diagnosis for Fibroid
In most cases, the symptoms of fibroids are rarely felt and the patient does not know she has them. They are usually discovered during a vaginal examination. The following are the tests conducted for the diagnosis of fibroids.
Ultrasound: The doctor thinks fibroids may be present; he/she may use an ultrasound scan to find out. Ultrasound can also eliminate other possible conditions which may have similar symptoms. Ultrasound scans are often used when the patient has heavy periods and blood tests have revealed nothing conclusive.
Trans-vaginal scan: A small scanner is inserted into the patient's vagina so that the uterus can be viewed close up.
Hysteroscopy: This is a small telescope that examines the inside of the uterus. During this procedure, if necessary, a biopsy can be taken of the lining of the uterus (womb).
Laparoscopy: A laparoscope is a small device that looks at the outside of the uterus - where the doctor examines its size and shape. A laparoscope is a small flexible tube. During this procedure, if necessary, a biopsy can be taken of the outer layer of the uterus.
Biopsy: A small sample of the lining of the uterus is taken and then examined under a microscope.
Preparing for Fibroid Surgery
Your doctor/health practitioner should check whether you are pregnant, before he/she gives any treatment for fibroids. The fact that you have fibroids does not mean you are infertile; many women have had successful pregnancies with fibroids in their womb. Sometimes they are only diagnosed on for the first time during an ultrasound during pregnancy. Surgery, of any kind, can cause a disruption of the normal functioning of the body's systems. The following measures should promote general good health, thereby helping the body to be in the best shape possible for surgery. When planning for surgery, whether or not it requires a stay in the hospital, several steps can be taken to prepare both you and those around you for what is to come. Preparation can summed up in the following ways:
Doing things to promote health and eliminate unhealthy habits, such as cigarette smoking, recreational use of drugs, or excessive drinking of alcoholic beverages.
Providing your doctor with a full personal and family health history,
Deciding whether or not to donate some of your own blood for use during surgery,
Preparing your home to be as convenient as possible for your recovery,
Having some laboratory tests done, and
Doing some immediate preparation before surgery
Eat a well balanced diet, which includes plenty of fresh foods and vitamins and minerals. Vitamin C, in particular, is thought to play an important role in healing.
Provide the Doctor with information about all prescription and over-the-counter medications you have recently taken or are currently taking.
Ask friends or family to help out when you get home from the hospital. Check with your doctor about what you should or shouldn't eat before surgery
Some people choose to donate some of their own blood before surgery, which can be used to replace any blood lost during the procedure
Fibroid Surgery Procedures
When medications have not worked, the patient may have to undergo surgery. The following surgical procedures may be considered:
Hysterectomy: Hysterectomy is the surgical removal of the uterus (and usually of the cervix as well). It is the most common treatment for fibroids. Three out of every 10 hysterectomies in the United States are performed because of fibroids. Currently, hysterectomy is the only permanent cure for fibroids. However, a woman cannot become pregnant or carry a baby after having a hysterectomy. Hysterectomy is often considered when the uterus reaches the size it would be at 12 weeks of pregnancy. In the past, many doctors recommended a hysterectomy because they feared that such large fibroids could hide the presence of cancer of the uterus. A hysterectomy is usually performed through an incision in the abdomen. Sometimes the ovaries are removed in addition to the uterus and cervix. The decision to remove the ovaries depends on the woman's age and on whether the ovaries are diseased. Sometimes, for smaller fibroids, the uterus can be removed through the vagina. This is known as a vaginal hysterectomy. After a vaginal hysterectomy, the only stitches are inside the vagina. The body absorbs the stitches in four to six weeks.
Myomectomy: Myomectomy is the removal of fibroids without removing the uterus. This operation preserves a woman's ability to bear children. However, a successful pregnancy is not guaranteed. Only 4 or 5 out of 10 women become pregnant and give birth after a myomectomy. Heavy bleeding can occur when the fibroids are removed. A woman is more likely to need a blood transfusion after a myomectomy than after a hysterectomy. She is also at higher risk for problems such as infection and blood clots in the legs. Fibroids may grow back after a myomectomy, and another operation may be needed later to remove them. The risk of re-growth is related to the number, not the size, of fibroids removed. If more than three fibroids are removed, the risk of re-growth is about 50-50. Like a hysterectomy, a myomectomy is usually performed through an incision in the abdomen. The risks and recovery time are about the same as for a hysterectomy. Sometimes a myomectomy can be performed with the assistance of a laparoscope or hysteroscope.
