A combined inspiratory and expiratory muscle training program improves respiratory muscle strength and fatigue in multiple sclerosis.

PubMed

Ray, Andrew D; Udhoji, Supriya; Mashtare, Terry L; Fisher, Nadine M

2013-10-01

To determine the effects of a short-duration, combined (inspiratory and expiratory), progressive resistance respiratory muscle training (RMT) protocol on respiratory muscle strength, fatigue, health-related quality of life, and functional performance in individuals with mild-to-moderate multiple sclerosis (MS). Quasi-experimental before-after trial. University rehabilitation research laboratory. Volunteers with MS (N=21) were divided into 2 groups: RMT (n=11; 9 women, 2 men; mean age ± SD, 50.9 ± 5.7y, mean Expanded Disability Status Scale score ± SD, 3.2 ± 1.9) and a control group that did not train (n=10; 7 women, 3 men; mean age ± SD, 56.2 ± 8.8y, mean Expanded Disability Status Scale score ± SD, 4.4 ± 2.1). Expanded Disability Status Scale scores ranged from 1 to ≤6.5. No patients withdrew from the study. Training was a 5-week combined progressive resistance RMT program, 3d/wk, 30 minutes per session. The primary outcome measures were maximal inspiratory pressure and expiratory pressure and the Modified Fatigue Impact Scale. All subjects completed secondary measures of pulmonary function, the six-minute walk test, the timed stair climb, the Multiple Sclerosis Self-Efficacy Scale, the Medical Outcomes Study 36-Item Short-Form Health Survey, and the Physical Activity Disability Scale. Maximal inspiratory pressure and expiratory pressure (mean ± SD) increased 35% ± 22% (P<.001) and 26% ± 17% (P<.001), respectively, whereas no changes were noted in the control group (12% ± 23% and -4% ± 17%, respectively). RMT improved fatigue (Modified Fatigue Impact Scale, P<.029), with no change or worsening in the control group. No changes were noted in the six-minute walk test, stair climb, Multiple Sclerosis Self-Efficacy Scale, or Physical Activity Disability Scale in the RMT group. The control group had decreases in emotional well-being and general health (Medical Outcomes Study 36-Item Short-Form Health Survey). A short-duration, combined RMT program improved inspiratory and expiratory muscle strength and reduced fatigue in patients with mild to moderate MS. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Patients after colostomy: relationship between quality of life and acceptance of disability and social support.

PubMed

Zhang, Tie-Ling; Hu, Ai-Ling; Xu, Hong-Lian; Zheng, Mei-Chun; Liang, Ming-Juan

2013-11-01

The aim of this research was to explore quality of life (QOL) and acceptance of disability and social support of colostomy patients as well as the relationship between these factors. A descriptive, correlational study was conducted using four scales: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and European Organization for Research and Treatment of Cancer Colorectal Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-CR38) scales, the Acceptance of Disability Scale (ADS), and the Social Relational Quality Scale (SRQS). A convenience sample of 111 colostomy patients from four hospitals in Guangzhou who underwent colostomy operation at least one month prior to the study and who visited the stoma clinic or association from August 2011 to February 2012 was evaluated for inclusion in the study. All statistical analyses were performed using SPSS 17.0 software (SPSS Inc., Chicago, IL, USA). The patients' general health status was better than the reference level recommended by European Organization for Research and Treatment of Cancer, and the overall ADS score was average. The SRQS score was similar to that found in a Hong Kong study. The general health status and dimensions of QOL were significantly correlated with ADS and all of its dimensions (P < 0.05). The general health status and dimensions of QOL were also significantly correlated with SRQS and all of its dimensions (P < 0.05). QOL, acceptance of disability, and social relational quality of colostomy patients were closely related. Our results emphasize that patients should work to form rational values and close bonds with families and friends to achieve a better QOL.

The longitudinal impact of depression on disability in Parkinson disease.

PubMed

Pontone, Gregory M; Bakker, Catherine C; Chen, Shaojie; Mari, Zoltan; Marsh, Laura; Rabins, Peter V; Williams, James R; Bassett, Susan S

2016-05-01

Depression in Parkinson disease (PD) is a common problem that worsens quality of life and causes disability. However, little is known about the longitudinal impact of depression on disability in PD. This study examined the association between disability and DSM-IV-TR depression status across six years. Longitudinal cohort study with assessments at study entry, year two, four, and six conducted in the Morris K. Udall Parkinson Disease Research Center. Recruitment totaled 137 adult men and women with idiopathic PD in which up to six years of data on demographic, motor, and non-motor variables was collected. Movement disorder specialists used the structured interview for DSM-IV-TR depressive disorders and the Northwestern Disability Scale to assess depression and disability. A generalized linear mixed model was fitted with Northwestern Disability Scale score as the dependent variable to determine the effect of baseline depression status on disability. A total of 43 participants were depressed at baseline compared to 94 without depression. Depressed participants were more likely to be female, were less educated, were less likely to take dopamine agonists, and more likely to have motor fluctuations. Controlling for these variables, symptomatic depression predicted greater disability compared to both never depressed (p = 0.0133) and remitted depression (p = 0.0009). Disability associated with symptomatic depression at baseline was greater over the entire six-year period compared to participants with remitted depressive episodes or who were never depressed. Persisting depression is associated with a long-term adverse impact on daily functioning in PD. Adequate treatment or spontaneous remission of depression improves ADL function. Copyright © 2015 John Wiley & Sons, Ltd.

Relationship between Intellectual Status and Reading Skills for Developmentally Disabled Children.

ERIC Educational Resources Information Center

Bloom, Allan; And Others

1981-01-01

For 80 developmentally disabled children (ages 6-10), scores on the Woodcock Reading Mastery Tests correlated moderately and significantly with IQ. Abstract reading skills correlated more fully with WISC-R Full Scale IQ than did concrete skills. The emotional importance of concrete learning patterns to these children is noted. (Author/SJL)

Measuring and Promoting Acceptance of Young Children with Disabilities.

ERIC Educational Resources Information Center

Favazza, Paddy C.; Phillipsen, Leslie; Kumar, Poonam

2000-01-01

Results of two studies indicate the Acceptance Scale for Kindergartners was reliable with a sample of minority, low socioeconomic status children and that children exposed to all of the components of an intervention designed to promote acceptance of young children with disabilities had short-term and long-term gains in acceptance. (Contains…

Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review

PubMed Central

2011-01-01

Background Interest in measuring functional status among nondisabled older adults has increased in recent years. This is, in part, due to the notion that adults identified as 'high risk' for functional decline portray a state that is potentially easier to reverse than overt disability. Assessing relatively healthy older adults with traditional self-report measures (activities of daily living) has proven difficult because these instruments were initially developed for institutionalised older adults. Perhaps less evident, are problems associated with change scores and the potential for 'construct under-representation', which reflects the exclusion of important features of the construct (e.g., disability). Furthermore, establishing a formal hierarchy of functional status tells more than the typical simple summation of functional loss, and may have predictive value to the clinician monitoring older adults: if the sequence task difficulty is accelerated or out of order it may indicate the need for interventions. Methods This review identified studies that employed item response theory (IRT) to examine or revise functional status scales. IRT can be used to transform the ordinal nature of functional status scales to interval level data, which serves to increase diagnostic precision and sensitivity to clinical change. Furthermore, IRT can be used to rank items unequivocally along a hierarchy based on difficulty. It should be noted that this review is not concerned with contrasting IRT with more traditional classical test theory methodology. Results A systematic search of four databases (PubMed, Embase, CINAHL, and PsychInfo) resulted in the review of 2,192 manuscripts. Of these manuscripts, twelve met our inclusion/exclusion requirements and thus were targeted for further inspection. Conclusions Manuscripts presented in this review appear to summarise gerontology's best efforts to improve construct validity and content validity (i.e., ceiling effects) for scales measuring the early stages of activity restriction in community-dwelling older adults. Several scales in this review were exceptional at reducing ceiling effects, reducing gaps in coverage along the construct, as well as establishing a formal hierarchy of functional decline. These instrument modifications make it plausible to detect minor changes in difficulty for IADL items positioned at the edge of the disability continuum, which can be used to signal the onset of progressive type disability in older adults. PMID:21846335

Development of the Communication Complexity Scale

ERIC Educational Resources Information Center

Brady, Nancy C.; Fleming, Kandace; Thiemann-Bourque, Kathy; Olswang, Lesley; Dowden, Patricia; Saunders, Muriel D.; Marquis, Janet

2012-01-01

Purpose: Accurate description of an individual's communication status is critical in both research and practice. Describing the communication status of individuals with severe intellectual and developmental disabilities is difficult because these individuals often communicate with presymbolic means that may not be readily recognized. Our goal was…

Psychological status and coping styles of caregivers of individuals with intellectual disability and psychiatric illness.

PubMed

Panicker, Anuja S; Ramesh, Sonali

2018-06-27

The psychological status of caregivers of individuals with intellectual disability and psychiatric illness (PI) is important for effective management. The aim of this study was to examine the psychological status and its relationship with coping styles among these caregivers. Caregivers (N = 80) of individuals with intellectual disability (n = 40) and PI (n = 40) were administered a socio-demographic questionnaire, depression, anxiety and stress scale and COPE Inventory. Caregivers experienced depression, anxiety and stress symptoms. These symptoms were found to be significantly higher among caregivers of individuals with intellectual disability than those with PI. The most common coping style used was religious coping. Use of positive reinterpretation and growth was associated with lower levels of depression and stress symptoms. Caregivers' mental health plays an important role in the quality of care delivery and outcome. Use of appropriate coping styles can reduce the impact of these symptoms. © 2018 John Wiley & Sons Ltd.

Relationship Between the Functional Status Scale and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category Scales FREE

PubMed Central

Pollack, Murray M.; Holubkov, Richard; Funai, Tomohiko; Clark, Amy; Moler, Frank; Shanley, Thomas; Meert, Kathy; Newth, Christopher J. L.; Carcillo, Joseph; Berger, John T.; Doctor, Allan; Berg, Robert A.; Dalton, Heidi; Wessel, David L.; Harrison, Rick E.; Dean, J. Michael; Jenkins, Tammara L.

2015-01-01

Importance Functional status assessment methods are important as outcome measures for pediatric critical care studies. Objective To investigate the relationships between the 2 functional status assessment methods appropriate for large-sample studies, the Functional Status Scale (FSS) and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category (POPC/PCPC) scales. Design, Setting, and Participants Prospective cohort study with random patient selection at 7 sites and 8 children’s hospitals with general/medical and cardiac/cardiovascular pediatric intensive care units (PICUs) in the Collaborative Pediatric Critical Care Research Network. Participants included all PICU patients younger than 18 years. Main Outcomes and Measures Functional Status Scale and POPC/PCPC scores determined at PICU admission (baseline) and PICU discharge. We investigated the association between the baseline and PICU discharge POPC/PCPC scores and the baseline and PICU discharge FSS scores, the dispersion of FSS scores within each of the POPC/PCPC ratings, and the relationship between the FSS neurologic components (FSS-CNS) and the PCPC. Results We included 5017 patients. We found a significant (P < .001) difference between FSS scores in each POPC or PCPC interval, with an FSS score increase with each worsening POPC/PCPC rating. The FSS scores for the good and mild disability POPC/PCPC ratings were similar and increased by 2 to 3 points for the POPC/PCPC change from mild to moderate disability, 5 to 6 points for moderate to severe disability, and 8 to 9 points for severe disability to vegetative state or coma. The dispersion of FSS scores within each POPC and PCPC rating was substantial and increased with worsening POPC and PCPC scores. We also found a significant (P < .001) difference between the FSS-CNS scores between each of the PCPC ratings with increases in the FSS-CNS score for each higher PCPC rating. Conclusions and Relevance The FSS and POPC/PCPC system are closely associated. Increases in FSS scores occur with each higher POPC and PCPC rating and with greater magnitudes of change as the dysfunction severity increases. However, the dispersion of the FSS scores indicated a lack of precision in the POPC/PCPC system when compared with the more objective and granular FSS. The relationship between the PCPC and the FSS-CNS paralleled the relationship between the FSS and POPC/PCPC system. PMID:24862461

Comparing the Self-Concept of Students with and without Learning Disabilities.

ERIC Educational Resources Information Center

Gans, Amy M.; Kenny, Maureen C.; Ghany, Dave L.

2003-01-01

A study compared self-concept in 50 Hispanic middle school children with learning disabilities and 70 controls. Differences were found between the groups on the Intellectual and Social Status and Behavior subscales of the Piers-Harris Children's Self-Concept Sale, with controls scoring higher on both scales. No differences were found on global…

Predictors of employment status among adults with Autism Spectrum Disorder.

PubMed

Ohl, Alisha; Grice Sheff, Mira; Small, Sarah; Nguyen, Jamie; Paskor, Kelly; Zanjirian, Aliza

2017-01-01

In the United States, adults with Autism Spectrum Disorder (ASD) experience high rates of unemployment and underemployment in relation to adults with other disabilities and the general population. Yet there is little research examining their employment experiences and the predictors of employment status. The purpose of this study was to examine the employment characteristics and histories of both employed and unemployed adults with ASD, and the factors that contributed to their employment status. This cross-sectional study used an online survey and the Short Effort Reward Imbalance (ERI) Scale to gather data. Multivariate logistic regression analyses were used to examine predictors of employment status and self-reported health. Of the 254 adults with ASD who participated in this study, 61.42% were employed and 38.58% were unemployed. Over half of the participants reported job imbalance on the Short ERI Scale and the vast majority did not receive any job assistance. Participants who disclosed their ASD diagnosis to their employer were more than three times as likely to be employed than those who did not disclose. Education level was also a significant predictor of employment status. This study suggests disability disclosure and education level are factors that contribute to employment status.

The Complexities of Intimate Partner Violence: Mental Health, Disabilities, and Child Abuse History for White, Indigenous, and Other Visible Minority Canadian Women.

PubMed

Tutty, Leslie M; Radtke, H L; Ateah, Christine A; Ursel, E Jane; Thurston, Wilfreda E Billie; Hampton, Mary; Nixon, Kendra

2017-11-01

This research examines how mental health issues associated with intimate partner violence (IPV) relate to women's intersecting identities of race/ethnicity, disability status, and child abuse history. Data ( N = 595) from a Canadian triprovincial study included women who were White ( n = 263, 44.8%), Indigenous ( n = 292, 49.7%), or visible minority ( n = 32, 5.5%). Few demographic differences were found. None of the mental health measures (Symptom Checklist-Short Form [SCL-10], Centre for Epidemiological Studies-Depression [CES-D-10], Posttraumatic Stress Disorder [PTSD] Checklist) were in the clinical ranges. In a MANCOVA on the mental health scales, with IPV severity, racial group, disability status, and child abuse history as variables, only disability was significantly associated with more mental health symptoms.

Predicting the changes in depressive symptomatology in later life: how much do changes in health status, marital and caregiving status, work and volunteering, and health-related behaviors contribute?

PubMed

Choi, Namkee G; Bohman, Thomas M

2007-02-01

This study examined the unique effects of four variable groups on changes in older adults' depressive symptoms for a 2-year period: (1) baseline health and disability status, (2) changes in health and disability since baseline, (3) stability and changes in marital and caregiving status and in work and volunteering, and (4) stability and changes in health-related behaviors. With data from the 1998 and 2000 interview waves of the Health and Retirement Study, the authors used gender-separate multistep (hierarchical) residualized regression analyses in which the Center for Epidemiological Studies Depression scale (CES-D) score at follow-up is modeled as a function of the effect of each group of independent variables. As hypothesized, changes in health, disability, marital, and caregiving status explained a larger amount of variance than the existing and stable conditions, although each group of variables explained a relatively small amount (0.3-3.4%) of variance in the follow-up CES-D score.

National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities.

PubMed

Havercamp, Susan M; Scott, Haleigh M

2015-04-01

People with disabilities experience worse health and poorer access to health care compared to people without disability. Large-scale health surveillance efforts have largely excluded adults with intellectual and developmental disability. This study expands knowledge of health status, health risks and preventative health care in a representative US sample comparing the health of adults with no disability to adults with intellectual and developmental disability and to adults with other types of disability. The purposes of this study were (1) to identify disparities between adults with intellectual and developmental disability and adults with no disability and (2) compare this pattern of disparities to the pattern between adults with other types of disability and adults without disability. This study compares health status, health risks and preventative health care in a national sample across three groups of adults: No Disability, Disability, and Intellectual and Developmental Disability. Data sources were the 2010 Behavior Risk Factor Surveillance Survey and the National Core Indicators Consumer Survey. Adults with disability and with intellectual and developmental disability were more likely to report being in poor health compared to adults without disability. Disability and intellectual and developmental disability conferred unique health risks and health care utilization patterns. Significant disparities in health and health care utilization were found for adults with disability and developmental disability relative to adults without disability. Disability training for health care providers and health promotion research that identifies disability as a demographic group is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

[Employment conditions and a system of occupational health administration for disabled workers].

PubMed

Nagae, S; Baba, Y; Inoue, N

1985-12-01

A survey using a questionaire was conducted to elucidate the employment conditions and a system of occupational health administration status of the disabled workers in private enterprises. The average employment rate of disabled workers was found to be higher in small-scale enterprises, than in large-scale enterprises. Also, the low employment rate was found among cases of spinal cord injuries and hemipregia. The reasons for workers becoming disabled were "private accident and illness" (59.2%) "congenital" (30.6%) and "labor accident" (10.2%). The main physical factor influencing work efficiency of disabled workers was "degree of disability" while "work morale" was found to be the most influential psychological factor. Also it was found that about 50% of private enterprises will accept the reinstatement and employment of spinal cord injury or hemipregia workers. But it will be necessary that the disabled workers are able to do the requested job. However, it is necessary for employers of disabled workers to make various efforts in overcoming situations such as, changes in organization, improvement of occupational health administration staffs and improvements in the working environment and equipment.

Study of Barrier to Help Seeking and its Relationships with Disability in Patients with Headache.

PubMed

John, Deepa; Ram, Dushad; Sundarmurthy, Harsha; Rathod, Harshal; Rathod, Snehal

2016-10-01

Headache is among the first three most prevalent disorders with a wide treatment gap due to barriers in help seeking. Headache has been associated with disability. However, the relationship of barriers to help-seeking and disability are unexplored. To find out the barriers to help seeking and its relationship with headache related disability in patients with headache. In this hospital based cross-sectional study, 200 consecutive subjects with headache attending a tertiary care centre were recruited as per selection criteria and assessed with Sociodemographic & Clinical Proforma, Mini International Neuropsychiatric Interview (MINI), Barriers to Help Seeking Scale (BHSS), The Henry Ford Hospital Headache Disability Inventory (HDI). High mean score was observed on BHSS subscale need for control and self reliance (19.45; SD ±9.66) and minimizing problem and resignation (10.02; SD ±6.98). Mean score on the HDI was 25.65 (SD ± 14.09). Socioeconomic status of the patient was statistically significant and positively associated with need for control and self reliance (p=0.035), concrete barriers and distrust of care givers (p=0.039), emotional control (p=0.005), and privacy (p=0.002). Occupational status had significant association with need for control and self-reliance (p=0.01), minimizing problem and resignation (p=0.033), and emotional control (p=0.006). Score on hospital headache disability inventory significantly predicted the value of score on concrete barriers and distrust of caregivers domain of HDI (p=0.001). Autonomy and under estimation of seriousness of headache are common barriers to help seeking. Pattern of help seeking barriers may vary with socio-economic status and occupational status, while disability varies with gender and severity of headache. Headache associated disability is positively associated with concrete barriers.

Intervening to reduce the risk of future disability from multiple sclerosis: are we there yet?

PubMed

Dahdaleh, Maurice; Alroughani, Raed; Aljumah, Mohammed; AlTahan, Abdulrahman; Alsharoqi, Issa; Bohlega, Saeed A; Daif, Abdulkader; Deleu, Dirk; Inshasi, Jihad; Karabudak, Rana; Sahraian, Mohammed A; Taha, Karim; Yammout, Bassem I; Zakaria, Magd

2017-10-01

Disease-modifying therapies (DMTs) delay or may prevent the progression of patients with high-risk clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (MS), and from relapsing-remitting MS to secondary progressive MS. Current evidence on the effects of DMT on disability in MS is supported by the use of the Expanded Disability Status Scale (EDSS), which is dominated by ambulation, and usually used as a secondary outcome measure. Less is known about the long-term effects of DMTs on other aspects of functional status, particularly cognition, which is a key determinant of ability to work. The time scale for measurements of disability is at most a few years, with scant data from more than 10 years of observation. Longer prospective follow-up of large numbers of patients with CIS is needed to determine whether early intervention with a DMT influences long-term disease progression. Finally, the emergence of the radiologically isolated syndrome (RIS) as a clinical entity has shifted the debate about when to intervene to an even earlier time frame. Balancing the significant side-effects associated with DMT in general and the expected outcome of pharmacologic intervention is increasingly problematic for managing patients with uncertain prognosis, as many patients may have low-risk CIS, benign MS or patients with RIS only. Preventing long-term disability in MS should be recognised more clearly as an important outcome in its own right, with disability measured more consistently with more sensitive instruments beyond the use of the EDSS.

Reliability and validity of two self-report measures of impairment and disability for MS. North American Research Consortium on Multiple Sclerosis Outcomes Study Group.

PubMed

Schwartz, C E; Vollmer, T; Lee, H

1999-01-01

To describe the results of a multicenter study that validated two new patient-reported measures of neurologic impairment and disability for use in MS clinical research. Self-reported data can provide a cost-effective means to assess patient functioning, and can be useful for screening patients who require additional evaluation. Thirteen MS centers from the United States and Canada implemented a cross-sectional validation study of two new measures of neurologic function. The Symptom Inventory is a measure of neurologic impairment with six subscales designed to correlate with localization of brain lesion. The Performance Scales measure disability in eight domains of function: mobility, hand function, vision, fatigue, cognition, bladder/bowel, sensory, and spasticity. Measures given for comparison included a neurologic examination (Expanded Disability Status Scale, Ambulation Index, Disease Steps) as well as the patient-reported Health Status Questionnaire and the Quality of Well-being Index. Participants included 274 MS patients and 296 healthy control subjects who were matched to patients on age, gender, and education. Both the Symptom Inventory and the Performance Scales showed high test-retest and internal consistency reliability. Correlational analyses supported the construct validity of both measures. Discriminant function analysis reduced the Symptom Inventory to 29 items without sacrificing reliability and increased its discriminant validity. The Performance Scales explained more variance in clinical outcomes and global quality of life than the Symptom Inventory, and there was some evidence that the two measures complemented each other in predicting Quality of Well-being Index scores. The Symptom Inventory and the Performance Scales are reliable and valid measures.

Psychometric Properties of the Young Children’s Participation and Environment Measure

PubMed Central

Khetani, Mary A.; Graham, James E.; Davies, Patricia L.; Law, Mary C.; Simeonsson, Rune J.

2014-01-01

Objective To evaluate the psychometric properties of the newly developed Young Children’s Participation and Environment Measure (YC-PEM). Design Cross-sectional study. Setting Data were collected online and by telephone. Participants Convenience and snowball sampling methods were used to survey caregivers of 395 children (93 children with developmental disabilities and delays, 302 without developmental disabilities and delays) between 0–5 years (mean = 35.33 months, SD = 20.29) and residing in North America. Interventions Not applicable. Main Outcome Measure(s) The YC-PEM includes three participation scales and one environment scale. Each scale is assessed across three settings: home, daycare/preschool, and community. Data were analyzed to derive estimates of internal consistency, test-retest reliability, and construct validity. Results Internal consistency ranged from .68 to .96 and .92 to .96 for the participation and environment scales, respectively. Test-retest reliability (2–4 weeks) ranged from .31 to .93 for participation scales and from .91 to .94 for the environment scale. One of three participation scales and the environment scale demonstrated significant group differences by disability status across all three settings, and all four scales discriminated between disability groups for the daycare/preschool setting. The participation scales exhibited small to moderate positive associations with functional performance scores. Conclusion(s) Results lend initial support for the use of the YC-PEM in research to assess the participation of young children with disabilities and delays in terms of 1) home, daycare/preschool, and community participation patterns, 2) perceived environmental supports and barriers to participation, and 3) activity-specific parent strategies to promote participation. PMID:25449189

Stanford-Binet & WAIS IQ Differences and Their Implications for Adults with Intellectual Disability (aka Mental Retardation).

PubMed

Silverman, Wayne; Miezejeski, Charles; Ryan, Robert; Zigman, Warren; Krinsky-McHale, Sharon; Urv, Tiina

2010-03-01

Stanford-Binet and Wechsler Adult Intelligence Scale (WAIS) IQs were compared for a group of 74 adults with intellectual disability (ID). In every case, WAIS Full Scale IQ was higher than the Stanford-Binet Composite IQ, with a mean difference of 16.7 points. These differences did not appear to be due to the lower minimum possible score for the Stanford-Binet. Additional comparisons with other measures suggested that the WAIS might systematically underestimate severity of intellectual impairment. Implications of these findings are discussed regarding determination of disability status, estimating prevalence of ID, assessing dementia and aging-related cognitive declines, and diagnosis of ID in forensic cases involving a possible death penalty.

Stanford-Binet & WAIS IQ Differences and Their Implications for Adults with Intellectual Disability (aka Mental Retardation)

PubMed Central

Silverman, Wayne; Miezejeski, Charles; Ryan, Robert; Zigman, Warren; Krinsky-McHale, Sharon; Urv, Tiina

2010-01-01

Stanford-Binet and Wechsler Adult Intelligence Scale (WAIS) IQs were compared for a group of 74 adults with intellectual disability (ID). In every case, WAIS Full Scale IQ was higher than the Stanford-Binet Composite IQ, with a mean difference of 16.7 points. These differences did not appear to be due to the lower minimum possible score for the Stanford-Binet. Additional comparisons with other measures suggested that the WAIS might systematically underestimate severity of intellectual impairment. Implications of these findings are discussed regarding determination of disability status, estimating prevalence of ID, assessing dementia and aging-related cognitive declines, and diagnosis of ID in forensic cases involving a possible death penalty. PMID:20401180

Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination.

PubMed

van Brakel, Wim H; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I; Wilder-Smith, Annelies

2012-01-01

Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention. Stigma was a major determinant of social participation, and therefore disability. Stigma reduction activities and socio-economic rehabilitation are urgently needed in addition to strategies to reduce the development of further physical impairment after release from treatment.

Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

PubMed Central

van Brakel, Wim H.; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I.; Wilder-Smith, Annelies

2012-01-01

Background Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. Methods We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Results Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. Discussion The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention. Stigma was a major determinant of social participation, and therefore disability. Stigma reduction activities and socio-economic rehabilitation are urgently needed in addition to strategies to reduce the development of further physical impairment after release from treatment. PMID:22826694

Ankle fractures and employment: a life-changing event for patients.

PubMed

Thakore, Rachel V; Hooe, Benjamin S; Considine, Perrin; Sathiyakumar, Vasanth; Onuoha, Gerald; Hinson, Julian K; Obremskey, William T; Sethi, Manish K

2015-01-01

Ankle fractures, one of the most common types of orthopaedic injury, have been associated with reduced functional outcome and significant changes in long-term employment. Although information on unemployment following ankle fractures can be important in cases of financial compensation, no studies have investigated rates of short-term disability and employment status among patients who have suffered isolated ankle fractures in the US. We retrospectively reviewed 573 medical charts for patients who were treated for ankle fractures in the last 3 years at a level I trauma center. A total of 83 non-elderly patients that had isolated ankle fractures were contacted and surveyed over the phone. Patients were asked about employment history and current status, disability, type of fracture, and demographic information. Fifty-three (62%) patients contacted were employed at the time of injury. In all, 34% (n = 18) of patients lost their job because of their injury, of which only 8 (44%) received new employment. A total of 15% (n = 8) of patients that were previously employed decided to no longer return to work. Ten patients (56%) received disability status. Ankle fracture patients are likely to suffer high rates of unemployment or disability shortly after their injury. Further investigations with a larger-scale, randomized patient population can provide important information on employment status following ankle fractures.

Disability in society-medical and non-medical determinants for disability pension in a Norwegian total county population study.

PubMed

Krokstad, Steinar; Westin, Steinar

2004-05-01

The objective of this study was to describe sociomedical determinants and developments for the medically based disability pension in Norway by linking individual based data from a county health survey to data on disability from the National Insurance Administration. Two cross-sectional total population health surveys with an approximate 10-year interval were conducted in Nord-Trøndelag county, HUNT I (1984-86) and HUNT II (1995-97), which allows for analyses of changes over time, supplied with official incidence data on disability pension. The large-scale variations and overall increasing incidence rates of disability pension in Norway during the last 20 years also applied to the county of Nord-Trøndelag. The prevalence of disability pension generally increased in the population from the mid-1980s to the mid-1990s. A striking finding was a consistent pattern of increasing prevalence of disability pension with decreasing socio-economic status and education. A geographic pattern for disability pension prevalence on a municipality level suggested that structural and cultural factors were important in determining the level of disability in society. Medical determinants alone cannot explain either the dramatic variations or the overall increased incidence rates of disability pension in the last two decades in Norway. The results demonstrate the importance of social, non-medical and contextual determinants for disability pension, how these determinants result in important prevalence differences by socio-economic status, and their impact on the level of disability in society.

Employment status, social function decline and caregiver burden among stroke survivors. A South Indian study.

PubMed

Sreedharan, Sapna Erat; Unnikrishnan, J P; Amal, M G; Shibi, B S; Sarma, Sankara; Sylaja, P N

2013-09-15

Stroke leaves at least 60% of the survivors with moderate to severe disability limiting their employment status and social functioning leading to high levels of caregiver burden. We sought to study the employment status and level of change of social functioning of stroke survivors and their principal caregiver and correlate it with severity of stroke, functional disability, and anxiety and depression scores. One hundred and fifty stroke survivors and principal caregivers (3 months-2 years post-stroke) were recruited for the study. The employment status pre- and post-stroke was assessed. The social function of the patient and caregiver was analyzed using a 6 item social function scale developed for the study, encompassing culturally relevant questions. A 20 point scale adapted from Burden assessment schedule was used to assess the caregiver burden. Mean age of the study group was 54.37±12.072 (range 22-75 years), with 116 males and 34 females. Spouse was the principal caregiver for 142/150 patients (94.6%). In the stroke survivors, compared to the pre-stroke employment status of 62.7%, only 20.7% were employed post-stroke with half having change of job. But the employment status of caregiver was not reduced post-stroke (34.7% vs 33.3%). Employment loss in stroke survivors had a statistically significant association with severity of functional disability, male gender and presence of limb weakness (p values 0.037, 0.0001 and 0.043 respectively). There was an overall decline in social functions among the 6 parameters assessed in both the stroke survivors and caregivers. Of the caregiver burden, financial burden was more among female and older caregivers. The functional status and motor weakness of the stroke survivors did not tend to worsen the overall caregiver burden. Loss of occupation among stroke survivors is high. The decline in social function among stroke survivors and caregivers was significant. Even though functional disability contributed to employment loss and social function decline among stroke survivors, it did not have a significant impact on caregiver burden. © 2013 Elsevier B.V. All rights reserved

Progressive decline of decision-making performances during multiple sclerosis.

PubMed

Simioni, Samanta; Ruffieux, Christiane; Kleeberg, Joerg; Bruggimann, Laure; du Pasquier, Renaud A; Annoni, Jean-Marie; Schluep, Myriam

2009-03-01

The purpose of this study was to evaluate longitudinally, using the Iowa Gambling Task (IGT), the dynamics of decision-making capacity at a two-year interval (median: 2.1 years) in a group of patients with multiple sclerosis (MS) (n = 70) and minor neurological disability [Expanded Disability Status Scale (EDSS) < or = 2.5 at baseline]. Cognition (memory, executive functions, attention), behavior, handicap, and perceived health status were also investigated. Standardized change scores [(score at retest-score at baseline)/standard deviation of baseline score] were computed. Results showed that IGT performances decreased from baseline to retest (from 0.3, SD = 0.4 to 0.1, SD = 0.3, p = .005). MS patients who worsened in the IGT were more likely to show a decreased perceived health status and emotional well-being (SEP-59; p = .05 for both). Relapsing rate, disability progression, cognitive, and behavioral changes were not associated with decreased IGT performances. In conclusion, decline in decision making can appear as an isolated deficit in MS.

Disability in older adults with acute low back pain: the study Back Complaints in the Elderly - (Brazil).

PubMed

Aguiar, Alessandra Regina Silva Araujo; Ribeiro-Samora, Giane Amorim; Pereira, Leani Souza Maximo; Godinho, Larissa Birro; Assis, Marcella Guimarães

The increase in the older adult and oldest old population in Brazil is growing. This phenomenon may be accompanied by an increase in musculoskeletal symptoms such as low back pain. This condition is usually associated with disability. To verify the association between pain intensity and disability in older adults with acute low back pain and assess whether these variables differ depending on the age group and marital status. This is a cross-sectional study conducted with 532 older adults with acute low back pain episodes. Pain intensity was assessed through the Numeric Pain Scale and disability through the Late Life Function and Disability Instrument, which shows two dimensions: "frequency" and "limitation" in performing activities. The association between pain and disability was analyzed. For the interaction effect between age groups and marital status, we found that the oldest old living with a partner performed activities of the personal domain less often compared to the oldest old living alone. The oldest old group living with a partner had a lower frequency of performing activities, but did not report feeling limited. The association of pain with disability was minimal (rho<0.20) and thus considered irrelevant. Disability in older adults with acute low back pain was influenced by the interaction between age groups and marital status and is not associated with pain intensity. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Validity of the Timed Up and Go Test as a Measure of Functional Mobility in Persons With Multiple Sclerosis.

PubMed

Sebastião, Emerson; Sandroff, Brian M; Learmonth, Yvonne C; Motl, Robert W

2016-07-01

To examine the validity of the timed Up and Go (TUG) test as a measure of functional mobility in persons with multiple sclerosis (MS) by using a comprehensive framework based on construct validity (ie, convergent and divergent validity). Cross-sectional study. Hospital setting. Community-residing persons with MS (N=47). Not applicable. Main outcome measures included the TUG test, timed 25-foot walk test, 6-minute walk test, Multiple Sclerosis Walking Scale-12, Late-Life Function and Disability Instrument, posturography evaluation, Activities-specific Balance Confidence scale, Symbol Digits Modalities Test, Expanded Disability Status Scale, and the number of steps taken per day. The TUG test was strongly associated with other valid outcome measures of ambulatory mobility (Spearman rank correlation, rs=.71-.90) and disability status (rs=.80), moderately to strongly associated with balance confidence (rs=.66), and weakly associated with postural control (ie, balance) (rs=.31). The TUG test was moderately associated with cognitive processing speed (rs=.59), but not associated with other nonambulatory measures (ie, Late-Life Function and Disability Instrument-upper extremity function). Our findings support the validity of the TUG test as a measure of functional mobility. This warrants its inclusion in patients' assessment alongside other valid measures of functional mobility in both clinical and research practice in persons with MS. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Influence of educational attainment on pain intensity and disability in patients with lumbar spinal stenosis: mediation effect of pain catastrophizing.

PubMed

Kim, Ho-Joong; Kim, Sung-Chan; Kang, Kyoung-Tak; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S

2014-05-01

Level IV, prospective case series. To investigate the influence of educational attainment on the level of pain intensity and disability in patients with lumbar spinal stenosis (LSS) and determine how coping behavior, such as catastrophizing, may mediate the association between educational attainment and clinical impairments. Educational attainment has been thought to influence disability caused by chronic painful disease, mediated by pain behavior or a coping strategy such as catastrophizing. Nevertheless, little is known about the role of educational attainment on pain intensity or disability related with LSS. A total of 155 patients who were diagnosed as degenerative LSS participated in the study. Data on detailed medical history, physical examination, and series of questionnaires were collected, including pain catastrophizing scale, Oswestry Disability Index, and visual analogue pain scale for back and leg pain. For measures of socioeconomic status, educational attainment and occupation were assessed. Radiological analysis was performed using magnetic resonance images and computed tomographic scans. After adjustment of covariates, multivariate regression analysis was used to assess each component of the proposed mediation models among visual analogue pain scale for back/leg pain, Oswestry Disability Index, the level of education, occupation and pain catastrophizing scale. Mediation was also assessed by the bootstrapping technique. Educational attainment was negatively correlated with pain intensity, disability, and catastrophizing. Pain catastrophizing were also significantly correlated with disability and pain intensity for back/leg pain in the patients with LSS. In the relationship among variables, the mediation analysis with bootstrapping clearly showed the role of catastrophizing in the mediation between visual analogue pain scale for back pain/leg pain, Oswestry Disability Index, and the level of education. This study demonstrated that lower educational attainment was associated with increased pain intensity and disability in patients with LSS, which was mediated by the coping mechanism, catastrophizing.

The impact of epilepsy on preschool children and their families.

PubMed

Tanriverdi, Müberra; Mutluay, Fatma Karantay; Tarakçi, Devrim; Güler, Serhat; Iscan, Akin

2016-09-01

This study investigated the possible presence of sensory-motor developmental impairments in preschool children with epilepsy and explored epilepsy impact on their activities and quality of life and on the stress load of their family. Study participants were children aged 2-6years diagnosed with epilepsy without any other comorbidities (epi-only children). The instruments used for assessment included the Neurological, Sensory, Motor, Developmental Assessment (NSMDA) scale for sensory-motor development, the Impact of Childhood Neurologic Disability Scale (ICNDS), and the Impact of Pediatric Epilepsy Scale (IPES) for disease impact on disability and Quality of Life (QoL), as well as the Pediatric Outcomes Data Collection Instrument (PODCI) for functional health status, and the Parental Stress Scale (PSS) for the family stress load. Required data were obtained from direct testing or observation of children's activities and mother-supplied answers to questions. Eighty-two children were investigated. The NSMDA scores were in the normal development range 6-8. Significant moderate impact of the disease on disability and QoL was estimated with the ICNDS and IPES instruments. The PODCI scores were similar to healthy population levels except for the happiness dimension which was better for children with epilepsy. PSS were significantly above normal. The functional health and QoL of the children as well as their family stress were found to be positively correlated with increasing age. It is found that epilepsy does not degrade neuromotor development and functional health status of preschool epi-only children, though it has a significant impact on their neurological disability and QoL and the stress level of their families; this impact seems to decrease with age. Copyright © 2016 Elsevier Inc. All rights reserved.

Study of Barrier to Help Seeking and its Relationships with Disability in Patients with Headache

PubMed Central

John, Deepa; Sundarmurthy, Harsha; Rathod, Harshal; Rathod, Snehal

2016-01-01

Introduction Headache is among the first three most prevalent disorders with a wide treatment gap due to barriers in help seeking. Headache has been associated with disability. However, the relationship of barriers to help-seeking and disability are unexplored. Aim To find out the barriers to help seeking and its relationship with headache related disability in patients with headache. Materials and Methods In this hospital based cross-sectional study, 200 consecutive subjects with headache attending a tertiary care centre were recruited as per selection criteria and assessed with Sociodemographic & Clinical Proforma, Mini International Neuropsychiatric Interview (MINI), Barriers to Help Seeking Scale (BHSS), The Henry Ford Hospital Headache Disability Inventory (HDI). Results High mean score was observed on BHSS subscale need for control and self reliance (19.45; SD ±9.66) and minimizing problem and resignation (10.02; SD ±6.98). Mean score on the HDI was 25.65 (SD ± 14.09). Socioeconomic status of the patient was statistically significant and positively associated with need for control and self reliance (p=0.035), concrete barriers and distrust of care givers (p=0.039), emotional control (p=0.005), and privacy (p=0.002). Occupational status had significant association with need for control and self-reliance (p=0.01), minimizing problem and resignation (p=0.033), and emotional control (p=0.006). Score on hospital headache disability inventory significantly predicted the value of score on concrete barriers and distrust of caregivers domain of HDI (p=0.001). Conclusion Autonomy and under estimation of seriousness of headache are common barriers to help seeking. Pattern of help seeking barriers may vary with socio-economic status and occupational status, while disability varies with gender and severity of headache. Headache associated disability is positively associated with concrete barriers. PMID:27891430

Cerebrospinal fluid ATP metabolites in multiple sclerosis.

PubMed

Lazzarino, G; Amorini, A M; Eikelenboom, M J; Killestein, J; Belli, A; Di Pietro, V; Tavazzi, B; Barkhof, F; Polman, C H; Uitdehaag, B M J; Petzold, A

2010-05-01

Increased axonal energy demand and mitochondrial failure have been suggested as possible causes for axonal degeneration and disability in multiple sclerosis. Our objective was to test whether ATP depletion precedes clinical, imaging and biomarker evidence for axonal degeneration in multiple sclerosis. The method consisted of a longitudinal study which included 21 patients with multiple sclerosis. High performance liquid chromatography was used to quantify biomarkers of the ATP metabolism (oxypurines and purines) from the cerebrospinal fluid at baseline. The Expanded Disability Status Scale, MRI brain imaging measures for brain atrophy (ventricular and parenchymal fractions), and cerebrospinal fluid biomarkers for axonal damage (phosphorylated and hyperphosphorylated neurofilaments) were quantified at baseline and 3-year follow-up. Central ATP depletion (sum of ATP metabolites >19.7 micromol/litre) was followed by more severe progression of disability if compared to normal ATP metabolites (median 1.5 versus 0, p< 0.05). Baseline ATP metabolite levels correlated with change of Expanded Disability Status Scale in the pooled cohort (r= 0.66, p= 0.001) and subgroups (relapsing-remitting patients: r= 0.79, p< 0.05 and secondary progressive/primary progressive patients: r= 0.69, p< 0.01). There was no relationship between central ATP metabolites and either biomarker or MRI evidence for axonal degeneration. The data suggests that an increased energy demand in multiple sclerosis may cause a quantifiable degree of central ATP depletion. We speculate that the observed clinical disability may be related to depolarisation associated conduction block.

Comparison of Personal Resources in Patients Who Differently Estimate the Impact of Multiple Sclerosis.

PubMed

Wilski, Maciej; Tomczak, Maciej

2017-04-01

Discrepancies between physicians' assessment and patients' subjective representations of the disease severity may influence physician-patient communication and management of a chronic illness, such as multiple sclerosis (MS). For these reasons, it is important to recognize factors that distinguish patients who differently estimate the impact of MS. The purpose of this study was to verify if the patients who overestimate or underestimate the impact of MS differ in their perception of personal resources from individuals presenting with a realistic appraisal of their physical condition. A total of 172 women and 92 men diagnosed with MS completed Multiple Sclerosis Impact Scale, University of Washington Self Efficacy Scale, Rosenberg Self-Esteem Scale, Body Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale, and Socioeconomic resources scale. Physician's assessment of health status was determined with Expanded Disability Status Scale. Linear regression analysis was conducted to identify the subsets of patients with various patterns of subjective health and Expanded Disability Status Scale (EDSS) scores. Patients overestimating the impact of their disease presented with significantly lower levels of self-esteem, self-efficacy in MS, and body esteem; furthermore, they perceived their condition more threatening than did realists and underestimators. They also assessed anti-MS treatment worse, had less socioeconomic resources, and received less support than underestimators. Additionally, underestimators presented with significantly better perception of their disease, self, and body than did realists. Self-assessment of MS-related symptoms is associated with specific perception of personal resources in coping with the disease. These findings may facilitate communication with patients and point to new directions for future research on adaptation to MS.

Spousal Caregiver Burden and Its Relation with Disability in Schizophrenia

PubMed Central

Arun, R.; Inbakamal, S.; Tharyan, Anna; Premkumar, Prasanna S.

2018-01-01

Background: Schizophrenia, a chronic psychiatric disorder, can affect one's productivity and psychosocial functioning. In Indian context, the responsibility of caring persons with schizophrenia is increasingly on their spouses. Spousal caregiver experience and its relation with disability in schizophrenia need to be studied. Materials and Methods: We conducted a cross-sectional study among 52 outpatients with schizophrenia and their spouses attending a tertiary psychiatric center. The objectives were: (a) to explore spousal caregiver burden in schizophrenia and (b) to assess the relation between disability and spousal caregiver burden. The study adopted recommended ethical principles. Scales such as Burden Assessment Schedule, Indian Disability Evaluation and Assessment Scale (IDEAS), and Positive and Negative Syndrome Scale were used to collect appropriate data. Descriptive analysis, bivariate analysis, and multivariate analysis were done in SPSS software version 16.0. Results: The mean spousal caregiver burden score was 73.5 (standard deviation: 14.0). In bivariate analysis, disability, duration of schizophrenia, severity of schizophrenia, place of residence, and socioeconomic status had statistically significant relation with spousal caregiver burden. Adjusted for spouses’ age, gender, and other significant factors in bivariate analysis, the IDEAS global disability score (2.6, [confidence interval 0.5–3.8, P = 0.013]) retained statistically significant association with spousal caregiver burden. Conclusion: Spouses of persons with schizophrenia experience significant caregiver burden. Disability was found to be the most powerful determinant of spousal caregiver burden in the sample. Focus on disability alleviation in the management of schizophrenia may help reduce spousal caregiver burden. PMID:29403125

Sex Differences in Concomitant Trajectories of Self-Reported Disability and Measured Physical Capacity in Older Adults

PubMed Central

Allore, Heather G.; Mendes de Leon, Carlos F.; Gahbauer, Evelyne A.; Gill, Thomas M.

