Special needs The Children Act 1989, Education Acts 1981, 1986 and 1993, and the Chronically Sick and Disabled Persons Legislation 1979 impose various statutory duties to identify and provide assistance for children with special needs. They include the chronically ill as well as those with impaired development or disabilities such as CEREBRAL PALSY, or hearing, vision or intellectual impairment. Many CDTs keep a register of such children so that services can be e?ciently planned and evaluated. Parents of disabled children often feel isolated and neglected by society in general; they are frequently frustrated by the lack of resources available to help them cope with the sheer hard work involved. The CDT, through its key workers, does its best to absorb anger and divert frustration into constructive actions.
There are other groups of children who come to the attention of child health services. Community paediatricians act as advisers to adoption and fostering agencies, vital since many children needing alternative homes have special medical or educational needs or have behavioural or psychiatric problems. Many see a role in acting as advocates, not just for those with impairments but also for socially disadvantaged children, including those ‘looked after’ in children’s homes and those of travellers, asylum seekers, refugees and the homeless.
Child protection Regrettably, some children come to the attention of child health specialists because they have been beaten, neglected, emotionally or nutritionally starved or sexually assaulted by their parents or carers. Responsibility for the investigation of these children is that of local-authority social-services departments. However, child health professionals have a vital role in diagnosis, obtaining forensic evidence, advising courts, supervising the medical aspects of follow-up and teaching doctors, therapists and other professionals in training. (See CHILD ABUSE.)
School health services Once children have reached school age, the emphasis changes. The prime need becomes identifying those with problems that may interfere with learning – including those with special needs as de?ned above, but also those with behavioural problems. Teachers and parents are advised on how to manage these problems, while health promotion and health education are directed at children. Special problems, especially as children reach secondary school (aged 11–18) include accidents, substance abuse, psychosexual adjustment, antisocial behaviour, eating disorders and physical conditions which loom large in the minds of adolescents in particular, such as ACNE, short stature and delayed puberty.
There is no longer, in the UK, a universal school health service as many of its functions have been taken over by general practitioners and hospital and community paediatricians. However, most areas still have school nurses, some have school doctors, while others do not employ speci?c individuals for these tasks but share out aspects of the work between GPs, health visitors, community nurses and consultant paediatricians in child health.
Complementing their work is the community dental service whose role is to monitor the whole child population’s dental health, provide preventive programmes for all, and dental treatment for those who have di?culty using general dental services – for example, children with complex disability. All children in state-funded schools are dentally screened at ages ?ve and 15.
Successes and failures Since the inception of the NHS, hospital services for children have had enormous success: neonatal and infant mortality rates have fallen by two-thirds; deaths from PNEUMONIA have fallen from 600 per million children to a handful; and deaths from MENINGITIS have fallen to one-?fth of the previous level. Much of this has been due to the revolution in the management of pregnancy and labour, the invention of neonatal resuscitation and neonatal intensive care, and the provision of powerful antibiotics.
At the same time, some children acquire HIV infection and AIDS from their affected mothers (see AIDS/HIV); the prevalence of atopic (see ATOPY) diseases (ASTHMA, eczema – see DERMATITIS, HAY FEVER) is rising; more children attend hospital clinics with chronic CONSTIPATION; and little can be done for most viral diseases.
Community child health services can also boast of successes. The routine immunisation programme has wiped out SMALLPOX, DIPHTHERIA and POLIOMYELITIS and almost wiped out haemophilus and meningococcal C meningitis, measles and congenital RUBELLA syndrome. WHOOPING COUGH outbreaks continue but the death and chronic disability rates have been greatly reduced. Despite these huge health gains, continuing public scepticism about the safety of immunisation means that there can be no relaxation in the educational and health-promotion programme.
Services for severely and multiply disabled children have improved beyond all recognition with the closure of long-stay institutions, many of which were distinctly child-unfriendly. Nonetheless, scarce resources mean that families still carry heavy burdens. The incidence of SUDDEN INFANT DEATH SYNDROME (SIDS) has more than halved as a result of an educational programme based on ?rm scienti?c evidence that the risk can be reduced by putting babies to sleep on their backs, avoidance of parental smoking, not overheating, breast feeding and seeking medical attention early for illness.