UFE (Uterine Fibroid Embolization): Uterine fibroid embolization (UFE) is a minimally invasive treatment for fibroid tumors of the uterus. The procedure is also sometimes referred to as Uterine Artery Embolization (UAE), but this term is less specific and, as will be discussed below; UAE is used for conditions other than fibroids. Fibroid tumors, also known as myomas, are benign tumors that arise from the muscular wall of the uterus. It is extremely rare for them to turn cancerous. More commonly, they cause heavy menstrual bleeding, pain in the pelvic region, and pressure on the bladder or bowel. In a UFE procedure, physicians use an x-ray camera called a fluoroscope to guide the delivery of small particles to the uterus and fibroids. The small particles are injected through a thin, flexible tube called a catheter. These block the arteries that provide blood flow, causing the fibroids to shrink. Nearly 90 percent of women with fibroids experience relief of their symptoms. Because the effect of uterine fibroid embolization on fertility is not fully understood, UFE is typically offered to women who no longer wish to become pregnant or who want or need to avoid having a hysterectomy, which is the operation to remove the uterus.
Endometrial Ablation: This involves removing the lining of the uterus. This procedure may be used if the patient's fibroids are near the inner surface of the uterus. This procedure is considered as an effective alternative to a hysterectomy. The entire lining of the uterus (the endometrium) is removed or destroyed. The standard endometrial ablation and resection techniques are equally effective in reducing bleeding. In general, either one reduces bleeding by about half. At least 90% of women find either procedure acceptable and about three-quarters are totally or generally satisfied with the treatment. Only about 15% of women require a hysterectomy later on. Since no procedure has any particular advantage, a woman's best option may be to select the procedure based on their surgeon's skill and experience with it.
Magnetic Resonance Guided Percutaneous Laser Ablation - An MRI (magnetic resonance imaging) scan is used to locate the fibroids. Then very fine needles are inserted through the patient's skin and pushed until they reach the targeted fibroids. A fiber-optic cable is inserted through the needles. A laser light goes through the fiber-optic cable, hits the fibroids and shrinks them.
Magnetic Resonance Guided Focused Ultrasound Surgery: Is an MRI (magnetic resonance imaging) scan locates the fibroids, and then sound waves are aimed at them. This procedure also shrinks the fibroids. Most experts say Magnetic-resonance-guided percutaneous laser ablation and Magnetic-resonance-guided focused ultrasound surgery are both effective - however, there is some uncertainty regarding their benefits vs. risks.
Post Operative Care after Fibroid Surgery
Full recover will take about 2-4 weeks. When you return home, do the following to help ensure a smooth recovery:
Be sure to follow your doctor's instructions.
?
Wear sanitary pads or napkins to absorb blood. The first menstruation after the procedure may be heavier than normal.
Try to walk often. This will decrease the risk of blood clots.
Take medicines as prescribed by your doctor. If you had to stop medicines before the procedure, ask your doctor when you can start again.
Bathe or shower as normal. Gently wash the incision area with mild soap.
Ask your doctor when you will be able to:
Return to work and drive
Resume sexual activity
Resume strenuous activity (You may need to wait 2-6 weeks.)
Recovering after Fibroid Surgery
The recovery from fibroid removal may require a hospital inpatient stay of a few days and recovery can take several weeks. The following are the recovery for Hysterectomy and Myomectomy
Recovery from Hysterectomy: An abdominal hysterectomy involves a large incision and has a recovery time of 4 to 6 weeks. Laparoscopic and vaginal hysterectomies utilize small incisions reducing recovery time to 3 to 4 weeks. All hysterectomies require 2 to 3 day hospital stays, painkillers, potentially a catheter to assist with the passage for urine, and moving around to prevent blood clots.
Recovery from Myomectomy: Recovery time after a single, large incision myomectomy lasts about 4 to 6 weeks. Laparoscopic and vaginal myomectomies have shorter recovery times of 1 to 3 weeks. All mymectomies require 2 to 3 day hospital stays, painkillers, and moving around as quickly as possible to prevent blood clots.
Advance Treatment Options for Fibroid Surgery
The following are newer treatment options for Fibroid Surgery:
Embolization: This procedure shrinks fibroids by cutting off their blood supply. Guided by an X-ray image, the doctor threads a small catheter (a thin flexible tube) through a tiny incision in the groin into the main arteries that supply blood to the uterus. He or she then injects particles of inert plastic through the catheter to block these blood vessels. The uterus itself is not damaged because smaller arteries continue to supply the nutrients and oxygen it needs. The procedure takes about an hour. It may be performed with local or general anesthesia. The woman must lie flat on her back for six hours afterward to stop bleeding from the incision in the groin. Cramps in the pelvis are common, and the doctor usually prescribes a pain medication for them.