2016-01-01

Background: Despite documented age-related declines in self-reported functional status and measured physical capacity, it is unclear whether these functional indicators follow similar trajectories over time or whether the patterns of change differ by sex. Methods: We used longitudinal data from 687 initially nondisabled adults, aged 70 or older, from the Precipitating Events Project, who were evaluated every 18 months for nearly 14 years. Self-reported disability was assessed with a 12-item disability scale. Physical capacity was measured using grip strength and a modified version of Short Physical Performance Battery. Hierarchical linear models estimated the intra-individual trajectory of each functional indicator and differences in trajectories’ intercept and slope by sex. Results: Self-reported disability, grip strength, and Short Physical Performance Battery score declined over 13.5 years following nonlinear trajectories. Women experienced faster accumulation of self-reported disability, but slower declines in measured physical capacity, compared with men. Trajectory intercepts revealed that women had significantly weaker grip strength and reported higher levels of disability compared with men, with no differences in starting Short Physical Performance Battery scores. These findings were robust to adjustments for differences in sociodemographic characteristics, length-of-survival, health risk factors, and chronic-disease status. Conclusions: Despite the female disadvantage in self-reported disability, older women preserve measured physical capacity better than men over time. Self-reported and measured indicators should be viewed as complementary rather than interchangeable assessments of functional status for both clinical and research purposes, especially for sex-specific comparisons. PMID:27071781

Place of birth, age of immigration, and disability in Hispanics with multiple sclerosis

PubMed Central

Amezcua, Lilyana; Conti, David V.; Liu, Lihua; Ledezma, Karina; Langer-Gould, Annette M

2015-01-01

Background Hispanics in the US are a diverse community where their knowledge and risk for developing disability in multiple sclerosis (MS) may relate to their level of acculturation. Objective To compare the risk of disability in Hispanics with MS in the US by place of birth and age of immigration. Methods We conducted a cross-sectional study of 304 Hispanics with MS residing in Southern California. Place of birth and age of immigration were used as proxies to acculturation. Individuals were classified as US-born, early and late-immigrant (<15 and ≥15 years at immigration to the US, respectively). Risk of disability (expanded disability status scale ≥6) was adjusted for age at symptom onset, sex, socioeconomic status, and disease duration, using logistic regression. Results Late-immigrants were older at symptom onset (34.2±11.9 vs. 31.9±12.9 vs. 28.5±10.2 years, p<0.001) and had more disability (28% vs. 9% vs. 18%, p=0.04) compared to early-immigrant and US-born respectively. There was no difference between groups by female sex, type of MS, ethnicity, chronic medical conditions, and disease duration while differences were noted by socioeconomic status. Being late-immigrant was independently associated with increased disability (adjusted OR 2.2, 95% CIs1.04-4.74; p=0.04) compared to US-born. Conclusion Later immigration to the US in Hispanics with MS is associated with greater disability. These findings may reflect differences in social, environmental and cultural factors that may act as barriers for accessibility and utilization of health services. An in-depth assessment of the perceptions and attitudes about MS are warranted in this population. PMID:25729639

Place of birth,age of immigration,and disability in Hispanics with multiple sclerosis.

PubMed

Amezcua, Lilyana; Conti, David V; Liu, Lihua; Ledezma, Karina; Langer-Goulda, Annette M

2015-01-01

Hispanics in the US are a diverse community where their knowledge and risk for developing disability in multiple sclerosis (MS) may relate to their level of acculturation. To compare the risk of disability in Hispanics with MS in the US by place of birth and age of immigration. We conducted a cross-sectional study of 304 Hispanics with MS residing in Southern California. Place of birth and age of immigration were used as proxies to acculturation. Individuals were classified as US-born, early and late-immigrant (<15 and ≥15 years at immigration to the US, respectively). Risk of disability (expanded disability status scale ≥6) was adjusted for age at symptom onset, sex, socioeconomic status, and disease duration, using logistic regression. Late-immigrants were older at symptom onset (34.2±11.9 vs. 31.9±12.9 vs. 28.5±9.7 years, p<0.001) and had more disability (28% vs. 9% vs. 18%, p=0.04) compared to early-immigrant and US-born respectively. There was no difference between groups by female sex, type of MS, ethnicity, chronic medical conditions, and disease duration while differences were noted by socioeconomic status. Being late-immigrant was independently associated with increased disability (adjusted OR 2.3 95% CIs 1.07–4.82; p=0.03) compared to US-born. Later immigration to the US in Hispanics with MS is associated with greater disability. These findings may reflect differences in social, environmental and cultural factors that may act as barriers for accessibility and utilization of health services. An in-depth assessment of the perceptions and attitudes about MS are warranted in this population.

Predicting the effect of disability on employment status and income.

PubMed

Randolph, Diane Smith

2004-01-01

Research shows that participation in employment contributes to life satisfaction for persons with disabilities [18]. Title I of the Americans with Disabilities Act (ADA) sought to prohibit discrimination against persons with disabilities in the workplace, however, the ADA's effectiveness remains controversial. This research utilizes data from the disability supplement of the 2000 Behavioral Risk Factor Surveillance System to examine the impact of disability status on predicting employment status and income. Confounding variables such as gender, age, educational level, race and marital/parental status are examined regarding their influence on results. Results from analysis utilizing zero-order correlation, linear and logistic regression analysis techniques revealed that disability status has a significant predictive effect on inability to work. Furthermore, results continue to show that despite legislation, the higher the level of disability, the lower the employment status (those employed for wages) and income. Finally, disability status, coupled with being female or decreased educational level, consistently shows significance in predicting lower employment status and income than men or non-minorities with disabilities. Future research opportunities and policy implications are discussed with regard to the results presented.

Fatigue and physical fitness of mildly disabled persons with multiple sclerosis: a cross-sectional study.

PubMed

Valet, Maxime; Lejeune, Thierry; Glibert, Yumiko; Hakizimana, Jean C; Van Pesch, Vincent; El Sankari, Souraya; Detrembleur, Christine; Stoquart, Gaëtan

2017-09-01

Fatigue is frequent and disabling in persons with multiple sclerosis (pwMS) with mild neurological disability. These patients also have impaired physical fitness. Whether mildly disabled pwMS are deconditioned, and this deconditioning is linked to fatigue, remains unknown. Our aim is to determine the physical fitness of mildly disabled patients with multiple sclerosis and study its relationship with perceived fatigue and to link perceived fatigue with other parameters. Twenty patients (14 women; mean age: 45.5 years) with mild disability (Expanded Disability Status Scale 0-4) underwent a 2-min walking test, Timed Up-and-Go test, aerobic capacity testing, and isometric knee extension testing to assess strength and neuromuscular fatigability. They completed questionnaires assessing perceived fatigue, psychological status, and physical activity. Correlation coefficients and multivariate regression were used to analyze the relationships among variables. Seventeen (85%) patients reported a high level of fatigue. Thirteen (65%) patients had subnormal aerobic capacity. Fatigue was weakly to moderately associated with aerobic capacity, mobility, walking capacity, depression, and neuromuscular fatigability. An association of disease duration, aerobic capacity, and the neuromuscular fatigability index explained 65.1% of fatigue. A high proportion of pwMS with mild neurological disability are fatigued and deconditioned. Perceived fatigue is linked to aerobic capacity, neuromuscular fatigability, depression, mobility, and walking capacity. Focusing on these parameters could help in the management of fatigue.

Persian version of the Moorong Self-Efficacy Scale: psychometric study among subjects with physical disability.

PubMed

Rajati, Fatemeh; Ghanbari, Masoud; Hasandokht, Tolou; Hosseini, Seyed Younes; Akbarzadeh, Rasool; Ashtarian, Hossein

2017-11-01

Self-efficacy plays a key role in varying areas of human conditions which can be measured by different scales. The present study was aimed to evaluate the psychometric properties of Moorong Self-Efficacy Scale (MSES) in Iranian Subjects with Physical Disability (SWPD). Data were collected by face-to-face interviews and self-report surveys from 214 subjects. The face and content validity, and reliability were evaluated. Discriminates were evaluated between the sub-groups of disability levels, physical activity, and health condition levels. The concurrent, convergent, divergent, and construct validity were assessed by short form health survey scale (SF-36), general self-efficacy scale (GSES), hospital anxiety and depression scale (HADS), respectively. Replaceable exploratory factor analysis was evaluated. SPSS software was used for statistical analysis. There were acceptable face and content validity, and reliability. Furthermore, significant correlation was found between PSES and SF-36 (p < 0.001). Self-efficacy was statistically different among the disability levels (p = 0.02), physical activity levels (p < 0.001), and health status (p = 0.001). The correlation of Persian Self-Efficacy Scale (PSES) scores with GSES (r = 0.61, p < 0.001), and HADS (R = -0.53, p < 0.001) was significant. This scale yielded a two-dimensional structure, with a good internal replicability. The external replicability was satisfactory when we compared factor loadings with the original study. The PSES is a valid, reliable and sensitive tool to measure the self-efficacy among SWPD for planning and managing of disability problems. Implications for rehabilitation Psychometric properties of the Persian version of self-Efficacy scale (PSES) appear to be similar to original, English version. The PSES has been shown to have validity and reliability in Persian physical disables and can be used for patients with more different types of physical disability than individuals suffering from only Spinal Cord Injury (SCI). The PSES can be used in clinical practice and research work to evaluate the patients' confidence in performing daily activities.

[Influencing factors on HRQOL of physically disabled persons].

PubMed

Kim, Kye-Ha; Kim, Ok-Soo

2005-06-01

The purpose of this study was to investigate the influencing factors on health-related quality of life of physically disabled persons. Data was collected from 96 persons with a physical disability in three cities in Korea from June to September, 2003. Social support and depression were measured by a Social Support Questionnaire 6 (SSQ6) and Center for Epidemiologic Studies Depression questionnaire (CES-D). The Rosenberg Self-esteem Scale was used to measure self-esteem. Health-related quality of life (HRQOL) was measured using Smith Kline Beecham Quality of Life Scale (SBQOL). The SPSS WIN 11.0 version program was used for data analysis. There were significant differences of HRQOL according to monthly income and economic status. All subjects had a high level of depression and low self-esteem. The findings of this study show that self-esteem and the size of the social support network are significant influencing variables on HRQOL in physically disabled persons. Nursing intervention and counseling programs which improve self-esteem and increase the size of a social support network are needed to promote HRQOL in physically disabled persons.

Monitoring My Multiple Sclerosis

PubMed Central

Namey, Marie; Halper, June

2011-01-01

Optimal health of people with multiple sclerosis (MS) can be promoted by patients' sharing of health information gained through periodic self-monitoring with their health-care providers. The purpose of this study was to develop a valid and reliable self-administered scale to obtain information about MS patients' health status and the impact of the disease on their daily lives. We named this scale “Monitoring My Multiple Sclerosis” (MMMS). A cross-sectional survey was conducted of 171 MS patients who completed the MMMS and Patient-Determined Disease Steps (PDDS) scales and provided information on their MS disease classification and demographic characteristics. Data analysis included several parametric procedures. Factor analysis of the 26-item MMMS resulted in four factors with satisfactory α reliability coefficients for the total scale (0.90) and factored subscales: Physical (0.85), Relationships (0.80), Energy (0.70), and Cognitive/Mental (0.67). Analysis of variance demonstrated that the total scale and the Physical subscale, but not the Relationships subscale, showed significantly worse functioning for patients with either moderate or severe disability as measured by the PDDS than for patients with mild disability (P < .001). The Cognitive/Mental subscale showed significantly worse functioning for patients with moderate disability than for patients with mild disability (P < .05). However, the Energy subscale showed significantly worse functioning among moderately disabled patients than among severely disabled patients (P < .01). Independent t tests demonstrated that patients classified as having secondary progressive multiple sclerosis had significantly worse scores on the total MMMS (P < .05) and the Physical subscale (P < .001) than those classified as having relapsing-remitting multiple sclerosis. The MMMS demonstrated satisfactory reliability and validity and is recommended for use by MS patients and their health-care providers as a mechanism to promote the sharing of health information, to the benefit of both patients and providers. PMID:24453717

Application of Item Response Theory to Modeling of Expanded Disability Status Scale in Multiple Sclerosis.

PubMed

Novakovic, A M; Krekels, E H J; Munafo, A; Ueckert, S; Karlsson, M O

2017-01-01

In this study, we report the development of the first item response theory (IRT) model within a pharmacometrics framework to characterize the disease progression in multiple sclerosis (MS), as measured by Expanded Disability Status Score (EDSS). Data were collected quarterly from a 96-week phase III clinical study by a blinder rater, involving 104,206 item-level observations from 1319 patients with relapsing-remitting MS (RRMS), treated with placebo or cladribine. Observed scores for each EDSS item were modeled describing the probability of a given score as a function of patients' (unobserved) disability using a logistic model. Longitudinal data from placebo arms were used to describe the disease progression over time, and the model was then extended to cladribine arms to characterize the drug effect. Sensitivity with respect to patient disability was calculated as Fisher information for each EDSS item, which were ranked according to the amount of information they contained. The IRT model was able to describe baseline and longitudinal EDSS data on item and total level. The final model suggested that cladribine treatment significantly slows disease-progression rate, with a 20% decrease in disease-progression rate compared to placebo, irrespective of exposure, and effects an additional exposure-dependent reduction in disability progression. Four out of eight items contained 80% of information for the given range of disabilities. This study has illustrated that IRT modeling is specifically suitable for accurate quantification of disease status and description and prediction of disease progression in phase 3 studies on RRMS, by integrating EDSS item-level data in a meaningful manner.

The contribution of rib fractures to chronic pain and disability.

PubMed

Gordy, Stephanie; Fabricant, Loic; Ham, Bruce; Mullins, Richard; Mayberry, John

2014-05-01

The contribution of rib fractures to chronic pain and disability is not well described. Two hundred three patients with rib fractures were followed for 6 months. Chronic pain was assessed using the McGill Pain Questionnaire Pain Rating Index and Present Pain Intensity (PPI) scales. Disability was defined as a decrease in work or functional status. The prevalence of chronic pain was 22% and disability was 53%. Acute PPI predicted chronic pain. Associated injuries, bilateral rib fractures, injury severity score, and number of rib fractures were not predictive of chronic pain. No acute injury characteristics were predictive of disability. Among 89 patients with isolated rib fractures, the prevalence of chronic pain was 28% and of disability was 40%. No injury characteristics predicted chronic pain. Bilateral rib fractures and acute PPI predicted disability. The contribution of rib fractures to chronic pain and disability is significant but unpredictable with conventional injury descriptors. Copyright © 2014 Elsevier Inc. All rights reserved.

Beyond Type D personality: reduced positive affect (anhedonia) predicts impaired health status in chronic heart failure.

PubMed

Pelle, Aline J; Pedersen, Susanne S; Szabó, Balázs M; Denollet, Johan

2009-08-01

Type D personality has been associated with impaired health status in chronic heart failure (CHF), but other psychological factors may also be important. To determine whether non-Type D patients with low positive affect and Type D patients report lower health status, compared with non-Type D patients with high positive affect at 12-month follow-up in chronic heart failure. Consecutive CHF outpatients (n = 276) filled out the Short Form-12 (health status) and Health Complaints Scale (disease-specific complaints) at inclusion and 12-month follow-up, and the DS14 (Type D personality) and positive affect (Global Mood Scale) at inclusion. Three groups were composed: non-Type D patients without anhedonia, non-Type D patients with anhedonia, and Type D patients. After controlling for demographic and clinical confounders, and scores at inclusion, anhedonic non-Type D patients reported lower mental health status (beta = -.19, P < .004), and more feelings of disability (beta = .10, P = .04), marginally lower physical health status (beta = -.11, P = .07), and equal levels of cardiac symptoms (beta = .04, P = .43), when compared with non-Type D's without anhedonia. Type D patients reported lower levels of impaired mental health status, more cardiac symptoms and feelings of disability (-.31 < beta < .17, all Ps < .05). A trend was shown for physical health status (beta = -.11, P = .09). Non-Type D patients low on positive affect and Type D patients report lower levels of health status in CHF, compared with non-Type D patients with high positive affect. Future studies need to determine whether lack of positive affect is associated with impaired clinical outcome.

Predictors of psychological morbidity in parents of children with intellectual disabilities.

PubMed

Gallagher, Stephen; Phillips, Anna C; Oliver, Christopher; Carroll, Douglas

2008-01-01

This study examined predictors of excess psychological morbidity in parents of children with intellectual disabilities. Thirty-two parents of children with intellectual disabilities and 29 parents of typically developing children completed the Hospital Depression and Anxiety Scale, and measures of social support, child problem behaviors, sleep quality, and perceived caregiver burden. Parents of children with intellectual disabilities registered high depression and anxiety scores, and the majority met the criteria for possible clinical depression and/or anxiety. The strongest predictor of psychological morbidity was caregiver burden. Analyses of its component dimensions indicated that feelings of guilt held the greatest consequence for depression and anxiety. Caregiver burden, in general, and its guilt component, in particular, predicted symptoms of depression and anxiety in parents of children with intellectual disabilities. Assisting such parents to resolve their feelings of guilt should benefit their psychological status.

Disease progress and response to treatment as predictors of survival, disability, cognitive impairment and depression in Parkinson's disease

PubMed Central

Vu, Thuy C.; Nutt, John G.; Holford, Nicholas H. G.

2012-01-01

AIM To describe the time to clinical events (death, disability, cognitive impairment and depression) in Parkinson's disease using the time course of disease status and treatment as explanatory variables. METHODS Disease status based on the Unified Parkinson's Disease Rating Scale (UPDRS) and the time to clinical outcome events were obtained from 800 patients who initially had early Parkinson's disease. Parametric hazard models were used to describe the time to the events of interest. RESULTS Time course of disease status (severity) was an important predictor of clinical outcome events. There was an increased hazard ratio for death 1.4 (95% CI 1.31, 149), disability 2.75 (95% CI 2.30, 3.28), cognitive impairment 4.35 (95% CI 1.94, 9.74), and depressive state 1.43 (95% CI 1.26, 1.63) with each 10 unit increase of UPDRS. Age at study entry increased the hazard with hazard ratios of 49.1 (95% CI 8.7, 278) for death, 4.76 (95% CI 1.10, 20.6) for disability and 90.0 (95% CI 63.3–128) for cognitive impairment at age 60 years. Selegiline treatment had independent effects as a predictor of death at 8 year follow-up with a hazard ratio of 2.54 (95% CI 1.51, 4.25) but had beneficial effects on disability with a hazard ratio of 0.363 (95% CI 0.132, 0.533) and depression with a hazard ratio of 0.372 (95% CI 0.12, 0.552). CONCLUSIONS Our findings show that the time course of disease status based on UPDRS is a much better predictor of future clinical events than any baseline disease characteristic. Continued selegiline treatment appears to increase the hazard of death. PMID:22300470

Psychometric properties of the Young Children's Participation and Environment Measure.

PubMed

Khetani, Mary A; Graham, James E; Davies, Patricia L; Law, Mary C; Simeonsson, Rune J

2015-02-01

To evaluate the psychometric properties of the newly developed Young Children's Participation and Environment Measure (YC-PEM). Cross-sectional study. Data were collected online and by telephone. Convenience and snowball sampling methods were used to survey caregivers of children (N=395, comprising children with [n=93] and without [n=302] developmental disabilities and delays) between the ages of 0 and 5 years (mean age±SD, 35.33±20.29 mo) and residing in North America. Not applicable. The YC-PEM includes 3 participation scales and 1 environment scale. Each scale is assessed across 3 settings: home, daycare/preschool, and community. Data were analyzed to derive estimates of internal consistency, test-retest reliability, and construct validity. Internal consistency ranged from .68 to .96 and .92 to .96 for the participation and environment scales, respectively. Test-retest reliability (2-4 wk) ranged from .31 to .93 for participation scales and from .91 to .94 for the environment scale. One of 3 participation scales and the environment scale demonstrated significant group differences by disability status across all 3 settings, and all 4 scales discriminated between disability groups for the daycare/preschool setting. The participation scales exhibited small to moderate positive associations with functional performance scores. Results lend initial support for the use of the YC-PEM in research to assess the participation of young children with disabilities and delays in terms of (1) home, daycare/preschool, and community participation patterns; (2) perceived environmental supports and barriers to participation; and (3) activity-specific parent strategies to promote participation. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Predictors of suicidal ideation in older individuals receiving home-care services.

PubMed

Park, Jong-Il; Han, Myeong-Il; Kim, Myung Sig; Yoon, Myeong-Sook; Ko, Sung-Hee; Cho, Hye-Chung; Chung, Young-Chul

2014-04-01

Despite the importance of tending to older individuals who are vulnerable to suicide, little is known about suicidal ideation in the portion of this population receiving home-care services in Asian countries. The objective of this cross-sectional study was to examine predictors of suicidal ideation in older individuals using home-care service. Participants were randomly selected from the individuals 50 years old and over using home-care services across Jeollabuk-do Province, Korea. A total of 697 subjects participated in this study. Each participant completed the short version of the Geriatric Depression Scale, the Scale for Suicidal Ideation, the Multidimensional Scale of Perceived Social Support, and the World Health Organization Disability Assessment Schedule II. Hierarchical regression analyses revealed that depression, perceived social support, and disability were significant predictors of suicidal ideation, whereas the roles of subjective health status and fish consumption remained ambiguous in this regard. In terms of social support, we also found that less perceived social support from family members was related to higher levels of suicidal ideation. The associations between various categories of disability and suicidal ideation disappeared after controlling for depression. Our investigation of the mediating effect of depression on the relationship between disability and suicidal ideation revealed that depression was either a complete (disability related to cognition, self-care, getting along with others, and life activities) or partial (disability related to participation) mediator. Preventive strategies focusing on depression, social support, and disability should be emphasized during encounters with older people receiving home-care services. Copyright © 2013 John Wiley & Sons, Ltd.

Analysis of Community Participation Levels of Individuals Who Are Physically Disabled and Working in Industrial Environments.

PubMed

Tonak, Hasan Atacan; Kitis, Ali; Zencir, Mehmet

2016-01-01

The purpose of this study was to determine quality of life, leisure time satisfaction, activity performance, and community participation and analyze the relationship between these determinants and community participation in both physically disabled individuals working in industrial environments and nonworking individuals who are physically disabled. Sociodemographic data was registered into a sociodemographic form. World Health Organization Disability Assessment Schedule 2.0 was used to assess community participation. Activity performance was evaluated with Canadian Occupational Performance Measure. Leisure Satisfaction Scale was used to determine leisure time satisfaction. Short Form-36 was used for evaluating quality of life. When the participants were compared in terms of working status, a significant difference according to their WHO-DAS-II total scores were found (p < 0.05). When all participants were compared in terms of activity performance, lesisure time satisfaction, quality of life a significant differences according to their WHO-DAS-II total scores were found (p>0.05). This study shows that community participation was affected by working status, disability level, activity performance, leisure time satisfaction and quality of life. In this regard, occupational therapy and physiotherapy approaches were found necessary for developing community participation. We conclude that this study's results can be used as a guide for community participation in disabled people in community based rehabilitation politics.

Descriptive epidemiology of physical activity in university graduates with locomotor disabilities.

PubMed

Washburn, R; Hedrick, B N

1997-09-01

The descriptive epidemiology of physical activity in a sample of 577 University of Illinois graduates (1952-1991) with locomotor disabilities was assessed by mail survey. The survey requested basic demographic information, age, gender, marital status, household income. Respondents were asked to rate their current activity levels and activity levels during their college years compared to others their age on a 5 point scale: (1) much less active to (5) much more active. Completed surveys were received from 229 alumni (40%); 59 semi-ambulatory, 115 paraplegic, 55 quadriplegic. Results indicated current physical activity was associated with mobility limitation. With more severe mobility limitations the percentage reporting being less/much less active increased (42.4% semi-ambulatory, 56.5% paraplegic, 66.7% quadriplegic, P < 0.001) and the percentage reporting being more active decreased (20.3% semi-ambulatory, 16.5% paraplegic, 13.0% quadriplegic, P < 0.001). Current physical activity was significantly lower (P < 0.05) with increasing age, lower self-rated health, higher disability severity and among those who were sedentary during college. Physical activity did not differ by gender, marital status or household income. Multiple regression analysis indicated that health status was a significant predictor of current physical activity in all mobility categories (P < 0.001) after controlling for age, gender, income, disability severity and college activity. Among both paraplegics and quadriplegics physical activity during college was significantly associated (P < 0.001 paraplegic; P < 0.01 quadriplegic) with current physical activity. These results document a low level of physical activity in a well-educated sample of individuals with locomotor disabilities and suggest that exposure to physical activity in an educational setting may be an effective technique for increasing physical activity in individuals with locomotor disabilities.

Pain in patients with transverse myelitis and its relationship to aquaporin 4 antibody status.

PubMed

Kong, Yazhuo; Okoruwa, Helen; Revis, Jon; Tackley, George; Leite, Maria Isabel; Lee, Michael; Tracey, Irene; Palace, Jacqueline

2016-09-15

Pain in transverse myelitis has been poorly studied. The aim of the study was to investigate the relationship between transverse myelitis related pain and disability, quality of life, anxiety and depression, cognitive-affective states in neuromyelitis optica (NMO) patients and aquaporin4 antibody status (AQP4-Ab +ve as positive and AQP4-Ab -ve as negative). Transverse myelitis patients (44 in total; 29 AQP4-Ab +ve and 15 AQP4-Ab -ve) completed questionnaires including Pain Severity Index (PSI), Pain Catastrophising Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Short Form-36 quality of life (SF-36 QOL). Clinical details such as disability, gender, age and spinal cord lesion type (short or long lesion) were noted. Correlation and multiple linear regression tests were performed using these clinical scores. Pain was found to be correlated strongly with quality of life in both groups but only correlated with disability in the AQP4-Ab +ve group. PCS, HADS and EDMUS were found to be highly correlated with pain severity using partial correlation, however, a stronger relationship between pain severity and PCS was found in the AQP4-Ab -ve group. Multiple regression analysis showed that pain severity was the most important factor for quality of life but not disability or anxiety and depression symptoms in the whole patient group. We confirm that pain is an important symptom of transverse myelitis and has more influence on quality of life than disability despite health services being predominantly focused on the latter. There may be different factors associated with pain between AQP4-Ab +ve and -ve patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Health status, activity limitations, and disability in work and housework among Latinos and non-Latinos with arthritis: an analysis of national data.

PubMed

Abraído-Lanza, Ana F; White, Kellee; Armbrister, Adria N; Link, Bruce G

2006-06-15

To document disparities in health status, activity limitations, and disability in work and housework between Latinos and non-Latino whites with arthritis. We examined whether sociodemographic factors (age, income, and education) account for the disparities between the ethnic groups, and whether comorbid conditions, disease duration, health care utilization, and functional abilities predict health status, activity limitations, and work and housework disability after controlling for sociodemographic variables. We analyzed data from the Condition file of the 1994 National Health Interview Survey on Disability, Phase I. The risk of worse health, activity limitations, and work and housework disability was >2 times greater among Latinos compared with non-Latino whites. In the regression models accounting for potential confounders, Latino ethnicity remained significantly associated with poorer health status, but not activity limitations or disability in work or housekeeping. Of the socioeconomic status variables, education had a significant protective effect on work disability and health status. Comorbid conditions and health care utilization increased the likelihood of worse health, activity limitations, and work disability. Limitations in physical function were associated with poorer health and disability in work and homemaking. Social status differences between Latinos and non-Latinos may account for disparities in activity limitations and disability in work and housework. Education may provide various health benefits, including access to a range of occupations that do not require physical demands. The findings help to address the great gap in knowledge concerning factors related to the health and disability status of Latinos with arthritis.

Depression, functional disability and quality of life among Nigerian older adults: Prevalences and relationships.

PubMed

Akosile, Christopher Olusanjo; Mgbeojedo, Ukamaka Gloria; Maruf, Fatai Adesina; Okoye, Emmanuel Chiebuka; Umeonwuka, Ifeanyi Chuka; Ogunniyi, Adesola

2018-01-01

Ageing is associated with increased morbidity, depression and decline in function. These may consequently impair the quality of life (QoL) of older adults. This study was used to investigate the prevalence of functional disability, depression, and level of quality of life of older adults residing in Uyo metropolis and its environs, Nigeria. This cross sectional survey involved 206 (116 females and 90 males) older adults with mean age of 69.8±6.7. The World Health Organization Quality of Life-OLD, Functional status Questionnaire (FSQ) and Geriatric Depression Scale (GDS) were used to measure quality of life, functional disability and depression respectively. Data was analysed using frequency counts and percentages and Spearman rank-order correlation coefficient, at 0.05 alpha level. 45.5% of participants had depression, and at least 30% had functional disability in at least one domain, but their quality of life was fairly good (>60.0%) across all domains. Significant correlation existed between depression scores and individual quality of life and functional disability domains and between overall QoL and each functional disability domain (p<0.001). Depression and functional disability were quite prevalent among sampled older adults but their QOL was not too severely affected. Since the constructs were interrelated, it seems interventions targeted at depression and functional status may invariably enhance the quality of life of the older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Function and the patient with chronic low back pain.

PubMed

Strong, J; Ashton, R; Large, R G

1994-09-01

To undertake a comparative examination of the reliability and validity of two frequently used self-report measures of functional disability, the Pain Disability Index (PDI) and the Oswestry Low Back Pain Disability Questionnaire (OLBPDQ). A descriptive ex-post facto design was used in the study. Pain clinics and neurosurgical units at three metropolitan hospitals. One hundred patients with chronic low back pain of noncancer origin were administered the two questionnaires as part of a larger questionnaire battery. Acceptable internal consistency values of 0.76 for the PDI and 0.71 for the OLBPDQ were obtained. A correlation of r = 0.63 was found between the PDI and the OLBPDQ, supporting the concurrent validity of the two scales. Both the scales were found to be correlated to the Beck Depression Inventory scores (PDI, r = 0.42; OLBPDQ, r = 0.39), with higher disability associated with greater depression. Only the total PDI score was found to be sensitive to functional status differences within the patient sample. These findings support other recent work in favor of the PDI. The PDI had a slightly higher internal consistency and was more sensitive than the OLBPDQ.

13 CFR 125.25 - How does one file a service disabled veteran-owned status protest?

Code of Federal Regulations, 2013 CFR

2013-01-01

... disabled veteran-owned status protest? 125.25 Section 125.25 Business Credit and Assistance SMALL BUSINESS... disabled veteran-owned status protest? (a) General. The protest procedures described in this part are... service-disabled veteran. The protest does not state any basis for this assertion. The protest allegation...

13 CFR 125.25 - How does one file a service disabled veteran-owned status protest?

Code of Federal Regulations, 2012 CFR

2012-01-01

... disabled veteran-owned status protest? 125.25 Section 125.25 Business Credit and Assistance SMALL BUSINESS... disabled veteran-owned status protest? (a) General. The protest procedures described in this part are... service-disabled veteran. The protest does not state any basis for this assertion. The protest allegation...

13 CFR 125.25 - How does one file a service disabled veteran-owned status protest?

Code of Federal Regulations, 2014 CFR

2014-01-01

... disabled veteran-owned status protest? 125.25 Section 125.25 Business Credit and Assistance SMALL BUSINESS... disabled veteran-owned status protest? (a) General. The protest procedures described in this part are... service-disabled veteran. The protest does not state any basis for this assertion. The protest allegation...

Exploring factors related to physical activity in cervical dystonia.

PubMed

Zetterberg, Lena; Urell, Charlotte; Anens, Elisabeth

2015-12-01

People with disabilities have reported worse health status than people without disabilities and receiving fewer preventive health services such as counseling around exercise habits. This is noteworthy considering the negative consequences associated with physical inactivity. No research has been conducted on physical activity in cervical dystonia (CD), despite its possible major impact on self-perceived health and disability. Considering the favorable consequences associated with physical activity it is important to know how to promote physical activity behavior in CD. Knowledge of variables important for such behavior in CD is therefore crucial. The aim of this study was to explore factors related to physical activity in individuals with cervical dystonia. Subjects included in this cross-sectional study were individuals diagnosed with CD and enrolled at neurology clinics (n = 369). Data was collected using one surface mailed self-reported questionnaire. Physical activity was the primary outcome variable, measured with the Physical Activity Disability Survey. Secondary outcome variables were: impact of dystonia measured with the Cervical Dystonia Impact Scale; fatigue measured with the Fatigue Severity Scale; confidence when carrying out physical activity measured with the Exercise Self-Efficacy Scale; confidence in performing daily activities without falling measured with the Falls Efficacy Scale; enjoyment of activity measured with Enjoyment of Physical Activity Scale, and social influences on physical activity measured with Social Influences on Physical Activity in addition to demographic characteristics such as age, education level and employment status. The questionnaire was completed by 173 individuals (47% response rate). The multivariate association between related variables and physical activity showed that employment, self-efficacy for physical activity, education level and consequences for daily activities explained 51% of the variance in physical activity (Adj R 0.51, F (5, 162) = 35.611, p = 0.000). Employment and self-efficacy for physical activity contributed most strongly to the association with physical activity. Considering the favorable consequences associated with physical activity it could be important to support the individuals with CD to remain in work and self-efficacy to physical activity as employment and self-efficacy had significant influence on physical activity level. Future research is needed to evaluate causal effects of physical activity on consequences related to CD.

Associations Between Fatigue and Disability, Functional Mobility, Depression, and Quality of Life in People with Multiple Sclerosis

PubMed Central

Bush, Steffani; Gappmaier, Eduard

2016-01-01

Background: Fatigue is a common symptom in people with multiple sclerosis (MS), but its associations with disability, functional mobility, depression, and quality of life (QOL) remain unclear. We aimed to determine the associations between different levels of fatigue and disability, functional mobility, depression, and physical and mental QOL in people with MS. Methods: Eighty-nine individuals with MS (mean [SD] disease duration = 13.6 [9.8] years, mean [SD] Expanded Disability Status Scale [EDSS] score = 5.3 [1.5]) and no concurrent relapses were retrospectively analyzed. Participants were divided into two groups based on five-item Modified Fatigue Impact Scale (MFIS-5) scores: group LF (n = 32, MFIS-5 score ≤10 [low levels of fatigue]) and group HF (n = 57, MFIS-5 score >10 [high levels of fatigue]). Results: Sixty-four percent of the sample reported high levels of fatigue. Compared with group LF, group HF demonstrated significantly (P < .05) greater impairments in the Timed Up and Go test, Activities-specific Balance Confidence scale, and 12-item Multiple Sclerosis Walking Scale scores; depression; and QOL but not in the EDSS scores, which were not significantly different between groups. Conclusions: Fatigue was found to be a predominant symptom in the study participants. Individuals reporting higher levels of fatigue concomitantly exhibited greater impairments in functional mobility, depression, and physical and mental QOL. Disability was not found to be related to level of fatigue. These findings can be important for appropriate assessment and management of individuals with MS with fatigue. PMID:27134580

Evidence for early neurodegeneration in the cervical cord of patients with primary progressive multiple sclerosis

PubMed Central

Schneider, Torben; Solanky, Bhavana S.; Yiannakas, Marios C.; Altmann, Dan R.; Wheeler-Kingshott, Claudia A. M.; Peters, Amy L.; Day, Brian L.; Thompson, Alan J.; Ciccarelli, Olga

2015-01-01

Spinal neurodegeneration is an important determinant of disability progression in patients with primary progressive multiple sclerosis. Advanced imaging techniques, such as single-voxel 1H-magnetic resonance spectroscopy and q-space imaging, have increased pathological specificity for neurodegeneration, but are challenging to implement in the spinal cord and have yet to be applied in early primary progressive multiple sclerosis. By combining these imaging techniques with new clinical measures, which reflect spinal cord pathology more closely than conventional clinical tests, we explored the potential for spinal magnetic resonance spectroscopy and q-space imaging to detect early spinal neurodegeneration that may be responsible for clinical disability. Data from 21 patients with primary progressive multiple sclerosis within 6 years of disease onset, and 24 control subjects were analysed. Patients were clinically assessed on grip strength, vibration perception thresholds and postural stability, in addition to the Expanded Disability Status Scale, Nine Hole Peg Test, Timed 25-Foot Walk Test, Multiple Sclerosis Walking Scale-12, and Modified Ashworth Scale. All subjects underwent magnetic resonance spectroscopy and q-space imaging of the cervical cord and conventional brain and spinal magnetic resonance imaging at 3 T. Multivariate analyses and multiple regression models were used to assess the differences in imaging measures between groups and the relationship between magnetic resonance imaging measures and clinical scores, correcting for age, gender, spinal cord cross-sectional area, brain T2 lesion volume, and brain white matter and grey matter volume fractions. Although patients did not show significant cord atrophy when compared with healthy controls, they had significantly lower total N-acetyl-aspartate (mean 4.01 versus 5.31 mmol/l, P = 0.020) and glutamate-glutamine (mean 4.65 versus 5.93 mmol/l, P = 0.043) than controls. Patients showed an increase in q-space imaging-derived indices of perpendicular diffusivity in both the whole cord and major columns compared with controls (P < 0.05 for all indices). Lower total N-acetyl-aspartate was associated with higher disability, as assessed by the Expanded Disability Status Scale (coefficient = −0.41, 0.01 < P < 0.05), Modified Ashworth Scale (coefficient = −3.78, 0.01 < P < 0.05), vibration perception thresholds (coefficient = −4.37, P = 0.021) and postural sway (P < 0.001). Lower glutamate-glutamine predicted increased postural sway (P = 0.017). Increased perpendicular diffusivity in the whole cord and columns was associated with increased scores on the Modified Ashworth Scale, vibration perception thresholds and postural sway (P < 0.05 in all cases). These imaging findings indicate reduced structural integrity of neurons, demyelination, and abnormalities in the glutamatergic pathways in the cervical cord of early primary progressive multiple sclerosis, in the absence of extensive spinal cord atrophy. The observed relationship between imaging measures and disability suggests that early spinal neurodegeneration may underlie clinical impairment, and should be targeted in future clinical trials with neuroprotective agents to prevent the development of progressive disability. PMID:25863355

20 CFR 404.1588 - Your responsibility to tell us of events that may change your disability status.

Code of Federal Regulations, 2010 CFR

2010-04-01

... may change your disability status. 404.1588 Section 404.1588 Employees' Benefits SOCIAL SECURITY... Continuing Or Stopping Disability § 404.1588 Your responsibility to tell us of events that may change your disability status. (a) Your responsibility to report changes to us. If you are entitled to cash benefits or...

Associations between disability prevalence and local-area characteristics in a general community-living population.

PubMed

Philibert, M D; Pampalon, R; Hamel, D; Daniel, M

2013-10-01

Disability is understood to arise from person-environment interactions. Hence, heterogeneity in local-area characteristics should be associated with local-area variation in disability prevalence. This study evaluated the associations of disability prevalence with local-area socioeconomic status and contextual features. Disability prevalence was obtained from the Canada census of 2001 for the entire province of Québec at the level of dissemination areas (617 individuals on average) based on responses from 20% of the population. Data on local-area characteristics were urban-rural denomination, social and material deprivation, active and collective commuting, residential stability, and housing quality. Associations between local-area characteristics and disability prevalence were assessed using multilevel logistic regressions. Disability was associated with local-area socioeconomic status and contextual characteristics, and heterogeneity in these factors accounted for urban-rural differences in disability prevalence. Associations between contextual features and disability prevalence were confounded by local-area socioeconomic status. Some associations between local-area socioeconomic status and disability prevalence were moderated by contextual characteristics. The importance of this effect modification is greater when expressed in terms of the absolute magnitude of disability than in the relative likelihood of disability. Explanation of rural-urban differences by the contribution of other local-area characteristics is consistent with the conceptualization of urban-rural categories as the reflection of spatially varying ensembles of compositional and contextual factors. Although local-area socioeconomic status explains most variability in disability prevalence, this study shows that contextual characteristics are relevant to analyses of the spatial patterning of disability as they predict spatial variations of disability, sometimes in interaction with socioeconomic status. This study demonstrates that absolute and relative perspectives on effect modification may lead to differing conclusions. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Apgar scores at 10 min and outcomes at 6-7 years following hypoxic-ischaemic encephalopathy.

PubMed

Natarajan, Girija; Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; Bann, Carla M; McDonald, Scott A; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R; Vohr, Betty R

2013-11-01

To determine the association between 10 min Apgar scores and 6-7-year outcomes in children with perinatal hypoxic-ischaemic encephalopathy (HIE) enrolled in the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) whole body cooling randomised controlled trial (RCT). Evaluations at 6-7 years included the Wechsler Preschool and Primary Scale of Intelligence III or Wechsler Intelligence Scale for Children IV and Gross Motor Functional Classification Scale. Primary outcome was death/moderate or severe disability. Logistic regression was used to examine the association between 10 min Apgar scores and outcomes after adjusting for birth weight, gestational age, gender, outborn status, hypothermia treatment and centre. In the study cohort (n=174), 64/85 (75%) of those with 10 min Apgar score of 0-3 had death/disability compared with 40/89 (45%) of those with scores >3. Each point increase in 10 min Apgar scores was associated with a significantly lower adjusted risk of death/disability, death, death/IQ <70, death/cerebral palsy (CP) and disability, IQ<70 and CP among survivors (all p<0.05). Among the 24 children with a 10 min Apgar score of 0, five (20.8%) survived without disability. The risk-adjusted probabilities of death/disability were significantly lower in cooled infants with Apgar scores of 0-3; there was no significant interaction between cooling and Apgar scores (p=0.26). Among children with perinatal HIE enrolled in the NICHD cooling RCT, 10 min Apgar scores were significantly associated with school-age outcomes. A fifth of infants with 10 min Apgar score of 0 survived without disability to school age, suggesting the need for caution in limiting resuscitation to a specified duration.

Apgar scores at 10 min and outcomes at 6–7 years following hypoxic-ischaemic encephalopathy

PubMed Central

Natarajan, Girija; Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; Bann, Carla M; McDonald, Scott A; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R; Vohr, Betty R

2014-01-01

Aim To determine the association between 10 min Apgar scores and 6–7-year outcomes in children with perinatal hypoxic-ischaemic encephalopathy (HIE) enrolled in the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) whole body cooling randomised controlled trial (RCT). Methods Evaluations at 6–7 years included the Wechsler Preschool and Primary Scale of Intelligence III or Wechsler Intelligence Scale for Children IV and Gross Motor Functional Classification Scale. Primary outcome was death/moderate or severe disability. Logistic regression was used to examine the association between 10 min Apgar scores and outcomes after adjusting for birth weight, gestational age, gender, outborn status, hypothermia treatment and centre. Results In the study cohort (n=174), 64/85 (75%) of those with 10 min Apgar score of 0–3 had death/disability compared with 40/89 (45%) of those with scores >3. Each point increase in 10 min Apgar scores was associated with a significantly lower adjusted risk of death/disability, death, death/IQ <70, death/cerebral palsy (CP) and disability, IQ<70 and CP among survivors (all p<0.05). Among the 24 children with a 10 min Apgar score of 0, five (20.8%) survived without disability. The risk-adjusted probabilities of death/disability were significantly lower in cooled infants with Apgar scores of 0–3; there was no significant interaction between cooling and Apgar scores (p=0.26). Conclusions Among children with perinatal HIE enrolled in the NICHD cooling RCT, 10 min Apgar scores were significantly associated with school-age outcomes. A fifth of infants with 10 min Apgar score of 0 survived without disability to school age, suggesting the need for caution in limiting resuscitation to a specified duration. PMID:23896791

Injuries and Individuals with Disabilities

ERIC Educational Resources Information Center

Waldman, H. Barry; Perlman, Steven P.; Chaudhry, Ramiz A.

2009-01-01

Children and adults with disabilities are at an increased risk of injury. Falls are the leading mechanism of injury regardless of the disability status and are even more common in those with moderate or severe disabilities. The setting for the injury differs with the disability status. Compared to individuals with moderate or no disabilities,…

Further validation of the peripheral artery questionnaire: results from a peripheral vascular surgery survey in the Netherlands.

PubMed

Smolderen, K G; Hoeks, S E; Aquarius, A E; Scholte op Reimer, W J; Spertus, J A; van Urk, H; Denollet, J; Poldermans, D

2008-11-01

Peripheral arterial disease (PAD) is associated with adverse cardiovascular events and can significantly impair patients' health status. Recently, marked methodological improvements in the measurement of PAD patients' health status have been made. The Peripheral Artery Questionnaire (PAQ) was specifically developed for this purpose. We validated a Dutch version of the PAQ in a large sample of PAD patients. Cross-sectional study. The Dutch PAQ was completed by 465 PAD patients (70% men, mean age 65+/-10 years) participating in the Euro Heart Survey Programme. Principal components analysis and reliability analyses were performed. Convergent validity was documented by comparing the PAQ with EQ-5D scales. Three factors were discerned; Physical Function, Perceived Disability, and Treatment Satisfaction (factor loadings between 0.50 and 0.90). Cronbach's alpha values were excellent (mean alpha=0.94). Shared variance of the PAQ domains with EQ-5D scales ranged from 3 to 50%. The Dutch PAQ proved to have good measurement qualities; assessment of Physical Function, Perceived Disability, and Treatment Satisfaction facilitates the monitoring of patients' perceived health in clinical research and practice. Measuring disease-specific health status in a reliable way becomes essential in times were a wide array of treatment options are available for PAD patients.

Influence of spasticity on mobility and balance in persons with multiple sclerosis.

PubMed

Sosnoff, Jacob J; Gappmaier, Eduard; Frame, Amy; Motl, Robert W

2011-09-01

Spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes that presumably affects mobility and balance. This investigation examined the hypothesis that persons with multiple sclerosis (MS) who have spasticity of the lower legs would have more impairment of mobility and balance compared to those without spasticity. Participants were 34 ambulatory persons with a definite diagnosis of MS. The expanded disability status scale (EDSS) was used to characterize disability in the study sample. All participants underwent measurements of spasticity in the gastroc-soleus muscles of both legs (modified Ashworth scale), walking speed (timed 25-foot walk), mobility (Timed Up and Go), walking endurance (6-minute walk test), self-reported impact of MS on walking ability (Multiple Sclerosis Walking Scale-12), and balance (Berg Balance Test and Activities-specific Balance Confidence Scale). Fifteen participants had spasticity of the gastroc-soleus muscles based on modified Ashworth scale scores. The spasticity group had lower median EDSS scores indicating greater disability (P=0.03). Mobility and balance were significantly more impaired in the group with spasticity compared to the group without spasticity: timed 25-foot walk (P = 0.02, d = -0.74), Timed Up and Go (P = 0.01, d = -0.84), 6-minute walk test (P < 0.01, d = 1.03), Multiple Sclerosis Walking Scale-12 (P = 0.04, d = -0.76), Berg Balance Test (P = 0.02, d = -0.84) and Activities-specific Balance Confidence Scale (P = 0.04, d = -0.59). Spasticity in the gastroc-soleus muscles appears to have negative effect on mobility and balance in persons with MS. The relationship between spasticity and disability in persons with MS requires further exploration.

Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients.

PubMed

Moreira, N C V; Damasceno, R S; Medeiros, C A M; Bruin, P F C de; Teixeira, C A C; Horta, W G; Bruin, V M S de

2008-10-01

We have tested the hypothesis that restless leg syndrome (RLS) is related to quality of sleep, fatigue and clinical disability in multiple sclerosis (MS). The diagnosis of RLS used the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Fatigue was assessed by the Fatigue Severity Scale (FSS >27), quality of sleep by the Pittsburgh Sleep Quality Index (PSQI >6), excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS >10) and clinical disability by the Expanded Disability Status Scale (EDSS). Forty-four patients (32 women) aged 14 to 64 years (43 +/- 14) with disease from 0.4 to 23 years (6.7 +/- 5.9) were evaluated. Thirty-five were classified as relapsing-remitting, 5 as primary progressive and 4 as secondary progressive. EDSS varied from 0 to 8.0 (3.6 +/- 2.0). RLS was detected in 12 cases (27%). Patients with RLS presented greater disability (P = 0.01), poorer sleep (P = 0.02) and greater levels of fatigue (P = 0.03). Impaired sleep was present in 23 (52%) and excessive daytime sleepiness in 3 cases (6.8%). Fatigue was present in 32 subjects (73%) and was associated with clinical disability (P = 0.000) and sleep quality (P = 0.002). Age, gender, disease duration, MS pattern, excessive daytime sleepiness and the presence of upper motor neuron signs were not associated with the presence of RLS. Fatigue was best explained by clinical disability and poor sleep quality. Awareness of RLS among health care professionals may contribute to improvement in MS management.

Clinical Correlations of Brain Lesion Location in Multiple Sclerosis: Voxel-Based Analysis of a Large Clinical Trial Dataset.

PubMed

Altermatt, Anna; Gaetano, Laura; Magon, Stefano; Häring, Dieter A; Tomic, Davorka; Wuerfel, Jens; Radue, Ernst-Wilhelm; Kappos, Ludwig; Sprenger, Till

2018-05-29

There is a limited correlation between white matter (WM) lesion load as determined by magnetic resonance imaging and disability in multiple sclerosis (MS). The reasons for this so-called clinico-radiological paradox are diverse and may, at least partly, relate to the fact that not just the overall lesion burden, but also the exact anatomical location of lesions predict the severity and type of disability. We aimed at studying the relationship between lesion distribution and disability using a voxel-based lesion probability mapping approach in a very large dataset of MS patients. T2-weighted lesion masks of 2348 relapsing-remitting MS patients were spatially normalized to standard stereotaxic space by non-linear registration. Relations between supratentorial WM lesion locations and disability measures were assessed using a non-parametric ANCOVA (Expanded Disability Status Scale [EDSS]; Multiple Sclerosis Functional Composite, and subscores; Modified Fatigue Impact Scale) or multinomial ordinal logistic regression (EDSS functional subscores). Data from 1907 (81%) patients were included in the analysis because of successful registration. The lesion mapping showed similar areas to be associated with the different disability scales: periventricular regions in temporal, frontal, and limbic lobes were predictive, mainly affecting the posterior thalamic radiation, the anterior, posterior, and superior parts of the corona radiata. In summary, significant associations between lesion location and clinical scores were found in periventricular areas. Such lesion clusters appear to be associated with impairment of different physical and cognitive abilities, probably because they affect commissural and long projection fibers, which are relevant WM pathways supporting many different brain functions.

2008 Disability Status Report: The United States

ERIC Educational Resources Information Center

Erickson, W. Lee C.; von Schrader, S.

2010-01-01

The Annual Disability Status Reports provide policy makers, disability advocates, reporters, and the public with a summary of the most recent demographic and economic statistics on the non-institutionalized population with disabilities. They contain information on the population size and disability prevalence for various demographic…

Symptom Reporting Patterns of US Military Service Members with a History of Concussion According to Duty Status.

PubMed

Lu, Lisa H; Cooper, Doug B; Reid, Matthew W; Khokhar, Bilal; Tsagaratos, Jennifer E; Kennedy, Jan E

2018-03-28

To compare symptom reporting patterns of service members with a history of concussion based on work status: full duty, limited duty, or in the Medical Evaluation Board (MEB)/disability process. Retrospective analysis of 181 service members with a history of concussion (MEB n = 56; limited duty n = 62; full duty n = 63). Neurobehavioral Symptom Inventory (NSI) Validity-10 cutoff (>22) and Mild Brain Injury Atypical Symptoms Scale (mBIAS) cutoffs (≥10 and ≥8) were used to evaluate potential over-reporting of symptoms. The MEB group displayed significantly higher NSI scores and significantly higher proportion scored above the mBIAS ≥10 cutoff (MEB = 15%; limited duty = 3%; full duty = 5%). Validity-10 cutoff did not distinguish between groups. MEB but not limited duty status was associated with increased risk of over-reporting symptoms in service members with a history of concussion. Results support the use of screening measures for over-reporting in the MEB/disability samples.

Predictors of short-term work-related disability among active duty US Navy personnel: a cohort study in patients with acute and subacute low back pain.

PubMed

Hiebert, Rudi; Campello, Marco A; Weiser, Sherri; Ziemke, Gregg W; Fox, Bryan A; Nordin, Margareta

2012-09-01

Musculoskeletal disorders of the spine in the US military account for the single largest proportion of the absence of sickness causes leading to early termination. We explored if selected psychological and physical factors were associated with poor outcome after episodes of low back pain (LBP). To identify clinical, demographic, and psychological factors predictive of work duty status after a complaint of LBP. A prospective clinical cohort of US Navy personnel treated for LBP. Eligible cases were active duty US Navy or Marine Corps personnel presenting to an emergency clinic or primary care clinic with a complaint of LBP, where the index episode of LBP was no more than 12 weeks duration before enrollment. The subject's work status (full duty, light duty, sick in quarters [SIQ], limited duty, or medically released to full duty) was abstracted from the subject's electronic medical record at approximately 4 weeks and then again 12 weeks after study enrollment. Work status in this study population is assigned by a Navy health-care provider at the time of a clinical visit and based on the health-care provider's determination of medical fitness for duty. This study collapsed work status into two groups, "full duty" (consisting of "full duty" and "medically released to full duty") and "not at full duty" (consisting of "light duty," "SIQ," and "limited duty"). Volunteers completed a baseline questionnaire consisting of recommended well-validated measures, including attitudes and beliefs about LBP and work (Fear-Avoidance Beliefs Questionnaire [FABQ] and the Tampa Scale of Kinesiophobia), distress (the Pain Catastrophizing Scale), clinical depression (The Center for Epidemiologic Studies Depression scale), a numeric pain intensity scale, self-perceived disability (Oswestry Disability Index), and general health status (12-Item Short Form Health Survey). Navy health-care providers conducted a back pain-specific medical evaluation. Associations are expressed as multivariate-adjusted prevalence ratios (PRs) estimated using Poisson regression. Two hundred fifty-three participants were enrolled. Work status outcome was collected for 239 participants. Predictors of "not at full duty" at 4 weeks after enrollment included having back pain for 4 weeks or less before study enrollment (PR, 2.69; 95% CI, 1.21-5.97) and increased FABQ Work subscale score (PR, 1.05; 95% CI, 1.01-1.08). The sole predictor of work status at 12 weeks after enrollment was increased FABQ Physical Activity (FABQ Physical) subscale score (PR=1.14; 95% CI, 1.00-1.30). The findings that fear-avoidance beliefs were predictive of subsequent work status among active duty service personnel in this study population (after adjusting for clinical, demographic, and psychological covariates) suggest the clinical utility of addressing these factors during treatment of back pain episodes in the military. These findings reflect the important role that psychological factors may play in the return to work process in an active duty military population. Copyright © 2012 Elsevier Inc. All rights reserved.

20 CFR 410.476 - Responsibility to give notice of event which may affect a change in disability status.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Responsibility to give notice of event which may affect a change in disability status. 410.476 Section 410.476 Employees' Benefits SOCIAL SECURITY... change in disability status. An individual who is determined to be totally disabled due to pneumoconiosis...

20 CFR 410.476 - Responsibility to give notice of event which may affect a change in disability status.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Responsibility to give notice of event which may affect a change in disability status. 410.476 Section 410.476 Employees' Benefits SOCIAL SECURITY... change in disability status. An individual who is determined to be totally disabled due to pneumoconiosis...

Pharmacometric Analysis of the Relationship Between Absolute Lymphocyte Count and Expanded Disability Status Scale and Relapse Rate, Efficacy End Points, in Multiple Sclerosis Trials.

PubMed

Novakovic, A M; Thorsted, A; Schindler, E; Jönsson, S; Munafo, A; Karlsson, M O

2018-05-10

The aim of this work was to assess the relationship between the absolute lymphocyte count (ALC), and disability (as measured by the Expanded Disability Status Scale [EDSS]) and occurrence of relapses, 2 efficacy endpoints, respectively, in patients with remitting-relasping multiple sclerosis. Data for ALC, EDSS, and relapse rate were available from 1319 patients receiving placebo and/or cladribine tablets. Pharmacodynamic models were developed to characterize the time course of the endpoints. ALC-related measures were then evaluated as predictors of the efficacy endpoints. EDSS data were best fitted by a model where the logit-linear disease progression is affected by the dynamics of ALC change from baseline. Relapse rate data were best described by the Weibull hazard function, and the ALC change from baseline was also found to be a significant predictor of time to relapse. Presented models have shown that once cladribine exposure driven ALC-derived measures are included in the model, the need for drug effect components is of less importance (EDSS) or disappears (relapse rate). This simplifies the models and theoretically makes them mechanism specific rather than drug specific. Having a reliable mechanism-specific model would allow leveraging historical data across compounds, to support decision making in drug development and possibly shorten the time to market. © 2018, The American College of Clinical Pharmacology.

Functional Disability and Social Conflict Increase Risk of Depression in Older Adulthood Among Bolivian Forager-Farmers.

PubMed

Stieglitz, Jonathan; Schniter, Eric; von Rueden, Christopher; Kaplan, Hillard; Gurven, Michael

2015-11-01

To present an explanatory framework for depression in older adulthood in a small-scale society. We propose that depression is a consequence of functional disability, which can reduce subsistence productivity and resource transfers within and across generations. Social conflict can also disrupt resource flows and should be associated with depression. To evaluate depression among Tsimane forager-farmers of Bolivia, we developed a reliable interview based on focus groups and a review of validated depression scales. Older adults (mean ± SD age = 62 ± 9, n = 325) were recruited regardless of their health status. Demographic, economic, and medical data were collected during annual censuses and routine medical exams. Depression is associated with reduced energetic status, greater physical limitations, and reduced subsistence involvement after controlling for potential confounds such as age, sex, number of reported unresolved conflicts, and market involvement. Depression is also associated with greater reported conflict, particularly with non-kin. Tsimane depression is associated with disability, reduced subsistence productivity, and interpersonal conflict, all of which can disrupt resource flows. Depression appears to be a response to conditions regularly experienced over human history, and not simply a by-product of modernity. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Child's Challenging Behaviour Scale, Version 2 (CCBS-2): Psychometric Evaluation With Young Children.

PubMed

Bourke-Taylor, Helen; Pallant, Julie; Cordier, Reinie

In this article, we evaluate psychometric properties of the Child's Challenging Behaviour Scale, Version 2 (CCBS-2) with mothers of young, typically developing children. A cross-sectional mail survey with Australian mothers (N = 337) included the CCBS-2, the Depression Anxiety Stress Scales, and the Parents' Evaluation of Developmental Status scale. Internal consistency was good, and no gender differences in CCBS-2 scores were significant. Significant results included differences between CCBS-2 scores: among children grouped according to age, among children grouped according to pre- and post-school entry, among mothers grouped according to extent of any symptom type, and between this sample and a previously collected age-matched sample of children with disabilities. Of the properties tested, results support sound psychometrics. The CCBS-2 can be used to differentiate children according to age, school entry, and disability as well as to identify families for potential services in behavior management and mental health. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Examining the Association Between Different Aspects of Socioeconomic Status, Race, and Disability in Hawaii.

PubMed

Seto, Jason; Davis, James; Taira, Deborah Ann

2018-02-20

Socioeconomic status and race/ethnicity are known to be associated with health disparities. This study used data (2010-2014) from the American Community Survey. Respondents over age 30 from Hawaii were included (n = 44,921). Outcome variables were self-reported disability in vision, hearing, ambulatory function, self-care, independent living, or cognitive function. Four measures of socioeconomic status were personal income, average income for the area, income inequality for area, and education. This study used multivariable logistic regression to predict disability by race/ethnicity and socioeconomic status, controlling for age and gender. All four measures of socioeconomic status were significant predictors of at least one type of disability after adjustment for age, gender, and other measures of socioeconomic status. Higher education was significantly related to having every type of disability. Similarly, people with high personal income were less likely to have each type of disability than those with middle income, and those with low income were more likely to have all disabilities except hearing. Income inequality was significantly associated with half the disabilities. Low area income was significantly associated with increased vision-related disability, while high income was associated with less likelihood of hearing-related disability. Native Hawaiians were significantly more likely to report having a disability than Filipinos and Chinese for all six types of disability, Japanese for four, and whites for two, after adjustment. These results suggest that in order to reduce health disparities for Native Hawaiians, as well as other ethnic groups, a range of socioeconomic factors need to be addressed.

Peer victimization as a mediator of the relationship between disability status and psychosocial distress.

PubMed

McGee, Marjorie G

2015-04-01

Youth with disabilities experience greater levels of peer victimization and psychosocial distress than non-disabled youth. However, the extent to which exposure to peer victimization mediates the relationship between disability status and psychosocial distress is unknown. To determine whether the relationship between disability status and psychological distress was mediated by exposure to peer victimization, and if so, whether the mediation effects of peer victimization on psychosocial distress was moderated by sex. This cross-sectional study involved a series of regressions to test for mediation and moderated mediation using complex survey data from 6664 Oregon 11th graders. Peer victimization partially mediated the relationship between disability status and psychosocial distress. Sex, however, did not significantly moderate the mediating effects of peer victimization on psychosocial distress. Exposure to peer victimization mediated the relationship between disability status and psychosocial distress; there was little support for sex as a moderator. Copyright © 2015 Elsevier Inc. All rights reserved.

[The influence of high-tone power therapy on the functional status of patients with multiple sclerosis].

PubMed

Kubsik, Anna; Klimkiewicz, Paulina; Klimkiewicz, Robert; Jankowska, Katarzyna; Jankowska, Agnieszka; Woldańska-Okońska, Marta

2014-07-01

Multiple sclerosis is a chronic, inflammatory, demyelinating disease of the central nervous system, which is characterized by diverse symptomatology. Most often affects people at a young age gradually leading to their disability. Looking for new therapies to alleviate neurological deficits caused by the disease. One of the alternative methods of therapy is high - tone power therapy. The article is a comparison of high-tone power therapy and kinesis in improving patients with multiple sclerosis. The aim of this study was to evaluate the effectiveness of high-tone power therapy and exercises in kinesis on the functional status of patients with multiple sclerosis. The study involved 20 patients with multiple sclerosis, both sexes, treated at the Department of Rehabilitation and Physical Medicine in Lodz. Patients were randomly divided into two groups studied. In group high-tone power therapy applied for 60 minutes, while in group II were used exercises for kinesis. Treatment time for both groups of patients was 15 days. To assess the functional status scale was used: Expanded Disability Status Scale of Kurtzke (EDSS), as well as by Barthel ADL Index. Assessment of quality of life were made using MSQOL Questionnaire-54. For the evaluation of gait and balance using Tinetti scale, and pain VAS rated, and Laitinen. Changes in muscle tone was assessed on the basis of the Ashworth scale. Both group I and II improved on scales conducted before and after therapy. In group I, in which the applied high-tone power therapy, reported statistically significant results in 9 out of 10 tested parameters, while in group II, which was used in the exercises in kinesis an improvement in 6 out of 10 tested parameters. Correlating the results of both the test groups in relation to each other did not show statistically significant differences. High-Tone Power Therapy beneficial effect on the functional status of patients with multiple sclerosis. Obtaining results in terms of number of tested parameters allows for the use of this therapy in the comprehensive improvement of patients with multiple sclerosis. Exercises from the scheme kinesis favorable impact on the functional status of patients with MS and are essential in the rehabilitation of these patients. In any group, no adverse effects were observed.

Dysphagia and nutritional status in multiple sclerosis.

PubMed

Thomas, F J; Wiles, C M

1999-08-01

In this observational study of patients with multiple sclerosis (MS) admitted to a regional neurology centre we assessed the frequency of dysphagia (objectively defined), dysphagia related symptoms, bulbar signs and nutritional status. We studied 79 consecutive admissions with MS (24 at diagnostic admission and 55 more advanced cases admitted for treatment and/or rehabilitation): normative swallowing data were from 181 healthy controls. Swallowing symptoms and signs were semi-quantitatively measured and compared to healthy controls. Dysphagia was defined by a quantitative water test. Disability was determined by Kurtzke's Expanded Disability Status Scale and Barthel's index. Nutritional status was assessed by body mass index, estimated percentage body fat from skin fold thickness measurements at four sites, a global evaluation of nutrition, the presence of pressure sores and the pressure sore risk using the Waterlow score. Patients with MS were more likely to complain of abnormal swallowing, of coughing when eating, and of food 'going down the wrong way' than healthy controls (P < 0.005). These significantly associated symptoms had high specificity but relatively low sensitivity. 43% of patients had abnormal swallowing, almost half of whom did not complain of it: abnormal swallowing was associated with several factors including abnormal brainstem/cerebellar function, disability, vital capacity, and depression score. Those with abnormal swallowing had higher Waterlow scores (P < 0.001), but, overall, abnormal swallowing was not associated with a difference in nutritional indices or incidence of pressure sores. In summary, abnormal swallowing is common in MS although often not complained of. It is associated with disordered brainstem/cerebellar function, overall disability, depressed mood and low vital capacity. It was not associated with major nutritional failure or pressure sores in this study.

Predictors of poststroke health-related quality of life in Nigerian stroke survivors: a 1-year follow-up study.

PubMed

Hamza, Ashiru Mohammad; Al-Sadat, Nabilla; Loh, Siew Yim; Jahan, Nowrozy Kamar

2014-01-01

This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.

Prevalence and predictors of depression in Iranian patients with multiple sclerosis: a population-based study.

PubMed

Seyed Saadat, Seyed Mohammad; Hosseininezhad, Mozaffar; Bakhshayesh, Babak; Seyed Saadat, Seyedeh Nastaran; Nabizadeh, Seyedeh Parand

2014-05-01

Depression is a frequent symptom in multiple sclerosis (MS) which has a negative impact on quality of life and cognitive status. The purpose of this study was to determine the prevalence and associated factors of depression, and status of antidepressant use in Iranian MS patients. One-hundred and sixty patients with definite MS were included. Demographic and clinical characteristics were recorded. Fatigue and depression were evaluated using the fatigue severity scale and Beck depression inventory-II. Cognitive performance and disability were examined by mini-mental status examination and expanded disability status scale. Multiple logistic regressions were used to determine the associated factors of depression and antidepressant use. The prevalence of depression and severe depression was 59.4 and 18.1 %, respectively. However, only 21.1 % of patients were on antidepressant treatment, while the prevalence of unrecognized/untreated depression was found to be as high as 44.1 %. Multivariable analysis showed that fatigue (P < 0.0001, OR = 5.98, 95 % CI = 2.9-12.3) and older age (P = 0.027, OR = 2.24, 95 % CI = 1.09-4.6) were associated with depression in MS patient. A significant association was found between fatigue and antidepressant use (P = 0.001, OR = 6.81, 95 % CI = 2.26-20.48). Our findings demonstrate that depression is significantly associated with fatigue and older age, regardless of other factors. Moreover, despite the high prevalence of depression in MS, most patients do not receive adequate treatment.

Chiropractic care of musculoskeletal disorders in a unique population within Canadian community health centers.

PubMed

Garner, Michael J; Aker, Peter; Balon, Jeff; Birmingham, Michael; Moher, David; Keenan, Dirk; Manga, Pran

2007-01-01

This study was part of a larger demonstration project integrating chiropractic care into publicly funded Canadian community health centers. This pre/post study investigated the effectiveness of chiropractic care in reducing pain and disability as well as improving general health status in a unique population of urban, low-income, and multiethnic patients with musculoskeletal (MSK) complaints. All patients who presented to one of two community health center-based chiropractic clinics with MSK complaints between August 2004 and December 2005 were recruited to participate in this study. Outcomes were assessed by a general health measure (Short Form-12), a pain scale (VAS), and site-specific disability indexes (Roland-Morris Questionnaire and Neck Disability Index), which were administered before and after a 12-week treatment period. Three hundred twenty-four patients with MSK conditions were recruited into the study, and 259 (80.0%) of them were followed to the study's conclusion. Clinically important and statistically significant positive changes were observed for all outcomes (Short Form-12: physical composite score mean change = 4.9, 95% confidence interval [CI] = 3.8-6.0; VAS: current pain mean change = 2.3, 95% CI = 1.9-2.6; Neck Disability Index: mean change = 6.8, 95% CI = 5.4-8.1; Roland-Morris Questionnaire: mean change = 4.3, 95% CI = 3.6-5.1). No adverse events were reported. Patients of low socioeconomic status face barriers to accessing chiropractic services. This study suggests that chiropractic care reduces pain and disability as well as improves general health status in patients with MSK conditions. Further studies using a more robust methodology are needed to investigate the efficacy and cost-effectiveness of introducing chiropractic care into publicly funded health care facilities.

Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model.

PubMed

Bustos-Vázquez, Eduardo; Fernández-Niño, Julián Alfredo; Astudillo-Garcia, Claudia Iveth

2017-04-01

Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status. To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults. We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health. A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20). A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.

Prevalence and predictors of dysphagia in Iranian patients with multiple sclerosis

PubMed Central

Tarameshlu, Maryam; Azimi, Amir Reza; Ghelichi, Leila; Ansari, Noureddin Nakhostin

2017-01-01

Background: Dysphagia is frequently observed in patients with multiple sclerosis (MS). Dysphagia and its complications are common causes of morbidity and mortality in final stages of MS disease. This study aimed at determining the prevalence of dysphagia in Iranian patients with MS and identifying predictors associated with dysphagia. Methods: A total of 230 MS patients were enrolled in this cross-sectional study. Dysphagia was evaluated using Mann Assessment of Swallowing Ability (MASA). Demographic characteristics (age and gender), duration of the disease, disease course, and Expanded Disability Status Scale (EDSS) were recorded for all participants. Results: In total, dysphagia was found in 85 participants (37%) with mild to severe dysphagia (mild 50.6%; moderate 29.4%; and severe 20%). The logistic regression model demonstrated that disability status in EDSS (OR= 2.1; 95% CI 0.5-1.2) and disease duration (OR= 2.3; 95% CI 0.4-1.1) predicts a high risk for dysphagia in MS patients. Conclusion: Dysphagia is prevalent in Iranian patients with MS. Disability level and disease duration are significant predictors of dysphagia after MS.

Change in quality of life and predictors of change among patients with multiple sclerosis: a prospective cohort study.

PubMed

Tepavcevic, Darija Kisic; Pekmezovic, Tatjana; Stojsavljevic, Nebojsa; Kostic, Jelena; Basuroski, Irena Dujmovic; Mesaros, Sarlota; Drulovic, Jelena

2014-04-01

The aim of this study was to determine the changes in the health-related quality of life (HRQoL) and predictors of change among patients with multiple sclerosis (MS) at 3 and 6 years during the follow-up period. A group of 109 consecutive MS patients (McDonald's criteria) referred to the Clinic of Neurology, Belgrade, were enrolled in the study. At three time points during the study (baseline, and at 3 and 6 years during the follow-up period), the HRQoL (measured by MSQoL-54), Expanded Disability Status Scale, and Hamilton Rating Scale for Depression and Fatigue Severity Scale were assessed. During the study period, 93 patients provided both follow-up assessments. Statistically significant deterioration in the HRQoL at each subsequent time point was detected for all scales of the MSQoL-54 except for the pain and change in health scales. A higher level of education was a significant prognostic factor for a better HRQoL on the cognitive function scale throughout the entire period of observation, while marital status (single, including divorced and widowed) and increased age at the onset of MS had significant predictive values of poorer quality-of-life scores on the overall quality-of-life scale at 6-year follow-up. Higher levels of physical disability and depression at baseline were statistically significant prognostic markers for deterioration in HRQoL for the majority of MSQoL-54 scales during the entire follow-up period. Our study suggests that baseline demographic and clinical characteristics could be applied as prognostic markers of the HRQOL for patients diagnosed with MS.

Places, people and mental health: a multilevel analysis of economic inactivity.

PubMed

Fone, David; Dunstan, Frank; Williams, Gareth; Lloyd, Keith; Palmer, Stephen

2007-02-01

This paper investigates multilevel associations between the common mental disorders of anxiety, depression and economic inactivity measured at the level of the individual and the UK 2001 census ward. The data set comes from the Caerphilly Health & Social Needs study, in which a representative survey of adults aged 18-74 years was carried out to collect a wide range of information which included mental health status (using the Mental Health Inventory (MHI-5) scale of the Short Form-36 health status questionnaire), and socio-economic status (including employment status, social class, household income, housing tenure and property value). Ward level economic inactivity was measured using non-means tested benefits data from the Department of Work and Pensions (DWP) on long-term Incapacity Benefit and Severe Disablement Allowance. Estimates from multilevel linear regression models of 10,653 individuals nested within 36 census wards showed that individual mental health status was significantly associated with ward-level economic inactivity, after adjusting for individual-level variables, with a moderate effect size of -0.668 (standard error=0.258). There was a significant cross-level interaction between ward-level and individual economic inactivity from permanent sickness or disability, such that the effect of permanent sickness or disability on mental health was significantly greater for people living in wards with high levels of economic inactivity. This supports the hypothesis that living in a deprived neighbourhood has the most negative health effects on poorer individuals and is further evidence for a substantive effect of the place where you live on mental health.

Women with Chronic Physical Disabilities: Correlates of Their Long-Term Psychosocial Adaptation.

ERIC Educational Resources Information Center

Dangoor, Nira; Florian, Victor

1994-01-01

This study examined the effects of demographic factors, disability status, and individual internal resources to the long-term psychosocial adjustment of 88 married women with orthopedic, neurological, and internal chronic diseases. Results suggest that sense of coherence and socioeconomic status, rather than disability status variables, accounted…

Economic Model Cost-Satisfaction in Inclusive Education. Based on Research Made in Georgia

ERIC Educational Resources Information Center

Mantaluta, Ovidiu; Rukhadze, Nino

2008-01-01

This research comprises a brief analysis of the economic model design, projected for poor countries, where complex assessments of the health status, education outcomes and motivation for children with disabilities are impossible to be done; is possible to be applied on a national scale in Georgia, if the actual government has the necessary…

Development of an Objective Measure to Assess Ego Identity in Adolescence: Validation and Replication.

ERIC Educational Resources Information Center

Grotevant, Harold D., Adams, Gerald R.

1984-01-01

Three studies evaluating the reliability and validity of the Objective Measure of Ego Identity Status (OM-EIS) are reported. Two studies analyzed college students' results from the OM-EIS, the Extended Range Vocabulary Test, the Crowne-Marlowe Social Disability Scale and achievement records. Study 3 correlated high school seniors' OM-EIS scores…

The relationship between employment and veteran status, disability and gender from 2004-2011 Behavioral Risk Factor Surveillance System (BRFSS).

PubMed

Smith, Diane L

2014-01-01

In 2011, about 1.8 million or 8 percent of the 22.2 million veterans were women in the US. The unemployment rate for female veterans of the wars in Iraq and Afghanistan rose to 13.5%, above the 8.4% for non-veteran adult women. To examine data from the Behavioral Risk Factor Surveillance System (BRFSS), from 2004-2011 to determine the relationship between employment and veteran status, disability and gender. Chi square analysis was used to determine if significant differences existed between the employment rate of female veterans with disabilities and female veterans without disabilities, female non-veterans with disabilities and male veterans with disabilities. Binomial logistic regression analysis was used to determine how veteran status, disability and gender affected the likelihood of not being employed. Significant differences were found in employment rate between female veterans with disabilities and female veterans without disabilities, but not when compared to female non-veterans with disabilities or male veterans with disabilities. Disability was the strongest factor increasing the likelihood of not being employed, though veteran status and female gender were also predictive. Female veterans with disabilities experience low levels of employment. Policies and programs are needed to address the unique needs of these veterans.

The frequency of CSF oligoclonal banding in multiple sclerosis increases with latitude.

PubMed

Lechner-Scott, J; Spencer, B; de Malmanche, T; Attia, J; Fitzgerald, M; Trojano, M; Grand'Maison, F; Gomez, J Antonio C; Izquierdo, G; Duquette, P; Girard, M; Grammond, P; Oreja-Guevara, C; Hupperts, R; Bergamaschi, R; Boz, C; Giuliani, G; van Pesch, V; Iuliano, G; Fiol, M; Cristiano, E; Verheul, F; Saladino, M Laura; Slee, M; Barnett, M; Deri, N; Flechter, S; Vella, N; Shaw, C; Herbert, J; Moore, F; Petkovska-Boskova, T; Jokubaitis, V; Butzkueven, H

2012-07-01

With the advent of MRI scanning, the value of lumbar puncture to assess oligoclonal band (OCB) status-for the diagnosis of multiple sclerosis (MS) is increasingly uncertain. One major issue is that the reported frequency of cerebrospinal fluid (CSF)-restricted oligoclonal banding for the diagnosis of MS varies considerably in different studies. In addition, the relationship between OCB positivity and disease outcome remains uncertain, as reported studies are generally too small to assess comparative disability outcomes with sufficient power. In order to further investigate variation of OCB positivity in patients with MS, we utilized MSBase, a longitudinal, Web-based collaborative MS outcomes registry following clinical cohorts in several continents and latitudes. We also assessed whether OCB positivity affects long-term disability outcome. A total of 13,242 patient records were obtained from 37 MS specialist centres in 19 different countries. OCB status was documented in 4481 (34%) patients and 80% of these were OCB positive. The presence of OCB was associated with degree of latitude (p = 0.02). Furthermore, the outcome of patients negative for CSF-specific OCB was significantly better in comparison to the OCB positive patients, as assessed by Expanded Disability Status Scale change (p < 0.001). The results of this study indicate that latitude could explain some of the inconsistencies in OCB status reported in different populations. The study confirms that OCB positivity in MS is associated with a worse long-term prognosis.

Living with disability: patterns of health problems and symptom mediation of health consequences.

PubMed

Patterson, Brandon J; Doucette, William R; Lindgren, Scott D; Chrischilles, Elizabeth A

2012-07-01

People with disability experience a range of symptoms that may serve as an important linkage between disability and other health consequences. The aims of this study were to describe and compare symptom experiences of people with and without disability using a population-based sample and to test direct relationships between disability and health status and indirect effects of disability mediated through symptom experience. A Midwestern sample of 12,249 adults aged 40 and older responded to a cross-sectional survey. Data collected included symptom prevalence and frequencies for 21 commonly reported symptoms, self-perceived health status and physical functioning, number of medications, and demographic variables. Two mediation analyses were conducted using cumulative symptom frequency as the mediator between disability status and both self-rated health and physical functioning. Adults with disability reported significantly greater prevalence and frequencies for all 21 symptoms, with pain and fatigue being the most common. The indirect effect through cumulative symptom frequency explained roughly half of the total effect of disability on general health status, and about one third of the total effect of disability on physical functioning. This study found evidence supporting the diverse and significant symptom experience of people living with disability, especially for symptoms of pain and fatigue. Moreover, symptom experience was found to partially mediate the effects of disability on self-reported general health status and physical functioning. This provides support for symptoms serving as an important link to health outcomes in patients with disability. Copyright © 2012 Elsevier Inc. All rights reserved.

76 FR 38396 - Notice of Availability of Proposed Data Collection Standards for Race, Ethnicity, Primary...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... Standards for Race, Ethnicity, Primary Language, Sex, and Disability Status Required by Section 4302 of the... standards for race, ethnicity, sex, primary language and disability status, as required by Section 4302 of... collection standards for race, ethnicity, sex, primary language, and disability status. The law requires that...

48 CFR 19.1403 - Status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-disabled veteran-owned small business concern. 19.1403 Section 19.1403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Service-Disabled Veteran-Owned Small Business Procurement Program 19.1403 Status as a service-disabled veteran-owned small...

48 CFR 19.1403 - Status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-disabled veteran-owned small business concern. 19.1403 Section 19.1403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Service-Disabled Veteran-Owned Small Business Procurement Program 19.1403 Status as a service-disabled veteran-owned small...

48 CFR 19.1403 - Status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-disabled veteran-owned small business concern. 19.1403 Section 19.1403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Service-Disabled Veteran-Owned Small Business Procurement Program 19.1403 Status as a service-disabled veteran-owned small...

48 CFR 19.1403 - Status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-disabled veteran-owned small business concern. 19.1403 Section 19.1403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Service-Disabled Veteran-Owned Small Business Procurement Program 19.1403 Status as a service-disabled veteran-owned small...

48 CFR 19.1403 - Status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-disabled veteran-owned small business concern. 19.1403 Section 19.1403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Service-Disabled Veteran-Owned Small Business Procurement Program 19.1403 Status as a service-disabled veteran-owned small...

Evidence for early neurodegeneration in the cervical cord of patients with primary progressive multiple sclerosis.

PubMed

Abdel-Aziz, Khaled; Schneider, Torben; Solanky, Bhavana S; Yiannakas, Marios C; Altmann, Dan R; Wheeler-Kingshott, Claudia A M; Peters, Amy L; Day, Brian L; Thompson, Alan J; Ciccarelli, Olga

2015-06-01

Spinal neurodegeneration is an important determinant of disability progression in patients with primary progressive multiple sclerosis. Advanced imaging techniques, such as single-voxel (1)H-magnetic resonance spectroscopy and q-space imaging, have increased pathological specificity for neurodegeneration, but are challenging to implement in the spinal cord and have yet to be applied in early primary progressive multiple sclerosis. By combining these imaging techniques with new clinical measures, which reflect spinal cord pathology more closely than conventional clinical tests, we explored the potential for spinal magnetic resonance spectroscopy and q-space imaging to detect early spinal neurodegeneration that may be responsible for clinical disability. Data from 21 patients with primary progressive multiple sclerosis within 6 years of disease onset, and 24 control subjects were analysed. Patients were clinically assessed on grip strength, vibration perception thresholds and postural stability, in addition to the Expanded Disability Status Scale, Nine Hole Peg Test, Timed 25-Foot Walk Test, Multiple Sclerosis Walking Scale-12, and Modified Ashworth Scale. All subjects underwent magnetic resonance spectroscopy and q-space imaging of the cervical cord and conventional brain and spinal magnetic resonance imaging at 3 T. Multivariate analyses and multiple regression models were used to assess the differences in imaging measures between groups and the relationship between magnetic resonance imaging measures and clinical scores, correcting for age, gender, spinal cord cross-sectional area, brain T2 lesion volume, and brain white matter and grey matter volume fractions. Although patients did not show significant cord atrophy when compared with healthy controls, they had significantly lower total N-acetyl-aspartate (mean 4.01 versus 5.31 mmol/l, P = 0.020) and glutamate-glutamine (mean 4.65 versus 5.93 mmol/l, P = 0.043) than controls. Patients showed an increase in q-space imaging-derived indices of perpendicular diffusivity in both the whole cord and major columns compared with controls (P < 0.05 for all indices). Lower total N-acetyl-aspartate was associated with higher disability, as assessed by the Expanded Disability Status Scale (coefficient = -0.41, 0.01 < P < 0.05), Modified Ashworth Scale (coefficient = -3.78, 0.01 < P < 0.05), vibration perception thresholds (coefficient = -4.37, P = 0.021) and postural sway (P < 0.001). Lower glutamate-glutamine predicted increased postural sway (P = 0.017). Increased perpendicular diffusivity in the whole cord and columns was associated with increased scores on the Modified Ashworth Scale, vibration perception thresholds and postural sway (P < 0.05 in all cases). These imaging findings indicate reduced structural integrity of neurons, demyelination, and abnormalities in the glutamatergic pathways in the cervical cord of early primary progressive multiple sclerosis, in the absence of extensive spinal cord atrophy. The observed relationship between imaging measures and disability suggests that early spinal neurodegeneration may underlie clinical impairment, and should be targeted in future clinical trials with neuroprotective agents to prevent the development of progressive disability. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Long-term outcomes of allogeneic haematopoietic stem cell transplantation for adult cerebral X-linked adrenoleukodystrophy.

PubMed

Kühl, Jörn-Sven; Suarez, Felipe; Gillett, Godfrey T; Hemmati, Philipp G; Snowden, John A; Stadler, Michael; Vuong, Giang L; Aubourg, Patrick; Köhler, Wolfgang; Arnold, Renate

2017-04-01

The adult cerebral inflammatory form of X-linked adrenoleukodystrophy is a rapidly progressive neurodegenerative disease, as devastating as childhood cerebral adrenoleukodystrophy. Allogeneic haematopoietic stem cell transplantation has been demonstrated to provide long-term neurological benefits for boys with the childhood cerebral form, but results in adults are sparse and inconclusive. We analysed data from 14 adult males with adult cerebral adrenoleukodystrophy treated with allogeneic haematopoietic stem cell transplantation on a compassionate basis in four European centres. All presented with cerebral demyelinating lesions and gadolinium enhancement. Median age at diagnosis of adult cerebral adrenoleukodystrophy was 33 years (range 21-48 years). In addition to cerebral inflammation, five patients had established severe motor disability from adrenomyeloneuropathy affecting only the spinal cord and peripheral nerves (Expanded Disability Status Scale score ≥ 6). Eight patients survived (estimated survival 57 ± 13%) with a median follow-up of 65 months (minimum 38 months). Death was directly transplant-/infection-related (n = 3), due to primary disease progression in advanced adult cerebral adrenoleukodystrophy (n = 1), or secondary disease progression (n = 2) after transient multi-organ failure or non-engraftment. Specific complications during stem cell transplantation included deterioration of motor and bladder functions (n = 12) as well as behavioural changes (n = 8). Arrest of progressive cerebral demyelination and prevention of severe loss of neurocognition was achieved in all eight survivors, but deterioration of motor function occurred in the majority (n = 5). Limited motor dysfunction (Expanded Disability Status Scale score < 6) prior to transplantation was associated with significantly improved survival [78 ± 14% (n = 9) versus 20 ± 18%(n = 5); P < 0.05] and maintenance of ambulation (Expanded Disability Status Scale score < 7) post-transplant (78% versus 0%; P = 0.021). In contrast, bilateral involvement of the internal capsule on brain MRI was associated with poorer survival [20 ± 18% (n = 5) versus 78 ± 14% (n = 9); P < 0.05]. This study is the first to support the feasibility, complications and potential long-term neurological benefit of allogeneic haematopoietic stem cell transplantation in adult cerebral adrenoleukodystrophy. Further studies are warranted to attempt to improve outcomes through patient selection and optimization of transplantation protocols. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Employment as a health promotion intervention for persons with multiple sclerosis.

PubMed

Chiu, Chung-Yi; Chan, Fong; Edward Sharp, Seneca; Dutta, Alo; Hartman, Ellie; Bezyak, Jill

2015-01-01

To examine the relationship between employment status (no employment, part-time employment, and full-time employment) and functional disability, health-related quality of life, and life satisfaction of people with MS. 157 individuals with MS completed a survey packet, including employment status, self-report disability severity, and health-related scales. A series of multivariate analysis of variance was performed to determine the differences between employment groups in health-related outcomes. The unemployed group had the highest levels of incapacity and social impairments among the three groups. They also had the lowest physical health-related quality of life and life satisfaction. The part-time employed group had the lowest levels of depression and higher levels of physical activity participation among the three groups of individuals with MS. Employment is significantly related to health-related quality of life, and as a result, it should be considered an important public health intervention for people with MS.

The role of physical activity and diabetes status as a moderator: functional disability among older Mexican Americans.

PubMed

Palmer, Raymond F; Espino, David V; Dergance, Jeannae M; Becho, Johanna; Markides, Kyriakos

2012-11-01

we investigate the temporal association between the rate of change in physical function and the rate of change in disability across four comparison groups: Those with and without diabetes who report >30 min of physical activity per day, and those who report <30 min of physical activity per day. six waves of longitudinal data from the Hispanic Established Population for Epidemiologic Studies of the Elderly were utilised. At baseline, there were a total of 3,050 elder participants aged 65 years old or greater. The longitudinal rates of change in disability and physical function were compared by the diabetes status (ever versus none) and the physical activity status (less than or greater than or equal to 30 min per day). disability and physical function data were analysed using a latent growth curve modelling approach adjusted for relevant demographic/health-related covariates. There were statistically significant longitudinal declines in physical function and disability (P < 0.001) in all groups. Most notable, the physical activity status was an important moderator. Those with >30 min of activity demonstrated better baseline function and less disability as well as better temporal trajectories than those reporting <30 min of physical activity per day. Comparisons between diabetes statuses within the same physical activity groups showed worse disability trajectories among those with diabetes. a longitudinal decline in physical function and disability is moderated most notably by physical activity. The diabetes status further moderates decline in function and disability over time. Increased physical activity appears to be protective of disability in general and may lessen the influence of diabetes-related disability in older Mexican Americans, particularly at the end of life.

Health problems account for a small part of the association between socioeconomic status and disability pension award. Results from the Hordaland Health Study.

PubMed

Østby, Kristian Amundsen; Ørstavik, Ragnhild E; Knudsen, Ann Kristin; Reichborn-Kjennerud, Ted; Mykletun, Arnstein

2011-01-06

Low socioeconomic status is a known risk factor for disability pension, and is also associated with health problems. To what degree health problems can explain the increased risk of disability pension award associated with low socioeconomic status is not known. Information on 15,067 participants in the Hordaland Health Study was linked to a comprehensive national registry on disability pension awards. Level of education was used as a proxy for socioeconomic status. Logistic regression analyses were employed to examine the association between socioeconomic status and rates of disability pension award, before and after adjusting for a wide range of somatic and mental health factors. The proportion of the difference in disability pension between socioeconomic groups explained by health was then calculated. Unadjusted odds ratios for disability pension was 4.60 (95% CI: 3.34-6.33) for the group with elementary school only (9 years of education) and 2.03 (95% CI 1.49-2.77) for the group with high school (12 years of education) when compared to the group with higher education (more than 12 years). When adjusting for somatic and mental health, odds ratios were reduced to 3.87 (2.73-5.47) and 1.81 (1.31-2.52). This corresponds to health explaining only a marginal proportion of the increased level of disability pension in the groups with lower socioeconomic status. There is a socioeconomic gradient in disability pension similar to the well known socioeconomic gradient in health. However, health accounts for little of the socioeconomic gradient in disability pension. Future studies of socioeconomic gradients in disability pension should focus on explanatory factors beyond health.

Health problems account for a small part of the association between socioeconomic status and disability pension award. Results from the Hordaland Health Study

PubMed Central

2011-01-01

Background Low socioeconomic status is a known risk factor for disability pension, and is also associated with health problems. To what degree health problems can explain the increased risk of disability pension award associated with low socioeconomic status is not known. Methods Information on 15,067 participants in the Hordaland Health Study was linked to a comprehensive national registry on disability pension awards. Level of education was used as a proxy for socioeconomic status. Logistic regression analyses were employed to examine the association between socioeconomic status and rates of disability pension award, before and after adjusting for a wide range of somatic and mental health factors. The proportion of the difference in disability pension between socioeconomic groups explained by health was then calculated. Results Unadjusted odds ratios for disability pension was 4.60 (95% CI: 3.34-6.33) for the group with elementary school only (9 years of education) and 2.03 (95% CI 1.49-2.77) for the group with high school (12 years of education) when compared to the group with higher education (more than 12 years). When adjusting for somatic and mental health, odds ratios were reduced to 3.87 (2.73-5.47) and 1.81 (1.31-2.52). This corresponds to health explaining only a marginal proportion of the increased level of disability pension in the groups with lower socioeconomic status. Conclusion There is a socioeconomic gradient in disability pension similar to the well known socioeconomic gradient in health. However, health accounts for little of the socioeconomic gradient in disability pension. Future studies of socioeconomic gradients in disability pension should focus on explanatory factors beyond health. PMID:21210992

The combined effect of visual impairment and cognitive impairment on disability in older people.