Children have fewer accidents and better teeth but new problems have arisen: in the 1990s children throughout the developed world became fatter. A UK survey in 2004 found that one in ?ve children are overweight and one in 20 obese. Lack of exercise, the easy availability of food at all times and in all places, together with the rise of ‘snacking’, are likely to provoke signi?cant health problems as these children grow into adult life. Adolescents are at greater risk than ever of ill-health through substance abuse and unplanned pregnancy. Child health services are facing new challenges in the 21st century.... child development teams (cdts)
The principle of one-to-one, 24-hours-a-day care for seriously ill patients has been widely adopted and developed for the initial treatment of many patients with life-threatening conditions. Thus, severely injured patients – those with serious medical conditions such as coronary thrombosis or who have undergone major surgery, and individuals suffering from potentially lethal toxic affects of poisons – are treated in an INTENSIVE THERAPY UNIT (ITU). Patients whose respiratory or circulatory systems have failed bene?t especially by being intensively treated. Most patients, especially post-operative ones, leave intensive care when their condition has been stabilised, usually after 24 or 48 hours. Some, however, need support for several weeks or even months. Since 1952, intensive medicine has become a valued specialty and a demanding one because of the range of skills needed by the doctors and nurses manning the ITUs.... intensive care medicine
Certain specialties – for example, orthopaedic and reconstructive/cosmetic surgery and mental health – attract more private patients than others, such as paediatrics or medicine for the elderly. The standards of clinical care are generally the same in the two systems, but private patients can see the specialist of their choice at a time convenient to them. Waiting times for consultations and treatment are short and, when in hospital, private patients usually have their own room, telephone, TV, open visiting hours, etc.
A substantial proportion of private medical-care services are those provided for elderly people requiring regular nursing care and some medical supervision. The distinction between residential care and nursing care for the elderly is often blurred, but the government policy of providing means-tested state funding only for people genuinely needing regular nursing care – a system operated by local-authority social-service departments in England and Wales – has necessitated clearer de?nitions of the facilities provided for the elderly by private organisations. The strict criteria for state support (especially in England), the budget-conscious approach of local authorities when negotiating fees with private nursing homes, and the fact that NHS hospital trusts also have to pay for some patients discharged to such homes (to free-up hospital beds for new admissions) have led to intense ?nancial pressures on private facilities for the elderly. This has caused the closure of many homes, which, in turn, is worsening the level of BED-BLOCKING by elderly patients who do not require hospital-intensity nursing but who lack family support in the community and cannot a?ord private care.... private health care
An adequate daily intake of essential fatty acids is assured by the golden oils (Sunflower, Corn, etc) which can be well supported by Evening Primrose oil capsules.
Internal: Bamboo gum. Nettle tea, Alfalfa, Horsetail, Soya.
Topical. Shampoo. Soapwort or Yucca. Chop 2 tablespoons (dry) or 1 tablespoon (fresh) leaves or root. Place in cup of warm water. Stir until a froth is produced. Decant and massage liquor into scalp.
Aloe Vera gel is noted for its moisturising effect and to provide nutrients. It may be used as a shampoo, hair set and conditioner. Jojoba oil has been used for centuries by the Mexican Indians for a healthy scalp; today, it is combined with Evening Primrose and Vitamin E with good effect. Olive oil stimulates strong growth.
One of several herbs may be used as a rinse, including Nettles, Rosemary, Southernwood, Fennel, Chamomile, Yellow Dock and Quassia. Hair should be washed not more than once weekly with warm water and simple vegetable soap; rinse four times with warm rinse, finishing off with cold. Brunettes should add a little vinegar; blondes, lemon juice. Selenium once had a reputation as a hair conditioner; recent research confirms. Selenium shampoos are available.
Supplements: Vitamins B (complex), B6, Choline, C and E. Copper, Zinc, Selenium, Vitamin B12 (50mg thrice daily).
Aromatherapy. 2 drops each: Sage, Nettles, Thyme; to 2 teaspoons Gin or Vodka, and massage into the scalp daily. ... hair care
Pain can be relieved by regular low doses of analgesic drugs. Opioid analgesics, such as morphine, may be given if pain is severe. Other methods of pain relief include nerve blocks, cordotomy, and TENS. Nausea and vomiting may be controlled by drugs. Constipation can be treated with laxatives. Breathlessness is another common problem in the dying and may be relieved by morphine.
Towards the end, the dying person may be restless and may suffer from breathing difficulty due to heart failure or pneumonia. These symptoms can be relieved by drugs and by placing the patient in a more comfortable position.
Emotional care is as important as the relief of physical symptoms.
Many dying people feel angry or depressed and feelings of guilt or regret are common responses.