Laparoscopic Surgery: Some procedures can be performed using a laparoscope, a pencil-thin surgical telescope similar to a hysteroscope. The surgeon inserts the laparoscope and tiny surgical instruments through one or more small incision in the abdomen. If the fibroids are small and easy to reach, the surgeon makes an incision in the uterus and removes them. This is called a laparoscopic myomectomy. It may require an overnight hospital stay. When the fibroids are larger or harder to reach, the surgeon may use a laser or an electric needle to destroy or shrink them. This procedure is known as laparoscopic myolysis. Women who have this procedure done can often go home the same day.
Hysteroscopic Resection: This procedure uses a hysteroscope, a thin telescope that is inserted through the cervix. It enables the surgeon to see inside the uterus. The surgeon may then remove the fibroids with a laser or an electrical knife, wire, or probe. No incision is made. The procedure may be done with local or general anesthesia. The woman may stay overnight in the hospital or be treated as an outpatient. Full recovery takes a week or two.
Fibroid Surgery in India
India has emerged as an option abroad for Fibroid Surgery and other medical treatments for the international patients looking for low cost solutions with high quality service. Surgeons performing Fibroid Surgery in India treat with best medical facilities and provide highest successful results to these patients.
India finds the infrastructure and technology at par with that in USA, UK and Europe. Fibroid Surgery is one the common treatments for global patients coming to India. The good facilities provided in India are certainly beneficial but also the skyrocketing medical costs and long waiting lists to get treated by the specialists in the western countries are helping Indian medical tourism industry.
India has highly trained doctors to appeal to the medical tourists with a large pool of professionally qualified doctors, nurses and paramedics. The world-class facilities and infrastructure is further supported by low cost airfare and other facilities related to their stay in India in the following cities:
Mumbai
Hyderabad
Kerala
Delhi
Pune
Goa
Bangalore
Nagpur
Jaipur
Chennai
Gurgaon
Chandigarh
Cost of Fibroid surgery in India
The cost of surgery less when it is compared with the other western countries, it is relatively cheap because that is the way the international economy runs. A cost comparison of various medical treatments can give you the exact idea about the difference:
Medical Treatment
Procedure Cost (US$)
United States
India
Hysterectomy
42,000
3,300
Myomectomy
42,000
3,600
Uterine Artery Embolization
48,000
3,300
Tuesday, December 3, 2013
International day for people with disabilities 3.12.2013
Patients with disability due to Spinal cord injury
Every year, around the world, between 250 000 and 500 000 people suffer a spinal cord injury (SCI).
The majority of spinal cord injuries are due to preventable causes such as road traffic crashes, falls or violence.
People with a spinal cord injury are two to five times more likely to die prematurely than people without a spinal cord injury, with worse survival rates in low- and middle-income countries.
Spinal cord injury is associated with lower rates of school enrollment and economic participation, and it carries substantial individual and societal costs.
Understanding spinal cord injury
The term ‘spinal cord injury’ refers to damage to the spinal cord resulting from trauma (e.g. a car crash) or from disease or degeneration (e.g. cancer). There is no reliable estimate of global prevalence, but estimated annual global incidence is 40 to 80 cases per million population. Up to 90% of these cases are due to traumatic causes, though the proportion of non-traumatic spinal cord injury appears to be growing.
Symptoms of spinal cord injury depend on the severity of injury and its location on the spinal cord. Symptoms may include partial or complete loss of sensory function or motor control of arms, legs and/or body. The most severe spinal cord injury affects the systems that regulate bowel or bladder control, breathing, heart rate and blood pressure. Most people with spinal cord injury experience chronic pain.
Demographic trends
Males are most at risk in young adulthood (20-29 years) and older age (70+). Females are most at risk in adolescence (15-19) and older age (60+). Studies report male-to-female ratios of at least 2:1 among adults, sometimes much higher.
Mortality
Mortality risk is highest in the first year after injury and remains high compared to the general population. People with spinal cord injury are 2 to 5 times more likely to die prematurely than people without SCI.
Mortality risk increases with injury level and severity and is strongly influenced by availability of timely, quality medical care. Transfer method to hospital after injury and time to hospital admission are important factors.
Preventable secondary conditions (e.g. infections from untreated pressure ulcers) are no longer among the leading causes of death of people with spinal cord injury in high-income countries, but these conditions remain the main causes of death of people with spinal cord injury in low-income countries.