PubMed

Whitson, Heather E; Cousins, Scott W; Burchett, Bruce M; Hybels, Celia F; Pieper, Carl F; Cohen, Harvey J

2007-06-01

To determine the risk of disability in individuals with coexisting visual and cognitive impairment and to compare the magnitude of risk associated with visual impairment, cognitive impairment, or the multimorbidity. Prospective cohort. North Carolina. Three thousand eight hundred seventy-eight participants in the North Carolina Established Populations for the Epidemiologic Studies of the Elderly with nonmissing visual status, cognitive status, and disability status data at baseline Short Portable Mental Status Questionnaire (cognitive impairment defined as > or =4 errors), self reported visual acuity (visual impairment defined as inability to see well enough to recognize a friend across the street or to read newspaper print), demographic and health-related variables, disability status (activities of daily living (ADLs), instrumental activities of daily living (IADLs), mobility), death, and time to nursing home placement. Participants with coexisting visual and cognitive impairment were at greater risk of IADL disability (odds ratio (OR)=6.50, 95% confidence interval (CI)=4.34-9.75), mobility disability (OR=4.04, 95% CI=2.49-6.54), ADL disability (OR=2.84, 95% CI=1.87-4.32), and incident ADL disability (OR=3.66, 95%, CI=2.36-5.65). In each case, the estimated OR associated with the multimorbidity was greater than the estimated OR associated with visual or cognitive impairment alone, a pattern that was not observed for other adverse outcomes assessed. No significant interactions were observed between cognitive impairment and visual impairment as predictors of disability status. Individuals with coexisting visual impairment and cognitive impairment are at high risk of disability, with each condition contributing additively to disability risk. Further study is needed to improve functional trajectories in patients with this prevalent multimorbidity. When visual or cognitive impairment is present, efforts to maximize the other function may be beneficial.

An endovascular treatment of Chronic Cerebro-Spinal Venous Insufficiency in multiple sclerosis patients - 6 month follow-up results.

PubMed

Kostecki, Jacek; Zaniewski, Maciej; Ziaja, Krzysztof; Urbanek, Tomasz; Kuczmik, Waclaw; Krzystanek, Ewa; Ziaja, Damian; Korzeniowski, Tomasz; Majewski, Eugeniusz; Hartel, Marcin; Swiat, Maciej; Sioma-Markowska, Urszula

2011-01-01

In this study, the mid-term results (6 month follow-up) of the endovascular treatment in patients with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and multiple sclerosis (MS) were prospectively evaluated. Thirty-six patients with confirmed MS and CCSVI underwent endovascular treatment by the means of the uni- or bilateral jugular vein angioplasty with optional stent placement. All the patients completed 6 month follow-up. Their MS-related disability status and quality of life were evaluated 1, 3 and 6 months postoperatively by means of the following scales: Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), Epworth Sleepiness Scale (ESS), Heat Intolerance scale (HIS) and Fatigue Severity Scale (FSS). For patency and restenosis rate assessment, the control US duplex Doppler examination was used. Six months after the procedure, restenosis in post-PTA jugular veins was found in 33% of cases. Among 17 patients who underwent stent implantation into the jugular vein, restenosis or partial in-stent thrombosis was identified in 55% of the cases. At the 6 month follow-up appointment, there was no significant improvement in the EDSS or the ESS. The endovascular treatment of the CCSVI improved the quality of life according to the MSIS-29 scale but only up to 3 months after the procedure (with no differences in the 6 month follow-up assessment). Six months after the jugular vein angioplasty (with or without stent placement), a statistically significant improvement was observed only in the FSS and the HIS. The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed.

Math Growth Trajectories of Students with Disabilities: Disability Category, Gender, Racial, and Socioeconomic Status Differences from Ages 7 to 17

ERIC Educational Resources Information Center

Wei, Xin; Lenz, Keith B.; Blackorby, Jose

2013-01-01

This study examined math growth trajectories by disability category, gender, race, and socioeconomic status using a nationally representative sample of students ages 7 to 17. The students represented 11 federal disability categories. Compared with the national norming sample, students in all 11 disability categories had lower math achievement…

Health Status and Health Risks of the "Hidden Majority" of Adults with Intellectual Disability

ERIC Educational Resources Information Center

Emerson, Eric

2011-01-01

Little is known about the health status of and health risks faced by adults with intellectual disability who do not use intellectual disability services. Self-report data collected from 1,022 people with mild intellectual disability in England indicated that people who do not use intellectual disability services are more likely to smoke tobacco…

Do attitudes toward exercise vary with differences in mobility and disability status? - a study among low-income seniors.

PubMed

Bean, Jonathan F; Bailey, Allison; Kiely, Dan K; Leveille, Suzanne G

2007-08-15

To examine attitudes toward exercise among a vulnerable aged population characterized by low socioeconomic status, poor functional status and lack of available therapeutic exercise resources. This cross-sectional survey among public low-income housing residents (n = 94), aged > 70 years utilizes these assessments: Physician-based Assessment & Counseling for Exercise (PACE) scale, exercise self-efficacy score, Short Physical Performance Battery (SPPB), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Readiness to exercise differed significantly (p < 0.001) across physical performance levels, and ADL and IADL groups. Exercise self-efficacy also differed significantly (p < 0.001) across performance levels. The highest performance level (score 7 - 12) had a significantly (p < 0.05) higher self-efficacy score (x=7.0+/-2.8) than the medium performance level (score 4 - 6) (x=5.3+/-2.8) and the lowest performance level (0 - 3) (x=4.3+/-2.5) groups. Exercise self-efficacy also differed significantly (p < 0.001) across ADL and IADL groups. However, interest in home-based or class-based exercise participation was high among all groups. More than 70% of subjects reported interest with no significant difference noted among groups. Attitudes toward exercise are significantly associated with observed physical function and self-reported disability among vulnerable older adults living in public low-income housing.

Accounting for the Process of Disablement and Longitudinal Outcomes Among the Near Elderly and Elderly.

PubMed

Rupp, Kalman; Dushi, Irena

2017-01-01

Using a new disability measure applicable to both the near elderly and elderly population, we track respondents aged 51-61 in 1992 from the Health and Retirement Study and account for their status over 20 years. We demonstrate that to screen in as disabled and to screen out as nondisabled require different analytic strategies and use multiple indicators to establish three groups: disabled, nondisabled, and a residual category with ambiguous status. We use work-disability and Supplemental Security Income/Disability Insurance (SSI/DI) receipt for testing distributional outcomes and assessing face validity of our disability measure. Selective attrition due to death and institutionalization is substantial over 20 years. Persistent disability is the dominant adverse outcome of initial disability shock. Overtime exits due to death become progressively more important; 44% disabled at baseline are dead by Wave 11 compared to 21% for nondisabled. Disability status at baseline is associated with financial insecurity persisting to Wave 11 among survivors.

A comparison of upper limb amputees and patients with upper limb injuries using the Disability of the Arm, Shoulder and Hand (DASH).

PubMed

Davidson, Judith

To use the Disability of the Arm Shoulder and Hand (DASH) scale to measure the disability of patients with upper limb amputation(s) and to compare these to other upper limb injuries. All 274 patients over the age of 18 years presenting to Prince Henry Hospital in Sydney over a 4-year time frame were given the DASH assessment tool and asked to complete it under supervision of the Occupational Therapist. Patients with brachial plexus injuries, Complex Regional Pain Syndrome and bilateral upper limb amputations demonstrated significantly higher levels of disability to patients with unilateral upper limb amputations. Partial hand amputees reported a higher level of disability than major unilateral upper limb amputees. For the 48 patients who completed pre- and post-treatment assessments, there was a significant improvement in their health status. Further research is required to understand the factors that affect a patient's perceptions of their disability. Perhaps the definitive nature of an amputation and the immediate involvement of highly skilled health professionals serve to assist patients to accept their injury and therefore minimizes the level of disability.

Quality of life attenuates age-related decline in functional status of older adults.

PubMed

Palgi, Yuval; Shrira, Amit; Zaslavsky, Oleg

2015-08-01

In the present study, we aimed to examine the total and moderating effects of needs-satisfaction-driven quality-of-life (QoL) measure on age-related change in functional status. Participants in the Survey of Health and Retirement in Europe (N = 18,781 at Wave 1) completed a measure of QoL (CASP-12) at baseline and reported their functional status across subsequent three waves using activities of daily living (ADL), instrumental activities of daily living (IADL), and functional limitation indices. Growth-curve model estimates revealed that aged individuals with lower QoL scores at baseline had a steeper increase in disability deficits accumulation and functional limitation progression than their counterparts with a higher sense of QoL. The effects were more pronounced in ADL and IADL disability scales in which QoL moderated both linear and quadratic age-related changes. Higher QoL attenuates processes of functional decline in late adulthood. Practitioners may seek strategies for improving and enhancing patients' QoL, as its salutary effects diffuse beyond psychological experience and include long-term effects on physical functioning.

Self-perception of disability and prospects for employment among U.S. veterans.

PubMed

Griffin, Christopher L; Stein, Michael Ashley

2015-01-01

Barriers to employment in the civilian labor force are increasingly difficult problems for returning veterans with disabilities. Reduced self-perception of disability status because of predominant military norms can be particularly harmful to reintegration efforts. We analyze rates of self-identified and externally determined disability status among U.S. veterans. Evidence of a lower self-report rate would confirm the hypothesis that armed forces culture might hold back truly deserving veterans from seeking the benefits owed, including specialized employment training programs. We use data from the Current Population Survey Veterans Supplement over the sample period 1995-2010 on disability status and associated demographic characteristics to present descriptive measures and limited statistical inference. Over the entire sample period, federal agencies considered 29% of the survey respondents to have a service-connected disability versus a 9% self-identification rate. The rate of more severe service-connected disabilities has risen steadily, while less drastic disability rates have fallen. Non-white respondents and those with lower education levels were less likely to self-identify. Large disparities in internal and external disability status identification raise questions about targeting soldiers re-entering the labor force. Employment policy should focus on overcoming negative cultural stereotypes and encouraging self-identification.

20 CFR 416.988 - Your responsibility to tell us of events that may change your disability or blindness status.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Your responsibility to tell us of events that may change your disability or blindness status. 416.988 Section 416.988 Employees' Benefits SOCIAL... us of events that may change your disability or blindness status. If you are entitled to payments...

20 CFR 416.988 - Your responsibility to tell us of events that may change your disability or blindness status.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Your responsibility to tell us of events that may change your disability or blindness status. 416.988 Section 416.988 Employees' Benefits SOCIAL... us of events that may change your disability or blindness status. If you are entitled to payments...

48 CFR 19.307 - Protesting a firm's status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2014 CFR

2014-10-01

... as a service-disabled veteran-owned small business concern. 19.307 Section 19.307 Federal Acquisition...-disabled veteran-owned small business concern. (a) Definition. Interested party, as used in this section... contracting officer, or the SBA may protest the apparently successful offeror's status as a service-disabled...

An Examination of the Nutritional Intake and Anthropometric Status of Individuals with Intellectual Disabilities: Results from the SOPHIE Study

ERIC Educational Resources Information Center

Hoey, Edel; Staines, Anthony; Walsh, Denise; Corby, Deirdre; Bowers, Kirsty; Belton, Sarahjane; Meegan, Sarah; McVeigh, Treasa; McKeon, Michael; Trépel, Dominic; Griffin, Peter; Sweeney, Mary Rose

2017-01-01

The prevalence of obesity appears greater in people with intellectual disabilities than those in the general population. This study aimed to examine the nutritional intake and anthropometric status of individuals with intellectual disabilities. Participants aged 16-64 years were recruited from intellectual disability service provider organizations…

State-level differences in breast and cervical cancer screening by disability status: United States, 2008.

PubMed

Armour, Brian S; Thierry, JoAnn M; Wolf, Lesley A

2009-01-01

Despite reported disparities in the use of preventive services by disability status, there has been no national surveillance of breast and cervical cancer screening among women with disabilities in the United States. To address this, we used state-level surveillance data to identify disparities in breast and cervical cancer screening among women by disability status. Data from the 2008 Behavioral Risk Factor Surveillance System were used to estimate disability prevalence and state-level differences in breast and cervical cancer screening among women by disability status. Overall, modest differences in breast cancer screening were found; women with a disability were less likely than those without to report receiving a mammogram during the past 2 years (72.2% vs. 77.8%; p < .001). However, disparities in breast cancer screening were more pronounced at the state level. Furthermore, women with a disability were less likely than those without a disability to report receiving a Pap test during the past 3 years (78.9% vs. 83.4%; p < .001). This epidemiologic evidence identifies an opportunity for federal and state programs, as well as other stakeholders, to form partnerships to align disability and women's health policies. Furthermore, it identifies the need for increased public awareness and resource allocation to reduce barriers to breast and cervical cancer screening experienced by women with disabilities.

The evaluation of cervical spinal angle in patients with acute and chronic neck pain.

PubMed

Aşkin, Ayhan; Bayram, Korhan Barış; Demirdal, Ümit Seçil; Atar, Emel; Arifoğlu Karaman, Çiğdem; Güvendi, Ece; Tosun, Aliye

2017-06-12

Clinicians associate the changes in cervical lordosis with neck pain, but there is no clear consensus on this. We aimed to investigate the relationships of cervical angles, neck pain, disability, and the psychological status of the patients with acute and chronic neck pain. A total of 110 patients with neck pain were included in this study. Demographic and clinical characteristics of the patients were recorded. The lordosis angle was determined by the posterior tangent method. A visual analog scale (VAS), the Neck Disability Index (NDI), and the Hospital Anxiety and Depression (HAD) scale were administered to all patients. The mean cervical lordosis angle was 23.10 ± 8.07 degrees. A statistically negative correlation was detected between cervical angle and duration of disease (P < 0.05). The cervical angle of the acute neck pain group was higher than that of the chronic pain group (P < 0.05). There was no difference between the acute and chronic neck pain groups with respect to VAS, NDI, and HAD scores (P > 0.05). We found that the cervical angle was significantly lower in chronic neck pain patients when compared to acute patients, and patients with higher pain scores had more severe disability and that disability increased with the duration of disease.

Depressive symptoms among the visually disabled in Wuhan: an epidemiological survey

PubMed Central

LI, Wenxue; ZHONG, Baoliang; LIU, Xiujun; HUANG, Xian'e; DAI, Xiaoyan; HU, Qiongfang; ZHANG, Huishi; XU, Hanming

2013-01-01

Background There are no representative studies on the mental health status of persons with disabilities in China. Objective Estimate the prevalence of depressive symptoms and identify the factors associated with depressive symptoms in a representative sample of individuals with serious visually disabilities in Wuhan, China. Methods A multi-stage stratified cluster sampling method was used to identify 1200 visually disabled individuals from among the 22,000 persons with serious visual disabilities who were registered with the Wuhan Disabled Persons' Federation. Identified individuals were administered the Center for Epidemiological Studies Depression Scale (CES-D) and the Revised Eysenck Personality Questionnaire-Short Scale for Chinese (EPQ-RSC) by trained interviewers. Results The adjusted prevalence of mild, moderate and severe depressive symptoms among the 1003 individuals who successfully completed the survey were 8.8% (95% confidence interval [CI]=5.7-11.8%), 15.6% (CI=12.8-18.5%) and 16.0% (CI=13.7-18.3%), respectively. Factors significantly associated with more severe depressive symptoms in the multivariate logistic regression analysis (in order of importance) were emotional instability (OR=5.84, CI=4.19-8.14), introverted personality (OR=2.94, CI=2.10-4.12), having religious beliefs (OR=2.03, CI=1.06-3.90), being blind (versus those who were only visually impaired) (OR=1.52, CI=1.09-1.95), being unmarried (OR=1.51, CI=1.06-2.15), and having limited education (OR=1.49, CI=1.06-2.10). Conclusions Over one-third of all individuals with visual disabilities registered with the Disabled Persons' Federation in in Wuhan have clinically significant depressive symptoms. Almost none of these individuals receive treatment. Services for persons with serious visual disabilities – and for individuals with other types of serious physical or sensory disabilities – should include activities aimed at improving psychological wellbeing, periodic screening for psychological problems and, when needed, professional treatment for mental disorders. PMID:24991169

Racial/Ethnic Disparities in Disability Prevalence.

PubMed

Goyat, Rashmi; Vyas, Ami; Sambamoorthi, Usha

2016-12-01

Worldwide, the number of disabled individuals is used as a marker for population health status because of high morbidity and mortality burden associated with disability. The primary objective of the current study is to use the 2012 NHIS disability supplement and examine racial/ethnic disparities in disability after controlling for a comprehensive list of factors, using the World Health Organization's International Classification of Functioning, Disability, and Health (WHO-ICF). A retrospective cross-sectional study design with data from 7993 individuals aged above 21 years from the 2012 National Health Interview Survey (NHIS) was adopted. Disability was defined based on a standard set of questions related to mobility, self-care, and cognition from the "Functioning and Disability" supplement of 2012 NHIS. Chi-squared tests and multinomial logistic regressions were conducted to examine the association between race/ethnicity and disability. There were statistically significant racial/ethnic differences in disability status; 10.2 % non-Hispanic whites, 14.8 % non-Hispanic African Americans, 8.1 % Latino, and 6.7 % other racial minorities had severe disability. Non-Hispanic African Americans were more likely to have severe disability than were non-Hispanic whites (OR = 1.56, 95 % CI = 1.24, 1.95), and Latinos were less likely to have severe disability (OR = 0.70, 95 % CI = 0.55, 0.90) in the unadjusted model. There was no difference in disability status among non-Hispanic African Americans and non-Hispanic whites after adjusting for socio-economic status. The study findings highlighted the role of socio-economic characteristics in reducing disparities in disability between non-Hispanic African Americans and non-Hispanic whites. As SES can affect health through a complex interaction of biological, psychological, lifestyle, environmental, social, and neighborhood factors, a multipronged approach that focuses on primary, secondary, and territory prevention of disability is needed.

Preference-based Health status in a German outpatient cohort with multiple sclerosis

PubMed Central

2013-01-01

Background To prospectively determine health status and health utility and its predictors in patients with multiple sclerosis (MS). Methods A total of 144 MS patients (mean age: 41.0 ±11.3y) with different subtypes (patterns of progression) and severities of MS were recruited in an outpatient university clinic in Germany. Patients completed a questionnaire at baseline (n = 144), 6 months (n = 65) and 12 months (n = 55). Health utilities were assessed using the EuroQol instrument (EQ-5D, EQ VAS). Health status was assessed by several scales (Expanded Disability Severity Scale (EDSS), Modified Fatigue Impact Scale (M-FIS), Functional Assessment of MS (FAMS), Beck Depression Inventory (BDI-II) and Multiple Sclerosis Functional Composite (MSFC)). Additionally, demographic and socioeconomic parameters were assessed. Multivariate linear and logistic regressions were applied to reveal independent predictors of health status. Results Health status is substantially diminished in MS patients and the EQ VAS was considerably lower than that of the general German population. No significant change in health-status parameters was observed over a 12-months period. Multivariate analyses revealed M-FIS, BDI-II, MSFC, and EDSS to be significant predictors of reduced health status. Socioeconomic and socio-demographic parameters such as working status, family status, number of household inhabitants, age, and gender did not prove significant in multivariate analyses. Conclusion MS considerably impairs patients’ health status. Guidelines aiming to improve self-reported health status should include treatment options for depression and fatigue. Physicians should be aware of depression and fatigue as co-morbidities. Future studies should consider the minimal clinical difference when health status is a primary outcome. PMID:24089999

Work status and disability trajectories over 12 months after injury among workers in New Zealand.

PubMed

Langley, John; Lilley, Rebbecca; Samaranayaka, Ari; Derrett, Sarah

2014-03-07

To describe work and disability trajectories over 12 months following injury among workers. Workers injured at work or elsewhere (n=2626) were sourced from the Prospective Outcomes of Injury Study, a longitudinal cohort study in New Zealand, with the primary objective of identifying factors associated with disability following injury. Work and disability status was assessed at 3- and 12-months post injury. The measure of disability was the brief WHODAS II 12-item instrument. Participants were dichotomised into 'disability' or 'no disability' groups based on whether their WHODAS score was greater than, or equal to, 10. In terms of 12-month work status, there are 16 different scenarios. These were grouped into 4 categories: sustained work (SW), delayed return to work (RTW), non-sustained RTW, and sustained off-work. We had complete information for 1975 workers. The largest group (68%) was SW, 32% of which had disability at either time point. The second largest group consisted of 17% of workers who were classified as delayed RTW, 76% of whom were disabled at either time point. Among the non-sustained RTW group (7%), 52% had disability at either time point. Of the sustained off-work group (8%), 80% were disabled at either 3- or 12-months. Although return to work is a useful provider performance indicator of injury compensation and rehabilitation it is inadequate from a wider societal perspective and needs to be complemented by other important outcome measures such as disability status.

Self-reported levels of education and disability progression in multiple sclerosis.

PubMed

D'hooghe, M B; Haentjens, P; Van Remoortel, A; De Keyser, J; Nagels, G

2016-12-01

The purpose of our study is to investigate whether socioeconomic indicators such as education, financial concerns, employment, and living status are associated with disease progression in relapsing-onset and progressive-onset Multiple Sclerosis (MS). We performed a cross-sectional survey among individuals with MS, registered by the Flemish MS society and included socioeconomic indicators. A Cox proportional hazard regression was performed with the time from MS onset and from birth to reach an ambulatory disability milestone corresponding to Expanded Disability Status Scale (EDSS) 6 (requiring a cane) as outcome measure, adjusted for gender, age at MS onset, and immunomodulatory treatment. Among the participants with relapsing-onset MS, subjects reporting education for more than 12 years had a reduced risk of reaching EDSS 6 compared to subjects reporting education for less than 12 years [HR from onset 0.68 (95% CI 0.49-0.95); HR from birth 0.71 (95% CI 0.51-0.99)]. In progressive-onset MS, longer education was associated with an increased hazard to reach EDSS 6 [HR from onset 1.25 (95% CI 0.91-1.70); HR from birth 1.39 (95% CI 1.02-1.90)]. Our study shows an association of self-reported levels of education with disability progression in MS, with the highest level being protective in relapsing-onset MS. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Patient Satisfaction, Empowerment, and Health and Disability Status Effects of a Disease Management-Health Promotion Nurse Intervention among Medicare Beneficiaries with Disabilities

ERIC Educational Resources Information Center

Friedman, Bruce; Wamsley, Brenda R.; Liebel, Dianne V.; Saad, Zabedah B.; Eggert, Gerald M.

2009-01-01

Purpose: To report the impact on patient and informal caregiver satisfaction, patient empowerment, and health and disability status of a primary care-affiliated disease self-management-health promotion nurse intervention for Medicare beneficiaries with disabilities and recent significant health services use. Design and Methods: The Medicare…

Disability, Health Insurance Coverage, and Utilization of Acute Health Services in the United States. Disability Statistics Report 4.

ERIC Educational Resources Information Center

LaPlante, Mitchell P.

This report uses data from the 1989 National Health Interview Survey to estimate health insurance coverage of children and nonelderly adults with disabilities and their utilization of physician and hospital care as a function of health insurance status. In part 1, national statistics on disability and insurance status are provided for different…

The relationship of disability and employment for veterans from the 2010 Medical Expenditure Panel Survey (MEPS).

PubMed

Smith, Diane L

2015-06-05

Veterans with disabilities, especially those with posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) have difficulty obtaining and maintaining competitive employment. To determine if there are significant differences in employment between veterans with and without disability, between veterans with a disability and nonveterans with a disability, and to investigate the association of veteran status and disability with employment. Chi square analyses were conducted on data obtained from the 2010 Medical Expenditure Panel Survey to determine if significant differences in employment occurred between veterans with disabilities, veterans without disabilities and nonveterans with disabilities. Multivariate regression analyses were used to determine how veteran status and disability are associated with employment. Significant differences in employment were found between veterans with and without a disability; however, no significant differences existed in employment between veterans and nonveterans with a disability. Multivariate analysis showed that veteran status (aOR=1.80), having any disability (aOR=7.29), social disability (aOR=3.47) or a cognitive disability (aOR=3.16) were associated with not being employed. Veterans with disabilities are more likely not to be employed than veteran populations without disabilities. Veterans; however have unique disabilities, different than nonveterans with disabilities, that need to be addressed, such as social and cognitive disabilities resulting from TBI and PTSD. Future research should focus on evaluating the effectiveness of employment programs and policies designed to address the unique issues faced by veterans with disabilities.

Do experiences and perceptions about quality of care differ among social groups in Nepal? : A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women

PubMed Central

Clarke, Andrew; Murray, Emily; Groce, Nora

2017-01-01

Background Suboptimal quality of care and disparities in services by healthcare providers are often reported in Nepal. Experience and perceptions about quality of care may differ according to women’s socio-cultural background, individual characteristics, their exposure and expectations. This study aimed to compare perceptions of the quality of maternal healthcare services between two groups that are consistently considered vulnerable, women with disabilities from both the non-Dalit population and Dalit population and their peers without disabilities from both non-Dalit and Dalit communities. Methods A cross-sectional survey was conducted among 343 total women that included women with disabilities, Dalits and non-Dalits. Women were recruited for interview, who were aged 15–49 years, had been pregnant within the last five years and who had used maternal care services in one of the public health facilities of Rupandehi district. A 20-item, Likert-type scale with four sub-scales or dimensions: ‘Health Facility’, ‘Healthcare Delivery’, ‘Inter-personal’ and ‘Access to Care’ was used to measure women’s perceptions of quality of care. Chi-square test and t test were used to compare groups and to assess differences in perceptions; and linear regression was applied to assess confounding effects of socio-demographic factors. The mean score was compared for each item and separately for each dimension. Results All groups, women with disabilities and women without disabilities, Dalit and non-Dalit rated their perceptions and experiences of quality of care lowly in a number of items. While perceived quality of care between women with disabilities and without disabilities in the ‘Health Facility’ dimension and associated items, was found to differ (p<0.05), this difference was linked to disability status, but was not linked to caste differences. For example, differences in mean scores relating to ‘Cleanliness and Facilities’, ‘Open and Friendliness’ and ‘Compassion and Kindness’ were highly significant (p<0.001), with women with disabilities rating these as better than women without disabilities. On the other hand, women without disabilities rated the ‘Availability of cash Incentives’ more highly (p<0.01). No significant differences were found between Dalit and non-Dalit women in perceived quality of care, except in relation to ‘Cleanliness and facilities’, which Dalit women rated lower than non-Dalits (p<0.05). Conclusions Perceptions about the quality of care differed significantly by disability status but not by caste. All groups rated the quality of healthcare delivery, interpersonal and personal factors as well as access to services ‘low.’ Poor service user experiences and perceptions of quality of care undermine opportunities to translate increased healthcare coverage into improved access and outcomes. Greater attention is required by policy makers, health planners and providers to the improvement of quality of care in health facilities. PMID:29261691

Do experiences and perceptions about quality of care differ among social groups in Nepal? : A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women.

PubMed

Devkota, Hridaya Raj; Clarke, Andrew; Murray, Emily; Groce, Nora

2017-01-01

Suboptimal quality of care and disparities in services by healthcare providers are often reported in Nepal. Experience and perceptions about quality of care may differ according to women's socio-cultural background, individual characteristics, their exposure and expectations. This study aimed to compare perceptions of the quality of maternal healthcare services between two groups that are consistently considered vulnerable, women with disabilities from both the non-Dalit population and Dalit population and their peers without disabilities from both non-Dalit and Dalit communities. A cross-sectional survey was conducted among 343 total women that included women with disabilities, Dalits and non-Dalits. Women were recruited for interview, who were aged 15-49 years, had been pregnant within the last five years and who had used maternal care services in one of the public health facilities of Rupandehi district. A 20-item, Likert-type scale with four sub-scales or dimensions: 'Health Facility', 'Healthcare Delivery', 'Inter-personal' and 'Access to Care' was used to measure women's perceptions of quality of care. Chi-square test and t test were used to compare groups and to assess differences in perceptions; and linear regression was applied to assess confounding effects of socio-demographic factors. The mean score was compared for each item and separately for each dimension. All groups, women with disabilities and women without disabilities, Dalit and non-Dalit rated their perceptions and experiences of quality of care lowly in a number of items. While perceived quality of care between women with disabilities and without disabilities in the 'Health Facility' dimension and associated items, was found to differ (p<0.05), this difference was linked to disability status, but was not linked to caste differences. For example, differences in mean scores relating to 'Cleanliness and Facilities', 'Open and Friendliness' and 'Compassion and Kindness' were highly significant (p<0.001), with women with disabilities rating these as better than women without disabilities. On the other hand, women without disabilities rated the 'Availability of cash Incentives' more highly (p<0.01). No significant differences were found between Dalit and non-Dalit women in perceived quality of care, except in relation to 'Cleanliness and facilities', which Dalit women rated lower than non-Dalits (p<0.05). Perceptions about the quality of care differed significantly by disability status but not by caste. All groups rated the quality of healthcare delivery, interpersonal and personal factors as well as access to services 'low.' Poor service user experiences and perceptions of quality of care undermine opportunities to translate increased healthcare coverage into improved access and outcomes. Greater attention is required by policy makers, health planners and providers to the improvement of quality of care in health facilities.

Depression during the menopause transition: impact on quality of life, social adjustment, and disability.

PubMed

Wariso, Bathsheba A; Guerrieri, Gioia M; Thompson, Karla; Koziol, Deloris E; Haq, Nazli; Martinez, Pedro E; Rubinow, David R; Schmidt, Peter J

2017-04-01

The impact of depression on quality of life (QOL) and social support has neither been well characterized in clinical samples of women with perimenopausal depression (PMD) nor have the relative contributions of depression and other menopausal symptoms (e.g., hot flushes) to declining QOL been clarified. In this study, we compared QOL measures, social support, and functional disability in PMD and non-depressed perimenopausal women. We evaluated women aged 40-60 years who presented with menstrual cycle irregularity, elevated plasma FSH levels, and met criteria for perimenopause. A structured clinical interview was administered to determine the presence or absence of major and minor depression. Outcome measures included the Quality of Life Enjoyment Scale Questionnaire, the Sheehan Disability Scale, the Global Assessment of Functioning, the Social Adjustment Scale, and the Duke Social Support Index. Kruskal-Wallis tests and ANOVAs were used to compare outcome measures. Ninety women with PMD and 51 control women participated in this study. Women with PMD reported significantly decreased QOL, social support, and adjustment and increased disability compared with non-depressed perimenopausal women. Neither perimenopausal reproductive status alone nor the presence of hot flushes had a significant negative impact on QOL measures. PMD is accompanied by significant reductions in QOL, social support, and disability similar to depression in women at other stages of life. PMD may also contribute to decreased QOL in community- or clinic-based samples of perimenopausal women. It remains unclear whether the clinical characteristics we identified reflect pre-existing risk factors for depression during the perimenopause or the effects of a current depression. Future clinical and treatment studies in perimenopausal women should distinguish depressed women when outcome measures include QOL.

Exploring Undergraduate Student Attitudes toward Persons with Disabilities: Application of the Disability Social Relationship Scale

ERIC Educational Resources Information Center

Hergenrather, Kenneth; Rhodes, Scott

2007-01-01

The Disability Social Relations Generalized Disability (DSRGD) Scale was used to explore the influence of the social context on attitudes toward persons with disabilities. The DSRGD Scale was based on the Disability Social Relationship (DSR) Scale (Grand, Bernier, & Strohmer, 1982; Strohmer, Grand, & Purcell, 1984). A sample of 1,013 undergraduate…

Unmet need for disability-related health care services and employment status among adults with disabilities in the Massachusetts Medicaid program.

PubMed

Henry, Alexis D; Long-Bellil, Linda; Zhang, Jianying; Himmelstein, Jay

2011-10-01

The employment rate among adults with disabilities is significantly lower than that among adults without disabilities. Ensuring access to rehabilitative and other health care services may help to address health-related barriers to employment for working-age people with disabilities. This study examined the relationship of unmet need for 6 disability-related health care services to current employment status among working-age adults with disabilities enrolled in the Massachusetts Medicaid (MassHealth Standard) program. Study participants included 436 MassHealth Standard members aged 19 to 64 who responded to the 2005/2006 MassHealth Employment and Disability Survey. Variables included members' demographic characteristics; Medicaid health plan and Medicare enrollment; members' self-report of potentially disabling conditions and current health status; access to health care as well as need and unmet need for 6 specific disability-related health care services (medications, mental health services, substance abuse services, medical supplies, durable medical equipment, personal assistance services); and current employment status. Fifteen percent of members reported currently working. Logistic regression analysis showed that (controlling for demographics, disability, health status, and other factors) members with greater unmet need were significantly less likely to be working (odds ratio = 0.58; 95% confidence interval = 0.33 to 0.99). Members' experience of unmet need was significantly greater for physical health services (supplies, durable medical equipment, personal assistance services) than for behavioral health services (mental health and substance abuse services) or medications. Working members generally rated services as important to work. Approximately 10% to 22% of nonworking members thought they would be able to work if needs were met. Meeting unmet needs for disability-related health care services may result in modest increases in employment among certain working-age adults with disabilities enrolled in the Massachusetts Medicaid program. Copyright © 2011 Elsevier Inc. All rights reserved.

Health and educational status of children raised by a caregiver with a disability.

PubMed

Miles, Donna R; Steiner, Michael J; Luken, Karen J; Sanderson, Michael R; Coyne-Beasley, Tamera; Herrick, Harry; Mizelle, Elizabeth; Ford, Carol A

2011-07-01

Research on children raised by adults with disability is limited. Our goal was to provide a profile of the health and educational status of children raised by a caregiver with disability. In 2007-2008, 4571 adults completed the North Carolina Behavior Risk Factor Surveillance System (BRFSS) and Child Health Assessment Monitoring Program (CHAMP) surveys. Analyses using weighted data provided population-based health/educational status comparisons of children (0 to 17 years old) raised by caregivers with and without disability. Twenty-three percent of caregivers reported disability. Rates of insurance coverage and preventive care did not differ by caregiver disability status, although children of caregivers with disability were more likely to have publicly funded insurance. The majority of children of caregivers with disability were in excellent/very good health (70%), healthy weight (58%), and making above-average grades (74%). Nonetheless, children raised by caregivers with disability appear to be at disproportionately higher risk for overall poorer outcomes. Children raised by caregivers with disability were more likely to be in fair/poor health (adjusted odds ratio [aOR] 2.2; 95% confidence interval [CI] 1.3 to 3.6), overweight/obese (aOR = 1.5, 95% CI 1.1-2.0), need medical/educational services (aOR = 2.0, 95% CI 1.5-2.6), have lower grades (aOR = 1.9, 95% CI 1.4-2.5), and higher rates of school absenteeism (aOR = 2.4, 95% CI 1.8-3.4), compared to children of caregivers without disability. Children raised by a caregiver with disability show good overall wellness; however, caregiver disability status was found to be associated with an increased risk for poor child health and educational outcomes. Future research is needed to clarify the causes of these disparities and inform policies to alleviate them. Published by Elsevier Inc.

Different factors influence self-reports and third-party reports of anger by adults with intellectual disabilities.

PubMed

Rose, John; Willner, Paul; Shead, Jennifer; Jahoda, Andrew; Gillespie, David; Townson, Julia; Lammie, Claire; Woodgate, Christopher; Stenfert Kroese, Biza; Felce, David; MacMahon, Pamela; Rose, Nikki; Stimpson, Aimee; Nuttall, Jacqueline; Hood, Kerenza

2013-09-01

Many people with intellectual disabilities display high levels of anger, and cognitive-behavioural anger management interventions are used routinely. However, for these methods to be used optimally, a better understanding is needed of different forms of anger assessment. The aim of this study was to investigate the relationship of a range of measures to self- and carer reports of anger expression, including instruments used to assess mental health and challenging behaviour. Adults with intellectual disabilities, who had been identified as having problems with anger control, their key-workers and home carers all rated the service users' trait anger, using parallel versions of the same instrument (the Provocation Inventory). In addition, service users completed a battery of mental health assessments (the Glasgow Depression Scale, Glasgow Anxiety Scale and Rosenberg Self-Esteem Scale), and both groups of carers completed a battery of challenging behaviour measures (the Hyperactivity and Irritability domains of the Aberrant Behavior Checklist and the Modified Overt Anger Scale). Participants had high levels of mental health problems (depression: 34%; anxiety: 73%) and severe challenging behaviour (26%). Hierarchical linear regression analysis was used to explore the extent to which anger ratings by the three groups of respondents were predicted by demographic factors, mental health measures and challenging behaviour measures. Older service users rated themselves as less angry and were also rated as less angry by home carers, but not by key-workers. More intellectually able service users were rated as more angry by both sets of carers, but not by the service users themselves. Significantly, mental health status (but not challenging behaviour) predicted service users' self-ratings of anger, whereas challenging behaviour (but not mental health status) predicted carers' ratings of service users' anger. Service users and their carers appear to use different information when rating the service users' anger. Service users' self-ratings reflect their internal emotional state and mental health, as reflected by their ratings of anxiety and depression, whereas staff rate service users' anger on the basis of overt behaviours, as measured by challenging behaviour scales. © 2013 John Wiley & Sons Ltd.

Rehabilitation Counselor Knowledge, Comfort, Approach, and Attitude toward Sex and Disability

ERIC Educational Resources Information Center

Pebdani, Roxanna N.

2013-01-01

This study examined the effect of rehabilitation counseling students' age, sex, disability status, geographic location, marital status, religion, sexual orientation, and level of sexuality training on knowledge, comfort, approach, and attitudes toward the sexuality of people with disabilities. Participants were 312 rehabilitation counseling…

When Do Older Adults Become “Disabled”? Social and Health Antecedents of Perceived Disability in a Panel Study of the Oldest Old*

PubMed Central

KELLEY-MOORE, JESSICA A.; SCHUMACHER, JOHN G.; KAHANA, EVA; KAHANA, BOAZ

2007-01-01

Disability carries negative social meaning, and little is known about when (or if), in the process of health decline, persons identify themselves as “disabled” We examine the social and health criteria that older adults use to subjectively rate their own disability status. Using a panel study of older adults (ages 72+), we estimate ordered probit and growth curve models of perceived disability over time. Total prevalent morbidity, functional limitations, and cognitive impairment are predictors of perceived disability. Cessation of driving and receipt of home health care also influence older adults’ perceptions of their own disability. A dense social network slowed the rate of labeling oneself disabled, while health anxiety accelerated the process over time, independent of health status. When considering perceived disability, the oldest old use multidimensional criteria capturing function, recent changes in health status and social networks, and anxiety about their health. PMID:16821507

Psychological Distress Is Associated with Greater Perceived Disability and Pain in Patients Presenting to a Shoulder Clinic.

PubMed

Menendez, Mariano E; Baker, Dustin K; Oladeji, Lasun O; Fryberger, Charles T; McGwin, Gerald; Ponce, Brent A

2015-12-16

Shoulder disorders are a common cause of disability and pain. The Shoulder Pain and Disability Index (SPADI) is a frequently employed and previously validated measure of shoulder pain and disability. Although the SPADI has high reliability and construct validity, greater differences between individual patients are often observed than would be expected on the basis of diagnosis and pathophysiology alone. This study aims to determine how psychological factors (namely depression, catastrophic thinking, and self-efficacy) affect pain and perceived disability in the shoulder. A cohort of 139 patients completed a sociodemographic survey and elements from the SPADI, Pain Self-Efficacy Questionnaire (PSEQ), Pain Catastrophizing Scale (PCS), and Patient Health Questionnaire Depression Scale (PHQ-2). Bivariate and multivariate analyses were performed to determine the association of psychosocial factors, demographic characteristics, and specific diagnosis with shoulder pain and disability. The SPADI score showed medium correlation with the PCS (r = 0.43; p < 0.001), PHQ-2 (r = 0.39; p < 0.001), and PSEQ (r = -0.45; p < 0.001). Current work status (F = 4.35; p = 0.006) and body mass index (r = 0.27; p = 0.002) were also associated with the SPADI score. In the multivariate analysis, greater catastrophic thinking (estimate, 0.003; p = 0.029), lower self-efficacy (estimate, -0.005; p = 0.001), higher body mass index (estimate, 0.006; p = 0.048), and being disabled (estimate, 0.15; p = 0.017) or retired (estimate, 0.16; p < 0.001) compared with being employed were associated with worse SPADI scores. The primary diagnosis did not have a significant relationship (p > 0.05) with the SPADI. Catastrophic thinking and decreased self-efficacy are associated with greater shoulder pain and disability. Our data support the notion that patient-to-patient variation in symptom intensity and magnitude of disability is more strongly related to psychological distress than to the specific shoulder diagnosis. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Longitudinal relationships among posturography and gait measures in multiple sclerosis.

PubMed

Fritz, Nora E; Newsome, Scott D; Eloyan, Ani; Marasigan, Rhul Evans R; Calabresi, Peter A; Zackowski, Kathleen M

2015-05-19

Gait and balance dysfunction frequently occurs early in the multiple sclerosis (MS) disease course. Hence, we sought to determine the longitudinal relationships among quantitative measures of gait and balance in individuals with MS. Fifty-seven ambulatory individuals with MS (28 relapsing-remitting, 29 progressive) were evaluated using posturography, quantitative sensorimotor and gait measures, and overall MS disability with the Expanded Disability Status Scale at each session. Our cohort's age was 45.8 ± 10.4 years (mean ± SD), follow-up time 32.8 ± 15.4 months, median Expanded Disability Status Scale score 3.5, and 56% were women. Poorer performance on balance measures was related to slower walking velocity. Two posturography measures, the anterior-posterior sway and sway during static eyes open, feet apart conditions, were significant contributors to walk velocity over time (approximate R(2) = 0.95), such that poorer performance on the posturography measures was related to slower walking velocity. Similarly, the anterior-posterior sway and sway during static eyes closed, feet together conditions were also significant contributors to the Timed 25-Foot Walk performance over time (approximate R(2) = 0.83). This longitudinal cohort study establishes a strong relationship between clinical gait measures and posturography. The data show that increases in static posturography and reductions in dynamic posturography are associated with a decline in walk velocity and Timed 25-Foot Walk performance over time. Furthermore, longitudinal balance measures predict future walking performance. Quantitative walking and balance measures are important additions to clinical testing to explore longitudinal change and understand fall risk in this progressive disease population. © 2015 American Academy of Neurology.

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Reciprocal transfer or initial transfer to disability inactive status. 11.29 Section 11.29 Patents, Trademarks, and Copyrights..., Sanctions, Investigations, and Proceedings § 11.29 Reciprocal transfer or initial transfer to disability...

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Reciprocal transfer or initial transfer to disability inactive status. 11.29 Section 11.29 Patents, Trademarks, and Copyrights..., Sanctions, Investigations, and Proceedings § 11.29 Reciprocal transfer or initial transfer to disability...

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Reciprocal transfer or initial transfer to disability inactive status. 11.29 Section 11.29 Patents, Trademarks, and Copyrights..., Sanctions, Investigations, and Proceedings § 11.29 Reciprocal transfer or initial transfer to disability...

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Reciprocal transfer or initial transfer to disability inactive status. 11.29 Section 11.29 Patents, Trademarks, and Copyrights..., Sanctions, Investigations, and Proceedings § 11.29 Reciprocal transfer or initial transfer to disability...

Righting the ADA

ERIC Educational Resources Information Center

National Council on Disability, 2004

2004-01-01

Many Americans with disabilities feel that a series of negative court decisions is reducing their status to that of "second-class citizens," a status that the Americans with Disabilities Act (ADA) was supposed to remedy forever. In this report, the National Council on Disability (NCD), which first proposed the enactment of an ADA and…

Earnings and Financial Compensation from Social Security Systems Correlate Strongly with Disability for Multiple Sclerosis Patients.

PubMed

Kavaliunas, Andrius; Wiberg, Michael; Tinghög, Petter; Glaser, Anna; Gyllensten, Hanna; Alexanderson, Kristina; Hillert, Jan

2015-01-01

Multiple sclerosis (MS) patients earn lower incomes and receive higher benefits. However, there is limited knowledge of how this is correlated with their disability. To elucidate sources and levels of income among MS patients with different disability, assessed with the Expanded Disability Status Scale. A total of 7929 MS patients aged 21-64 years and living in Sweden in 2010 were identified for this cross-sectional study. Descriptive statistics, logistic and truncated linear regression models were used to estimate differences between MS patients regarding earnings, disability pension, sickness absence, disability allowance, unemployment compensation, and social assistance. The average level of earnings was ten times lower and the average level of health- related benefits was four times higher when comparing MS patients with severe and mild disability. MS patients with severe disability had on average SEK 166,931 less annual income from earnings and SEK 54,534 more income from benefits compared to those with mild disability. The combined average income for MS patients was 35% lower when comparing patients in the same groups. The adjusted risk ratio for having earnings among MS patients with severe disability compared to the patients with mild disability was 0.33 (95% CI 0.29-0.39), while the risk ratio for having benefits was 1.93 (95% CI 1.90-1.94). Disease progression affects the financial situation of MS patients considerably. Correlations between higher disability and patient income were observed, suggesting that earnings and benefits could be used as measures of MS progression and proxies of disability.

In-school service predictors of employment for individuals with intellectual disability.

PubMed

Park, Jiyoon; Bouck, Emily

2018-06-01

Although there are many secondary data analyses of the National Longitudinal Transition Study-2 (NLTS-2) to investigate post-school outcome for students with disabilities, there has been a lack of research with in-school service predictors and post-school outcome for students with specific disability categories. This study was a secondary data analysis of NLTS-2 to investigate the relationship between current employment status and in-school services for individuals with intellectual disability. Statistical methods such as descriptive statistics and logistic regression were used to analyze NLTS-2 data set. The main findings included that in-school services were correlated with current employment status, and that primary disability (i.e., mild intellectual disability and moderate/severe intellectual disability) was associated with current employment status. In-school services are critical in predicting current employment for individuals with intellectual disability. Also, data suggest additional research is needed to investigate various in-school services and variables that could predict employment differences between individuals with mild and moderate/severe intellectual disability. Copyright © 2018 Elsevier Ltd. All rights reserved.

T1 Recovery Is Predominantly Found in Black Holes and Is Associated with Clinical Improvement in Patients with Multiple Sclerosis.