Loving, caring support from family, friends, and others is important.
Many terminally ill people prefer to die at home.
Few terminally ill patients require complicated nursing for a prolonged period.
Care in a hospice may be offered.
Hospices are small units that have been established specifically to care for the dying and their families.... dying, care of the
DHSC section of the website: provides information on a wide range of public health issues... department of health and social care
Bergamot, camphor (white), cananga, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), clove bud, galbanum, geranium, grapefruit, immortelle, juniper, lavandin, lavender (spike & true), lemon, lemongrass, lime, linaloe, litsea cubeba, mandarin, mint (peppermint & spearmint), myrtle, niaouli, palmarosa, patchouli, petitgrain, rosemary, rosewood, sage (clary & Spanish), sandalwood, tea tree, thyme, vetiver, violet, yarrow, ylang ylang.
Allergies (M,S,F,B,I):
Melissa, chamomile (German & Roman), immortelle, true lavender, spikenard.
Athlete’s foot (S):
Clove bud, eucalyptus, lavender (true &spike), lemon, lemongrass, myrrh, patchouli, tea tree.
Baldness & hair care (S,H):
West Indian bay, white birch, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), grapefruit, juniper, patchouli, rosemary, sage (clary & Spanish), yarrow, ylang ylang.
Boils, abscesses & blisters (S,C,B):
Bergamot, chamomile (German & Roman), eucalyptus blue gum, galbanum, immortelle, lavandin, lavender (spike & true), lemon, mastic, niaouli, clary sage, tea tree, thyme, turpentine.
Bruises (S,C):
Arnica (cream), borneol, clove bud, fennel, geranium, hyssop, sweet marjoram, lavender, thyme.
Burns (C,N):
Canadian balsam, chamomile (German & Roman), clove bud, eucalyptus blue gum, geranium, immortelle, lavandin, lavender (spike & true), marigold, niaouli, tea tree, yarrow.
Chapped & cracked skin (S,F,B):
Peru balsam, Tofu balsam, benzoin, myrrh, patchouli, sandalwood.
Chilblains (S,N):
Chamomile (German & Roman), lemon, lime, sweet marjoram, black pepper.
Cold sores/herpes (S):
Bergamot, eucalyptus blue gum, lemon, tea tree.
Congested & dull skin (M,S,F,B,I):
Angelica, white birch, sweet fennel, geranium, grapefruit, lavandin, lavender (spike & true), lemon, lime, mandarin, mint (peppermint & spearmint), myrtle, niaouli, orange (bitter & sweet), palmarosa, rose (cabbage & damask), rosemary, rosewood, ylang ylang.
Cuts/sores (S,C):
Canadian balsam, benzoin, borneol, cabreuva, cade, chamomile (German & Roman), clove bud, elemi, eucalyptus (blue gum, lemon & peppermint), galbanum, geranium, hyssop, immortelle, lavender (spike & true), lavandin, lemon, lime, linaloe, marigold, mastic, myrrh, niaouli, Scotch pine, Spanish sage, Levant styrax, tea tree, thyme, turpentine, vetiver, yarrow.
Dandruff (S,H):
West Indian bay, cade, cedarwood (Atlas, Texas & Virginian), eucalyptus, spike lavender, lemon, patchouli, rosemary, sage (clary & Spanish), tea tree.
Dermatitis (M,S,C,F,B):
White birch, cade, cananga, carrot seed, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), geranium, immortelle, hops, hyssop, juniper, true lavender, linaloe, litsea cubeba, mint (peppermint & spearmint), palmarosa, patchouli, rosemary, sage (clary & Spanish), thyme.
Dry & sensitive skin (M,S,F,B):
Peru balsam, Tolu balsam, cassie, chamomile (German & Roman), frankincense, jasmine, lavandin, lavender (spike & true), rosewood, sandalwood, violet.
Eczema (M,S,F,B):
Melissa, Peru balsam, Tolu balsam, bergamot, white birch, cade, carrot seed, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), geranium, immortelle, hyssop, juniper, lavandin, lavender (spike & true), marigold, myrrh, patchouli, rose (cabbage & damask), rosemary, Spanish sage, thyme, violet, yarrow.
Excessive perspiration (S,B):
Citronella, cypress, lemongrass, litsea cubeba, petitgrain, Scotch pine, Spanish sage.