Health, economic and social consequences
Spinal cord injury is associated with a risk of developing secondary conditions that can be debilitating and even life-threatening—e.g. deep vein thrombosis, urinary tract infections, muscle spasms, osteoporosis, pressure ulcers, chronic pain, and respiratory complications. Acute care, rehabilitation services and ongoing health maintenance are essential for prevention and management of these conditions.
Spinal cord injury may render a person dependent on caregivers. Assistive technology is often required to facilitate mobility, communication, self-care or domestic activities. An estimated 20-30% of people with spinal cord injury show clinically significant signs of depression, which in turn has a negative impact on improvements in functioning and overall health.
Misconceptions, negative attitudes and physical barriers to basic mobility result in the exclusion of many people from full participation in society. Children with spinal cord injury are less likely than their peers to start school, and once enrolled, less likely to advance. Adults with spinal cord injury face similar barriers to economic participation, with a global unemployment rate of more than 60%.
Existing data do not allow for global cost estimates of spinal cord injury, but they do offer a general picture.
The level and severity of the injury have an important influence on costs--injuries higher up on the spinal cord (e.g. tetraplegia vs. paraplegia) incur higher costs.
Direct costs are highest in the first year after spinal cord injury onset and then decrease significantly over time.
Indirect costs, in particular lost earnings, often exceed direct costs.
Much of the cost is borne by people with spinal cord injury.
Costs of spinal cord injury are higher than those of comparable conditions such as dementia, multiple sclerosis and cerebral palsy.
Prevention
The leading causes of spinal cord injury are road traffic crashes, falls and violence (including attempted suicide). A significant proportion of traumatic spinal cord injury is due to work or sports-related injuries. Effective interventions are available to prevent several of the main causes of spinal cord injury, including improvements in roads, vehicles and people’s behaviour on the roads to avoid road traffic crashes, window guards to prevent falls, and policies to thwart the harmful use of alcohol and access to firearms to reduce violence.
Improving care and overcoming barriers
Many of the consequences associated with spinal cord injury do not result from the condition itself, but from inadequate medical care and rehabilitation services, and from barriers in the physical, social and policy environments.
Implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD) requires action to address these gaps and barriers.
Essential measures for improving the survival, health and participation of people with spinal cord injury include the following.
Timely, appropriate pre-hospital management: quick recognition of suspected spinal cord injury, rapid evaluation and initiation of injury management, including immobilization of the spine.
Acute care (including surgical intervention) appropriate to the type and severity of injury, degree of instability, presence of neural compression, and in accordance with the wishes of the patient and their family.
Access to ongoing health care, health education and products (e.g. catheters) to reduce risk of secondary conditions and improve quality of life.
Access to skilled rehabilitation and mental health services to maximize functioning, independence, overall wellbeing and community integration. Management of bladder and bowel function is of primary importance.
Access to appropriate assistive devices that can enable people to perform everyday activities they would not otherwise be able to undertake, reducing functional limitations and dependency. Only 5-15% of people in low- and middle-income countries have access to the assistive devices they need.
Specialized knowledge and skills among providers of medical care and rehabilitation services.
Essential measures to secure the right to education and economic participation include legislation, policy and programmes that promote the following:
physically accessible homes, schools, workplaces, hospitals and transportation;
inclusive education;
elimination of discrimination in employment and educational settings;
Vocational rehabilitation to optimize the chance of employment;
micro-finance and other forms of self-employment benefits to support alternative forms of economic self-sufficiency;
access to social support payments that do not act as disincentive to return to work; and
correct understanding of spinal cord injury and positive attitudes towards people living with it.
Every year, around the world, between 250 000 and 500 000 people suffer a spinal cord injury (SCI).
The majority of spinal cord injuries are due to preventable causes such as road traffic crashes, falls or violence.
People with a spinal cord injury are two to five times more likely to die prematurely than people without a spinal cord injury, with worse survival rates in low- and middle-income countries.
Spinal cord injury is associated with lower rates of school enrollment and economic participation, and it carries substantial individual and societal costs.
Understanding spinal cord injury
The term ‘spinal cord injury’ refers to damage to the spinal cord resulting from trauma (e.g. a car crash) or from disease or degeneration (e.g. cancer). There is no reliable estimate of global prevalence, but estimated annual global incidence is 40 to 80 cases per million population. Up to 90% of these cases are due to traumatic causes, though the proportion of non-traumatic spinal cord injury appears to be growing.
Symptoms of spinal cord injury depend on the severity of injury and its location on the spinal cord. Symptoms may include partial or complete loss of sensory function or motor control of arms, legs and/or body. The most severe spinal cord injury affects the systems that regulate bowel or bladder control, breathing, heart rate and blood pressure. Most people with spinal cord injury experience chronic pain.