PubMed

Thaler, C; Faizy, T D; Sedlacik, J; Holst, B; Stürner, K; Heesen, C; Stellmann, J-P; Fiehler, J; Siemonsen, S

2017-02-01

Quantitative MR imaging parameters help to evaluate disease progression in multiple sclerosis and increase correlation with clinical disability. We therefore hypothesized that T1 values might be a marker for ongoing tissue damage or even remyelination and may help increase clinical correlation. MR imaging was performed in 17 patients with relapsing-remitting MS at baseline and after 12 months of starting immunotherapy with dimethyl fumarate. On baseline images, lesion segmentation was performed for normal-appearing white matter, T2 hyperintense (FLAIR lesions), T1 hypointense (black holes), and contrast-enhancing lesions, and T1 relaxation times were obtained at baseline and after 12 months. Changes in clinical status were assessed by using the Expanded Disability Status Scale and Symbol Digit Modalities Test at both dates (Expanded Disability Status Scale-difference/Symbol Digit Modalities Test-diff). The highest T1 relaxation time at baseline was measured in black holes (1460.2 ± 209.46 ms) followed by FLAIR lesions (1400.38 ± 189.1 ms), pure FLAIR lesions (1327.5 ± 210.04 ms), contrast-enhancing lesions (1205.59 ± 199.95 ms), and normal-appearing white matter (851.34 ± 30.61 ms). After 12 months, T1 values had decreased significantly in black holes (1369.4 ± 267.81 ms), contrast-enhancing lesions (1079.57 ± 183.36 ms) (both P < .001), and normal-appearing white matter (841.98 ± 36.1 ms, P = .006). With the Jonckheere-Terpstra Test, better clinical scores were associated with decreasing T1 relaxation times in black holes ( P < .05). T1 relaxation time is a useful quantitative MR imaging technique, which helps detect changes in MS lesions with time. We assume that these changes are associated with the degree of myelination within the lesions themselves and are pronounced in black holes. Additionally, decreasing T1 values in black holes were associated with clinical improvement. © 2017 by American Journal of Neuroradiology.

Smokers' increased risk for disability pension: social confounding or health-mediated effects? Gender-specific analyses of the Hordaland Health Study cohort.

PubMed

Haukenes, Inger; Riise, Trond; Haug, Kjell; Farbu, Erlend; Maeland, John Gunnar

2013-09-01

Studies indicate that cigarette smokers have an increased risk for disability pension, presumably mediated by adverse health effects. However, smoking is also related to socioeconomic status. The current study examined the association between smoking and subsequent disability pension, and whether the association is explained by social confounding and/or health-related mediation. A subsample of 7934 men and 8488 women, aged 40-46, from the Hordaland Health Study, Norway (1997-1999), provided baseline information on smoking status, self-reported health measures and socioeconomic status. Outcome was register-based disability pension from 12 months after baseline to end of 2004. Gender stratified Cox regression analyses were used adjusted for socioeconomic status, physical activity, self-reported health and musculoskeletal pain sites. A total of 155 (2%) men and 333 (3.9%) women were granted disability pension during follow-up. The unadjusted disability risk associated with heavy smoking versus non-smoking was 1.88 (95% CI 1.23 to 2.89) among men and 3.06 (95% CI 2.23 to 4.20) among women. In multivariate analyses, adjusting for socioeconomic status, HRs were 1.33 (95% CI 0.84 to 2.11) among men and 2.22 (95% CI 1.58 to 3.13) among women. Final adjustment for physical activity, self-reported health and musculoskeletal pain further reduced the effect of heavy smoking in women (HR=1.53, 95% CI 1.09 to 2.16). Socioeconomic status confounded the smoking-related risk for disability pension; for female heavy smokers, however, a significant increased risk persisted after adjustment. Women may be particularly vulnerable to heavy smoking and to its sociomedical consequences, such as disability pension.

Walking Distance as a Predictor of Falls in People With Multiple Sclerosis.

PubMed

Nilsagård, Ylva; Westerdahl, Elisabeth; Wittrin, Anna; Gunnarsson, Martin

2016-06-01

People with multiple sclerosis (PwMS) experience falls, usually when walking and transferring. The aim was to investigate if walking distance and patient overestimate of walking distance are predictors of falls in PwMS. A prospective study was conducted, with a single test occasion followed by prospective registration of falls for 3 months. All PwMS in Region Örebro County with a previously registered Expanded Disability Status Scale score between 3.0 and 7.0 in the Swedish MS Registry were invited to participate (n = 149). Altogether, data from 49 PwMS being relapse free for at least 3 months and with a confirmed Expanded Disability Status Scale between 1.5 and 7.0 upon study entry were analysed. Twenty-two PwMS (45%) fell during the study period, providing information of 66 falls. Walking distance or overestimate of one's walking distance, as compared with test results, did not predict falls in this MS sample. Walking and standing activities are associated with numerous falls in PwMS. Our data do not clearly support routine measurements of walking distance in assessing individual fall risk. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd.

Depressive symptoms in older female carers of adults with intellectual disabilities.

PubMed

Chou, Y C; Pu, C-Y; Fu, L-Y; Kröger, T

2010-12-01

This survey study aims to examine the prevalence and factors associated with depressive symptoms among primary older female family carers of adults with intellectual disabilities (ID). In total, 350 female family carers aged 55 and older took part and completed the interview in their homes. The survey package contained standardised scales to assess carer self-reported depressive symptoms, social support, caregiving burden and disease and health, as well as adult and carer sociodemographic information. Multiple linear regressions were used to identify the factors associated with high depressive symptoms in carers. Between 64% and 72% of these carers were classified as having high depressive symptoms. The factors associated with carer self-reported depressive symptoms were carer physical health, social support and caregiving burden; overall, the carer self-reported physical health was a stronger factor associated with depressive symptoms than their physical disease status. The level of the adult with ID's behavioural functioning and the carer age, marital status, employment status, education level and the family income level were not significantly associated with carer depressive symptoms. The factors identified in this study as correlating with self-reported depressive symptoms suggest that researchers and mental health professionals should collaborate to help improve the physical health and social support networks of the most vulnerable older female family carers. This should reduce depressive symptoms directly among this high-risk group. © 2010 The Authors. Journal of Intellectual Disability Research © 2010 Blackwell Publishing Ltd.

Impact of Children's Identified Disability Status on Parent and Teacher Behavior Ratings

ERIC Educational Resources Information Center

Schwehr, Ethan; Bocanegra, Joel O.; Kwon, Kyongboon; Sheridan, Susan M.

2014-01-01

This study was an examination of the possible influence of a child's pre-identified disability on parent and teacher behavior ratings and whether a child's disability status affected parent ratings, when controlling for parenting stress. The sample included 206 kindergarten through third grade students and their teachers and parents from a…

Examining the Moderating Effect of Disability Status on the Relationship between Trauma Symptomatology and Select Career Variables

ERIC Educational Resources Information Center

Strauser, David R.; Lustig, Daniel C.; Uruk, Aye Ciftci

2006-01-01

In the current study, the authors examined whether the influence of trauma symptomatology on select career variables differs based on disability status. A total of 131 college students and 81 individuals with disabilities completed the "Career Thoughts Inventory," "My Vocational Situation," "Developmental Work Personality…

Association between somatic amplification, anxiety, depression, stress and migraine

PubMed Central

2013-01-01

Background The aim of this study is to investigate the associations between migraine related disability and somatosensory amplification, depression, anxiety, and stress. Method Fifty-five migraine patients who applied to the outpatient unit of the Neurology Department of Acibadem University School of Medicine, Maslak Hospital in Istanbul, Turkey, and twenty-eight subjects without migraine were recruited for the study. The participants were asked to complete a sociodemographic form, Migraine Disability Assessment Scale (MIDAS), Depression Anxiety Stress Scale, Somatosensory Amplification Scale (SSAS). Results Somatosensory amplification scores were significantly higher in the migraineurs than in the control group (29.85+/−6.63 vs 26.07+/−7.1; p=0.027). Somatosensory amplification scores and depression scores were significantly higher in migraineurs with moderate and severe disability than in patients with minimal and mild disability (31.7+/−6.4 vs 27.71+/−5.49; p=0.01, 11.27+/−8.7 vs 7.38+/−8.11; p=0.04, respectively). A significant positive correlation was found between the frequency of migraine attacks for at least three consecutive months (MIDAS A scores) and the SSAS scores (r=0.363, p=0.007) in migraineurs. The MIDAS total scores were also significantly correlated with the DASS depression subcale scores (r=0.267, p=0.04), and the DASS stress subscale scores (r=0.268, p=0.05). Conclusion Psychological factors, and vulnerability to bodily sensations may incease the burden of migraine. We point out that the timely assessing of somatic amplification and the evaluation of mental status would help improve the quality of life of in migraineurs. PMID:23799958

Level of functioning, perceived work ability, and work status among psychiatric patients with major mental disorders.

PubMed

Karpov, B; Joffe, G; Aaltonen, K; Suvisaari, J; Baryshnikov, I; Näätänen, P; Koivisto, M; Melartin, T; Oksanen, J; Suominen, K; Heikkinen, M; Isometsä, E

2017-07-01

Major mental disorders are highly disabling conditions that result in substantial socioeconomic burden. Subjective and objective measures of functioning or ability to work, their concordance, or risk factors for them may differ between disorders. Self-reported level of functioning, perceived work ability, and current work status were evaluated among psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n=113), bipolar disorder (BD, n=99), or depressive disorder (DD, n=188) within the Helsinki University Psychiatric Consortium Study. Correlates of functional impairment, subjective work disability, and occupational status were investigated using regression analysis. DD patients reported the highest and SSA patients the lowest perceived functional impairment. Depressive symptoms in all diagnostic groups and anxiety in SSA and BD groups were significantly associated with disability. Only 5.3% of SSA patients versus 29.3% or 33.0% of BD or DD patients, respectively, were currently working. About half of all patients reported subjective work disability. Objective work status and perceived disability correlated strongly among BD and DD patients, but not among SSA patients. Work status was associated with number of hospitalizations, and perceived work disability with current depressive symptoms. Psychiatric care patients commonly end up outside the labour force. However, while among patients with mood disorders objective and subjective indicators of ability to work are largely concordant, among those with schizophrenia or schizoaffective disorder they are commonly contradictory. Among all groups, perceived functional impairment and work disability are coloured by current depressive symptoms, but objective work status reflects illness course, particularly preceding psychiatric hospitalizations. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Interactions between neighborhood characteristics and individual functional status in relation to disability among Québec urbanites.

PubMed

Philibert, Mathieu D; Pampalon, Robert; Hamel, Denis; Daniel, Mark

2013-10-01

Disability is conceived as a person-context interaction. Neighborhoods are among the contexts potentially influencing disability. It is thus expected that neighborhood characteristics will be associated with disability prevalence and that such associations will be moderated by individual-level functional status. Empirical research targeting the influences of features of urban environments is relatively rare. To evaluate the presence of contextual differences in disability prevalence and to assess the moderating role of individual functional status on the association between neighborhood characteristics and disability prevalence. Multi-level analyses of individual-level data obtained from the Canadian Community Health Survey and neighborhood-level data derived from the Canada census. A contextual component was observed in the variability of disability prevalence. Significant neighborhood-level differences in disability were found across levels of social deprivation. Evidence of person-place interaction was equivocal. The contextual component of the variability in disability prevalence offers potential for targeting interventions to neighborhoods. The pathway by which social structure is associated with disability prevalence requires further research. Analyses of particular functional limitations may enhance our understanding of the mechanisms by which socioenvironmental factors affect disability. Publicly available survey data on disability in the general Canadian population, while useful, has limitations with respect to estimating socioenvironmental correlates of disability and potential person-place interactions. Copyright © 2013 Elsevier Inc. All rights reserved.

Hypertension Among US Adults by Disability Status and Type, National Health and Nutrition Examination Survey, 2001–2010

PubMed Central

Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S.

2014-01-01

The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001–2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility limitations were more likely to have hypertension than adults without disabilities (adjusted prevalence ratio: 1.23; 95% confidence interval: 1.16–1.32). Our results suggest that adults living with disabilities are an important subpopulation to include in hypertension reporting and intervention efforts. PMID:25121351

Hypertension among US adults by disability status and type, National Health and Nutrition Examination Survey, 2001-2010.

PubMed

Stevens, Alissa; Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S

2014-08-14

The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001-2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility limitations were more likely to have hypertension than adults without disabilities (adjusted prevalence ratio: 1.23; 95% confidence interval: 1.16-1.32). Our results suggest that adults living with disabilities are an important subpopulation to include in hypertension reporting and intervention efforts.

Violence exposure among children with disabilities.

PubMed

Sullivan, Patricia M

2009-06-01

The focus of this paper is children with disabilities exposed to a broad range of violence types including child maltreatment, domestic violence, community violence, and war and terrorism. Because disability research must be interpreted on the basis of the definitional paradigm employed, definitions of disability status and current prevalence estimates as a function of a given paradigm are initially considered. These disability paradigms include those used in federal, education, juvenile justice, and health care arenas. Current prevalence estimates of childhood disability in the U.S. are presented within the frameworks of these varying definitions of disability status in childhood. Summaries of research from 2000 to 2008 on the four types of violence victimization addressed among children with disabilities are presented and directions for future research suggested.

The Nottingham Adjustment Scale: a validation study.

PubMed

Dodds, A G; Flannigan, H; Ng, L

1993-09-01

The concept of adjustment to acquired sight loss is examined in the context of existing loss models. An alternative conceptual framework is presented which addresses the 'blindness experience', and which suggests that the depression so frequently encountered in those losing their sight can be understood better by recourse to cognitive factors than to psychoanalytically based theories of grieving. A scale to measure psychological status before and after rehabilitation is described, its factorial validity is demonstrated, and its validity in enabling changes to be measured. Practitioners are encouraged to adopt a similar perspective in other areas of acquired disability.

Prevalence of Overweight and Mothers' Perception of Weight Status of Their Children with Intellectual Disabilities in South Korea

ERIC Educational Resources Information Center

Ha, Yeongmi; Jacobson Vann, Julie C.; Choi, Eunsook

2010-01-01

The purpose of this study was to estimate the prevalence of overweight and examine relationships between weight status of children with intellectual disabilities (IDs), mothers' perceived weight status of children, and socioeconomic status (SES). A cross-sectional study of 206 mothers of children with IDs in six special schools in Seoul, South…

76 FR 70921 - Implementation of the Fair Housing Act's Discriminatory Effects Standard

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

... race, color, religion, sex, disability, familial status, or national origin.\\1\\ HUD, to which Congress... effect upon persons of a particular race, color, religion, sex, familial status, national origin or... segregate by race, color, religion, sex, familial status, national origin, or disability. Examples of such...

Prolonged-release fampridine and walking and balance in MS: randomised controlled MOBILE trial

PubMed Central

Hupperts, Raymond; Lycke, Jan; Short, Christine; Gasperini, Claudio; McNeill, Manjit; Medori, Rossella; Tofil-Kaluza, Agata; Hovenden, Maria; Mehta, Lahar R; Elkins, Jacob

2016-01-01

Background: Mobility impairment is a common disability in MS and negatively impacts patients’ lives. Objective: Evaluate the effect of prolonged-release (PR) fampridine (extended-release dalfampridine in the United States) on self-assessed walking disability, dynamic/static balance and safety in patients with MS. Methods: MOBILE was a randomised, double-blind, exploratory, placebo-controlled trial. Patients with progressive/relapsing-remitting MS and Expanded Disability Status Scale score of 4.0–7.0 were treated with PR-fampridine or placebo twice daily for 24 weeks. Efficacy endpoints included change from baseline in the 12-item MS Walking Scale (MSWS-12), Timed Up and Go (TUG) test and Berg Balance Scale (BBS). Results: 132 patients were randomised at 24 sites in six countries. PR-fampridine therapy resulted in greater median improvements from baseline in MSWS-12 score, TUG speed and BBS total score versus placebo over 24 weeks. A higher proportion of patients receiving PR-fampridine versus placebo experienced significant improvements at MSWS-12 improvement thresholds ⩾7 (p = 0.0275), ⩾8 (p = 0.0153) and ⩾9 points (p = 0.0088) and TUG speed thresholds ⩾10% (p = 0.0021) and ⩾15% (p = 0.0262). PR-fampridine was well tolerated. Conclusions: PR-fampridine therapy resulted in early and sustained improvements in broad measures of walking and balance over six months. PMID:25921050

Patterns of Objective and Subjective Burden of Informal Caregivers in Multiple Sclerosis.

PubMed

Bayen, E; Papeix, C; Pradat-Diehl, P; Lubetzki, C; Joël, M E

2015-01-01

Home care for patients with Multiple Sclerosis (MS) relies largely on informal caregivers (ICs). Methods. We assessed ICs objective burden (Resource Utilization in Dementia measuring informal care time (ICT)) and ICs subjective burden (Zarit Burden Inventory (ZBI)). ICs (N = 99) were spouses (70%), mean age 52 years, assisting disabled patients with a mean EDSS (Expanded Disability Status Scale) of 5.5, with executive dysfunction (mean DEX (Dysexecutive questionnaire) of 25) and a duration of MS ranging from 1 to 44 years. burden was high (mean ICT = 6.5 hours/day), mostly consisting of supervision time. Subjective burden was moderate (mean ZBI = 27.3). Multivariate analyses showed that both burdens were positively correlated with higher levels of EDSS and DEX, whereas coresidency and IC's female gender correlated with objective burden only and IC's poor mental health status with subjective burden only. When considering MS aggressiveness, it appeared that both burdens were not correlated with a higher duration of MS but rather increased for patients with severe and early dysexecutive function and for patients classified as fast progressors according to the Multiple Sclerosis Severity Score. Evaluation of MS disability course and IC's personal situation is crucial to understand the burden process and to implement adequate interventions in MS.

Keeping Track: National Disability Status and Program Performance Indicators

ERIC Educational Resources Information Center

National Council on Disability, 2008

2008-01-01

This report is the result of a year-long effort by the National Council on Disability (NCD) to identify valid federal data and to describe the status of the U.S. population of Americans with disabilities. During the past 30 years, advocates, policymakers, and a variety of public and private organizations have undertaken significant efforts to…

Psychosocial correlates of fatigue in multiple sclerosis.

PubMed

Schwartz, C E; Coulthard-Morris, L; Zeng, Q

1996-02-01

To explore: (1) the interrelation among the neuropsychological, psychological, and psychosocial factors and fatigue as measured by the Multidimensional Assessment of Fatigue scale, and (2) the impact of fatigue on role performance. Clinical interview with neuropsychological testing and cross-sectional study by mail. Multiple sclerosis (MS) clinic registry of a large Boston teaching hospital. 139 MS patients representing a broad range of disability. The Multidimensional Assessment of Fatigue (MAF) scale, the Extended Disability Status Scale, the Sickness Impact Profile, Rao cognitive battery, the Trailmaking Test, depression, anxiety, and social activity limitations subscales from the Arthritis Impact Measurement Scales, and the Ryff Happiness Scale. Stepwise multiple regression analyses revealed that having a low sense of environmental mastery was the best psychosocial predictor of both global fatigue and fatigue-related distress, after adjusting for sociodemographic and medical factors. Further, people who reported being more depressed tended to report more severe fatigue. Neuropsychological performance was not associated with fatigue. Fatigue was found to limit social, work, and overall role performance, but not physical role performance. People who feel that they can choose or create environments suitable to their psychic or physical conditions report less global fatigue and less fatigue-related distress, and fatigue can have an important impact on role performance. The implications of these findings for designing fatigue management interventions are discussed.

Gait Profile Score in multiple sclerosis patients with low disability.

PubMed

Morel, Eric; Allali, Gilles; Laidet, Magali; Assal, Frédéric; Lalive, Patrice H; Armand, Stéphane

2017-01-01

Gait abnormalities are subtle in multiple sclerosis (MS) patients with low disability and need to be better determined. As a biomechanical approach, the Gait Profile Score (GPS) is used to assess gait quality by combining nine gait kinematic variables in one single value. This study aims i) to establish if the GPS can detect gait impairments and ii) to compare GPS with discrete spatiotemporal and kinematic parameters in low-disabled MS patients. Thirty-four relapsing-remitting MS patients with an Expanded Disability Status Scale (EDSS) score ≤2 (mean age 36.32±8.72 years; 12 men, 22 women; mean EDSS 1.19±0.8) and twenty-two healthy controls (mean age 36.85±7.87 years; 6 men, 16 women) matched for age, weight, height, body mass index and gender underwent an instrumented gait analysis. No significant difference in GPS values and in spatiotemporal parameters was found between patients and controls. However patients showed a significant alteration at the ankle and pelvis level. GPS fails to identify gait abnormalities in low-disabled MS patients, although kinematic analysis revealed subtle gait alterations. Future studies should investigate other methods to assess gait impairments with a gait score in low-disabled MS patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Validation of a multidimensional evaluation scale for use in elderly cancer patients.

PubMed

Monfardini, S; Ferrucci, L; Fratino, L; del Lungo, I; Serraino, D; Zagonel, V

1996-01-15

Although aging is one of the most important risk factors for cancer, elderly patients tend to be excluded from cancer clinical trials, only on the basis of chronologic age. Performance Status (PS) has been used widely to select adult patients for entry into clinical trials, but it does not include a comprehensive evaluation of various age-related factors in the elderly. This study was designed to assess the reliability and validity of a multidimensional geriatric assessment protocol for elderly patients with cancer. Thirty consecutive elderly patients (> or = 65 years), diagnosed with hematologic neoplasia or solid tumors and undergoing chemotherapy or radiotherapy, were given a specifically structured multidimensional questionnaire (MACE) three times during one week by two different physicians. MACE was intended to collect information on demographics, socioeconomic status, cognitive status, depression, physical performance, disability, and tumor characteristics. In parallel with MACE, information was collected by means of the Sickness Impact Profile (SIP). Both for inter-rater and test-retest reliability, the values of the intraclass correlation coefficient (ICC) were generally higher than 0.7. Disability, cognitive status, depressive symptoms, and the number of days spent in bed sick in the last two weeks were markedly correlated with the global, physical, and social SIP score. Disability alone explained 70% of the variance in the SIP global score, 83% of the variance in the SIP physical score, and 45% of the variance in the SIP psychosocial score. MACE proved to be applicable in a reasonable amount of time (around 30 minutes) for a medical oncology ward. These data indicate that this structured evaluation of functional status is feasible and reliable. MACE is therefore proposed as a clinical research tool to avoid arbitrary decisions on patient selection for enrollment in clinical trials, to favor uniform monitoring of treatment, and to allow a better comparison of results.

Social security work disability and its predictors in patients with fibromyalgia.

PubMed

Wolfe, Frederick; Walitt, Brian T; Katz, Robert S; Häuser, Winfried

2014-09-01

To determine prevalence and incidence of US Social Security Disability and Supplemental Security Income (SSD) in patients with fibromyalgia and to investigate prediction of SSD. Over a mean of 4 years (range 1-13 years), we studied 2,321 patients with physician-diagnosed fibromyalgia (prevalent cases) and applied modified American College of Rheumatology (ACR) 2010 research criteria to identify criteria-positive patients. During the study, 34.8% (95% confidence interval [95% CI] 32.9-36.8%) of fibromyalgia patients received SSD. The annual incidence of SSD among patients not receiving SSD at study enrollment was 3.4% (95% CI 3.0-3.9%), and 25% were estimated to be work disabled at 9.0 years of followup. By comparison, the prevalence of SSD in rheumatoid arthritis (RA) patients with concomitant fibromyalgia was 55.6% (95% CI 54.3-57.0%) and was 42.4% in osteoarthritis (OA). By study conclusion, 31.4% of SSD awardees were no longer receiving SSD. In univariate models, incident SSD in patients with fibromyalgia was predicted by sociodemographic measures and by symptom burden; but the strongest predictor was functional status (Health Assessment Questionnaire disability index [HAQ DI]). In multivariable models, the HAQ DI and the Short Form 36-item health survey physical and mental component summary scores, but no other variables, predicted SSD. Fibromyalgia criteria-positive patients had more SSD, but the continuous scale, polysymptomatic distress index derived from the ACR criteria was a substantially better predictor of SSD than a criteria-positive diagnosis. The prevalence of SSD is high in fibromyalgia, but not higher than in RA and OA patients who satisfy fibromyalgia criteria. The best predictors of work disability are functional status variables. Copyright © 2014 by the American College of Rheumatology.

Pain, functional disability, and psychologic status in tennis elbow.

PubMed

Alizadehkhaiyat, Omid; Fisher, Anthony C; Kemp, Graham J; Frostick, Simon P

2007-01-01

First to compare pain and functional disability in tennis elbow (TE) patients with healthy controls. Second, to evaluate the relationship between the 2 major psychologic factors (anxiety and depression) and TE. Sixteen TE patients were recruited from 46 consecutive attendees at an upper limb clinic: inclusion criteria were lateral epicondyle tenderness, pain with resisted wrist and middle finger extension and at least 3 months localized lateral elbow pain. Sixteen healthy controls with no upper limb problem were recruited from students and staff. Participants were given 4 questionnaires, together with instructions for completion: Disabilities of the Arm, Shoulder, and Hand, Patient-Rated Forearm Evaluation Questionnaire, Patient-Rated Wrist Evaluation Questionnaire, and Hospital Anxiety and Depression Scale. The independent t test was used to compare the total and subscale scores between the groups. Significantly higher scores were found in TE for pain and function subscales and also total score for Disabilities of the Arm, Shoulder, and Hand, Patient-Rated Forearm Evaluation Questionnaire, and Patient-Rated Wrist Evaluation Questionnaire. For Hospital Anxiety and Depression Scale, both anxiety and depression subscales (P<0.001) and the total score (P<0.01) were significantly higher in TE. According to the anxiety and depression subscales, 55% and 36% of patients, respectively, were classified as probable cases (score >11). TE patients showed markedly increased pain and functional disability. Significantly elevated levels of depression and anxiety pointed out the importance of psychologic assessment in TE patients. In the development of supportive and treatment strategies, we suggest the combination of "upper limb" and "psychologic" assessment tools.

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Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

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Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

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Have Disability Transfers Caused the Decline in Older Male Labor Force Participation? A Work-Status Rational Choice Model.

ERIC Educational Resources Information Center

Haveman, Robert H.; Wolfe, Barbara L.

This paper presents a decision-process model for explaining the growth in transfer recipiency (the receipt by working age people of disability income), the choice of work status, and the reduction in labor force participation of older workers. It is hypothesized that the attractiveness of disability income transfer options has led older male…

The Structural Relationships of Social Support, Mother's Psychological Status, and Maternal Sensitivity to Attachment Security in Children with Disabilities

ERIC Educational Resources Information Center

Kim, Eun Sil; Kim, Byeong Seok

2009-01-01

The purpose of this study was to explore how social support, mother's psychological status, and maternal sensitivity affected attachment security in children with disabilities by using the structural equation model (SEM). Subjects were 141 pairs of children with disabilities and theirs mothers. Empirical data was obtained through a series of…

Multiple-Component Remediation for Developmental Reading Disabilities: IQ, Socioeconomic Status, and Race as Factors in Remedial Outcome

ERIC Educational Resources Information Center

Morris, Robin D.; Lovett, Maureen W.; Wolf, Maryanne; Sevcik, Rose A.; Steinbach, Karen A.; Frijters, Jan C.; Shapiro, Marla B.

2012-01-01

Results from a controlled evaluation of remedial reading interventions are reported: 279 young disabled readers were randomly assigned to a program according to a 2 x 2 x 2 factorial design (IQ, socioeconomic status [SES], and race). The effectiveness of two multiple-component intervention programs for children with reading disabilities (PHAB +…

An Automated Statistical Technique for Counting Distinct Multiple Sclerosis Lesions.

PubMed

Dworkin, J D; Linn, K A; Oguz, I; Fleishman, G M; Bakshi, R; Nair, G; Calabresi, P A; Henry, R G; Oh, J; Papinutto, N; Pelletier, D; Rooney, W; Stern, W; Sicotte, N L; Reich, D S; Shinohara, R T

2018-04-01

Lesion load is a common biomarker in multiple sclerosis, yet it has historically shown modest association with clinical outcome. Lesion count, which encapsulates the natural history of lesion formation and is thought to provide complementary information, is difficult to assess in patients with confluent (ie, spatially overlapping) lesions. We introduce a statistical technique for cross-sectionally counting pathologically distinct lesions. MR imaging was used to assess the probability of a lesion at each location. The texture of this map was quantified using a novel technique, and clusters resembling the center of a lesion were counted. Validity compared with a criterion standard count was demonstrated in 60 subjects observed longitudinally, and reliability was determined using 14 scans of a clinically stable subject acquired at 7 sites. The proposed count and the criterion standard count were highly correlated ( r = 0.97, P < .001) and not significantly different (t 59 = -.83, P = .41), and the variability of the proposed count across repeat scans was equivalent to that of lesion load. After accounting for lesion load and age, lesion count was negatively associated ( t 58 = -2.73, P < .01) with the Expanded Disability Status Scale. Average lesion size had a higher association with the Expanded Disability Status Scale ( r = 0.35, P < .01) than lesion load ( r = 0.10, P = .44) or lesion count ( r = -.12, P = .36) alone. This study introduces a novel technique for counting pathologically distinct lesions using cross-sectional data and demonstrates its ability to recover obscured longitudinal information. The proposed count allows more accurate estimation of lesion size, which correlated more closely with disability scores than either lesion load or lesion count alone. © 2018 by American Journal of Neuroradiology.

A cross-sectional study of quality of life in incident stroke survivors in rural northern Tanzania.

PubMed

Howitt, Suzanne C; Jones, Matthew P; Jusabani, Ahmed; Gray, William K; Aris, Eric; Mugusi, Ferdinand; Swai, Mark; Walker, Richard W

2011-08-01

The aim of this study was to evaluate changes to, and predictors of, quality of life (QOL) in a community-based cohort of stroke survivors from an earlier stroke incidence study in rural northern Tanzania. Patients were assessed 1-5 years after their incident stroke. The study cohort was compared with an age- and sex-matched control group from the same rural district within a cross-sectional design. Patients and controls were asked a series of questions relating to their QOL [World Health Organization quality of life, abbreviated version (WHOQOL-BREF)], levels of anxiety and depression [hospital anxiety and depression (HAD) scale], cognitive function [community screening instrument for dementia (CSI-D) screening tool], socioeconomic status and demographic characteristics (e.g. age, sex, education and abode). Patients were further assessed for functional outcome and disability (Barthel index, modified Rankin scale), post-stroke care and psychosocial functioning. Patients (n = 58) were found to have significantly lower QOL than controls (n = 58) in all six domains of the WHOQOL-BREF. Gender, socioeconomic status, cognitive function and time elapsed since stroke were not associated with QOL. Older patients and those with more impaired motor function and disability (Barthel index, modified Rankin score) had significantly poorer physical health-related QOL. Greater anxiety and depression, reduced muscle power and less involvement in social events were significantly correlated with lower physical and psychological health-related QOL. To our knowledge, this is the first long-term study of QOL in survivors of incident stroke in Sub-Saharan Africa (SSA). Poorer QOL was associated with greater levels of physical disability, anxiety and depression and reduced social interaction. Demographic factors appear to be much less significant. Modifying these QOL predictors could be important in planning effective post-stroke care within a stretched healthcare system.

Work disability remains a major problem in rheumatoid arthritis in the 2000s: data from 32 countries in the QUEST-RA study.

PubMed

Sokka, Tuulikki; Kautiainen, Hannu; Pincus, Theodore; Verstappen, Suzanne M M; Aggarwal, Amita; Alten, Rieke; Andersone, Daina; Badsha, Humeira; Baecklund, Eva; Belmonte, Miguel; Craig-Müller, Jürgen; da Mota, Licia Maria Henrique; Dimic, Alexander; Fathi, Nihal A; Ferraccioli, Gianfranco; Fukuda, Wataru; Géher, Pál; Gogus, Feride; Hajjaj-Hassouni, Najia; Hamoud, Hisham; Haugeberg, Glenn; Henrohn, Dan; Horslev-Petersen, Kim; Ionescu, Ruxandra; Karateew, Dmitry; Kuuse, Reet; Laurindo, Ieda Maria Magalhaes; Lazovskis, Juris; Luukkainen, Reijo; Mofti, Ayman; Murphy, Eithne; Nakajima, Ayako; Oyoo, Omondi; Pandya, Sapan C; Pohl, Christof; Predeteanu, Denisa; Rexhepi, Mjellma; Rexhepi, Sylejman; Sharma, Banwari; Shono, Eisuke; Sibilia, Jean; Sierakowski, Stanislaw; Skopouli, Fotini N; Stropuviene, Sigita; Toloza, Sergio; Valter, Ivo; Woolf, Anthony; Yamanaka, Hisashi

2010-01-01

Work disability is a major consequence of rheumatoid arthritis (RA), associated not only with traditional disease activity variables, but also more significantly with demographic, functional, occupational, and societal variables. Recent reports suggest that the use of biologic agents offers potential for reduced work disability rates, but the conclusions are based on surrogate disease activity measures derived from studies primarily from Western countries. The Quantitative Standard Monitoring of Patients with RA (QUEST-RA) multinational database of 8,039 patients in 86 sites in 32 countries, 16 with high gross domestic product (GDP) (>24K US dollars (USD) per capita) and 16 low-GDP countries (<11K USD), was analyzed for work and disability status at onset and over the course of RA and clinical status of patients who continued working or had stopped working in high-GDP versus low-GDP countries according to all RA Core Data Set measures. Associations of work disability status with RA Core Data Set variables and indices were analyzed using descriptive statistics and regression analyses. At the time of first symptoms, 86% of men (range 57%-100% among countries) and 64% (19%-87%) of women <65 years were working. More than one third (37%) of these patients reported subsequent work disability because of RA. Among 1,756 patients whose symptoms had begun during the 2000s, the probabilities of continuing to work were 80% (95% confidence interval (CI) 78%-82%) at 2 years and 68% (95% CI 65%-71%) at 5 years, with similar patterns in high-GDP and low-GDP countries. Patients who continued working versus stopped working had significantly better clinical status for all clinical status measures and patient self-report scores, with similar patterns in high-GDP and low-GDP countries. However, patients who had stopped working in high-GDP countries had better clinical status than patients who continued working in low-GDP countries. The most significant identifier of work disability in all subgroups was Health Assessment Questionnaire (HAQ) functional disability score. Work disability rates remain high among people with RA during this millennium. In low-GDP countries, people remain working with high levels of disability and disease activity. Cultural and economic differences between societies affect work disability as an outcome measure for RA.

Work disability remains a major problem in rheumatoid arthritis in the 2000s: data from 32 countries in the QUEST-RA Study

PubMed Central

2010-01-01

Introduction Work disability is a major consequence of rheumatoid arthritis (RA), associated not only with traditional disease activity variables, but also more significantly with demographic, functional, occupational, and societal variables. Recent reports suggest that the use of biologic agents offers potential for reduced work disability rates, but the conclusions are based on surrogate disease activity measures derived from studies primarily from Western countries. Methods The Quantitative Standard Monitoring of Patients with RA (QUEST-RA) multinational database of 8,039 patients in 86 sites in 32 countries, 16 with high gross domestic product (GDP) (>24K US dollars (USD) per capita) and 16 low-GDP countries (<11K USD), was analyzed for work and disability status at onset and over the course of RA and clinical status of patients who continued working or had stopped working in high-GDP versus low-GDP countries according to all RA Core Data Set measures. Associations of work disability status with RA Core Data Set variables and indices were analyzed using descriptive statistics and regression analyses. Results At the time of first symptoms, 86% of men (range 57%-100% among countries) and 64% (19%-87%) of women <65 years were working. More than one third (37%) of these patients reported subsequent work disability because of RA. Among 1,756 patients whose symptoms had begun during the 2000s, the probabilities of continuing to work were 80% (95% confidence interval (CI) 78%-82%) at 2 years and 68% (95% CI 65%-71%) at 5 years, with similar patterns in high-GDP and low-GDP countries. Patients who continued working versus stopped working had significantly better clinical status for all clinical status measures and patient self-report scores, with similar patterns in high-GDP and low-GDP countries. However, patients who had stopped working in high-GDP countries had better clinical status than patients who continued working in low-GDP countries. The most significant identifier of work disability in all subgroups was Health Assessment Questionnaire (HAQ) functional disability score. Conclusions Work disability rates remain high among people with RA during this millennium. In low-GDP countries, people remain working with high levels of disability and disease activity. Cultural and economic differences between societies affect work disability as an outcome measure for RA. PMID:20226018

Perceptions of emotion expression and sibling-parent emotion communication in Latino and non-Latino white siblings of children with intellectual disabilities.

PubMed

Long, Kristin A; Lobato, Debra; Kao, Barbara; Plante, Wendy; Grullón, Edicta; Cheas, Lydia; Houck, Christopher; Seifer, Ronald

2013-06-01

Examine general emotion expression and sibling-parent emotion communication among Latino and non-Latino white (NLW) siblings of children with intellectual disabilities (ID) and matched comparisons. 200 siblings (ages 8-15 years) completed the newly developed Sibling-Parent Emotion Communication Scale and existing measures of general emotion expression and psychosocial functioning. Preliminary analyses evaluated scale psychometrics across ethnicity. Structure and internal consistency of the emotion expression and communication measures differed by respondent ethnicity. Latino siblings endorsed more general emotion expression problems and marginally lower sibling-parent emotion communication than NLW siblings. Siblings of children with ID reported marginally more general emotion expression problems than comparisons. Emotion expression problems and lower sibling-parent emotion communication predicted more internalizing and somatic symptoms and poorer personal adjustment, regardless of ID status. Siblings of children with ID endorsed poorer personal adjustment. Cultural differences in emotion expression and communication may increase Latino siblings' risk for emotional adjustment difficulties.

Racial differences in employment outcomes after traumatic brain injury.

PubMed

Arango-Lasprilla, Juan Carlos; Ketchum, Jessica M; Williams, Kelli; Kreutzer, Jeffrey S; Marquez de la Plata, Carlos D; O'Neil-Pirozzi, Therese M; Wehman, Paul

2008-05-01

To examine racial differences in employment status and occupational status 1 year after a traumatic brain injury (TBI). Retrospective study. Longitudinal dataset of the Traumatic Brain Injury Model Systems national database. Subjects with primarily moderate to severe TBI (3468 whites vs 1791 minorities) hospitalized between 1989 and 2005. Not applicable. Employment status (competitively employed or unemployed) and occupational status (professional/managerial, skilled, or manual labor) at 1 year postinjury. Race and/or ethnicity has a significant effect on employment status at 1 year postinjury (chi(1)(2)=58.23, P<.001), after adjusting for preinjury employment status, sex, Disability Rating Scale at discharge, marital status, cause of injury, age, and education. The adjusted odds of being unemployed versus competitively employed are 2.17 times (95% confidence interval, 1.78-2.65) greater for minorities than for whites. Race and ethnicity does not have a significant effect on occupational status at 1 year postinjury. With this empirical evidence supporting racial differences in employment outcomes between minorities and whites at 1 year postinjury, priority should be given to tailoring interventions to maximize minority survivors' work-related productivity.

Dopamine agonist therapy in low-response children following traumatic brain injury.

PubMed

Patrick, Peter D; Blackman, James A; Mabry, Jennifer L; Buck, Marcia L; Gurka, Matthew J; Conaway, Mark R

2006-10-01

The objective of this study was to determine whether a dopamine agonist could improve mental status among children in a low-response state following traumatic brain injury. In an 8-week, prospective, double-blind, randomized trial, 10 children and adolescents ages 8 to 21 years (X = 16.7 years) with traumatic brain injury sustained at least 1 month previously and remaining in a low-response state (Rancho Los Amigos Scale level pound 3) received pramipexole or amantadine. Medication dosage was increased over 4 weeks, weaned over 2 weeks, and then discontinued. At baseline and weekly during the study, subjects were evaluated with the Coma Near Coma Scale, Western NeuroSensory Stimulation Profile, and Disability Rating Scale. Scores improved significantly from baseline to the medication phase on the Coma Near Coma Scale, Western NeuroSensory Stimulation Profile, and Disability Rating Scale (P < .005). The weekly rate of change was significantly better for all three measures on medication than off medication (P < .05). Rancho Los Amigos Scale levels improved significantly on medication as well (P < .05). There was no difference in efficacy between amantadine and pramipexole. No unexpected or significant side effects were observed with either drug. This clinical trial supports the benefit of two dopamine agonists in the restoration of functional arousal, awareness, and communication. These drugs can be helpful in accelerating eligibility for acute rehabilitation among children and adolescents who have sustained significant brain injuries.

Human placenta-derived cells (PDA-001) for the treatment of adults with multiple sclerosis: a randomized, placebo-controlled, multiple-dose study.

PubMed

Lublin, Fred D; Bowen, James D; Huddlestone, John; Kremenchutzky, Marcelo; Carpenter, Adam; Corboy, John R; Freedman, Mark S; Krupp, Lauren; Paulo, Corri; Hariri, Robert J; Fischkoff, Steven A

2014-11-01

Infusion of PDA-001, a preparation of mesenchymal-like cells derived from full-term human placenta, is a new approach in the treatment of patients with multiple sclerosis. This safety study aimed to rule out the possibility of paradoxical exacerbation of disease activity by PDA-001 in patients with multiple sclerosis. This was a phase 1b, multicenter, randomized, double-blind, placebo-controlled, 2-dose ranging study including patients with relapsing-remitting multiple sclerosis or secondary progressive multiple sclerosis. The study was conducted at 6 sites in the United States and 2 sites in Canada. Patients were randomized 3:1 to receive 2 low-dose infusions of PDA-001 (150×10(6) cells) or placebo, given 1 week apart. After completing this cohort, subsequent patients received high-dose PDA-001 (600×10(6) cells) or placebo. Monthly brain magnetic resonance imaging scans were performed. The primary end point was ruling out the possibility of paradoxical worsening of MS disease activity. This was monitored using Cutter׳s rule (≥5 new gadolinium lesions on 2 consecutive scans) by brain magnetic resonance imaging on a monthly basis for six months and also the frequency of multiple sclerosis relapse. Ten patients with relapsing-remitting multiple sclerosis and 6 with secondary progressive multiple sclerosis were randomly assigned to treatment: 6 to low-dose PDA-001, 6 to high-dose PDA-001, and 4 to placebo. No patient met Cutter׳s rule. One patient receiving high-dose PDA-001 had an increase in T2 and gadolinium lesions and in Expanded Disability Status Scale score during a multiple sclerosis flare 5 months after receiving PDA-001. No other patient had an increase in Expanded Disability Status Scale score>0.5, and most had stable or decreasing Expanded Disability Status Scale scores. With high-dose PDA-001, 1 patient experienced a grade 1 anaphylactoid reaction and 1 had grade 2 superficial thrombophlebitis. Other adverse events were mild to moderate and included headache, fatigue, infusion site reactions, and urinary tract infection. PDA-001 infusions were safe and well tolerated in relapsing-remitting multiple sclerosis and secondary progressive multiple sclerosis patients. No paradoxical worsening of lesion counts was noted with either dose. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Eye movement desensitization and reprocessing in an adolescent with epilepsy and mild intellectual disability.

PubMed

Rodenburg, Roos; Benjamin, Anja; Meijer, Anne Marie; Jongeneel, Ruud

2009-09-01

Intellectual disability is a comorbid condition in epilepsy. People with epilepsy and intellectual disability are at high risk of developing behavioral problems. Among the many contributors to behavioral problems in people with epilepsy and intellectual disability are those of traumatic experiences. As such, behavioral problems can be seen as a reflection of these traumatic experiences. Among established trauma therapies, eye movement desensitization and reprocessing (EMDR) is an emerging treatment that is effective in adults and also seems to be effective in children. This article is a case report of EMDR in an adolescent with epilepsy and mild intellectual disability, in whom the EMDR children's protocol was used. The aim was to assess whether clinical trauma status significantly diminished to nonclinical status posttreatment. Change in trauma symptoms was evaluated with the Reliable Change Index (RCI). Results showed a significant decrease in trauma symptoms toward nonclinical status from pretreatment to posttreatment. EMDR consequences for epilepsy and intellectual disability are discussed.

Comparing Sociodemographic Factors Associated with Disability between Immigrants and the Chilean-Born: Are There Different Stories to Tell?

PubMed Central

Cabieses, Baltica; Pickett, Kate E.; Tunstall, Helena

2012-01-01

This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes). Sociodemographic variables: Demographic factors (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (SES: income, education, employment status, and an integrated indicator combining the SES measures through cluster analysis for the immigrant population), material factors (overcrowding, sanitation, housing quality) and migration related (country of origin and length of stay). Immigrants reported a significantly lower prevalence of any disability (3.55%), visual (1.00%) and physical disability (0.38%). Factors associated with any disability among immigrants were age, low SES or over 20 years duration of residence in Chile; while a range of sociodemographic factors were associated with disability in the Chilean-born. Conditional regression models by age group varied between populations, but SES remained significantly associated with disability across immigrants and the Chilean-born. However, there are no similar patterns of factors associated to different types of disability between the populations under study. Factors associated with disability varied between populations under study, but SES showed a consistent association with any disability in immigrants and the Chilean-born. Types of disability showed different patterns of factors associated to them between populations, which suggest the great complexity of underlying mechanisms related to disability in Chile. PMID:23211607

Comparing sociodemographic factors associated with disability between immigrants and the Chilean-born: are there different stories to tell?