Greasy or oily skin/scalp (M,S,H,F,B):
West Indian bay, bergamot, cajeput, camphor (white), cananga, carrot seed, citronella, cypress, sweet fennel, geranium, jasmine, juniper, lavender, lemon, lemongrass, !itsea cubeba, mandarin, marigold, mimosa, myrtle, niaouli, palmarosa, patchouli, petitgrain, rosemary, rosewood, sandalwood, clary sage, tea tree, thyme, vetiver, ylang ylang.
Haemorrhoids/piles (S,C,B):
Canadian balsam, Copaiba balsam, coriander, cubebs, cypress, geranium, juniper, myrrh, myrtle, parsley, yarrow.
Insect bites (S,N):
French basil, bergamot, cajeput, cananga, chamomile (German & Roman), cinnamon leaf, eucalyptus blue gum, lavandin, lavender (spike & true), lemon, marigold, melissa, niaouli, tea tree, thyme, ylang ylang.
Insect repellent (S,V):
French basil, bergamot, borneol, camphor (white), Virginian cedarwood, citronella, clove bud, cypress, eucalyptus (blue gum & lemon), geranium, lavender, lemongrass, litsea cubeba, mastic, melissa, patchouli, rosemary, turpentine.
Irritated & inflamed skin (S,C,F,B):
Angelica, benzoin, camphor (white), Atlas cedarwood, chamomile (German & Roman), elemi, immortelle, hyssop, jasmine, lavandin, true lavender, marigold, myrrh, patchouli, rose (cabbage & damask), clary sage, spikenard, tea tree, yarrow.
Lice (S,H):
Cinnamon leaf, eucalyptus blue gum, galbanum, geranium, lavandin, spike lavender, parsley, Scotch pine, rosemary, thyme, turpentine.
Mouth & gum infections/ulcers (S,C):
Bergamot, cinnamon leaf, cypress, sweet fennel, lemon, mastic, myrrh, orange (bitter & sweet), sage (clary & Spanish), thyme.
Psoriasis (M,S,F,B):
Angelica, bergamot, white birch, carrot seed, chamomile (German & Roman), true lavender.
Rashes (M,S,C,F,B):
Peru balsam, Tofu balsam, carrot seed, chamomile (German & Roman), hops, true lavender, marigold, sandalwood, spikenard, tea tree, yarrow.
Ringworm (S,H):
Geranium, spike lavender, mastic, mint (peppermint & spearmint), myrrh, Levant styrax, tea tree, turpentine.
Scabies (S):
Tolu balsam, bergamot, cinnamon leaf, lavandin, lavender (spike & true), lemongrass, mastic, mint (peppermint & spearmint), Scotch pine, rosemary, Levant styrax, thyme, turpentine.
Scars & stretch marks (M,S):
Cabreuva, elemi, frankincense, galbanum, true lavender, mandarin, neroli, palmarosa, patchouli, rosewood, sandalwood, spikenard, violet, arrow.
Slack tissue (M,S,B):
Geranium, grapefruit, juniper, lemongrass, lime, mandarin, sweet marjoram, orange blossom, black pepper, petitgrain, rosemary, yarrow.
Spots (S,N):
Bergamot, cade, cajeput, camphor (white), eucalyptus (lemon), immortelle, lavandin, lavender (spike & true), lemon, lime, litsea cubeba, mandarin, niaouli, tea tree.
Ticks (S,N):
Sweet marjoram.
Toothache & teething pain (S,C,N):
Chamomile (German & Roman), clove bud, mastic, mint (peppermint & spearmint), myrrh.
Varicose veins (S,C):
Cypress, lemon, lime, neroli, yarrow.
Verrucae (S,N):
Tagetes, tea tree.
Warts & corns (S,N):
Cinnamon leaf, lemon, lime, tagetes, tea tree.
Wounds (S,C,B):
Canadian balsam, Peru balsam, Tolu balsam, bergamot, cabreuva, chamomile (German & Roman), clove bud, cypress, elemi, eucalyptus (blue gum & lemon), frankincense, galbanum, geranium, immortelle, hyssop, juniper, lavandin, lavender (spike & true), linaloe, marigold, mastic, myrrh, niaouli, patchouli, rosewood, Levant styrax, tea tree, turpentine, vetiver, yarrow.
Wrinkles & mature skin (M,S,F,B):
Carrot seed, elemi, sweet fennel, frankincense, galbanum, geranium, jasmine, labdanum, true lavender, mandarin, mimosa, myrrh, neroli, palmarosa, patchouli, rose (cabbage & damask), rosewood, clary sage, sandalwood, spikenard, ylang ylang.... skin care