Demographic trends
Males are most at risk in young adulthood (20-29 years) and older age (70+). Females are most at risk in adolescence (15-19) and older age (60+). Studies report male-to-female ratios of at least 2:1 among adults, sometimes much higher.
Mortality
Mortality risk is highest in the first year after injury and remains high compared to the general population. People with spinal cord injury are 2 to 5 times more likely to die prematurely than people without SCI.
Mortality risk increases with injury level and severity and is strongly influenced by availability of timely, quality medical care. Transfer method to hospital after injury and time to hospital admission are important factors.
Preventable secondary conditions (e.g. infections from untreated pressure ulcers) are no longer among the leading causes of death of people with spinal cord injury in high-income countries, but these conditions remain the main causes of death of people with spinal cord injury in low-income countries.
Health, economic and social consequences
Spinal cord injury is associated with a risk of developing secondary conditions that can be debilitating and even life-threatening—e.g. deep vein thrombosis, urinary tract infections, muscle spasms, osteoporosis, pressure ulcers, chronic pain, and respiratory complications. Acute care, rehabilitation services and ongoing health maintenance are essential for prevention and management of these conditions.
Spinal cord injury may render a person dependent on caregivers. Assistive technology is often required to facilitate mobility, communication, self-care or domestic activities. An estimated 20-30% of people with spinal cord injury show clinically significant signs of depression, which in turn has a negative impact on improvements in functioning and overall health.
Misconceptions, negative attitudes and physical barriers to basic mobility result in the exclusion of many people from full participation in society. Children with spinal cord injury are less likely than their peers to start school, and once enrolled, less likely to advance. Adults with spinal cord injury face similar barriers to economic participation, with a global unemployment rate of more than 60%.
Existing data do not allow for global cost estimates of spinal cord injury, but they do offer a general picture.
The level and severity of the injury have an important influence on costs--injuries higher up on the spinal cord (e.g. tetraplegia vs. paraplegia) incur higher costs.
Direct costs are highest in the first year after spinal cord injury onset and then decrease significantly over time.
Indirect costs, in particular lost earnings, often exceed direct costs.
Much of the cost is borne by people with spinal cord injury.
Costs of spinal cord injury are higher than those of comparable conditions such as dementia, multiple sclerosis and cerebral palsy.
Prevention
The leading causes of spinal cord injury are road traffic crashes, falls and violence (including attempted suicide). A significant proportion of traumatic spinal cord injury is due to work or sports-related injuries. Effective interventions are available to prevent several of the main causes of spinal cord injury, including improvements in roads, vehicles and people’s behaviour on the roads to avoid road traffic crashes, window guards to prevent falls, and policies to thwart the harmful use of alcohol and access to firearms to reduce violence.
Improving care and overcoming barriers
Many of the consequences associated with spinal cord injury do not result from the condition itself, but from inadequate medical care and rehabilitation services, and from barriers in the physical, social and policy environments.
Implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD) requires action to address these gaps and barriers.
Essential measures for improving the survival, health and participation of people with spinal cord injury include the following.
Timely, appropriate pre-hospital management: quick recognition of suspected spinal cord injury, rapid evaluation and initiation of injury management, including immobilization of the spine.
Acute care (including surgical intervention) appropriate to the type and severity of injury, degree of instability, presence of neural compression, and in accordance with the wishes of the patient and their family.
Access to ongoing health care, health education and products (e.g. catheters) to reduce risk of secondary conditions and improve quality of life.
Access to skilled rehabilitation and mental health services to maximize functioning, independence, overall wellbeing and community integration. Management of bladder and bowel function is of primary importance.
Access to appropriate assistive devices that can enable people to perform everyday activities they would not otherwise be able to undertake, reducing functional limitations and dependency. Only 5-15% of people in low- and middle-income countries have access to the assistive devices they need.
Specialized knowledge and skills among providers of medical care and rehabilitation services.
Essential measures to secure the right to education and economic participation include legislation, policy and programmes that promote the following:
physically accessible homes, schools, workplaces, hospitals and transportation;
inclusive education;
elimination of discrimination in employment and educational settings;
Vocational rehabilitation to optimize the chance of employment;
micro-finance and other forms of self-employment benefits to support alternative forms of economic self-sufficiency;
access to social support payments that do not act as disincentive to return to work; and
correct understanding of spinal cord injury and positive attitudes towards people living with it.
Monday, December 2, 2013
Risk of hearing loss in teens
Less than 5% of parents think their child is at risk for high-frequency hearing loss despite the silent epidemic affecting almost 20% of adolescents.