PubMed

Cabieses, Baltica; Pickett, Kate E; Tunstall, Helena

2012-12-04

This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes). Sociodemographic variables: Demographic factors (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (SES: income, education, employment status, and an integrated indicator combining the SES measures through cluster analysis for the immigrant population), material factors (overcrowding, sanitation, housing quality) and migration related (country of origin and length of stay). Immigrants reported a significantly lower prevalence of any disability (3.55%), visual (1.00%) and physical disability (0.38%). Factors associated with any disability among immigrants were age, low SES or over 20 years duration of residence in Chile; while a range of sociodemographic factors were associated with disability in the Chilean-born. Conditional regression models by age group varied between populations, but SES remained significantly associated with disability across immigrants and the Chilean-born. However, there are no similar patterns of factors associated to different types of disability between the populations under study. Factors associated with disability varied between populations under study, but SES showed a consistent association with any disability in immigrants and the Chilean-born. Types of disability showed different patterns of factors associated to them between populations, which suggest the great complexity of underlying mechanisms related to disability in Chile.

Employment Status and Predictors among People with Visual Impairments in South Korea: Results of a National Survey

ERIC Educational Resources Information Center

Lee, Ik Seop; Park, Soo Kyung

2008-01-01

This study explored the employment status and its predictors among people with visual impairments in South Korea. Factors affecting employment status were gender, education, area of residence, degree of disability, having a secondary disability, living with a partner, practical support, and the receipt of adjustment training. (Contains 4 tables.)

The Relationship between Intellectual Disability, Indigenous Status and Risk of Reoffending in Juvenile Offenders on Community Orders

ERIC Educational Resources Information Center

Frize, M.; Kenny, D.; Lennings, C.

2008-01-01

Background: Intellectual disability (ID), age and aboriginal status have been independently implicated as risk factors for offending to varying degrees. This study examined the relationship between age, ID and the Indigenous status of juvenile offenders. It also examined the outcomes of the sample's offending in terms of court appearances and…

How little pain and disability do patients with low back pain have to experience to feel that they have recovered?

PubMed Central

Maher, Christopher G.; Herbert, Robert D.; Hancock, Mark J.; Hush, Julia M.; Smeets, Robert J.

2010-01-01

Epidemiological and clinical studies of people with low back pain (LBP) commonly measure the incidence of recovery. The pain numerical rating scale (NRS), scores from 0 to 10, and Roland Morris disability questionnaire (RMDQ), scores from 0 to 24, are two instruments often used to define recovery. On both scales higher scores indicate greater severity. There is no consensus, however, on the cutoff scores on these scales that classify people as having recovered. The aim of this study was to determine which cutoff scores most accurately classify those who had recovered from LBP. Subjects from four clinical studies were categorized as ‘recovered’ or ‘unrecovered’ according to their self-rating on a global perceived effect scale. Odd ratios were calculated for scores of 0, 1, 2, 3 and 4 on the NRS and RMDQ to predict perceived recovery. Scores of 0 on the NRS and ≤2 on the RMDQ most accurately identify patients who consider themselves completely recovered. The diagnostic odds ratio (OR) for predicting recovery was 43.9 for a score of 0 on the NRS and 17.6 for a score of ≤2 on the RMDQ. There was no apparent effect of LBP duration or length of follow-up period on the optimal cutoff score. OR for the NRS were generally higher than those for RMDQ. Cutoffs of 0 on the NRS and 2 on the RMDQ most accurately classify subjects as recovered from LBP. Subjects consider pain more than disability when determining their recovery status. PMID:20229120

Subjective memory and concentration deficits in medication-free, non-elderly Asians with major depressive disorder: prevalence and their correlates.

PubMed

Srisurapanont, Manit; Bautista, Dianne; Chen, Chia-Hui; Wang, Gang; Udomratn, Pichet; Eurviriyanukul, Kanokkwan

2015-01-15

Subjective cognitive impairment (SCI) in major depressive disorder (MDD) is prevalent and correlated with disability. This study aimed to examine the prevalence rates and correlates of subjective memory deficit (SMD) and subjective concentration deficit (SCD) in medication-free, non-elderly Asians with MDD. The SMD and SCD were assessed by using two items of the Symptom Checklist-90-Revised (SCL-90-R). Other measurements of interest included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the Sheehan Disability Scale (SDS), and the Short Form Health Survey (SF-36). Adjusted odds ratios with 95% confidence intervals were calculated. Of 515 participants from China, Korea, Malaysia, Singapore, Taiwan, and Thailand, 347 (67.4%) and 377 (73.2%) had SMD and SCD, respectively. In total, 420 participants (81.6%) had SMD alone, SCD alone, and both deficits. Severe depression and poor mental health were significant correlates of SMD. Severe depression, clinically significant disability, poor physical health, and poor mental health were significantly independent correlates of SCD. Compared with young adults (18-34 years), older adults aged 50-65 years had a significantly lower risk of SCD (OR=.33, 95% CI: .19-.57). Only two SCL-90-R items were used to assess the SMD and SCD. The exclusion of MDD patients treated with psychotropic medications eliminated many patients commonly seen in typical clinic settings. SMD and SCD are prevalent in medication-free, non-elderly Asians with MDD. Both deficits are correlated with depression and mental health status. The independent correlation between SCD and disability underscores the crucial role of SCI in MDD. Copyright © 2014 Elsevier B.V. All rights reserved.

Combined training improves walking mobility in persons with significant disability from multiple sclerosis: a pilot study.

PubMed

Motl, Robert W; Smith, Douglas C; Elliott, Jeannette; Weikert, Madeline; Dlugonski, Deirdre; Sosnoff, Jacob J

2012-03-01

The disabling consequences of multiple sclerosis (MS) emphasize the significance of developing physiologically relevant strategies for rehabilitation of function. This pilot study examined changes in walking function associated with combined exercise training consisting of aerobic, resistance, and balance activities in persons with MS who had recent onset of gait impairment. Thirteen participants with significant disability due to MS (Expanded Disability Status Scale range = 4.0-6.0) completed the Multiple Sclerosis Walking Scale-12, 2 trials of the Timed 25-Foot Walk, the Timed Up & Go, and functional ambulation profile score derived from 4 walking trials on an instrumented walkway (GaitRite) before and after an 8-week training period. The training program was designed by a physical therapist and was performed 3 days per week under the supervision of an exercise specialist. In week 1, the session was 15 minutes in duration (ie, 5 minutes of each mode of exercise), session durations were increased by approximately 5 minutes per week up to a maximum of 60 minutes in week 8 (ie, 20 minutes of each mode of exercise). There were significant improvements in Multiple Sclerosis Walking Scale-12 scores (Mpre = 56.0, Mpost = 46.7, P = 0.03, d = 0.56), Timed 25-Foot Walk (Mpre = 11.7, Mpost = 9.8, P = 0.004, d = 0.90) and Timed Up & Go (Mpre = 16.0, Mpost = 13.0, P = 0.01, d = 0.72) performance, and functional ambulation profile score (Mpre = 72.8, Mpost = 77.6, P = 0.02, d = 0.65). These results suggest that a moderately intense, comprehensive, combined exercise training program represents a rehabilitation strategy that is associated with improved walking mobility in a small sample of persons with MS who have recent onset of gait impairment.

20 CFR 404.133 - When we give you quarters of coverage based on military service to establish a period of disability.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false When we give you quarters of coverage based on military service to establish a period of disability. 404.133 Section 404.133 Employees' Benefits... Status and Quarters of Coverage Disability Insured Status § 404.133 When we give you quarters of coverage...

20 CFR 404.133 - When we give you quarters of coverage based on military service to establish a period of disability.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false When we give you quarters of coverage based on military service to establish a period of disability. 404.133 Section 404.133 Employees' Benefits... Status and Quarters of Coverage Disability Insured Status § 404.133 When we give you quarters of coverage...

20 CFR 404.133 - When we give you quarters of coverage based on military service to establish a period of disability.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false When we give you quarters of coverage based on military service to establish a period of disability. 404.133 Section 404.133 Employees' Benefits... Status and Quarters of Coverage Disability Insured Status § 404.133 When we give you quarters of coverage...

20 CFR 404.133 - When we give you quarters of coverage based on military service to establish a period of disability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When we give you quarters of coverage based on military service to establish a period of disability. 404.133 Section 404.133 Employees' Benefits... Status and Quarters of Coverage Disability Insured Status § 404.133 When we give you quarters of coverage...

Magnetic resonance spectroscopy of normal appearing white matter in early relapsing-remitting multiple sclerosis: correlations between disability and spectroscopy

PubMed Central

Ruiz-Peña, Juan Luis; Piñero, Pilar; Sellers, Guillermo; Argente, Joaquín; Casado, Alfredo; Foronda, Jesus; Uclés, Antonio; Izquierdo, Guillermo

2004-01-01

Background What currently appears to be irreversible axonal loss in normal appearing white matter, measured by proton magnetic resonance spectroscopy is of great interest in the study of Multiple Sclerosis. Our aim is to determine the axonal damage in normal appearing white matter measured by magnetic resonance spectroscopy and to correlate this with the functional disability measured by Multiple Sclerosis Functional Composite scale, Neurological Rating Scale, Ambulation Index scale, and Expanded Disability Scale Score. Methods Thirty one patients (9 male and 22 female) with relapsing remitting Multiple Sclerosis and a Kurtzke Expanded Disability Scale Score of 0–5.5 were recruited from four hospitals in Andalusia, Spain and included in the study. Magnetic resonance spectroscopy scans and neurological disability assessments were performed the same day. Results A statistically significant correlation was found (r = -0.38 p < 0.05) between disability (measured by Expanded Disability Scale Score) and N-Acetyl Aspartate (NAA/Cr ratio) levels in normal appearing white matter in these patients. No correlation was found between the NAA/Cr ratio and disability measured by any of the other disability assessment scales. Conclusions There is correlation between disability (measured by Expanded Disability Scale Score) and the NAA/Cr ratio in normal appearing white matter. The lack of correlation between the NAA/Cr ratio and the Multiple Sclerosis Functional Composite score indicates that the Multiple Sclerosis Functional Composite is not able to measure irreversible disability and would be more useful as a marker in stages where axonal damage is not a predominant factor. PMID:15191618

Pilot trial of intravenous autologous culture-expanded mesenchymal stem cell transplantation in multiple sclerosis.

PubMed

Cohen, Jeffrey A; Imrey, Peter B; Planchon, Sarah M; Bermel, Robert A; Fisher, Elizabeth; Fox, Robert J; Bar-Or, Amit; Sharp, Susan L; Skaramagas, Thomai T; Jagodnik, Patricia; Karafa, Matt; Morrison, Shannon; Reese Koc, Jane; Gerson, Stanton L; Lazarus, Hillard M

2018-04-01

Mesenchymal stem cells (MSCs) exhibit immunomodulatory, tissue-protective, and repair-promoting properties in vitro and in animals. Clinical trials in several human conditions support the safety and efficacy of MSC transplantation. Published experience in multiple sclerosis (MS) is modest. To assess feasibility, safety, and tolerability and explore efficacy of autologous MSC transplantation in MS. Participants with relapsing-remitting multiple sclerosis (RRMS) or secondary progressive multiple sclerosis (SPMS), Expanded Disability Status Scale score 3.0-6.5, disease activity or progression in the prior 2 years, and optic nerve involvement were enrolled. Bone-marrow-derived MSCs were culture-expanded and then cryopreserved. After confirming fulfillment of release criteria, 1-2 × 10 6 MSCs/kg were thawed and administered IV. In all, 24 of 26 screened patients were infused: 16 women and 8 men, 10 RRMS and 14 SPMS, mean age 46.5, mean Expanded Disability Status Scale score 5.2, 25% with gadolinium-enhancing magnetic resonance imaging (MRI) lesions. Mean cell dosage (requiring 1-3 passages) was 1.9 × 10 6 MSCs/kg (range, 1.5-2.0) with post-thaw viability uniformly ⩾95%. Cell infusion was tolerated well without treatment-related severe or serious adverse events, or evidence of disease activation. Autologous MSC transplantation in MS appears feasible, safe, and well tolerated. Future trials to assess efficacy more definitively are warranted.

Prognosis of the individual course of disease: the elements of time, heterogeneity and precision.

PubMed

Daumer, Martin; Neuhaus, Anneke; Herbert, Joseph; Ebers, George

2009-12-01

There is no gold standard in monitoring disease activity for clinical trials in multiple sclerosis. Various outcome measures, including relapses, disability and magnetic resonance imaging (MRI) measures have been used to demonstrate the efficacy of the different available therapies for multiple sclerosis. Recently, the potential limitations of these measures have received increasing attention, and these have stimulated research into more appropriate and sensitive outcome measures for clinical trials. For example, it has been shown that widely-used MRI measures add little, if any, independent information to that provided by more clinically relevant measures such as relapses and disability. Similarly, the Expanded Disability status Scale (EDSS), which is the most widely-used measure of disability related to multiple sclerosis, is insufficiently sensitive to detect robust changes in disability over the timeframes usually used in clinical trials. An alternative to the EDSS is the Multiple Sclerosis Severity Score (MSSS), a severity scale which relates clinical disability to disease duration. The MSSS was originally developed from a database of nearly ten thousand patients from eleven European countries and Australia and has since been reproduced in an independent dataset of 1134 patients from the placebo arms of randomised clinical trials. Based on the MSSS score, disease severity can be defined, which shows stability over time and may provide evidence-based decision support for patient management. Another alternative to measure disability is the objective quantification of physical activity. There is evidence that recent developments in pervasive computing using tiny accelerometers may have the potential to increase the reliability and precision of motor assessment, especially in the mid-range of the EDSS. The outcome measures discussed have potential use as online tools for evidence-based decision support which are increasingly being used in medical research and clinical decision-making. Copyright 2009 Elsevier Ltd. All rights reserved.

Disparities in chronic conditions and health status by type of disability

PubMed Central

Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M.

2013-01-01

Background Prior research has established health disparities between people with and without disabilities. However, disparities within the disability population, such as those related to type of disability, have been much less studied. Objective To examine differences in chronic conditions and health status between subgroups of people with different types of disability. Methods We analyzed Medical Expenditure Panel Survey annual data files from 2002-2008. Logistic regression analyses considered disparity from three perspectives: 1) basic differences, unadjusted for other factors; 2) controlling for key demographic and health covariates; and 3) controlling for a larger set of demographic variables and socioeconomic status as well as health and access to healthcare. Results Individuals with vision, physical, cognitive, or multiple disability types fared worse than people with hearing impairment on most health outcomes. This was most consistently true for people with multiple disabilities. Even when all covariates were accounted for, people with multiple types of disability were significantly more likely (p < 0.05) than those with hearing impairment (reference group) to report every poor health outcome with the exception of BMI ≥ 25 and lung disease. Conclusions While many of the differences between disability types were reduced when controlling for other factors, some differences remained significant. This argues for a more individualized approach to understanding and preventing chronic conditions and poor health in specific disability groups. PMID:24060250

Examining related influential factors for dental calculus scaling utilization among people with disabilities in Taiwan, a nationwide population-based study.

PubMed

Lai, Hsien-Tang; Kung, Pei-Tseng; Su, Hsun-Pi; Tsai, Wen-Chen

2014-09-01

Limited studies with large samples have been conducted on the utilization of dental calculus scaling among people with physical or mental disabilities. This study aimed to investigate the utilization of dental calculus scaling among the national disabled population. This study analyzed the utilization of dental calculus scaling among the disabled people, using the nationwide data between 2006 and 2008. Descriptive analysis and logistic regression were performed to analyze related influential factors for dental calculus scaling utilization. The dental calculus scaling utilization rate among people with physical or mental disabilities was 16.39%, and the annual utilization frequency was 0.2 times. Utilization rate was higher among the female and non-aboriginal samples. Utilization rate decreased with increased age and disability severity while utilization rate increased with income, education level, urbanization of residential area and number of chronic illnesses. Related influential factors for dental calculus scaling utilization rate were gender, age, ethnicity (aboriginal or non-aboriginal), education level, urbanization of residence area, income, catastrophic illnesses, chronic illnesses, disability types, and disability severity significantly influenced the dental calculus scaling utilization rate. Copyright © 2014 Elsevier Ltd. All rights reserved.

Economic Well-Being Among Older-Adult Households: Variation by Veteran and Disability Status

PubMed Central

Wilmoth, Janet M.; London, Andrew S.; Heflin, Colleen M.

2015-01-01

This analysis uses data from the Survey of Income and Program Participation (SIPP) to examine whether veteran and disability statuses are jointly associated with household-level poverty and material hardship among older adults. Compared to households that do not include a person with a disability or veteran, disabled non-veteran households are more likely to be in poverty and to experience home hardship, medical hardship, and bill-paying hardship. Disabled veteran households are not significantly different in terms of poverty, but exhibit the highest odds of home hardship, medical hardship, bill-paying hardship, and food insufficiency. The implications for social work practice are discussed. PMID:25750998

Whole-body cryostimulation (cryotherapy) provides benefits for fatigue and functional status in multiple sclerosis patients. A case-control study.

PubMed

Miller, E; Kostka, J; Włodarczyk, T; Dugué, B

2016-12-01

To study the effects of whole-body cryostimulation (WBC) on fatigue and functional status in multiple sclerosis (MS) patients with different levels of fatigue. Two groups of 24 MS patients with fatigue were studied. At the beginning of the study, the first group presented a Fatigue Severity Scale (FSS) score between 38 and 42 (low-fatigue (LF) group), and the second group had an FSS score between 48 and 52 (high-fatigue (HF) group). Both groups were matched for age and sex. All patients were exposed to 10.3-min session of WBC (one exposure per day at -110°C or lower). Functional status was assessed before and after the series of WBC exposures using the Rivermead Motor Assessment (RMA), the Multiple Sclerosis Impact Scale (MSIS-29), and the Expanded Disability Status Scale (EDSS). The RMA was estimated in three sections: gross function (RMA1), leg and trunk (RMA2), and arm (RMA3). MSIS-29 consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) status. In both groups, the WBC sessions induced a significant improvement in the functional status and in the feeling of fatigue. However, the changes observed in HF patients were significantly greater than those observed in LF patients, especially in the MSIS-29-PHYS, MSIS-29-PSYCH, RMA1, and RMA3. The changes observed in the EDSS, RMA2, and FSS were similar in both groups. WBC appears to be effective in improving functional status and the feeling of fatigue in patients with MS and especially in those who are the most fatigued. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Brain reserve against physical disability progression over 5 years in multiple sclerosis.

PubMed

Sumowski, James F; Rocca, Maria A; Leavitt, Victoria M; Meani, Alessandro; Mesaros, Sarlota; Drulovic, Jelena; Preziosa, Paolo; Habeck, Christian G; Filippi, Massimo

2016-05-24

The brain reserve hypothesis links larger maximal lifetime brain growth (MLBG, estimated with intracranial volume [ICV]) with lower risk for cognitive decline/dementia. We examined whether larger MLBG is also linked to less physical disability progression over 5 years in a prospective sample of treatment-naive patients with multiple sclerosis (MS). Physical disability was measured with the Expanded Disability Status Scale (EDSS) at baseline and 5-year follow-up in 52 treatment-naive Serbian patients with MS. MRI measured disease burden (cerebral atrophy, T2 lesion volume) and MLBG: a genetically determined, premorbid (established during adolescence, stable thereafter) patient characteristic estimated with ICV (adjusted for sex). Logistic regression tested whether MLBG (smaller vs larger) predicts disability progression (stable vs worsened) independently of disease burden. Disability progression was observed in 29 (55.8%) patients. Larger MLBG predicted lower risk for progression (odds ratio 0.13, 95% confidence interval 0.02-0.78), independently of disease burden. We also calculated absolute change in EDSS scores, and observed that patients with smaller MLBG showed worse EDSS change (0.91 ± 0.71) than patients with larger MLBG (0.42 ± 0.87). Larger MLBG was linked to lower risk for disability progression in patients with MS over 5 years, which is the first extension of the brain reserve hypothesis to physical disability. MLBG (ICV) represents a clinically available metric that may help gauge risk for future disability in patients with MS, which may advance the science and practice of early intervention. Potential avenues for future research are discussed. © 2016 American Academy of Neurology.

Oral Reading Fluency Development for Children with Emotional Disturbance or Learning Disabilities

PubMed Central

Wanzek, Jeanne; Al Otaiba, Stephanie; Petscher, Yaacov

2012-01-01

This study used a large state-wide database to examine the oral reading fluency development of second and third grade students with emotional disturbance or learning disabilities and their general education peers. Oral reading fluency measures were administered to 185,367 students without disabilities (general education), 2,146 students identified with an emotional disturbance, and 10,339 students with a learning disability. Student status and growth trends were examined in a piecewise model at each grade level for the full sample as well as for a subsample with reading difficulties. Data suggested students with disabilities performed significantly below students without disabilities in initial status and growth. Gender was also examined as a moderator of outcomes for each of the study groups. PMID:24532848

Factors associated with free adult preventive health care utilization among physically disabled people in Taiwan: nationwide population-based study.

PubMed

Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

2014-12-05

Few previous studies have specifically addressed the health care utilization situation of the physically disabled. This study aimed to investigate the utilization of free adult preventive health care for physically disabled people and its' affecting factors. The data was obtained from three nationwide databases from 2006 to 2008. This study comprised 329,264 physically disabled people in Taiwan above the age of 40 who had eligible health checks during 2008. We employed descriptive statistics to analyze the use and rate of free preventive health care use by physically disabled adults. Logistic regression analysis was used to explore the factors that affect physically disabled adults' use of free adult preventive health care. 16.37% of the physically disabled adults used free adult preventive health care. Women (17.66%), married (17.16%), a junior high education level (17.89%), and mildly disabled adults (18.77%) had the highest use rate among various participant subgroups. The variables that significantly influenced the use of free adult preventive health care by the physically disabled included gender, age, education, marital status, urbanization of the residence areas, monthly payroll, aboriginal status, catastrophic illnesses status, relevant chronic diseases, and severity of disability. Physically disabled using preventive health care tend to be low. Governments should use the media to reinforce propagation and education of these services to specific, low-utilization groups, and encourage doctors to actively provide preventive health care to communities.

Older Adults With Intellectual Disability in Residential Care Centers in Israel: Health Status and Service Utilization

ERIC Educational Resources Information Center

Merrick, Joav; Davidson, Philip W.; Morad, Mohammed; Janicki, Matthew P.; Wexler, Orren; Henderson, C. Michael

2004-01-01

To determine their health status, we studied 2,282 Israeli adults with intellectual disability who were at least 40 years of age and lived in residential care. Results showed that age is a significant factor in health status. The frequency of different disease categories (e.g., cardiovascular disease, cancer, and sensory impairments) increased…

Brief Report: Independent Validation of Autism Spectrum Disorder Case Status in the Utah Autism and Developmental Disabilities Monitoring (ADDM) Network Site

ERIC Educational Resources Information Center

Bakian, Amanda V.; Bilder, Deborah A.; Carbone, Paul S.; Hunt, Tyler D.; Petersen, Brent; Rice, Catherine E.

2015-01-01

An independent validation was conducted of the Utah Autism and Developmental Disabilities Monitoring Network's (UT-ADDM) classification of children with autism spectrum disorder (ASD). UT-ADDM final case status (n = 90) was compared with final case status as determined by independent external expert reviewers (EERs). Inter-rater reliability…

Equalization of Opportunities in Employment of People with Disabilities (Indonesian Experience).

ERIC Educational Resources Information Center

Mertopuspito, S.

The paper summarizes the incidence and status of disability in Indonesia and reports on rehabilitation services and facilities. The paper reports that 3.11% of the population is disabled and breaks down this number into those physically or orthopedically disabled (0.85%), visually disabled (0.90%), hearing/speech disabled (0.31%), mentally…

Disability status, mortality, and leading causes of death in the United States community population.

PubMed

Forman-Hoffman, Valerie L; Ault, Kimberly L; Anderson, Wayne L; Weiner, Joshua M; Stevens, Alissa; Campbell, Vincent A; Armour, Brian S

2015-04-01

We examined the effect of functional disability on all-cause mortality and cause-specific deaths among community-dwelling US adults. We used data from 142,636 adults who participated in the 1994-1995 National Health Interview Survey-Disability Supplement eligible for linkage to National Death Index records from 1994 to 2006 to estimate the effects of disability on mortality and leading causes of death. Adults with any disability were more likely to die than adults without disability (19.92% vs. 10.94%; hazard ratio=1.51, 95% confidence interval, 1.45-1.57). This association was statistically significant for most causes of death and for most types of disability studied. The leading cause of death for adults with and without disability differed (heart disease and malignant neoplasms, respectively). Our results suggest that all-cause mortality rates are higher among adults with disabilities than among adults without disabilities and that significant associations exist between several types of disability and cause-specific mortality. Interventions are needed that effectively address the poorer health status of people with disabilities and reduce the risk of death.

Mental Disorder, Psychological Distress, and Functional Status in Canadian Military Personnel.

PubMed

Sampasa-Kanyinga, Hugues; Zamorski, Mark A; Colman, Ian

2018-01-01

We examined the overlap between mood and anxiety disorders and psychological distress and their associations with functional status in Canadian Armed Forces (CAF) personnel. Data on Regular Forces personnel ( N = 6700) were derived from the 2013 Canadian Forces Mental Health Survey, a nationally representative survey of the CAF personnel. Current psychological distress was assessed using the Kessler K10 scale. Past-month mood and anxiety disorders were assessed using the World Health Organization World Mental Health Composite Diagnostic Interview. The prevalence of psychological distress was the same as that of any past-month mood or anxiety disorder (7.1% for each). A total of 3.8% had both distress and past-month mood or anxiety disorder, 3.3% had past-month disorder without psychological distress, while another 3.3% had psychological distress in the absence of a past-month mood or anxiety disorder. After adjusting for age, sex, marital, education, income, language, element, rank, and alcohol use disorder, individuals with both psychological distress and past-month mood and anxiety disorders exhibited the highest levels of disability, days out of role, and work absenteeism relative to those with neither mental disorders nor psychological distress. Relative to individuals with both disorder and distress, those who endured distress in the absence of mental disorder exhibited lower, but meaningful, levels of disability compared with those with neither disorder nor distress. Disability is most severe among CAF personnel with both distress and past-month mood and anxiety disorders. Nevertheless, distress in the absence of disorder is prevalent and is associated with meaningful levels of disability.

The dual task-cost of standing balance affects quality of life in mildly disabled MS people.

PubMed

Castelli, Letizia; De Luca, Francesca; Marchetti, Maria Rita; Sellitto, Giovanni; Fanelli, Fulvia; Prosperini, Luca

2016-05-01

The aim of this study was to explore the correlations between the dual-task cost (DTC) of standing balance and quality of life (QoL) in mildly disabled patients with multiple sclerosis (MS). In this cross-sectional study, patients affected by MS with an expanded disability status scale (EDSS) score of 3.0 or less and without an overt balance impairment were tested by means of static posturography under eyes-opened (single-task condition) and while performing the Stroop word-color test (dual-task condition), to estimate the DTC of standing balance. The self-reported 54-item MS quality of life questionnaire (MSQoL-54) was also administered to obtain a MS-specific assessment of health-related QoL. Among the 120 screened patients, 75 (53 women, 22 men) were tested. Although there was no impact of the DTC of standing balance on the physical and mental composite scores of MSQoL-54, patients who had a greater DTC of standing balance scored worse on role limitations due to physical problems (p = 0.007) and social function (p < 0.001), irrespective of demographic and other clinical characteristics including walking performance and cognitive status. However, the EDSS step and fatigue also contributed to reduced scores in these two QoL domains (p-values < 0.01). In conclusion, the phenomenon of cognitive-motor interference, investigated as DTC of standing balance, may affect specific QoL domains even in mildly disabled patients with MS and in the absence of an overt balance dysfunction.

Contribution of ethnic group and socioeconomic status to degree of disability in rheumatoid arthritis in Chilean patients.

PubMed

Alarcón, Ana M; Muñoz, Sergio; Kaufman, Jay S; Martínez, Carlos; Riedemann, Pablo; Kaliski, Sonia

2015-04-01

The aim of this study was to estimate the contributions of ethnic group and socioeconomic status as social determinants related to disability and disease activity in Chilean Mapuche and non-Mapuche patients with rheumatoid arthritis (RA). Descriptive cross-sectional study with a stratified hospital-based sample of 189 patients in treatment with disease-modifying anti-rheumatic drugs. We assessed disability as categorical variable with the Health Assessment Questionnaire, disease activity with the Disease Activity Score instrument, and socioeconomic status with a standard questionnaire used by the Chilean government. Measures of association, stratified analyses and a multiple logistic regression model were used to analyze the data using the Stata 12.1 software package. Low socioeconomic status (annual income below US$ 7,200) is associated with disability (OR 3.87 CI 1.68-9.20) and Mapuche ethnic identity also contributes to disability (OR 2.48, CI 1.09-5.89). Relevant but not statistically significant in multivariable models were variables such as age, gender and place of residence. RA patients with a low socioeconomic status have almost three times the odds of having a moderate to high disability, independent of their ethnic group, gender or place of residence. Therefore, healthcare efforts should be aimed at promoting early diagnosis and prompt treatment among populations with high levels of poverty, which in the region of the Araucanía means primarily indigenous rural areas.

Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis.

PubMed

Learmonth, Yvonne C; Motl, Robert W; Sandroff, Brian M; Pula, John H; Cadavid, Diego

2013-04-25

The Patient Determined Disease Steps (PDDS) is a promising patient-reported outcome (PRO) of disability in multiple sclerosis (MS). To date, there is limited evidence regarding the validity of PDDS scores, despite its sound conceptual development and broad inclusion in MS research. This study examined the validity of the PDDS based on (1) the association with Expanded Disability Status Scale (EDSS) scores and (2) the pattern of associations between PDDS and EDSS scores with Functional System (FS) scores as well as ambulatory and other outcomes. 96 persons with MS provided demographic/clinical information, completed the PDDS and other PROs including the Multiple Sclerosis Walking Scale-12 (MSWS-12), and underwent a neurological examination for generating FS and EDSS scores. Participants completed assessments of cognition, ambulation including the 6-minute walk (6 MW), and wore an accelerometer during waking hours over seven days. There was a strong correlation between EDSS and PDDS scores (ρ = .783). PDDS and EDSS scores were strongly correlated with Pyramidal (ρ = .578 &ρ = .647, respectively) and Cerebellar (ρ = .501 &ρ = .528, respectively) FS scores as well as 6 MW distance (ρ = .704 &ρ = .805, respectively), MSWS-12 scores (ρ = .801 &ρ = .729, respectively), and accelerometer steps/day (ρ = -.740 &ρ = -.717, respectively). This study provides novel evidence supporting the PDDS as valid PRO of disability in MS.

Improved self-efficacy in persons with relapsing remitting multiple sclerosis after an intensive social cognitive wellness program with participation of support partners: a 6-months observational study

PubMed Central

2014-01-01

Background For persons with multiple sclerosis (MS) it is important to preserve their autonomy, in spite of increasing disability. A major factor mediating autonomy is self-efficacy. According to the social cognitive theory stressors are crucial determinants of self-efficacy, as well as the interaction with partners. Methods In an explorative observational study we assessed in 47 persons with MS (PwMS) the effect of an intense, multidisciplinary, 3-day, social cognitive wellness program with the participation of support partners, after 1, 3 and 6 months. Primary outcomes: self-efficacy-control and -function (Multiple Sclerosis Self-Efficacy Scale [MSSES]),limitations to and problems with participation and autonomy (Impact on Participation and Autonomy [IPA] scale). Secondary outcomes: health-related quality of life (HRQoL) (MS Quality of Life-54 Items [MSQoL-54] questionnaire), anxiety, depression (Hospital Anxiety and Depression Scale [HADS]), and fatigue (Modified Fatigue Impact Scale-5 Items [MFIS-5]). Disability was measured with the Expanded Disability Status Scale (EDSS). Percentage changes from baseline were tested with T-tests, level of significance 0.05. Results In the whole group the MSQoL-54 Mental score was increased at 1, 3 and 6 months (+16.0%, +13.2%, +12.2%), and the MSQoL-54 Physical (+10.2%) at 6 months, with no changes in other outcomes. The relapsing remitting (RR) subgroup (n = 20) had at 6 months an increase in the MSSES-Control score (+24.8%) and in the MSQoL54 Mental and Physical scores (+22.3%, +17.6%). Progressive patients (n = 22) only showed an increase in the MSQoL-54 Mental score (+11.5%) at 1 month. In the low-disability (EDSS < 4.0) subgroup the MSSES-Control score was increased (+23.8%) at 6 months, and the IPA-Limitations and -Problems scores decreased at 3 months (−6.1%, −8.8%); the MSQoL-54 Mental score had increased at 1, 3 and 6 months (+19.3%, +21.5%, +19.3%). In the high-disability (EDSS > =4.0) subgroup no significant changes occurred. Conclusions Results from this observational study suggest that 6 months after an intense, 3-day, multidisciplinary, social cognitive wellness program with support partners, PwMS with a RR course or low disability may experience an improved self-efficacy-control and HRQoL. PMID:24646061

Toward a Theory of Disability and Gender.

ERIC Educational Resources Information Center

Gerschick, Thomas J.

2000-01-01

Presents a theory of the connections between disabilities and gender, arguing that because bodies are so central to gender, people with disabilities are vulnerable to being denied gender recognition. Though both sexes experience devaluation and discrimination when disabled, being disabled further diminishes women's already devalued status. For…

Contraceptive use at last intercourse among reproductive-aged women with disabilities: an analysis of population-based data from seven states.

PubMed

Haynes, Renee Monique; Boulet, Sheree L; Fox, Michael H; Carroll, Dianna D; Courtney-Long, Elizabeth; Warner, Lee

2018-06-01

To assess patterns of contraceptive use at last intercourse among women with physical or cognitive disabilities compared to women without disabilities. We analyzed responses to 12 reproductive health questions added by seven states to their 2013 Behavioral Risk Factor Surveillance System questionnaire. Using responses from female respondents 18-50 years of age, we performed multinomial regression to calculate estimates of contraceptive use among women at risk for unintended pregnancy by disability status and type, adjusted for age, race/ethnicity, marital status, education, health insurance status, and parity. Women with disabilities had similar rates of sexual activity as women without disabilities (90.0% vs. 90.6%, p=.76). Of 5995 reproductive-aged women at risk for unintended pregnancy, 1025 (17.1%) reported one or more disabilities. Contraceptive use at last intercourse was reported by 744 (70.1%) of women with disabilities compared with 3805 (74.3%) of those without disabilities (p=.22). Among women using contraception, women with disabilities used male or female permanent contraception more often than women without disabilities (333 [29.6%] versus 1337 [23.1%], p<.05). Moderately effective contraceptive (injection, oral contraceptive, patch, or ring) use occurred less frequently among women with cognitive (13.1%, n=89) or independent living (13.9%, n=40) disabilities compared to women without disabilities (22.2%, n=946, p<.05). The overall prevalence of sexual activity and contraceptive use was similar for women with and without physical or cognitive disabilities. Method use at last intercourse varied based on presence and type of disability, especially for use of permanent contraception. Although women with disabilities were sexually active and used contraception at similar rates as women without disabilities, contraception use varied by disability type, suggesting the importance of this factor in reproductive health decision-making among patients and providers, and the value of further research to identify reasons why this occurs. Published by Elsevier Inc.

Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan

PubMed Central

2014-01-01

Background This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database. Methods The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults’ use of preventive health services. Results Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p <0.001). The utilization rate decreased with increasing severity of intellectual disabilities. The utilization was lowest (13.83%) for those with very severe disability, whereas that was the highest (19.38%) for those with mild severity. The factors significantly influencing utilization of the services included gender, age, and marital status, urbanization of resident areas, monthly payroll, low-income household status, catastrophic illnesses status and relevant chronic diseases and severity of disability. Conclusions Although Taiwan’s Health Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health examinations for the persons with intellectual disabilities. It is also suggested to conduct media publicity and education to the public and the nursing facilities for the utilization of adult preventive health services. PMID:24923548

Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan.

PubMed

Yen, Suh-May; Kung, Pei-Tseng; Chiu, Li-Ting; Tsai, Wen-Chen

2014-06-12

This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database. The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults' use of preventive health services. Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p <0.001). The utilization rate decreased with increasing severity of intellectual disabilities. The utilization was lowest (13.83%) for those with very severe disability, whereas that was the highest (19.38%) for those with mild severity. The factors significantly influencing utilization of the services included gender, age, and marital status, urbanization of resident areas, monthly payroll, low-income household status, catastrophic illnesses status and relevant chronic diseases and severity of disability. Although Taiwan's Health Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health examinations for the persons with intellectual disabilities. It is also suggested to conduct media publicity and education to the public and the nursing facilities for the utilization of adult preventive health services.

Employment status and mental health among persons with and without a disability: evidence from an Australian cohort study.

PubMed

Milner, A; LaMontagne, A D; Aitken, Z; Bentley, R; Kavanagh, A M

2014-11-01

Unemployment and economic inactivity are associated with worse mental health in the general population, but there is limited understanding of whether these relationships are different for those persons with mental or physical disabilities. The aim of this study was to assess whether there were differences in mental health by labour force status among persons with and without disabilities. Over eight annual waves of the Household, Income and Labour Dynamics in Australia (HILDA) survey, a total of 2379 people with disabilities and 11 417 people without disabilities were identified. Mental health using the Mental Component Summary (MCS) from the Short Form 36 was modelled as a function of labour force status using fixed-effects regression models to control for time invariant confounding. Differences between those with and without disabilities were assessed by including an interaction term in regression models. After finding evidence of effect modification, regression models were stratified by disability status. After adjustment, unemployment and economic inactivity were associated with a -1.85 (95% CI -2.96 to -0.73, p=0.001) and -2.66 (95% CI -3.46 to -1.86, p<0.001) reduction in scores of the MCS among those with a disability. For those without a disability, there were smaller declines associated with unemployment (-0.57, 95% CI -1.02 to -0.12, p=0.013) and economic inactivity (-0.34, 95% CI -0.64 to 0.05, p=0.022). These results suggest a greater reduction in mental health for those persons with disabilities who were unemployed or economically inactive than those who were employed. This highlights the value of employment for people with disabilities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Wealth Inequality and Mental Disability Among the Chinese Population: A Population Based Study.

PubMed

Wang, Zhenjie; Du, Wei; Pang, Lihua; Zhang, Lei; Chen, Gong; Zheng, Xiaoying

2015-10-19

In the study described herein, we investigated and explored the association between wealth inequality and the risk of mental disability in the Chinese population. We used nationally represented, population-based data from the second China National Sample Survey on Disability, conducted in 2006. A total of 1,724,398 study subjects between the ages of 15 and 64, including 10,095 subjects with mental disability only, were used for the analysis. Wealth status was estimated by a wealth index that was derived from a principal component analysis of 10 household assets and four other variables related to wealth. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for mental disability for each category, with the lowest quintile category as the referent. Confounding variables under consideration were age, gender, residence area, marital status, ethnicity, education, current employment status, household size, house type, homeownership and living arrangement. The distribution of various types and severities of mental disability differed significantly by wealth index category in the present population. Wealth index category had a positive association with mild mental disability (p for trend <0.01), but had a negative association with extremely severe mental disability (p for trend <0.01). Moreover, wealth index category had a significant, inverse association with mental disability when all severities of mental disability were taken into consideration. This study's results suggest that wealth is a significant factor in the distribution of mental disability and it might have different influences on various types and severities of mental disability.

Wealth Inequality and Mental Disability Among the Chinese Population: A Population Based Study

PubMed Central

Wang, Zhenjie; Du, Wei; Pang, Lihua; Zhang, Lei; Chen, Gong; Zheng, Xiaoying

2015-01-01

In the study described herein, we investigated and explored the association between wealth inequality and the risk of mental disability in the Chinese population. We used nationally represented, population-based data from the second China National Sample Survey on Disability, conducted in 2006. A total of 1,724,398 study subjects between the ages of 15 and 64, including 10,095 subjects with mental disability only, were used for the analysis. Wealth status was estimated by a wealth index that was derived from a principal component analysis of 10 household assets and four other variables related to wealth. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for mental disability for each category, with the lowest quintile category as the referent. Confounding variables under consideration were age, gender, residence area, marital status, ethnicity, education, current employment status, household size, house type, homeownership and living arrangement. The distribution of various types and severities of mental disability differed significantly by wealth index category in the present population. Wealth index category had a positive association with mild mental disability (p for trend <0.01), but had a negative association with extremely severe mental disability (p for trend <0.01). Moreover, wealth index category had a significant, inverse association with mental disability when all severities of mental disability were taken into consideration. This study’s results suggest that wealth is a significant factor in the distribution of mental disability and it might have different influences on various types and severities of mental disability. PMID:26492258

Caring, employment, and quality of life: comparison of employed and nonemployed mothers of adults with intellectual disability.

PubMed

Chou, Yueh-Ching; Pu, Cheng-Yun; Kröger, Teppo; Fu, Li-yeh

2010-09-01

The effects of caregiving on mothers of adults with intellectual disability was examined by determining whether there are differences in quality of life and related factors between mothers with different employment status. Study participants were 302 working-age mothers who had adult children with intellectual disability based on the 2008 census survey on intellectual disability carried out in Hsinchu, City, Taiwan. Results revealed that nonemployed mothers are more likely to have a lower level of health status, including the WHOQOL Physical Health domain, than are mothers employed fulltime. Multiple regression analysis showed that mothers' quality of life was significantly determined by the availability of a person with whom they could share care work, family income, social support, and employment status.

Communicating personal amnesty: a model for health promotion in an Australian disability context.

PubMed

Vogelpoel, Nicholas; Gattenhof, Sandra; Shakespeare-Finch, Jane

2015-09-01

Currently pathological and illness-centric policy surrounds the evaluation of the health status of a person experiencing disability. In this research partnerships were built between disability service providers, community development organizations and disability arts organizations to build a translational evaluative methodology prior to implementation of an arts-based workshop that was embedded in a strengths-based approach to health and well-being. The model consisted of three foci: participation in a pre-designed drama-based workshop program; individualized assessment and evaluation of changing health status; and longitudinal analysis of participants changing health status in their public lives following the culmination of the workshop series. Participants (n = 15) were recruited through disability service providers and disability arts organizations to complete a 13-week workshop series and public performance. The study developed accumulative qualitative analysis tools and member-checking methods specific to the communication systems used by individual participants. Principle findings included increased confidence for verbal and non-verbal communicators; increased personal drive, ambition and goal-setting; increased arts-based skills including professional engagements as artists; demonstrated skills in communicating perceptions of health status to private and public spheres. Tangential positive observations were evident in the changing recreational, vocational and educational activities participants engaged with pre- and post- the workshop series; participants advocating for autonomous accommodation and health provision and changes in the disability service staff's culture. The research is an example of translational health methodologies in disability studies. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An Initial Evaluation of the Comprehensive Quality of Life Scale--Intellectual Disability.

ERIC Educational Resources Information Center

Cummins, Robert A.; And Others

1997-01-01

A study of 59 Australian people with an intellectual disability and 69 university students evaluated a new scale to measure the life quality of people with an intellectual disability. The Comprehensive Quality of Life Scale--Intellectual Disability was found to be a useful instrument to measure comparative life quality. (Author/CR)

Measurement of global functional performance in patients with rheumatoid arthritis using rheumatology function tests

PubMed Central

Escalante, Agustín; Haas, Roy W; del Rincón, Inmaculada

2004-01-01

Outcome assessment in patients with rheumatoid arthritis (RA) includes measurement of physical function. We derived a scale to quantify global physical function in RA, using three performance-based rheumatology function tests (RFTs). We measured grip strength, walking velocity, and shirt button speed in consecutive RA patients attending scheduled appointments at six rheumatology clinics, repeating these measurements after a median interval of 1 year. We extracted the underlying latent variable using principal component factor analysis. We used the Bayesian information criterion to assess the global physical function scale's cross-sectional fit to criterion standards. The criteria were joint tenderness, swelling, and deformity, pain, physical disability, current work status, and vital status at 6 years after study enrolment. We computed Guyatt's responsiveness statistic for improvement according to the American College of Rheumatology (ACR) definition. Baseline functional performance data were available for 777 patients, and follow-up data were available for 681. Mean ± standard deviation for each RFT at baseline were: grip strength, 14 ± 10 kg; walking velocity, 194 ± 82 ft/min; and shirt button speed, 7.1 ± 3.8 buttons/min. Grip strength and walking velocity departed significantly from normality. The three RFTs loaded strongly on a single factor that explained ≥70% of their combined variance. We rescaled the factor to vary from 0 to 100. Its mean ± standard deviation was 41 ± 20, with a normal distribution. The new global scale had a stronger fit than the primary RFT to most of the criterion standards. It correlated more strongly with physical disability at follow-up and was more responsive to improvement defined according to the ACR20 and ACR50 definitions. We conclude that a performance-based physical function scale extracted from three RFTs has acceptable distributional and measurement properties and is responsive to clinically meaningful change. It provides a parsimonious scale to measure global physical function in RA. PMID:15225367

Organizational justice and disability pension from all-causes, depression and musculoskeletal diseases: A Finnish cohort study of public sector employees.

PubMed

Juvani, Anne; Oksanen, Tuula; Virtanen, Marianna; Elovainio, Marko; Salo, Paula; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

2016-09-01

Work-related stress has been linked to increased risk of disability pensioning, but the association between perceived justice of managerial behavior and decision-making processes at the workplace (ie, organizational justice) and risk of disability pensioning remains unknown. We examined the associations of organizational justice and its relational and procedural components with all-cause and diagnosis-specific disability pensions with repeated measures of justice. Data from 24 895 employees responding to repeated surveys on organizational justice in 2000-2002 and 2004 were linked to the records of a national register for disability pensions from 2005-2011. Associations of long-term organizational justice (average score from two surveys) with disability pensions were studied with Cox proportional hazard regression adjusted for demographics, socioeconomic status, baseline health and health risk behavior, stratified by sex. During a mean follow-up of 6.4 years, 1658 (7%) employees were granted disability pension (282 due to depression; 816 due to musculoskeletal diseases). Higher organizational justice was associated with a lower risk of disability pensioning [hazard ratio (HR) per one-unit increase in 5-point justice scale 0.87 (95% CI 0.81-0.94)]. For disability pension due to depression and musculoskeletal diseases, the corresponding HR were 0.77 (95% CI 0.65-0.91) and 0.87 (95% CI 0.79-0.97), respectively. Adjustment for job strain and effort-reward imbalance attenuated the HR by 20-80%. Supervisors` fair treatment of employees and fair decision-making in the organizations are associated with a decreased risk of disability pensioning from all-causes, depression and musculoskeletal diseases. These associations may be attributable to a wider range of favorable work characteristics.