Few parents believe that their teenager is at risk of hearing loss and most parents have a poor understanding of hazardous noise exposures for adolescents. However, the 19.5% prevalence of hearing loss among 12- to 19-year-olds is comparable to the 18.4% obesity rate, which gets much more attention.
When presented with a list of activities, most only recognized headphone use with an iPod as being high-risk factor. Many other common sources of hearing loss were overlooked, such as talking on a loud cell phone, band practice, shop work, summertime lawnmower operation, and motorcycle riding.
"Certainly, many of the hearing-hazardous activities in which adolescents partake are also important components of their education, growth, and development. The goal is not to eliminate these activities but to approach them with some knowledge of the potential hearing risks and take the appropriate steps for hearing conservation.
Few parents believe that their teenager is at risk of hearing loss and most parents have a poor understanding of hazardous noise exposures for adolescents. However, the 19.5% prevalence of hearing loss among 12- to 19-year-olds is comparable to the 18.4% obesity rate, which gets much more attention.
When presented with a list of activities, most only recognized headphone use with an iPod as being high-risk factor. Many other common sources of hearing loss were overlooked, such as talking on a loud cell phone, band practice, shop work, summertime lawnmower operation, and motorcycle riding.
"Certainly, many of the hearing-hazardous activities in which adolescents partake are also important components of their education, growth, and development. The goal is not to eliminate these activities but to approach them with some knowledge of the potential hearing risks and take the appropriate steps for hearing conservation.
Risk of hearing loss in teens
Less than 5% of parents think their child is at risk for high-frequency hearing loss despite the silent epidemic affecting almost 20% of adolescents.
Few parents believe that their teenager is at risk of hearing loss and most parents have a poor understanding of hazardous noise exposures for adolescents. However, the 19.5% prevalence of hearing loss among 12- to 19-year-olds is comparable to the 18.4% obesity rate, which gets much more attention.
When presented with a list of activities, most only recognized headphone use with an iPod as being high-risk factor. Many other common sources of hearing loss were overlooked, such as talking on a loud cell phone, band practice, shop work, summertime lawnmower operation, and motorcycle riding.
"Certainly, many of the hearing-hazardous activities in which adolescents partake are also important components of their education, growth, and development. The goal is not to eliminate these activities but to approach them with some knowledge of the potential hearing risks and take the appropriate steps for hearing conservation.
Few parents believe that their teenager is at risk of hearing loss and most parents have a poor understanding of hazardous noise exposures for adolescents. However, the 19.5% prevalence of hearing loss among 12- to 19-year-olds is comparable to the 18.4% obesity rate, which gets much more attention.
When presented with a list of activities, most only recognized headphone use with an iPod as being high-risk factor. Many other common sources of hearing loss were overlooked, such as talking on a loud cell phone, band practice, shop work, summertime lawnmower operation, and motorcycle riding.
"Certainly, many of the hearing-hazardous activities in which adolescents partake are also important components of their education, growth, and development. The goal is not to eliminate these activities but to approach them with some knowledge of the potential hearing risks and take the appropriate steps for hearing conservation.
Thursday, November 28, 2013
World AIDS Day 1/12/2013- HIV and Adolescents
. More than 2 million adolescents between the ages of 10 and 19 years are living with HIV, and many do not receive the care and support that they need to stay in good health and prevent transmission. In addition, millions more adolescents are at risk of infection.
The failure to support effective and acceptable HIV services for adolescents has resulted in a 50% increase in reported AIDS-related deaths in this group compared with the 30% decline seen in the general population from 2005 to 2012.
Addressing the specific needs of adolescents
The WHO recommendations "HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV" are the first to address the specific needs of adolescents both for those living with HIV as well as those who are at risk of infection. They are being released in advance of World AIDS Day 2013 (1 December).
“Adolescents face difficult and often confusing emotional and social pressures as they grow from children into adults, “Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.”
Across sub-Saharan Africa, many who were infected at birth are becoming adolescents. In addition to the many changes associated with adolescence, they also face the challenges of living with a chronic infection: disclosing the news to friends and family and preventing transmission to sexual partners.
“Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.”
“Adolescent girls, young men who have sex with men, those who inject drugs or are subject to sexual coercion and abuse are at highest risk. They face many barriers, including harsh laws, inequalities, stigma and discrimination which prevent them from accessing services that could test, prevent, and treat HIV,”. “About one-seventh of all new HIV infections occur during adolescence. Unless the barriers are removed, the dream of an AIDS-free generation will never be realized.”
Making it easier to know HIV status
Furthermore, many young people do not know their HIV status. For example, in sub-Saharan Africa, it is estimated that only 10% of young men and 15% of young women (15-24 years) know their HIV status and, in other regions, although data is scarce, access to HIV testing and counseling by vulnerable adolescents is consistently reported as being very low.
WHO recommends governments review their laws to make it easier for adolescents to obtain HIV testing without needing consent from their parents. The guidelines also suggest ways that health services can improve the quality of care and social support for adolescents. And they highlight the value of involving this age group to create an adolescent-centered approach to the services that work for people of their age.
Better equipping adolescents
“Young people need to be better equipped to manage their HIV infection and take ownership of their health care,”. “We have seen for example in Zimbabwe that, by developing adolescent friendly services, it is possible to achieve good treatment outcomes among adolescents. We urge others to be inspired by these examples.”
To help health workers put these recommendations into practice WHO has developed a new online tool which will be launched in January 2014. It uses practical examples from country programmes that are working closely with adolescents on HIV issues.
The guidelines provide recommendations and expert suggestions – mainly for policy-makers and national programme managers – on prioritizing, planning and providing HIV testing, counselling and care services for adolescents. Designed to be used with the recent WHO consolidated Antiretroviral guidelines, these new guidelines provide complimentary recommendations and guidance to support better provision of services to help adolescents remain in care and adhere to treatment.
The guidelines were developed based on scientific evidence, community consultations with adolescents and health workers, field experience of health workers and expert opinion. WHO led the development of these guidelines in collaboration with the United Nations Children’s Fund (UNICEF), the Global Network of People Living with HIV (GNP+), the United Nations Educational, Scientific and Cultural Organization (UNESCO), and the United Nations Population Fund (UNFPA).
The failure to support effective and acceptable HIV services for adolescents has resulted in a 50% increase in reported AIDS-related deaths in this group compared with the 30% decline seen in the general population from 2005 to 2012.
Addressing the specific needs of adolescents
The WHO recommendations "HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV" are the first to address the specific needs of adolescents both for those living with HIV as well as those who are at risk of infection. They are being released in advance of World AIDS Day 2013 (1 December).
“Adolescents face difficult and often confusing emotional and social pressures as they grow from children into adults, “Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.”
Across sub-Saharan Africa, many who were infected at birth are becoming adolescents. In addition to the many changes associated with adolescence, they also face the challenges of living with a chronic infection: disclosing the news to friends and family and preventing transmission to sexual partners.
“Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.”
“Adolescent girls, young men who have sex with men, those who inject drugs or are subject to sexual coercion and abuse are at highest risk. They face many barriers, including harsh laws, inequalities, stigma and discrimination which prevent them from accessing services that could test, prevent, and treat HIV,”. “About one-seventh of all new HIV infections occur during adolescence. Unless the barriers are removed, the dream of an AIDS-free generation will never be realized.”
Making it easier to know HIV status
Furthermore, many young people do not know their HIV status. For example, in sub-Saharan Africa, it is estimated that only 10% of young men and 15% of young women (15-24 years) know their HIV status and, in other regions, although data is scarce, access to HIV testing and counseling by vulnerable adolescents is consistently reported as being very low.
WHO recommends governments review their laws to make it easier for adolescents to obtain HIV testing without needing consent from their parents. The guidelines also suggest ways that health services can improve the quality of care and social support for adolescents. And they highlight the value of involving this age group to create an adolescent-centered approach to the services that work for people of their age.
Better equipping adolescents
“Young people need to be better equipped to manage their HIV infection and take ownership of their health care,”. “We have seen for example in Zimbabwe that, by developing adolescent friendly services, it is possible to achieve good treatment outcomes among adolescents. We urge others to be inspired by these examples.”
To help health workers put these recommendations into practice WHO has developed a new online tool which will be launched in January 2014. It uses practical examples from country programmes that are working closely with adolescents on HIV issues.
The guidelines provide recommendations and expert suggestions – mainly for policy-makers and national programme managers – on prioritizing, planning and providing HIV testing, counselling and care services for adolescents. Designed to be used with the recent WHO consolidated Antiretroviral guidelines, these new guidelines provide complimentary recommendations and guidance to support better provision of services to help adolescents remain in care and adhere to treatment.
The guidelines were developed based on scientific evidence, community consultations with adolescents and health workers, field experience of health workers and expert opinion. WHO led the development of these guidelines in collaboration with the United Nations Children’s Fund (UNICEF), the Global Network of People Living with HIV (GNP+), the United Nations Educational, Scientific and Cultural Organization (UNESCO), and the United Nations Population Fund (UNFPA).