A qualitative study of U.S. veterans' reasons for seeking Department of Veterans Affairs disability benefits for posttraumatic stress disorder.

PubMed

Sayer, Nina A; Spoont, Michele; Murdoch, Maureen; Parker, Louise E; Hintz, Samuel; Rosenheck, Robert

2011-12-01

Posttraumatic stress disorder (PTSD) is the most prevalent compensable mental disorder within the U.S. Department of Veterans Affairs disability system and the number of veterans with PTSD service-connected disability has increased steadily over the past decade. An understanding of the reasons veterans apply for PTSD disability status may inform interpretation of this increase and policies and interventions to assist veterans with military-related PTSD. The authors conducted an exploratory qualitative study to describe the reasons veterans seek PTSD disability benefits and explored differences between those who served in different military service eras. They gathered data through in-depth interviews with 44 purposefully selected U.S. veterans, and conducted content analysis of transcribed interviews using inductive and deductive analysis with constant comparison. Participants described 5 interrelated categories of reasons for seeking PTSD disability benefits, including 3 internal factors (tangible need, need for problem identification or clarification, beliefs that justify/legitimize PTSD disability status) and 2 external factors (encouragement from trusted others and professional assistance). There were no major differences by service era. Findings may help policy makers, providers, and researchers understand what veterans hope to achieve through PTSD disability and the instrumental role of social networks and government systems in promoting the pursuit of PTSD disability status. Published 2011. This article is a US Government work and is in the public domain in the USA.

Functional status and use of healthcare facilities in long‐term survivors of transient ischaemic attack or minor ischaemic stroke

PubMed Central

van Wijk, I; Lindeman, E; Kappelle, L J; van Gijn, J; Koudstaal, P J; Gorter, J W; Algra, A

2006-01-01

Background Stroke may have a major effect on survivors and on the healthcare system. Aims To study the functional status and use of healthcare facilities in long‐term survivors of a transient ischaemic attack (TIA) or minor ischaemic stroke (MIS) and evaluate associations with baseline and follow‐up characteristics. Methods Follow‐up of patients who had participated in the Dutch TIA Trial or the European Atrial Fibrillation Trial was extended to a mean period of 15.6 years. Patients were interviewed through a postal questionnaire (n = 468) and a sample of this group was also interviewed at home (n = 198). Demographic data, information on comorbidity, functional status (Barthel Index, Frenchay Activities Index and modified Rankin Scale) and use of healthcare facilities were recorded. Results About one third of the survivors interviewed at home experienced any residual disability and 26% were moderately to severely handicapped. Factors associated with poor functional status were advanced age and the presence of any infarct on a baseline computed tomography scan, the recurrence of a new major stroke or the presence of comorbidity of locomotion. One third of survivors used any kind of professional care, which was predominantly related to the functional status at follow‐up. Conclusions Recurrent stroke and the presence of comorbidity of locomotion are important determinants of long‐term disability of survivors of a TIA or an MIS, which, in turn, is strongly associated with the long‐term use of professional care. The need for measuring comorbidity with regard to functional status is recommended in research on stroke outcome. PMID:16735396

Functional improvement after subthalamic stimulation in Parkinson's disease: a non-equivalent controlled study with 12-24 month follow up.

PubMed

Capecci, M; Ricciuti, R A; Burini, D; Bombace, V G; Provinciali, L; Iacoangeli, M; Scerrati, M; Ceravolo, M G

2005-06-01

This study aimed to assess the effectiveness of chronic bilateral STN-S in improving the functional status of PD patients compared with patients treated with drugs alone. Controlled study of disability index changes over 12 and 24 month chronic STN stimulation. Of 39 patients with advanced PD meeting CAPSIT criteria for STN-S, 23 underwent surgery; 16 patients decided against surgery and continued on drug schedule adjustments. Functional status was measured using the Activities of Daily Living section of the Unified Parkinson's Disease Rating Scale (UPDRS-ADL), Brown's Disability Scale, and Functional Independence Measure. UPDRS motor score and subscores for selected items, levodopa equivalent daily dose, and Beck Depression Inventory scores were also monitored. T12 follow up data were available for all 39 patients and T24 data for 13 STN-S and 8 control subjects. Compared with controls, STN-S patients experienced significant or highly significant improvements in all independence measures at both 12 and 24 months (time x treatment effect T12: F = 19.5, p = 0.00008; T24: F = 6.2, p = 0.005). Forward stepwise regression for independent predictors of the yearly rate of UPDRS-ADL score modification in the entire sample showed that treatment was the only factor significantly associated with functional status change (beta coefficient -0.54, t value -2.5, p = 0.02), whereas other variables-UPDRS motor score, BDI, and age at disease onset and enrolment-were not in the equation. STN-S is an effective therapeutic option in advanced PD. It induced a consistent improvement of functional abilities over two years to an extent that was not achieved with drug therapy alone.

Suicide Attempts Among Adolescents with Self-Reported Disabilities.

PubMed

Moses, Tally

2018-06-01

This study examines the relative risk for suicide attempts (SA) among high-school students self-identifying with one or more disability classifications (nine); assesses the extent to which youth with disabilities are disproportionately vulnerable to risk factors that predict suicidal behavior among all adolescents; and explores whether disability status adds to risk for SA after accounting for a comprehensive set of known risk and protective factors for SA. Analyses using Wisconsin's 2012 Dane County Youth Assessment Survey data found that youth in each disability category were 3-9 times more likely to report suicide attempt(s) relative to peers, and the endorsement of multiple disabilities tripled the risk SA relative to youth reporting a single disability. Some disability sub-groups, including youth reporting autism spectrum disorder, hearing, and vision impairments reported surprisingly high rates of SA. While youth with disabilities reported disproportionate exposure to adversity in every life domain examined, similar to youth reporting SA, disability status added unique risk for suicidal behavior. This suggests that disability may be a 'fundamental cause' of suicidal behavior, a question that requires further investigation.

Increasing positive attitudes toward individuals with disabilities through community service learning.

PubMed

Lawson, Janelle E; Cruz, Rebecca A; Knollman, Gregory A

2017-10-01

Providing equal-status contact between those with and without disabilities can improve attitudes and reduce discrimination toward individuals with disabilities. This study investigated community service learning as a means by which to provide college students with equal-status contact with individuals with disabilities and increase their positive attitudes toward those with disabilities. A total of 166 college students in one university in the United States enrolled in an Introduction to Disability course received content on disability in society and participated in community service involving 20h of direct contact with individuals with disabilities. Findings indicated that college students who had prior contact with individuals with disabilities had more positive attitudes toward individuals with disabilities than college students who did not have prior contact at the start of the course. For the college students who did not have any prior contact, their attitudes toward individuals with disabilities became significantly more positive at the end of the community service learning course. Implications and suggestions for future research are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of short-term active video game play on community adults: under International Classification of Functioning, Disability and Health consideration.

PubMed

Tseng, Wei-Che; Hsieh, Ru-Lan

2013-06-01

The effects of active video game play on healthy individuals remain uncertain. A person's functional health status constitutes a dynamic interaction between components identified in the International Classification of Functioning, Disability, and Health (ICF). The aim of this study was to investigate the short-term effects of active video game play on community adults using the ICF. Sixty community adults with an average age of 59.3 years and without physical disabilities were recruited. Over 2 weeks, each adult participated in six sessions of active video game play lasting 20 minutes each. Participants were assessed before and after the intervention. Variables were collected using sources related to the ICF components, including the Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Biodex Stability System, chair- rising time, Frenchay Activity Index, Rivermead Mobility Index, Chronic Pain Grade Questionnaire, Work Ability Index, and World Health Organization Quality of Life-Brief Version. Compared to baseline data, significantly reduced risk of a fall measured by Biodex Stability System and improvements in disability scores measured by the Chronic Pain Grade Questionnaire were noted. There was no significant change in the other variables measured. Short-term, active video game play reduces fall risks and ameliorates disabilities in community adults.

More Education May Limit Disability and Extend Life For People With Cognitive Impairment.

PubMed

Laditka, Sarah B; Laditka, James N

2014-08-01

Education is associated with longer life and less disability. Living longer increases risks of cognitive impairment, often producing disability. We examined associations among education, disability, and life expectancy for people with cognitive impairment, following a 1992 cohort ages 55+ for 23 063 person-years (Panel Study of Income Dynamics, n = 2165). We estimated monthly probabilities of disability and death for 7 education levels, adjusting for age, gender, ethnicity, and cognitive status. We used the probabilities to simulate populations with age-specific cognitive impairment incidence and monthly disability status through death. For those with cognitive impairment, education was associated with longer life and less disability. Among them, college-educated white women lived 3.2 more years than those with <8 years education, disabled 24.4% of life from age 55 compared with 36.7% (P< .0001). Increasing education will lengthen lives. Living longer, more people will have cognitive impairment. Education may limit their risk of disability and its duration. © The Author(s) 2014.

Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan.

PubMed

Olivares-Tirado, Pedro; Tamiya, Nanako; Kashiwagi, Masayo

2012-08-04

Japan is setting the pace among aging societies of the world. In 2005, Japan became the country with the highest proportion of elderly persons in the world. To deal with the accelerated ageing population and with an increased demand for long-term care services, in April 2000 the Japanese government introduced a mandatory social Long-Term Care Insurance System (LTCI), making long-term care services a universal entitlement for elderly. Overseas literature suggests that the effectiveness of a home visiting program is uncertain in terms of preventing a decline in the functional status of elderly individuals. In Japan, many studies regarding factors associated with LTC service utilization have been conducted, however, limited evidence about the effect of LTC services on the progression of recipient disability is available. Data were obtained from databases of the LTC insurer of City A. To examine the effect of in-home and community-based services on disability status of recipients, a survival analysis in a cohort of moderately disabled elderly people, was conducted. The mean age of participants was 81 years old, and females represented 69% of the participants. A decline or an improvement in functional status, was observed in 43% and 27% of the sample, respectively. After controlling for other variables, women had a significantly greater probability of improving their functional status during all phases of the observation period. The use of "one service" and the amount of services utilized (days/month), were marginally (p = < 0.10) associated with a greater probability of improving their functional status at 12 months into the observation period. The observed effects of in-home and community-based services on disability transition status were considered fairly modest and weak, in terms of their ability to improve or to prevent a decline in functional status. We suggest two mechanisms to explain these findings. First, disability transition as a measure of disability progression may not be specific enough to assess changes in functional status of LTCI recipients. Secondly, in-home and community-based services provided in City A, may be inappropriate in terms of intensity, duration or quality of care.

College and University Administrators with Disabilities: Experiences in the Workplace

ERIC Educational Resources Information Center

Williams, Joie B.

2010-01-01

In recent years, Disability has been argued as a minority group, no longer the exclusive realm of individuals born with disabilities. Disability is defined as a permanent state or chronic condition. Disability can enter into a person's life at any time. As a minority status, disability shares similar experiences with other minority populations,…

What are the specific disability and limitation types underlying responses to the BRFSS disability questions?

PubMed

Mann, Joshua; Balte, Pallavi; Clarkson, John; Nitcheva, Daniela; Graham, Catherine Leigh; McDermott, Suzanne

2015-01-01

Researchers rely on resources such as BRFSS data to understand the health status of people with disability. However, the survey data rely on a limited definition of disability resulting in imprecise inferences about the nature of disability. Understanding how health varies among people with different types of disability is vital to tailoring interventions for improving health and eliminating disparities. The purpose of this study was to utilize state added follow-up questions in the 2011 South Carolina BRFSS to describe the specific health conditions and limitations attributed to their disability and to compare health status across different types of disability. Participants reporting a disability were asked to name health condition(s) causing disability and describe their disability-related limitations. Descriptive statistics were calculated using weighted proportions. Logistic regression was used to model the associations of specific health conditions and limitations with the outcomes of self-rated general health and mental health status, controlling for demographic factors. The 5 most commonly reported health condition categories were (weighted percentage): musculoskeletal (68.56%); pulmonary (10.41%); neurologic (8.48%); heart disease (8%) and mental health (7.31%). The 5 most commonly reported limitation categories were: mobility/balance limitations (46.29%); pain (23.22%); breathing problems (12.36%); general weakness/fatigue (9.57%) and limited lifting (8.24%). There was substantial variation in the degree of association between categories of conditions and limitations and the outcomes of self-rated physical and mental health. Researchers and practitioners should consider variability in the nature of disability when designing interventions to improve the health of people with a disability. Copyright © 2015 Elsevier Inc. All rights reserved.

Socioeconomic factors and self-reported health outcomes in African Americans with rheumatoid arthritis from the Southeastern United States: the contribution of childhood socioeconomic status.

PubMed

Baldassari, Antoine R; Cleveland, Rebecca J; Luong, My-Linh N; Jonas, Beth L; Conn, Doyt L; Moreland, Larry W; Bridges, S Louis; Callahan, Leigh F

2016-01-12

There is abundant evidence that low socioeconomic status (SES) is associated with worse health outcomes among people with Rheumatoid Arthritis (RA); however, the influence of socioeconomic disadvantage in early life has yet to be studied within that population. Data originated from the cross-sectional arm of the Consortium Evaluation of African-Americans with Rheumatoid Arthritis (CLEAR II), which recruited African-Americans with RA from six sites in the Southeastern United States. We used linear regression models to evaluate associations of parental homeownership status and educational level at participant time of birth with participant-reported fatigue (Visual Analog scale, cm), pain (Visual Analog scale, cm), disability (Health Assessment Questionnaire) and helplessness (Rheumatology Attitudes Index), independently of participant homeownership status and educational level. Models included random effects to account for intra-site correlations, and were adjusted for variables identified using backward selection, from: age, disease-duration, sex, medication use, body-mass index, smoking history. Our sample included 516 CLEAR II participants with full data on demographics and covariates. 89% of participants were women, the mean age was 54.7 years and mean disease duration was 10.8 years. In age adjusted models, parental non-homeownership was associated with greater fatigue (β = 0.75, 95% CI = 0.36-1.14), disability (β = 0.12, 95% CI = 0.04-0.19) and helplessness (β = 0.12, 95% CI = 0.03-0.21), independently of participant homeownership and education; parental education had a further small influence on self-reported fatigue (β = 0.20, 95% CI = 0.15-0.24). Parental homeownership, and to a small extent parental education, had modest but meaningful relationships with self-reported health among CLEAR II participants.

Unemployment in the United States After Traumatic Brain Injury for Working-Age Individuals: Prevalence and Associated Factors 2 Years Postinjury

PubMed Central

Cuthbert, Jeffrey P.; Harrison-Felix, Cynthia; Corrigan, John D.; Bell, Jeneita M.; Haarbauer-Krupa, Juliet K.; Miller, A. Cate

2017-01-01

Objective To estimate the prevalence of unemployment and part-time employment in the United States for working-age individuals completing rehabilitation for a primary diagnosis of traumatic brain injury (TBI) between 2001 and 2010. Design Secondary data analysis. Setting Acute inpatient rehabilitation facilities. Participants Patients aged 16 to 60 years at injury who completed inpatient rehabilitation for TBI between 2001 and 2010. Main Outcome Measures Unemployment; Part-time employment. Results The prevalence of unemployment for persons in the selected cohort was 60.4% at 2-year postinjury. Prevalence of unemployment at 2-year postinjury was significantly associated with the majority of categories of age group, race, gender, marital status, primary inpatient rehabilitation payment source, education, preinjury vocational status, length of stay, and Disability Rating Scale. The direction of association for the majority of these variables complement previous research in this area, with only Hispanic ethnicity and the FIM Cognitive subscale demonstrating disparate findings. For those employed at 2-year postinjury, the prevalence of part-time employment was 35.0%. The model of prevalence for part-time employment at 2-year postinjury was less robust, with significant relationships with some categorical components of age group, gender, marital status, primary payment source, preinjury vocational status, and Disability Rating Scale. Conclusions The prevalence of unemployment for patients completing inpatient rehabilitation for TBI was substantial (60.4%). The majority of factors found to associate with 2 years’ unemployment were complementary of previously published research; however, these were often smaller in magnitude than previous reports. The prevalence of part-time employment was also an issue for this cohort and included 35.0% of all employed individuals. In regard to the determination of factors associated with part-time employment, additional analyses that include more fine-grained factors associated with employment, including physical and psychosocial functioning, are recommended. PMID:25955703

The Impact of Exercise Training on Living Quality in Multiple Sclerosis Individuals

ClinicalTrials.gov

2017-08-27

Multiple Sclerosis; Fatigue; Mental Status Change; Physical Disability; Physical Activity; Mental Impairment; Quality of Life; Disabilities Psychological; Disability Physical; Pain; Energy Supply; Deficiency; Motivation

Development of the Communication Complexity Scale

PubMed Central

Brady, Nancy C.; Fleming, Kandace; Thiemann-Bourque, Kathy; Olswang, Lesley; Dowden, Patricia; Saunders, Muriel D.

2011-01-01

Accurate description of an individual's communication status is critical in both research and practice. Describing the communication status of individuals with severe intellectual and developmental disabilities is difficult because these individuals often communicate with presymbolic means that may not be readily recognized. Our goal was to design a communication scale and summary score for interpretation that could be applied across populations of children and adults with limited (often presymbolic) communication forms. Methods The Communication Complexity Scale (CCS) was developed by a team of researchers and tested with 178 participants with varying levels of presymbolic and early symbolic communication skills. Correlations between standardized and informant measures were completed, and expert opinions were obtained regarding the CCS. Results CCS scores were within expected ranges for the populations studied and inter-rater reliability was high. Comparison across other measures indicated significant correlations with standardized tests of language. Scores on informant report measures tended to place children at higher levels of communication. Expert opinions generally favored the development of the CCS. Clinical implications The scale appears to be useful for describing a given individual's level of presymbolic or early symbolic communication. Further research is needed to determine if it is sensitive to developmental growth in communication. PMID:22049404

Reliability, construct validity, and responsiveness of the neck disability index, patient-specific functional scale, and numeric pain rating scale in patients with cervical radiculopathy.

PubMed

Young, Ian A; Cleland, Joshua A; Michener, Lori A; Brown, Chris

2010-10-01

To examine the psychometric properties of the Neck Disability Index, Patient-Specific Functional Scale, and the Numeric Pain Rating Scale in a cohort of patients with cervical radiculopathy. A single-group repeated-measures design. Patients (n = 165) presenting to physical therapy with cervical radiculopathy completed the Neck Disability Index, Patient-Specific Functional Scale, and Numeric Pain Rating Scale at the baseline examination and at a follow-up. At the time of follow-up, all patients also completed the Global Rating of Change, which was used to dichotomize patients as improved or stable. Baseline and follow-up scores were used to determine the test-retest reliability, construct validity, and minimal levels of detectable and clinically important change for the Neck Disability Index, Patient-Specific Functional Scale, and Numeric Pain Rating Scale. Both the Neck Disability Index and Numeric Pain Rating Scale exhibited fair test-retest reliability, whereas the Patient-Specific Functional Scale exhibited poor reliability in patients with cervical radiculopathy. All three outcome measures showed adequate responsiveness in this patient population. The minimal detectable change was 13.4 for the Neck Disability Index, 3.3 for the Patient-Specific Functional Scale, and 4.1 for the Numeric Pain Rating Scale. The threshold for the minimal clinically important difference was 8.5 for the Neck Disability Index and 2.2 for both the Patient-Specific Functional Scale and Numeric Pain Rating Scale. In light of the varied distribution of symptoms in patients with cervical radiculopathy, future studies should investigate the psychometric properties of other neck-related disability measures in this patient population.

Injuries among US adults with disabilities.

PubMed

Brophy, Megan; Zhang, Xiaofei; Xiang, Huiyun

2008-05-01

Injury prevention among individuals with disabilities is understudied. We compared the patterns of medically treated injuries among US adults with and without disabilities for clues to prevention. We used nationally representative data from the 2004-2005 National Health Interview Survey to compare medically attended injuries within the past 3 months among noninstitutionalized adults in the United States with no disabilities, moderate disabilities, and severe disabilities. The association between disability and injuries was examined in logistic regression analysis, taking into account sociodemographic factors. The 3-month cumulative incidence of injuries was 2.3% (95% confidence interval [CI] = 2.2%-2.4%) among adults with no disabilities, 3.8% (3.4%-4.2%) among adults with moderate disabilities, and 5.6% (4.9%-6.3%) among adults with severe disabilities. Falls were the leading mechanism of injury regardless of disability status, and were even more common in the severely or moderately disabled adults (68% and 47% respectively, compared with 28% among those without disabilities). The setting of the injury also differed with disability status. For the severely disabled, 57% (CI = 52%-62%) of injury episodes occurred at home, compared with only 32% (28%-37%) for the moderately disabled and 23% (21%-25%) for adults with no disabilities. Adults with disabilities are at an increased risk for injury. Programs specifically directed toward injury prevention may benefit adults with disabilities.

Veteran status, disability rating, and public sector employment.

PubMed

Winters, John V

2018-06-01

This paper used microdata from the 2013-2015 American Community Survey to examine differences in federal government, state and local government, private sector, and self-employment among employed veterans and nonveterans. The U.S. federal and state governments have hiring preferences to benefit veterans, especially disabled veterans. Other factors may also push veterans toward public sector employment. I found that veteran status substantially increased the likelihood of federal employment, with the largest magnitudes for severely disabled veterans. Differences in state and local government employment were modest and exhibited heterogeneity by disability severity. Copyright © 2018 John Wiley & Sons, Ltd.

[Application of WAIS-RC short forms and adult intelligence disability scale in mental impairment assessment].

PubMed

Pang, Yan-Xia; Zhang, Jian; Yang, Cheng-Long; Cang, Yong; Wang, Xue-Ling

2011-06-01

Study on the application of WAIS-RC short forms and adult intelligence disability scale in mental impairment assessment. Mental impairment assessment cases between July 2009 and March 2011 in judicial appraisal institute of Taizhou University were collected. Assessment results obtained with the WAIS-RC short forms and adult intelligence disability scale were compared with the experts assessing conclusions and analyzed using SPSS 11.5 software. Assessment results with the two scales did not fully comply with the expert's conclusions, with reliability coefficient were 0.785 and 0.940 respectively, correlation coefficient were 0.850 and 0.922 respectively. The intelligence assessment was influenced by many factors. When the appraised individuals had nerve dysfunction and mild intelligence disability or mental disorders, the two scales should be used together. When the appraised individuals had moderate intelligence disability or mental disorders, adult intelligence disability scale had advantage.

Resting-state connectivity of pre-motor cortex reflects disability in multiple sclerosis.

PubMed

Dogonowski, A-M; Siebner, H R; Soelberg Sørensen, P; Paulson, O B; Dyrby, T B; Blinkenberg, M; Madsen, K H

2013-11-01

To characterize the relationship between motor resting-state connectivity of the dorsal pre-motor cortex (PMd) and clinical disability in patients with multiple sclerosis (MS). A total of 27 patients with relapsing-remitting MS (RR-MS) and 15 patients with secondary progressive MS (SP-MS) underwent functional resting-state magnetic resonance imaging. Clinical disability was assessed using the Expanded Disability Status Scale (EDSS). Independent component analysis was used to characterize motor resting-state connectivity. Multiple regression analysis was performed in SPM8 between the individual expression of motor resting-state connectivity in PMd and EDSS scores including age as covariate. Separate post hoc analyses were performed for patients with RR-MS and SP-MS. The EDSS scores ranged from 0 to 7 with a median score of 4.3. Motor resting-state connectivity of left PMd showed a positive linear relation with clinical disability in patients with MS. This effect was stronger when considering the group of patients with RR-MS alone, whereas patients with SP-MS showed no increase in coupling strength between left PMd and the motor resting-state network with increasing clinical disability. No significant relation between motor resting-state connectivity of the right PMd and clinical disability was detected in MS. The increase in functional coupling between left PMd and the motor resting-state network with increasing clinical disability can be interpreted as adaptive reorganization of the motor system to maintain motor function, which appears to be limited to the relapsing-remitting stage of the disease. © 2013 John Wiley & Sons A/S.

Psychological predictors for health-related quality of life and disability in persons with chronic obstructive pulmonary disease (COPD).

PubMed

Mewes, Ricarda; Rief, Winfried; Kenn, Klaus; Ried, Jens; Stenzel, Nikola

2016-01-01

Individuals with chronic obstructive pulmonary disease (COPD) exhibit low physical and mental health-related quality of life (HRQL) and high susceptibility to disability. We investigated the influence of psychological factors on HRQL and disability in COPD individuals recruited from the general population. In line with Leventhal's common sense model, we expected psychological factors to be associated with HRQL and disability even after controlling for medical status. Individuals with COPD (n = 502; 59.7 years old; GOLD grades were I: 3%, II: 17%, III: 34%, IV: 46%) were assessed through an online survey administered via COPD patient organisations in Germany. Individuals filled in the Short Form Health Survey (SF-12), COPD Assessment Test, Patient Health Questionnaire (modules: GAD-2, PHQ-15, PHQ-9), Brief Illness Perception Questionnaire, a questionnaire that assesses causal illness attributions, and the internal illness-related locus of control scale of the 'KKG questionnaire for the assessment of control beliefs about illness and health'. Multiple linear regressions were calculated. The investigated factors explained high variances (disability = 56%, physical HRQL = 28%, mental HRQL = 63%, p ≤ .001). Better mental health, more optimistic illness perceptions, attribution to psychological causes, and stronger internal locus of control were associated with lower disability and better HRQL. Comorbid somatic symptoms contributed to high disability and low quality of life. Psychological factors, such as illness perception, attribution and internal locus of control, were associated with disability and HRQL. These factors should be considered when designing treatments for individuals with COPD, and adequate interventions should be provided to enhance illness understanding and self-management skills.

Gastrointestinal and nutritional issues in children with neurological disability.

PubMed

Romano, Claudio; Dipasquale, Valeria; Gottrand, Frederic; Sullivan, Peter B

2018-05-27

Neurological disability is often associated with feeding and gastrointestinal disorders leading to malnutrition and growth failure. Assessment of nutritional status represents the first step in the clinical evaluation of children with neurological disability. The European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recently issued a consensus statement on gastrointestinal and nutritional management in children with neurological disability. Here we critically review and address implications of this consensus for clinical practice, including assessment and monitoring of nutritional status, definition of nutritional requirements, diagnosis and treatment of gastro-oesophageal reflux disease, and indications for and modalities of nutritional support. There is a strong evidence base supporting the ESPGHAN guidelines; their application is expected to lead to better management of this group of children. Assessment of nutritional status in children with neurological disability should include the evaluation of body composition. Standard polymeric formula via gastrostomy tube is an effective, long-term nutritional intervention. Tube feeding should be started early, before the development of malnutrition. © 2018 Mac Keith Press.

38 CFR 36.4405 - Grant approval.

Code of Federal Regulations, 2011 CFR

2011-07-01

... sell or rent, after receiving a bona fide offer, or refuse to negotiate for the sale or rental of, or..., color, religion, sex, familial status, disability, or national origin; (ii) The eligible individual, and... housing unit relating to race, color, religion, sex, familial status, disability, or national origin is...

38 CFR 36.4405 - Grant approval.

Code of Federal Regulations, 2013 CFR

2013-07-01

... sell or rent, after receiving a bona fide offer, or refuse to negotiate for the sale or rental of, or..., color, religion, sex, familial status, disability, or national origin; (ii) The eligible individual, and... housing unit relating to race, color, religion, sex, familial status, disability, or national origin is...

38 CFR 36.4405 - Grant approval.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sell or rent, after receiving a bona fide offer, or refuse to negotiate for the sale or rental of, or..., color, religion, sex, familial status, disability, or national origin; (ii) The eligible individual, and... housing unit relating to race, color, religion, sex, familial status, disability, or national origin is...

38 CFR 36.4405 - Grant approval.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sell or rent, after receiving a bona fide offer, or refuse to negotiate for the sale or rental of, or..., color, religion, sex, familial status, disability, or national origin; (ii) The eligible individual, and... housing unit relating to race, color, religion, sex, familial status, disability, or national origin is...

Aging Well Among Women Veterans Compared With Non-Veterans in the Women’s Health Initiative

PubMed Central

LaCroix, Andrea Z.; Rillamas-Sun, Eileen; Woods, Nancy F.; Weitlauf, Julie; Zaslavsky, Oleg; Shih, Regina; LaMonte, Michael J.; Bird, Chloe; Yano, Elizabeth M.; LeBoff, Meryl; Washington, Donna; Reiber, Gayle

2016-01-01

Abstract Purpose of the Study: To examine whether Veteran status influences (a) women’s survival to age 80 years without disease and disability and (b) indicators of successful, effective, and optimal aging at ages 80 years and older. Design and Methods: The Women’s Health Initiative (WHI) enrolled 161,808 postmenopausal women aged 50–79 years from 1993 to 1998. We compared successful aging indicators collected in 2011–2012 via mailed questionnaire among 33,565 women (921 Veterans) who reached the age of 80 years and older, according to Veteran status. A second analysis focused on women with intact mobility at baseline who could have reached age 80 years by December 2013. Multinominal logistic models examined Veteran status in relation to survival to age 80 years without major disease or mobility disability versus having prevalent or incident disease, having mobility disability, or dying prior to age 80 years. Results: Women Veterans aged 80 years and older reported significantly lower perceived health, physical function, life satisfaction, social support, quality of life, and purpose in life scale scores compared with non-Veterans. The largest difference was in physical function scores (53.0 for Veterans vs 59.5 for non-Veterans; p < .001). Women Veterans were significantly more likely to die prior to age 80 years than non-Veteran WHI participants (multivariate adjusted odds ratio = 1.20; 95% confidence interval, 1.04–1.38). In both Veteran and non-Veteran women, healthy survival was associated with not smoking, higher physical activity, healthy body weight, and fewer depressive symptoms. Implications: Intervening upon smoking, low physical activity, obesity, and depressive symptoms has potential to improve chances for healthy survival in older women including Veterans. PMID:26768388

Bullying and Students with Disabilities: Examination of Disability Status and Educational Placement

ERIC Educational Resources Information Center

Rose, Chad A.; Stormont, Melissa; Wang, Ze; Simpson, Cynthia G.; Preast, June L.; Green, Ambra L.

2015-01-01

Students with disabilities are disproportionately represented within the bullying dynamic. However, few studies have investigated the interaction between disability identification and special education services. The current study evaluated bullying involvement (direct victimization, relational victimization, cybervictimization, bullying, fighting,…

Effect of nutritional status in individuals with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation.

PubMed

Günay, Ersin; Kaymaz, Dicle; Selçuk, Nursel Türkoglu; Ergün, Pinar; Sengül, Fatma; Demir, Nese

2013-11-01

Chronic obstructive pulmonary disease (COPD) is considered a worldwide major public health problem. Weight loss, muscle and fat mass depletion are common nutritional problems in COPD patients and are determinant factors in pulmonary function, health status, disability and mortality. We aimed to assess the relationships between nutritional status and perception of dyspnoea, pulmonary function tests (PFT), exercise capacity and health-related quality of life (HRQoL) using the subjective global assessment (SGA) in COPD patients who were referred for pulmonary rehabilitation programme. A total of 163 patients with stable COPD who are candidates for outpatient pulmonary rehabilitation programme were included in this study. Nutritional status for all patients was assessed by SGA. Association of SGA scores (A, B and C) and anthropometric measurements, PFT, dyspnoea scales (Medical Research Council and resting BORG scale), HRQoL (St. George Respiratory Questionnaire and Chronic Respiratory Diseases Questionnaire) and exercise testing (shuttle walking test) were studied for statistical significance. Based on SGA, 9.2% of patients were severely malnourished (SGA-C). There were significant decreases in forced expiratory volume in the first second (FEV1 ) (P = 0.009), Medical Research Council scales (P < 0.001) and exercise capacity (incremental shuttle walking test (P = 0.001) and endurance shuttle walking test (P = 0.009)) in SGA-C. Deterioration in anthropometric measurements and HRQoL measures were observed in malnourished patients. Identifying the nutritional status and determining any requirement for nutritional supplement is an important component of comprehensive pulmonary rehabilitation programme. SGA is an easy and practical method to assess nutritional status in pulmonary rehabilitation candidate patients with stable COPD. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

Comparative Policy Brief: Status of Intellectual Disabilities in the Republic of Haiti

ERIC Educational Resources Information Center

Jacobson, Erik

2008-01-01

An estimated 800,000 persons have disabilities in Haiti, but there are no data that refer specifically to those with intellectual disabilities. Traditional fears and stigma about disability are widespread. While the constitution supports the idea that people with disabilities should have autonomy and education, there are no laws to mandate…

20 CFR 404.1582 - A period of disability based on blindness.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false A period of disability based on blindness..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Blindness § 404.1582 A period of disability based on blindness. If we find that you are blind and you meet the insured status...

The Effect of Fatigue and Fatigue Intensity on Exercise Tolerance in Moderate COPD.

PubMed

Al-Shair, Khaled; Kolsum, Umme; Singh, Dave; Vestbo, Jørgen

2016-12-01

Fatigue is one of the most disabling symptoms in COPD, but little is known about the impact of fatigue on functional disability. We explored the impact of fatigue and fatigue intensity on exercise tolerance after adjusting for other factors using multivariate analysis and compared it to that of dyspnoea. A total of 119 patients with mainly moderate-severe stable COPD (38 % women, mean age 66 years) were enrolled. We used the Medical Research Council dyspnoea scores (MRC), Manchester COPD fatigue scale (MCFS) and its three dimensions, Borg scales for fatigue and dyspnoea, six-minute walk distance (6MWD), St George's Respiratory Questionnaire, the BODE index, and the Centre for Epidemiological Study on Depression scale (CES-D), and we measured spirometry, blood gases, systemic inflammatory markers and fat-free mass index (FFMI). Fatigue measured using the MCFS was associated with 6MWD and explained 22 % of the variability in 6MWD (p < 0.001). Fatigue remained associated with 6MWD after adjusting for MRC dyspnoea, FFMI and FEV 1 , FVC, PaO 2 , PaCO 2 , CES-D, TNF-alpha, smoking status, age and gender. We found that 33, 50 and 23 % of patients reported an increase by 2 scores on Borg scales for fatigue, dyspnoea or both at the end of the 6MWT. Fatigue scores (both before and after the 6MWT) were negatively correlated with 6MWD after adjusting for FEV 1 , FFMI, CES-D score and age (p = 0.007 and 0.001, respectively). In moderate stable COPD, fatigue may be a central driver of functional disability, to the same extent as dyspnoea.

Long term health impact of playing professional football in the United Kingdom

PubMed Central

Turner, A.; Barlow, J.; Heathcote-Elliott, C.

2000-01-01

Objective—To describe the long term impact of football on the health related quality of life (HRQL) of former professional footballers in the United Kingdom. Method—A cross sectional survey gathered data from 284 former professional players. Respondents reported medical treatments, osteoarthritis (OA) diagnosis, other morbidity, disability status, and work related disability since their football career. The EuroQol (EQ-5D) and global health rating scales were selected to assess HRQL. Results—Medical treatment for football related injuries was a common feature, as was OA, with the knee being the most commonly affected joint. Respondents with OA reported poorer HRQL compared with those without OA. As with medical treatments and problems on each of the five EQ-5D dimensions (pain, mobility, usual activities, anxiety/depression, self care), frequency of disability and work related disability were higher among respondents with OA than those without. Conclusion—This exploratory study suggests that playing professional football can impact on the health of United Kingdom footballers in later life. The development of OA was associated with poorer outcomes on all aspects of HRQL. Key Words: football; retirement; osteoarthritis; knee; health related quality of life PMID:11049141

Disability Status, Mortality, and Leading Causes of Death in the United States Community Population

PubMed Central

Forman-Hoffman, Valerie L.; Ault, Kimberly L.; Anderson, Wayne L.; Weiner, Joshua M.; Stevens, Alissa; Campbell, Vincent A.; Armour, Brian S.

2015-01-01

Objective We examined the effect of functional disability on all-cause mortality and cause-specific deaths among community-dwelling US adults. Methods We used data from 142,636 adults who participated in the 1994–1995 National Health Interview Survey-Disability Supplement eligible for linkage to National Death Index records from 1994 to 2006 to estimate the effects of disability on mortality and leading causes of death. Results Adults with any disability were more likely to die than adults without disability (19.92% vs. 10.94%; hazard ratio = 1.51, 95% confidence interval, 1.45–1.57). This association was statistically significant for most causes of death and for most types of disability studied. The leading cause of death for adults with and without disability differed (heart disease and malignant neoplasms, respectively). Conclusions Our results suggest that all-cause mortality rates are higher among adults with disabilities than among adults without disabilities and that significant associations exist between several types of disability and cause-specific mortality. Interventions are needed that effectively address the poorer health status of people with disabilities and reduce the risk of death. PMID:25719432

Lifetime Exposure to Family Violence: Implications for the Health Status of Older African American Women

PubMed Central

Sprauve-Holmes, Nancy E; Gaughan, John; Kaslow, Nadine J.

2009-01-01

Abstract Background Family violence among older women encompasses intimate partner violence (IPV) and elder maltreatment, both linked to poor health status. Little is known about the association between family violence and the health status of older innercity African American women. Methods One hundred fifty-eight African American women, aged ≥50, were interviewed in the ambulatory clinics of a large public hospital. Lifetime family violence exposure as an adult was measured by the Family Violence against Older Women (FVOW) scale; physical and mental health status were measured by the physical and mental component summary scores of the Short Form 8® scale. Results Mean participant age was 61.5 years (SD 7.1). Participants with FVOW scores in the top quartile were considered to have high lifetime family violence exposure. Participants with higher family violence exposure and those younger, unemployed, or disabled reported worse physical and mental health status. Lower income and not having Medicare were associated with worse physical and mental health status, respectively. Using stepwise linear regression techniques, only employment status and high family violence exposure were associated with worse physical (F = 7.16, p = 0.0011) and mental health (f = 7.09, p = 0.0012) status. Women with high FVOW scores reported physical and mental component summary scores that were 4.18 and 4.6 points lower, respectively, than those of women with lower FVOW scores. Conclusions Among older, innercity, African American women, lack of employment and high levels of family violence exposure as an adult are associated with worse physical and mental health status. Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status. PMID:19183088

Lifetime exposure to family violence: implications for the health status of older African American women.

PubMed

Paranjape, Anuradha; Sprauve-Holmes, Nancy E; Gaughan, John; Kaslow, Nadine J

2009-02-01

Family violence among older women encompasses intimate partner violence (IPV) and elder maltreatment, both linked to poor health status. Little is known about the association between family violence and the health status of older innercity African American women. One hundred fifty-eight African American women, aged >/=50, were interviewed in the ambulatory clinics of a large public hospital. Lifetime family violence exposure as an adult was measured by the Family Violence against Older Women (FVOW) scale; physical and mental health status were measured by the physical and mental component summary scores of the Short Form 8 scale. Mean participant age was 61.5 years (SD 7.1). Participants with FVOW scores in the top quartile were considered to have high lifetime family violence exposure. Participants with higher family violence exposure and those younger, unemployed, or disabled reported worse physical and mental health status. Lower income and not having Medicare were associated with worse physical and mental health status, respectively. Using stepwise linear regression techniques, only employment status and high family violence exposure were associated with worse physical (F = 7.16, p = 0.0011) and mental health (f = 7.09, p = 0.0012) status. Women with high FVOW scores reported physical and mental component summary scores that were 4.18 and 4.6 points lower, respectively, than those of women with lower FVOW scores. Among older, innercity, African American women, lack of employment and high levels of family violence exposure as an adult are associated with worse physical and mental health status. Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status.

37 CFR 11.19 - Disciplinary jurisdiction; Jurisdiction to transfer to disability inactive status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Disciplinary jurisdiction; Jurisdiction to transfer to disability inactive status. 11.19 Section 11.19 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE REPRESENTATION OF OTHERS BEFORE THE...

The Effect of Anxiety, Depression, and Optimism on Postoperative Satisfaction and Clinical Outcomes in Lumbar Spinal Stenosis and Degenerative Spondylolisthesis Patients: Cohort Study.

PubMed

Lee, Jaewon; Kim, Hong-Sik; Shim, Kyu-Dong; Park, Ye-Soo

2017-06-01

The aim of this study is to evaluate the effect of depression, anxiety, and optimism on postoperative satisfaction and clinical outcomes in patients who underwent less than two-level posterior instrumented fusions for lumbar spinal stenosis and degenerative spondylolisthesis. Preoperative psychological status of subjects, such as depression, anxiety, and optimism, was evaluated using the Hospital Anxiety and Depression Scale (HADS) and the Revised Life Orientation Test (LOT-R). Clinical evaluation was determined by measuring changes in a visual analogue scale (VAS) and the Oswestry Disability Index (ODI) before and after surgery. Postoperative satisfaction of subjects assessed using the North American Spine Society lumbar spine questionnaire was comparatively analyzed against the preoperative psychological status. The correlation between patient's preoperative psychological status (depression, anxiety, and optimism) and clinical outcomes (VAS and ODI) was evaluated. VAS and ODI scores significantly decreased after surgery ( p < 0.001), suggesting clinically favorable outcomes. Preoperative psychological status of patients (anxiety, depression, and optimism) was not related to the degree of improvement in clinical outcomes (VAS and ODI) after surgery. However, postoperative satisfaction was moderately correlated with optimism. Anxiety and optimism were more correlated with patient satisfaction than clinical outcomes. Accordingly, the surgeon can predict postoperative satisfaction of patients based on careful evaluation of psychological status before surgery.

The Social Networks of Children With and Without Disabilities in Early Childhood Special Education Classrooms.

PubMed

Chen, Jing; Lin, Tzu-Jung; Justice, Laura; Sawyer, Brook

2017-09-01

Interaction with peers is an important contributor to young children's social and cognitive development. Yet, little is known about the nature of social networks within preschool inclusive classrooms. The current study applied a social network analysis to characterize children's peer interactions in inclusive classrooms and their relations with children's disability status. The participants were 485 preschoolers from 64 early childhood special education (ECSE) inclusive classrooms. Results from teachers' report of children's social networks showed that children with disabilities formed smaller play networks compared to their typically developing peers in the classroom, but no evidence indicated that children with disabilities engaged in more conflict networks than their counterparts. Children's play and conflict networks were segregated by children's disability status.

Validity, invariance and responsiveness of a self-report measure of functional limitations and disability in multiple sclerosis.

PubMed

Motl, Robert W; McAuley, Edward; Suh, Yoojin

2010-01-01

This study examined the structural and external aspects of score validity for the abbreviated Late Life-Function and Disability Inventory (LL-FDI) as well as its longitudinal measurement invariance and responsiveness in individuals with multiple sclerosis (MS). The sample included 292 individuals with MS who completed a battery of questionnaires on two occasions separated by 6 months. The battery included the abbreviated LL-FDI along with measures of mobility disability; neurological impairments; symptoms of fatigue, anxiety, depression and pain; health status; and quality of life. The data were analysed using Analysis of Moment Structures (AMOS) and Statistical Package for the Social Sciences (SPSS), versions 16.0. Confirmatory factor analysis supported the structural validity and longitudinal measurement invariance of the disability and functional limitations components of the abbreviated LL-FDI. MANOVA and bivariate correlations supported the external aspects of score validity based on differences in mean scores as a function of clinical MS course (relapsing vs. progressive) and level of mobility disability (mild vs. moderate mobility disability) and associations with measures of neurological impairments, symptoms, health status and QOL, respectively. ANOVA established the responsiveness (i.e., sensitivity for reflecting clinically important differences in health status across time) of the functional limitations and disability components of the abbreviated LL-FDI for detecting changes in mobility disability across 6-months. Such findings provide a new option for the measurement of functional limitations and disability using the abbreviated LL-FDI in persons with MS.

Assessment of salivary and plaque pH and oral health status among children with and without intellectual disabilities.

PubMed

Radha, G; Swathi, V; Jha, Abhishek

2016-01-01

This study explores the association of disabilities and oral health. The aim of the study was to assess the salivary and plaque pH and oral health status of children with and without disabilities. A total of 100 schoolchildren (50 with disabilities and 50 without disabilities) were examined from 9 to 15 years age group. Saliva and plaque pH analysis were done to both the groups. Clinical data were collected on periodontal status, dental caries using WHO criteria. pH values of different groups, difference between the means were calculated using independent t-test, and frequency distribution was analyzed using Chi-square test. Statistical significance, P value was set at 0.05. Mean plaque and salivary pH scores were lesser (5.73 and 5.67) in children with intellectual disabilities (IDs) (P< 0.001). Subjects with disabilities had also statistically significant higher CPI scores and decayed, missing, and filled scores than their healthy counterparts (P< 0.001). There is a statistically significant difference in plaque and salivary pH among children with and without ID with lower plaque and salivary pH among children with ID. In addition to this, the oral health was also more compromised in children with ID, which confirms a need for preventive treatment for these children.