World AIDs Day 2013
World AIDS Day - 1 December 2013
Getting to zero: Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths
World AIDS Day is celebrated on 1 December every year to raise awareness about HIV/AIDS and to demonstrate international solidarity in the face of the pandemic. The day is an opportunity for public and private partners to disseminate information about the status of the pandemic and to encourage progress in HIV/AIDS prevention, treatment and care around the world, particularly in high prevalence countries.
Between 2011-2015, World AIDS Day has the theme: "Getting to zero: zero new HIV infections. Zero discrimination. Zero AIDS-related deaths".
The WHO’s focus for the 2013 campaign is improving access to prevention, treatment and care services for adolescents (10-19 years), a group that continues to be vulnerable despite efforts so far.
WHO will release new guidance for HIV testing and counselling and care for adolescents living with HIV on World AIDS Day 2013.
Getting to zero: Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths
World AIDS Day is celebrated on 1 December every year to raise awareness about HIV/AIDS and to demonstrate international solidarity in the face of the pandemic. The day is an opportunity for public and private partners to disseminate information about the status of the pandemic and to encourage progress in HIV/AIDS prevention, treatment and care around the world, particularly in high prevalence countries.
Between 2011-2015, World AIDS Day has the theme: "Getting to zero: zero new HIV infections. Zero discrimination. Zero AIDS-related deaths".
The WHO’s focus for the 2013 campaign is improving access to prevention, treatment and care services for adolescents (10-19 years), a group that continues to be vulnerable despite efforts so far.
WHO will release new guidance for HIV testing and counselling and care for adolescents living with HIV on World AIDS Day 2013.
Sunday, November 24, 2013
Role Of Music On Brain Function
There are new roles for musical training,which include fostering brain plasticity, providing an alternative educational tool, and treating learning disabilities, researchers say.
Playing a musical instrument is a multisensory and motor experience that creates emotions and motions — from finger tapping to dancing — and engages pleasure and reward systems in the brain. It has the potential to change brain function and structure when done over a long period of time.
These new findings show that "intense musical training generates new processes within the brain, at different stages of life, and with a range of impacts on creativity, cognition, and learning.
Start Music Lessons Early
Musical training at a young age may strengthen the brain, especially regions that influence language skills and executive function.
A formal musical training for at least a year, beginning sometime between age 3 and 15 help to improve brain function in later part of life
The volume of brain regions related to hearing and self-awareness appeared to be larger in those who began taking music lessons before age 7. This hints that early musical training could potentially be used as a therapeutic tool.
"Early musical training does more good for kids than just making it easier for them to enjoy music; it changes their brain and these brain changes could lead to cognitive advances as well. Early music training could change the structure of the brain's cortex.
"There is a lot of research showing that musical training has various cognitive benefits, such as better working memory, pitch discrimination performance, and selective attention.
It might be possible that some specified musical training could be applied to education in the future.
Childhood music lessons have neural benefit decades later. Older adults who took music lessons as children but haven't actively played an instrument in decades have a faster brain response to a speech sound than individuals who never played an instrument.
Music Training Influences Multiple Senses
Musical training improves the ability of the nervous system to integrate information from multiple senses.
Hemce there are broader role for musical training in improving the ability of the nervous system to integrate information from all senses
Playing a musical instrument is a multisensory and motor experience that creates emotions and motions — from finger tapping to dancing — and engages pleasure and reward systems in the brain. It has the potential to change brain function and structure when done over a long period of time.
These new findings show that "intense musical training generates new processes within the brain, at different stages of life, and with a range of impacts on creativity, cognition, and learning.
Start Music Lessons Early
Musical training at a young age may strengthen the brain, especially regions that influence language skills and executive function.
A formal musical training for at least a year, beginning sometime between age 3 and 15 help to improve brain function in later part of life
The volume of brain regions related to hearing and self-awareness appeared to be larger in those who began taking music lessons before age 7. This hints that early musical training could potentially be used as a therapeutic tool.
"Early musical training does more good for kids than just making it easier for them to enjoy music; it changes their brain and these brain changes could lead to cognitive advances as well. Early music training could change the structure of the brain's cortex.
"There is a lot of research showing that musical training has various cognitive benefits, such as better working memory, pitch discrimination performance, and selective attention.
It might be possible that some specified musical training could be applied to education in the future.
Childhood music lessons have neural benefit decades later. Older adults who took music lessons as children but haven't actively played an instrument in decades have a faster brain response to a speech sound than individuals who never played an instrument.
Music Training Influences Multiple Senses
Musical training improves the ability of the nervous system to integrate information from multiple senses.
Hemce there are broader role for musical training in improving the ability of the nervous system to integrate information from all senses
Subscribe to:
Posts (Atom)