Perceptions of Emotion Expression and Sibling–Parent Emotion Communication in Latino and Non-Latino White Siblings of Children With Intellectual Disabilities

PubMed Central

Lobato, Debra; Kao, Barbara; Plante, Wendy; Grullón, Edicta; Cheas, Lydia; Houck, Christopher; Seifer, Ronald

2013-01-01

Objective Examine general emotion expression and sibling–parent emotion communication among Latino and non-Latino white (NLW) siblings of children with intellectual disabilities (ID) and matched comparisons. Methods 200 siblings (ages 8–15 years) completed the newly developed Sibling–Parent Emotion Communication Scale and existing measures of general emotion expression and psychosocial functioning. Preliminary analyses evaluated scale psychometrics across ethnicity. Results Structure and internal consistency of the emotion expression and communication measures differed by respondent ethnicity. Latino siblings endorsed more general emotion expression problems and marginally lower sibling–parent emotion communication than NLW siblings. Siblings of children with ID reported marginally more general emotion expression problems than comparisons. Emotion expression problems and lower sibling–parent emotion communication predicted more internalizing and somatic symptoms and poorer personal adjustment, regardless of ID status. Siblings of children with ID endorsed poorer personal adjustment. Conclusion Cultural differences in emotion expression and communication may increase Latino siblings’ risk for emotional adjustment difficulties. PMID:23459309

Health examination utilization in the visually disabled population in Taiwan: a nationwide population-based study

PubMed Central

2013-01-01

Background People with visual disabilities have increased health needs but face worse inequity to preventive health examinations. To date, only a few nationwide studies have analyzed the utilization of preventive adult health examinations by the visually disabled population. The aim of this study was to investigate the utilization of health examinations by the visually disabled population, and analyze the factors associated with the utilization. Methods Visual disability was certified by ophthalmologists and authenticated by the Ministry of the Interior (MOI), Taiwan. We linked data from three different nationwide datasets (from the MOI, Bureau of Health Promotion, and National Health Research Institutes) between 2006 and 2008 as the data sources. Independent variables included demographic characteristics, income status, health status, and severity of disability; health examination utilization status was the dependent variable. The chi-square test was used to check statistical differences between variables, and a multivariate logistic regression model was used to examine the associated factors with health examination utilization. Results In total, 47,812 visually disabled subjects aged 40 years and over were included in this study, only 16.6% of whom received a health examination. Lower utilization was more likely in male subjects, in those aged 65 years and above, insured dependents and those with a top-ranked premium-based salary, catastrophic illness/injury, chronic diseases of the genitourinary system, and severe or very severe disabilities. Conclusion The overall health examination utilization in the visually disabled population was very low. Lower utilization occurred mainly in males, the elderly, and those with severe disabilities. PMID:24313981

Longitudinal follow-up of employment status in patients with chronic fatigue syndrome after mononucleosis

PubMed Central

Nyland, Morten; Naess, Halvor; Birkeland, Jon Steinar; Nyland, Harald

2014-01-01

Objective To examine the effect of early clinical and demographic factors on occupational outcome, return to work or awarded permanent disability pension in young patients with chronic fatigue syndrome (CFS). Design Longitudinal cohort study. Intervention A written self-management programme including a description of active coping strategies for daily life was provided. Setting, participants Patients with CFS after mononucleosis were evaluated at Department of Neurology, Haukeland University Hospital during 1996–2006 (contact 1). In 2009 self-report questionnaires were sent to all patients (contact 2). Primary and secondary outcome measures Primary measure was employment status at contact 2. Secondary measures included clinical symptoms, and Fatigue Severity Scale (FSS) scores on both contacts, and Work and Social Adjustment Scale (WSAS) at contact 2. Results Of 111 patients at contact 1, 92 (83%) patients returned the questionnaire at contact 2. Mean disease duration at contact 1 was 4.7 years and at contact 2 11.4 years. At contact 1, 9 (10%) were part-time or full-time employed. At contact 2, 49 (55%) were part-time or full-time employed. Logical regression analysis showed that FSS≥5 at contact 2 was associated with depression, arthralgia and long disease duration (all at contact 1). Conclusions About half of younger patients with CFS with long-term incapacity for work experienced marked improvement including full-time or part-time employment showing better outcomes than expected. Risk factors for transition to permanent disability were depression, arthralgia and disease duration. PMID:25428629

No evidence for an effect on brain atrophy rate of atorvastatin add-on to interferon β1b therapy in relapsing-remitting multiple sclerosis (the ARIANNA study).

PubMed

Lanzillo, Roberta; Quarantelli, Mario; Pozzilli, Carlo; Trojano, Maria; Amato, Maria Pia; Marrosu, Maria G; Francia, Ada; Florio, Ciro; Orefice, Giuseppe; Tedeschi, Gioacchino; Bellantonio, Paolo; Annunziata, Pasquale; Grimaldi, Luigi M; Comerci, Marco; Brunetti, Arturo; Bonavita, Vincenzo; Alfano, Bruno; Marini, Stefano; Brescia Morra, Vincenzo

2016-08-01

A previous phase 2 trial has suggested that statins might delay brain atrophy in secondary progressive multiple sclerosis. The objective of this study was to evaluate the effect of atorvastatin add-on therapy on cerebral atrophy in relapsing-remitting multiple sclerosis. This randomised, placebo-controlled study compared atorvastatin 40 mg or placebo add-on therapy to interferon β1b for 24 months. Brain magnetic resonance imaging, multiple sclerosis functional composite score, Rao neuropsychological battery and expanded disability status scale were evaluated over 24 months. A total of 154 patients were randomly assigned, 75 in the atorvastatin and 79 in the placebo arms, with a comparable drop-out rate (overall 23.4%). Brain atrophy over 2 years was not different in the two arms (-0.38% and -0.32% for the atorvastatin and placebo groups, respectively). Relapse rate, expanded disability status scale, multiple sclerosis functional composite score or cognitive changes were not different in the two arms. Patients withdrawing from the study had a higher number of relapses in the previous 2 years (P=0.04) and a greater probability of relapsing within 12 months. Our results suggest that the combination of atorvastatin and interferon β1b is not justified in early relapsing-remitting multiple sclerosis and adds to the body of evidence indicating an absence of significant radiological and clinical benefit of statins in relapsing-remitting multiple sclerosis. © The Author(s), 2015.

Multiple barriers to participation for people with psychosocial disability in Dehradun district, North India: a cross-sectional study.

PubMed

Mathias, Kaaren; Pant, Hira; Marella, Manjula; Singh, Lawrence; Murthy, Gvs; Grills, Nathan

2018-02-27

This study used a population-based cross-sectional survey to describe the prevalence of psychosocial disability and unmet need for access to services in North India. This study was conducted in Dehradun district, Uttarakhand, in 2014. A population-based sample of 2441 people over the age of 18 years. The Rapid Assessment of Disability survey tool identified people with disability and used an adapted version of the Kessler scale to identify those with psychosocial disability. It additionally collected information on socioeconomic variables, access to community services and barriers to participation. Prevalence of psychosocial disability and unmet needs and descriptions of barriers to services were calculated, and multivariable logistic regression was used to assess associations between risk factors and psychosocial disability. Prevalence of psychosocial disability was 4.8% and 75% of participants with psychological distress also reported comorbid functional impairments. Adjusted ORs for depression of more than two were found for people who were unschooled, unemployed and of moderate or poor socioeconomic status. The unmet need for access to services was significantly higher in every domain for people with psychosocial disability and was more than 25% in the areas of employment, health service access and community consultation. People with psychosocial disability encountered greater barriers in each domain compared with controls. People who are poor, uneducated and unemployed are two to four times more likely to have psychosocial disability in Dehradun district. They face unmet needs in accessing community services and perceive negative social attitudes, lack of physical accessibility and lack of information as barriers limiting their participation. Social policy must increase access to education and reduce poverty but additionally ensure action is taken in all community services to increase information, physical accessibility and social inclusion of people with psychosocial and other forms of disability. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: results from World Health Survey.

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kostanjsek, Nenad; Kowal, Paul; Officer, Alana; Chatterji, Somnath

2016-04-01

Our objective was to quantify disability prevalence among older adults of low- and middle-income countries, and measure socio-demographic distribution of disability. World Health Survey data included 53,447 adults aged 50 or older from 43 low- and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.

Children with Behavioral, Non-Behavioral, and Multiple Disabilities, and the Risk of Out-of-Home Placement Disruption

ERIC Educational Resources Information Center

Helton, Jesse J.

2011-01-01

Objective: This study examined the relative risk of placement disruption for 3-10 year-old children placed in out-of-home care based on the biological relatedness of the placement caregiver and child disability status: no disability, a non-behavioral disability only, a behavioral disability only, or both a non-behavioral and behavioral disability.…

The Americans with Disabilities Act, Students with Disabilities, and the Role of the Academic Advisor.

ERIC Educational Resources Information Center

Jarrow, Jane E.

1996-01-01

Presents both advice and cautions for the academic advisor working with college students with disabilities, in compliance with the Americans with Disabilities Act. Includes specific discussion of the dangers of stereotyping people or professions and a reminder to view this population as students, with disabilities secondary to student status, and…

Parental Characteristics, Family Ecology, and the Caregiving Environment of Adolescents with Disabilities.

ERIC Educational Resources Information Center

Bradley, Robert H.; And Others

This study examined relationships between the caregiving environment, severity of disability, and several aspects of family ecology for 102 adolescents with disabilities. Family ecology variables included poverty status, parental intelligence, social support, and marital quality. The disability categories were mental retardation; orthopedic…

Development and Psychometric Properties of the Disability Application Appraisal Inventory

ERIC Educational Resources Information Center

Sayer, Nina A.; Spoont, Michele; Nelson, David B.; Nugent, Sean

2004-01-01

This article describes the development and psychometric properties of an inventory to assess cognitive appraisal of the Department of Veterans Affairs (VA) disability application process, the Disability Application Appraisal Inventory (DAAI). Participants were 439 veterans seeking disability status for posttraumatic stress disorder through the VA…

Violence Exposure among Children with Disabilities

ERIC Educational Resources Information Center

Sullivan, Patricia M.

2009-01-01

The focus of this paper is children with disabilities exposed to a broad range of violence types including child maltreatment, domestic violence, community violence, and war and terrorism. Because disability research must be interpreted on the basis of the definitional paradigm employed, definitions of disability status and current prevalence…

The effects of lumbar extensor strength on disability and mobility in patients with persistent low back pain.

PubMed

Helmhout, Pieter H; Witjes, Marloes; Nijhuis-VAN DER Sanden, Ria W; Bron, Carel; van Aalst, Michiel; Staal, J Bart

2017-04-01

It is assumed that low back pain patients who use pain-avoiding immobilizing strategies may benefit from specific back flexion and extension exercises aimed at reducing sagittal lumbar hypomobility. The aim of this study was to test this potential working mechanism in chronic low back pain patients undergoing lumbar extensor strengthening training. A single-group prospective cohort design was used in this study. Patients with persistent low back complaints for at least 2 years were recruited at a specialized physical therapy clinics center. They participated in a progressive 11-week lumbar extensor strength training program, once a week. At baseline, sagittal lumbar mobility in flexion and extension was measured with a computer-assisted inclinometer. Self-rated pain intensity was measured using a visual analogue scale, back-specific functional status was assessed with the Quebec Back Pain Disability Scale and the Patient Specific Complains questionnaire. Statistically significant improvements were found in pain (28% decrease) and functional disability (23% to 36% decrease). Most progress was seen in the first 5 treatment weeks. Lumbar mobility in flexion showed non-significant increases over time (+12%). Pre-post treatment changes in flexion and extension mobility did not contribute significantly to the models. The retained factors together explained 15% to 48% of the variation in outcome. Specific lumbar strengthening showed clinically relevant improvements in pain and disability in patients with persistent chronic low back pain. These improvements did not necessarily relate to improvements in lumbar mobility. Parameters representing other domains of adaptations to exercise may be needed to evaluate the effects of back pain management.

Evaluation of the Personal Impact Health Assessment Questionnaire (PI HAQ) to capture the impact of disability in osteoarthritis.

PubMed

Wylde, Vikki; Livesey, Christine; Learmonth, Ian D; Blom, Ashley W; Hewlett, Sarah

2010-06-01

Measuring facts about disability may not reflect their personal impact. An individualized values instrument has been used to weight difficulty in performing activities of daily living in rheumatoid arthritis, and calculate personal impact (Personal Impact Health Assessment Questionnaire; PI HAQ). This study aimed to evaluate the PI HAQ in osteoarthritis (OA). Study 1: 51 people with OA completed short and long versions of the value instrument at 0 and 1 week. Study 2: 116 people with OA completed the short value instrument, disability and psychological measures at 0 and 4 weeks. Study 1: The eight-category and 20-item value instruments correlated well (r = 0.85) and scores differed by just 2.7%. The eight-category instrument showed good internal consistency reliability (Cronbach's alpha = 0.85) and moderate one-week test-retest reliability (r = 0.68, Wilcoxon signed-rank test p = 0.16, intra-class correlation coefficient [ICC] 0.62). Study 2: Values for disability were not associated with disability severity or clinical status. After weighting disability by value, the resulting PI HAQ scores were significantly associated with dissatisfaction with disability, perceived increase in disability, poor clinical status and life dissatisfaction, and differed significantly between people with high and low clinical status (convergent and discriminant construct validity). There was moderate association with the disease repercussion profile disability subscale (r = 0.511; p < 0.001) (criterion validity). The PI HAQ was stable over four weeks (ICC 0.81). These studies provide an initial evaluation of an instrument to measure the personal impact of disability in people with OA, setting disability within a personal context. Further studies, including sensitivity to change, are required.

Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community.

PubMed

Rajkumar, A P; Thangadurai, P; Senthilkumar, P; Gayathri, K; Prince, M; Jacob, K S

2009-04-01

Depression in old age is an important public health problem causing considerable morbidity and disability worldwide. There is a dearth of community studies from India investigating geriatric depression and its associated risk factors. This study aimed to establish the nature, prevalence and factors associated with geriatric depression in a rural south Indian community. We recruited 1000 participants aged over 65 years from Kaniyambadi block, Vellore, India. We assessed their socio-demographic profile, psychiatric morbidity, cognitive functioning, anthropometrics and disability status using the following structured assessment tools: Geriatric Mental State, Community Screening Instrument for Dementia, Modified CERAD 10 word list learning task, History and Aetiology Schedule Dementia Diagnosis and Subtype, WHO Disability Assessment Scale II, and Neuropsychiatric Inventory. We adopted a case control framework to study the factors associated with geriatric depression. Prevalence of geriatric depression (ICD-10) within the previous one month was 12.7% (95% CI 10.64-14.76%). Low income (OR 1.78; 95% CI 1.08-2.91), experiencing hunger (OR 2.58; 95% CI 1.56-4.26), history of cardiac illnesses (OR 4.75; 95% CI 1.96-11.52), transient ischemic attack (OR 2.43; 95% CI 1.17-5.05), past head injury (OR 2.70; 95% CI 1.36-5.36) and diabetes (OR 2.33; 95% CI 1.15-4.72) increased the risk for geriatric depression after adjusting for other determinants using conditional logistic regression. Having more confidants (OR 0.13; 95% CI 0.06-0.26) was the significant protective factor. Age, female gender, cognitive impairment and disability status were not significantly associated with geriatric depression. DSM-IV diagnosis of major depression was significantly correlated with experiencing hunger, diabetes, transient ischemic attack, past head injury, more disability and less nourishment; having more friends was protective. Geriatric depression is prevalent in rural south India. Poverty and physical ill health are risk factors for depression among elderly while good social support is protective.

75 FR 78999 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Maternal...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

..., Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Maternal Vitamin D Status and..., discussion, and evaluation of ``Maternal Vitamin D Status and Preterm Birth, DP11-002, initial review.'' Contact Person for More Information: Donald Blackman, PhD, Scientific Review Officer, CDC, National Center...

20 CFR 416.265 - Requirements for the special SSI eligibility status.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Requirements for the special SSI eligibility status. 416.265 Section 416.265 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Eligibility Special Provisions for People Who Work Despite A Disabling Impairment § 416.265 Requirement...

48 CFR 19.307 - Protesting a firm's status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2010 CFR

2010-10-01

... business status requirements will be processed concurrently by SBA. (c) All protests must be in writing and... as a service-disabled veteran-owned small business concern. 19.307 Section 19.307 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Determination...

Disability and Identity: The Challenge of Epilepsy

ERIC Educational Resources Information Center

Rhodes, Penny; Nocon, Andrew; Small, Neil; Wright, John

2008-01-01

Through examining the case of people with epilepsy (which, as we demonstrate, has an ambiguous status in relation to both popular and academic conceptions of disability) we explore the fluid, negotiable and contingent nature of identity and, in particular, the identification as "disabled". Disability, we argue, cannot be reduced to either biology…

Gender Discrepancies and Victimization of Students with Disabilities

ERIC Educational Resources Information Center

Simpson, Cynthia G.; Rose, Chad A.; Ellis, Stephanie K.

2016-01-01

Students with disabilities have been recognized as disproportionately involved within the bullying dynamic. However, few studies have examined the interaction between disability status, gender, and grade level. The current study explored the gender discrepancies among students with and without disabilities in middle and high school on bullying,…

The Effect of Socioeconomic Status on Specific Learning Disability Eligibility Decisions

ERIC Educational Resources Information Center

Kollister, Susan

2017-01-01

Public schools provide services for students with disabilities. Inaccurate disability diagnosis may result in inferior educational services or long-lasting educational struggles. The purpose of this quantitative causal comparative study was to determine if a difference existed between the decisions made for specific learning disability eligibility…

[The psychosocial status of patients with endogenous eczema. A study using cluster analysis for the correlation of psychological factors with somatic findings].

PubMed

Gieler, U; Ehlers, A; Höhler, T; Burkard, G

1990-08-01

The present study was performed to investigate whether patients with atopic dermatitis differ as a group from controls on psychological measures of mood and personality or whether psychologically deviant and normal patient subgroups can be distinguished. Furthermore, we were interested in what clinical characteristics might co-vary with psychological disability in patients with atopic dermatitis. In all, 93 patients filled in a standardized mood scale (Hamburg-Erlanger-Stimmungsbarometer) and a personality scale (Kurztest zur Erfassung der Persönlichkeitsstruktur). Compared with matched controls, patients described themselves as being more anxious, more aroused, more depressed and less energetic, and they reached higher neuroticism scores. A cluster analysis identified four patient subgroups. Only one of the subgroups (n = 17) was psychologically disabled according to the questionnaire scores. In contrast to a psychologically stabile patient group, the psychologically disabled patients showed an earlier age of onset of dermatitis, but less intense itching and scratching. They reported more somatic complaints and a higher level of familial stress, were more dissatisfied with their life situation and work, had fewer friends and experienced more losses of significant others. Furthermore, they more frequently rated their disorder as being determined by psychological factors and were more intelligent. Thus, the questionnaires identified a subgroup of patients who may need psychotherapeutic interventions.

Return to productive activity after traumatic brain injury: relationship with measures of disability, handicap, and community integration.

PubMed

Wagner, Amy K; Hammond, Flora M; Sasser, Howell C; Wiercisiewski, David

2002-01-01

To identify which factors are associated with successful return to productive activity (RTPA) 1 year after hospitalization with traumatic brain injury (TBI) and to examine the relations between successful RTPA and other measures of impairment, disability, handicap, and integration into the community. Prospective study with 1-year follow-up. Level I trauma center. One hundred five respondents from a cohort of 378 adults hospitalized with TBI admitted between September 1997 and May 1998. Not applicable. Return to productive work 1 year after injury; Disability Rating Scale (DRS); and Community Integration Scale (CIQ). Of the 105 participants, 72% achieved RTPA. Logistic regression showed an association between RPTA and the following factors: premorbid educational level, premorbid psychiatric history, violent mechanism of injury, discharge status after acute hospitalization, prior alcohol and drug use, and injury severity. Handicap and community integration at 1-year postinjury, as measured by subscales of the DRS and the CIQ, were also associated with RTPA. Premorbid and injury-related variables and measures of handicap and community integration were associated with RTPA at 1 year. To understand and effectively support vocational pursuits in the TBI population, future studies are needed to define further causality and origin of these relationships. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

The influence of veteran race and psychometric testing on veterans affairs posttraumatic stress disorder (PTSD) disability exam outcomes.

PubMed

Marx, Brian P; Engel-Rebitzer, Eden; Bovin, Michelle J; Parker-Guilbert, Kelly S; Moshier, Samantha; Barretto, Kenneth; Szafranski, Derek; Gallagher, Matthew W; Holowka, Darren W; Rosen, Raymond C; Keane, Terence M

2017-06-01

This study examined the influence of veterans' race and examiners' use of psychometric testing during a Department of Veterans Affairs posttraumatic stress disorder (PTSD) disability examination on diagnostic and service connection status outcomes. Participants were 764 veterans enrolled in a national longitudinal registry. Current and lifetime PTSD diagnostic status was determined with the Structured Clinical Interview for DSM-IV (SCID) and was compared with PTSD diagnosis conferred upon veterans by their compensation and pension (C&P) examiners as well as with ultimate Veterans Affairs (VA) PTSD service connected status. The concordance rate between independent SCID current PTSD diagnosis and PTSD disability examination diagnosis was 70.4%, and between SCID lifetime PTSD diagnosis and PTSD disability examination diagnosis was 77.7%. Among veterans with current SCID diagnosed PTSD, Black veterans were significantly less likely than White veterans to receive a PTSD diagnosis from their C&P examiner (odds ratio [OR] = .39, p = .003, confidence interval [CI] = .20-.73). Among veterans without current SCID diagnosed PTSD, White veterans were significantly more likely than Black veterans to receive a PTSD diagnosis from their C&P examiner (OR = 4.07, p = .005, CI = 1.51-10.92). Splitting the sample by use of psychometric testing revealed that examinations that did not include psychometric testing demonstrated the same relation between veteran race and diagnostic concordance. However, for examinations in which psychometric testing was used, the racial disparity between SCID PTSD status and disability exam PTSD status was no longer significant. Results suggest that psychometric testing may reduce disparities in VA PTSD disability exam outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Can cerebral MRI at age 1 year predict motor and intellectual outcomes in very-low-birthweight children?

PubMed

Skranes, J; Vik, T; Nilsen, G; Smevik, O; Andersson, H W; Brubakk, A M

1998-04-01

This follow-up study reports on cerebral MRI findings in 20 very-low-birthweight (VLBW) infants without disabilities at age 1 year in relation to motor, intellectual, and perceptual function at age 6 years. MRI findings, anthropometrics, and Bayley Scales of Infant Development scores at age 1 year as predictors of psychomotor status at age 6 years are also evaluated and compared. Outcome parameters were the Peabody Developmental Motor Scales and the Wechsler Preschool and Primary Scale of Intelligence. The results show that infants with myelin hyperintensities including the centrum semiovale or with occipital hyperintensities with associated ventricular dilatation at age 1 scored lower on the Peabody Gross Motor Locomotion Scale at age 6 than infants with normal myelination or with isolated occipital hyperintensities. This may indicate damage to motor fibers caused by perinatal periventricular leukomalacia. No relation was found between abnormal MRI findings at age 1 and later fine motor, intellectual, and perceptual function. Comparing different age 1-year predictors, an abnormality score defined by MRI was used as an independent predictor of gross motor locomotion function at age 6 years. However, the Bayley Mental Development Index scores and weight at age 1 were more important predictors of later motor and intellectual outcome, respectively, than MRI findings. It is recommended that cerebral MRI should not be used routinely to examine VLBW infants without disabilities at 1 year of age.

Young People with Intellectual Disability Transitioning to Adulthood: Do Behaviour Trajectories Differ in Those with and without Down Syndrome?

PubMed

Foley, Kitty-Rose; Taffe, John; Bourke, Jenny; Einfeld, Stewart L; Tonge, Bruce J; Trollor, Julian; Leonard, Helen

2016-01-01

Young people with intellectual disability exhibit substantial and persistent problem behaviours compared with their non-disabled peers. The aim of this study was to compare changes in emotional and behavioural problems for young people with intellectual disability with and without Down syndrome as they transition into adulthood in two different Australian cohorts. Emotional and behavioural problems were measured over three time points using the Developmental Behaviour Checklist (DBC) for those with Down syndrome (n = 323 at wave one) and compared to those with intellectual disability of another cause (n = 466 at wave one). Outcome scores were modelled using random effects regression as linear functions of age, Down syndrome status, ability to speak and gender. DBC scores of those with Down syndrome were lower than those of people without Down syndrome indicating fewer behavioural problems on all scales except communication disturbance. For both groups disruptive, communication disturbance, anxiety and self-absorbed DBC subscales all declined on average over time. There were two important differences between changes in behaviours for these two cohorts. Depressive symptoms did not significantly decline for those with Down syndrome compared to those without Down syndrome. The trajectory of the social relating behaviours subscale differed between these two cohorts, where those with Down syndrome remained relatively steady and, for those with intellectual disability from another cause, the behaviours increased over time. These results have implications for needed supports and opportunities for engagement in society to buffer against these emotional and behavioural challenges.

Early disturbances in multimodal evoked potentials as a prognostic factor for long-term disability in relapsing-remitting multiple sclerosis patients.

PubMed

London, Frédéric; El Sankari, Souraya; van Pesch, Vincent

2017-04-01

The aim of this study was to investigate whether early alterations in evoked potentials (EPs) have a prognostic value in relapsing-remitting multiple sclerosis (RRMS). We retrospectively selected 108 early MS patients with a neurological follow-up ranging from 5 to 15years, in whom multimodal EPs (visual, brainstem auditory, somatosensory and motor) were performed at diagnosis. A conventional ordinal score was used to quantify the observed abnormalities. The extent of change in the composite EP score was well correlated to the Expanded Disability Status Scale (EDSS) at ten years (Y 10 ) and up to 15years (Y 11-15 ) after disease onset. Analysis of the predictive value of the EP score showed an increased risk of disability progression at Y 10 and Y 11-15 of 60% (p<0.0001) and 73% (p<0.0001) respectively in patients with an EP score >4. Conversely, the risk of disability progression at Y 10 and Y 11-15 associated with a lower EP score (⩽4) was reduced to 16% and 20% respectively. Our data support the good predictive value for long-term disability progression of multimodal EPs performed early after disease onset in RRMS patients. This study, performed in a homogeneous RRMS cohort with long term follow-up, demonstrates the value of an early comprehensive neurophysiological assessment as a marker for future disability. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Concurrent and convergent validity of the mobility- and multidimensional-hierarchical disability categorization models with physical performance in community older adults.

PubMed

Hu, Ming-Hsia; Yeh, Chih-Jun; Chen, Tou-Rong; Wang, Ching-Yi

2014-01-01

A valid, time-efficient and easy-to-use instrument is important for busy clinical settings, large scale surveys, or community screening use. The purpose of this study was to validate the mobility hierarchical disability categorization model (an abbreviated model) by investigating its concurrent validity with the multidimensional hierarchical disability categorization model (a comprehensive model) and triangulating both models with physical performance measures in older adults. 604 community-dwelling older adults of at least 60 years in age volunteered to participate. Self-reported function on mobility, instrumental activities of daily living (IADL) and activities of daily living (ADL) domains were recorded and then the disability status determined based on both the multidimensional hierarchical categorization model and the mobility hierarchical categorization model. The physical performance measures, consisting of grip strength and usual and fastest gait speeds (UGS, FGS), were collected on the same day. Both categorization models showed high correlation (γs = 0.92, p < 0.001) and agreement (kappa = 0.61, p < 0.0001). Physical performance measures demonstrated significant different group means among the disability subgroups based on both categorization models. The results of multiple regression analysis indicated that both models individually explain similar amount of variance on all physical performances, with adjustments for age, sex, and number of comorbidities. Our results found that the mobility hierarchical disability categorization model is a valid and time efficient tool for large survey or screening use.

Long-term disability progression in primary progressive multiple sclerosis: a 15-year study.

PubMed

Rocca, Maria A; Sormani, Maria Pia; Rovaris, Marco; Caputo, Domenico; Ghezzi, Angelo; Montanari, Enrico; Bertolotto, Antonio; Laroni, Alice; Bergamaschi, Roberto; Martinelli, Vittorio; Comi, Giancarlo; Filippi, Massimo

2017-11-01

Prognostic markers of primary progressive multiple sclerosis evolution are needed. We investigated the added value of magnetic resonance imaging measures of brain and cervical cord damage in predicting long-term clinical worsening of primary progressive multiple sclerosis compared to simple clinical assessment. In 54 patients, conventional and diffusion tensor brain scans and cervical cord T1-weighted scans were acquired at baseline and after 15 months. Clinical evaluation was performed after 5 and 15 years in 49 patients. Lesion load, brain and cord atrophy, mean diffusivity and fractional anisotropy values from the brain normal-appearing white matter and grey matter were obtained. Using linear regression models, we screened the clinical and imaging variables as independent predictors of 15-year disability change (measured on the expanded disability status scale). At 15 years, 90% of the patients had disability progression. Integrating clinical and imaging variables at 15 months predicted disability changes at 15 years better than clinical factors at 5 years (R2 = 61% versus R2 = 57%). The model predicted long-term disability change with a precision within one point in 38 of 49 patients (77.6%). Integration of clinical and imaging measures allows identification of primary progressive multiple sclerosis patients at risk of long-term disease progression 4 years earlier than when using clinical assessment alone. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Brain MRI lesions and atrophy are associated with employment status in patients with multiple sclerosis.

PubMed

Tauhid, Shahamat; Chu, Renxin; Sasane, Rahul; Glanz, Bonnie I; Neema, Mohit; Miller, Jennifer R; Kim, Gloria; Signorovitch, James E; Healy, Brian C; Chitnis, Tanuja; Weiner, Howard L; Bakshi, Rohit

2015-11-01

Multiple sclerosis (MS) commonly affects occupational function. We investigated the link between brain MRI and employment status. Patients with MS (n = 100) completed a Work Productivity and Activity Impairment (WPAI) (general health version) survey measuring employment status, absenteeism, presenteeism, and overall work and daily activity impairment. Patients "working for pay" were considered employed; "temporarily not working but looking for work," "not working or looking for work due to age," and "not working or looking for work due to disability" were considered not employed. Brain MRI T1 hypointense (T1LV) and T2 hyperintense (T2LV) lesion volumes were quantified. To assess lesional destructive capability, we calculated each subject's ratio of T1LV to T2LV (T1/T2). Normalized brain parenchymal volume (BPV) assessed brain atrophy. The mean (SD) age was 45.5 (9.7) years; disease duration was 12.1 (8.1) years; 75 % were women, 76 % were relapsing-remitting, and 76 % were employed. T1LV, T1/T2, Expanded Disability Status Scale (EDSS) scores, and activity impairment were lower and BPV was higher in the employed vs. not employed group (Wilcoxon tests, p < 0.05). Age, disease duration, MS clinical subtype, and T2LV did not differ between groups (p > 0.05). In multivariable logistic regression modeling, adjusting for age, sex, and disease duration, higher T1LV predicted a lower chance of employment (p < 0.05). Pearson correlations showed that EDSS was associated with activity impairment (p < 0.05). Disease duration, age, and MRI measures were not correlated with activity impairment or other WPAI outcomes (p > 0.05). We report a link between brain atrophy and lesions, particularly lesions with destructive potential, to MS employment status.

Nutritional risk, nutritional status and incident disability in older adults. The FRADEA study.

PubMed

Martínez-Reig, M; Gómez-Arnedo, L; Alfonso-Silguero, S A; Juncos-Martínez, G; Romero, L; Abizanda, P

2014-03-01

To analyze if body mass index (BMI) and waist circumference (WC) as measures of nutritional status, and the Mini Nutritional Assessment Short Form (MNA-SF) as a nutritional risk measure are associated with increased risk of incident disability in basic activities of daily living (BADL) in a population based cohort of Spanish older adults. Concurrent cohort study. Albacete City, Spain. 678 subjects over age 70 from the FRADEA Study (Frailty and Dependence in Albacete). BMI, WC and MNA-SF were recorded at the basal visit of the FRADEA Study. Incident disability in BADL was defined as loss of the ability to perform bathing, grooming, dressing, toilet use, or feeding from basal to follow-up visit, using the Barthel index. The association between nutritional status and nutritional risk with incident BADL disability was determined by Kaplan-Meier analysis and logistic regression adjusted for age, sex, basal function, comorbidity, cognitive decline, depression risk and frailty status. Each point less of MNA-SF (OR 1.17, 95%CI 1.04-1.31) and MNA-SF<14 (OR 2.33, 95%CI 1.39-3.89), but not MNA-SF<12 (OR 1.47, 95%CI 0.89-2.42) had a greater adjusted risk of incident disability in BADL. Neither BMI (OR 1.02, 95%CI 0.97-1.06) nor WC (OR 1.01, 95%CI 0.99-1.03) were associated. Weight loss (OR 1.75, 95%CI 1.08-2.83) and mobility impairment (OR 3.35, 95%CI 1.67-6.73) remained as adjusted predictors of incident BADL disability, while anorexia almost reached the significance (OR 1.65, 95%CI 0.94-2.87). Nutritional risk measured with the MNA-SF is associated with incident disability in BADL in older adults, while nutritional status measured with BMI or WC is not.

What is different about workers' compensation patients? Socioeconomic predictors of baseline disability status among patients with lumbar radiculopathy.

PubMed

Atlas, Steven J; Tosteson, Tor D; Hanscom, Brett; Blood, Emily A; Pransky, Glenn S; Abdu, William A; Andersson, Gunnar B; Weinstein, James N

2007-08-15

Combined analysis of 2 prospective clinical studies. To identify socioeconomic characteristics associated with workers' compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Few studies have compared socioeconomic differences between those receiving or not receiving workers' compensation with the same underlying clinical conditions. Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers' compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers' compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers' compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers' compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers' compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers' compensation. Clinical trials involving conditions commonly seen in patients with workers' compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers' compensation. Identifying the independent effects of workers' compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status.

Life-Course Transitions Among Adolescents With and Without Disabilities

PubMed Central

Shandra, Carrie L.

2015-01-01

Research on adolescents suggests that young people are able to form reasonable expectations about future life-course transitions—and that these expectations are predictive of future outcomes. However, less is known about how these expectations might vary for adolescents with disabilities, who might face additional challenges when transitioning to adulthood. The present study addresses this gap in the literature by using nationally representative data from the National Longitudinal Survey of Youth (NLSY97) to suggest that young people's expectations about pregnancy, parenthood, education, and employment do vary according to disability status. Furthermore, disability status conditions the relationship between these expectations and their future outcomes. In general, adolescents with disabilities are more proficient in the prediction of educational outcomes than employment or pregnancy outcomes. However, their expectations about education are significantly lower—and expectations about teenage parenthood much higher—than those of adolescents without disabilities. PMID:25926707

Connecting impairment, disability, and handicap in immune mediated polyneuropathies

PubMed Central

Merkies, I; Schmitz, P; van der Meche, F G A; Samijn, J; van Doorn, P A

2003-01-01

Background: In the World Health Organisation (WHO) International Classification of Impairments, Disabilities, and Handicaps (ICIDH), it is suggested that various levels of outcome are associated with one another. However, the ICIDH has been criticised on the grounds that it only represents a general, non-specific relation between its entities. Objective: To examine the significance of the ICIDH in immune mediated polyneuropathies. Methods: Four impairment measures (fatigue severity scale, MRC sum score, "INCAT" sensory sum score, grip strength with the Vigorimeter), five disability scales (nine hole peg test, 10 metres walking test, an overall disability sum score (ODSS), Hughes functional grading scale, Rankin scale), and a handicap scale (Rotterdam nine items handicap scale (RIHS9)) were assessed in 113 clinically stable patients (83 with Guillain–Barré syndrome, 22 with chronic inflammatory demyelinating polyneuropathy, eight with a gammopathy related polyneuropathy). Regression analyses with backward and forward stepwise strategies were undertaken to determine the correlation between the various levels of outcome (impairment on disability, impairment on handicap, disability leading to handicap, and impairment plus disability on handicap). Results: Impairment measures explained a substantial part of disability (R2 = 0.64) and about half of the variance in handicap (R2 = 0.52). Disability measures showed a stronger association with handicap (R2 = 0.76). Combining impairment and disability scales accounted for 77% of the variance in handicap (RIHS9) scores. Conclusions: In contrast to some suggestions, support for the ICIDH model is found in the current study because significant associations were shown between its various levels in patients with immune mediated polyneuropathies. Further studies are required to examine other possible contributors to deficits in daily life and social functioning in these conditions. PMID:12486276

Real-world costs of ischemic stroke by discharge status.

PubMed

Mu, F; Hurley, D; Betts, K A; Messali, A J; Paschoalin, M; Kelley, C; Wu, E Q

2017-02-01

The objective of this study was to estimate the acute healthcare costs of ischemic stroke during hospitalization and the quarterly all-cause healthcare costs for the first year after discharge by discharge status. Adult patients with a hospitalization with a diagnosis of ischemic stroke (ICD-9-CM: 434.xx or 436.xx) between 1 January 2006 and 31 March 2015 were identified from a large US commercial claims database. Patients were classified into three cohorts based on their discharge status from the first stroke hospitalization, i.e. dead at discharge, discharged with disability, or discharged without disability. Third-party (medical and pharmacy) and out-of-pocket costs were adjusted to 2015 USD. A total of 7919 patients dead at discharge, 45,695 patients discharged with disability, and 153,778 patients discharged without disability were included in this analysis. The overall average age was 59.7 years and 52.3% were male. During hospitalization, mean total costs (third-party and out-of-pocket) were $68,370 for patients dead at discharge, $73,903 for patients discharged with disability, and $24,448 for patients discharged without disability (p < .001 for each pairwise comparison); mean third-party costs were $63,605 for patients dead at discharge, $67,861 for patients discharged with disability and $19,267 for patients discharged without disability (p < .001 for each pairwise comparison). During the first year after discharge, mean total costs for patients discharged with disability vs. without disability were $46,850 vs. $30,132 (p < .001). Mean third-party costs for patients discharged with disability vs. without disability were $19,116 vs. $10,976 during the first quarter after discharge, $10,236 vs. $6926 during the second quarter, $8241 vs. $5810 during the third quarter, and $6875 vs. $5292 during the fourth quarter (p < .001 for each quarter). The results demonstrated the high economic burden of ischemic stroke, especially among patients discharged with disability with the highest costs incurred during the inpatient stays.

Mobility, balance and falls in persons with multiple sclerosis.

PubMed

Sosnoff, Jacob J; Socie, Michael J; Boes, Morgan K; Sandroff, Brian M; Pula, John H; Suh, Yoojin; Weikert, Madeline; Balantrapu, Swathi; Morrison, Steven; Motl, Robert W

2011-01-01

There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS). 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established.

Mobility, Balance and Falls in Persons with Multiple Sclerosis

PubMed Central

Sosnoff, Jacob J.; Socie, Michael J.; Boes, Morgan K.; Sandroff, Brian M.; Pula, John H.; Suh, Yoojin; Weikert, Madeline; Balantrapu, Swathi; Morrison, Steven; Motl, Robert W.

2011-01-01

Background There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS). Methods 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. Results Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. Conclusions The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established. PMID:22132196

A medical/vocational case coordination system for persons with brain injury: an evaluation of employment outcomes.

PubMed

Malec, J F; Buffington, A L; Moessner, A M; Degiorgio, L

2000-08-01

To evaluate initial placement and 1-year employment outcomes of a Medical/Vocational Case Coordination System (MVCCS) for persons with brain injury (BI) that provides: (1) early case identification and coordination, (2) appropriate medical and vocational rehabilitation interventions, (3) work trials, and (4) supported employment interventions including job coaching. One hundred fourteen Minnesota residents, ages 18 to 65 years, with acquired BI. Five levels of Vocational Independence Scale (VIS). Preinjury employment status (VIS) and years of education, severity of initial injury, time since injury, current impairment/disability as measured by the Rasch-analyzed Staff Mayo-Portland Adaptability Inventory (MPAI), and impaired self-awareness measured by staff rating and the difference between Staff MPAI and Survivor MPAI. At placement, 46% in independent work; 25% in transitional placements; 9% in long-term supported employment; 10% in sheltered work; and 10% not placed. At 1-year follow-up (n = 101), 53% in independent work; 19% in transitional placement; 9% in supported work; 6% in sheltered work; and 13% unemployed. Regression analyses showed time since injury and Rasch Staff MPAI predicted VIS at placement; only VIS at placement independently predicted VIS at 1-year follow-up; Rasch Staff MPAI and preinjury education level predicted time to placement. The MVCCS optimized vocational outcome after BI. Time since injury and impairment/disability best predicted vocational placement. Level of initial placement best predicted employment status at follow-up. Persons with greater disability required more extended time and more extensive rehabilitation services before placement.

Disability inclusion in higher education in Uganda: Status and strategies.

PubMed

Emong, Paul; Eron, Lawrence

2016-01-01

Uganda has embraced inclusive education and evidently committed itself to bringing about disability inclusion at every level of education. Both legal and non-legal frameworks have been adopted and arguably are in line with the intent of the Convention on the Rights of Persons with Disabilities (CRPD) on education. The CRPD, in Article 24, requires states to attain a right to education for persons with disabilities without discrimination and on the basis of equal opportunities at all levels of education. Despite Uganda's robust disability legal and policy framework on education, there is evidence of exclusion and discrimination of students with disabilities in the higher education institutions. The main objective of this article is to explore the status of disability inclusion in higher education and strategies for its realisation, using evidence from Emong's study, workshop proceedings where the authors facilitated and additional individual interviews with four students with disabilities by the authors. The results show that there are discrimination and exclusion tendencies in matters related to admissions, access to lectures, assessment and examinations, access to library services, halls of residence and other disability support services. The article recommends that institutional policies and guidelines on support services for students with disabilities and special needs in higher education be developed, data on students with disabilities collected to help planning, collaboration between Disabled Peoples Organisations (DPO's) strengthened to ensure disability inclusion and the establishment of disability support centres.

Risk factors for disability discharge in enlisted active duty Army soldiers.

PubMed

Piccirillo, Amanda L; Packnett, Elizabeth R; Cowan, David N; Boivin, Michael R

2016-04-01

The rate of permanent disability retirement in U.S. Army soldiers and the prevalence of combat-related disabilities have significantly increased over time. Prior research on risk factors associated with disability retirement included soldiers retired prior to conflicts in Iraq and Afghanistan. To identify risk factors for disability discharge among soldiers enlisted in the U.S. Army during military operations in Iraq and Afghanistan. In this case-control study, cases included active duty soldiers evaluated for disability discharge. Controls, randomly selected from soldiers with no history of disability evaluation, were matched to cases based on enlistment year and sex. Conditional logistic regression models calculated odds of disability discharge. Attributable fractions estimated burden of disability for specific pre-existing condition categories. Poisson regression models compared risk of disability discharge related to common disability types by deployment and combat status. Characteristics at military enlistment with increased odds of disability discharge included a pre-existing condition, increased age or body mass index, white race, and being divorced. Musculoskeletal conditions and overweight contributed the largest proportion of disabilities. Deployment was protective against disability discharge or receiving a musculoskeletal-related disability, but significantly increased the risk of disability related to a psychiatric or neurological condition. Soldiers with a pre-existing condition at enlistment, particularly a musculoskeletal condition, had increased odds of disability discharge. Risk of disability was dependent on condition category when stratified by deployment and combat status. Additional research examining conditions during pre-disability hospitalizations could provide insight on specific conditions that commonly lead to disability discharge. Copyright © 2016 Elsevier Inc. All rights reserved.

[Occupational outcome of patients with schizophrenia after first request for disability status: a 2-year follow-up study].

PubMed

Verdoux, H; Goumilloux, R; Monello, F; Cougnard, A

2010-12-01

To assess occupational outcome of persons with schizophrenia over the 2 years following the first request of disability status. This study was carried out in collaboration with the Commission Technique d'Orientation et de Reclassement Professionnel (COTOREP) (technical commission for occupational guidance and rehabilitation of the disabled) de la Gironde (Bordeaux region, South Western France). Persons with schizophrenia or schizoaffective disorder requesting for the first time in 2006 a disability allowance or the status of disabled worker were assessed using a standardized questionnaire collecting data on clinical, occupational and income history. Information on occupational outcome over the 2 years after the first request was collected at the end of the follow-up using multiple sources of information. We used a broad definition of work, including moonlighting and episodic activities (baby-sitting or grape-harvesting), as well as study periods. Of the 121 patients included at baseline, direct or indirect information was available for 108 (90%) at the 24-month assessment. Persons lost to follow-up were less likely to have worked before first request of disability status compared to persons with information available at the end of the follow-up, but did not differ regarding the other characteristics. Nearly half of the persons (41.7%) had worked over the follow-up, irrespective of the type and duration of the occupation. The working periods were of short duration (median duration 14.5 days, interquartile range 6.5-47.5) and most (98%) were done in low-qualified jobs. Nearly half of the persons reported that they had benefitted from support for starting or returning to work, mainly from recruitment agencies specialized in supporting disabled workers. Persons with the status of disabled worker (Reconnaissance de la qualité de travailleur handicapé) (RTH) were more likely to have worked over the follow-up period (66.7% vs 33.3%; OR=3.9; 95%IC 1.3-11.3; p<0.01) as well as persons who had benefitted from institutional support (61.1% vs 38.9%; OR=3.0; 95%IC 1.2-7.8; p=0.02). However, a noteworthy result was that most jobs were obtained by the patient's personal effort. Nearly one out of four patients (23.2%) was involved in vocational training over the follow-up period. This prospective study demonstrates that half of persons with schizophrenia who benefit from the disabled status remain actively engaged in vocational rehabilitation. Hence, giving access to disability status does not act as a disincentive regarding the return or access to work. However, the benefit of being kept involved in vocational rehabilitation has to be weighted against the fact that most patients only obtained low-qualified jobs of short-duration. This precarious situation may be stressful and may have a deleterious impact regarding self-esteem. Copyright © 2010 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Later life disability status following incarceration as a prisoner of war.

PubMed

Hunt, Stephen C; Orsborn, Mack; Checkoway, Harvey; Biggs, Mary L; McFall, Miles; Takaro, Tim K

2008-07-01

Incarceration-related predictors of later life disability in former prisoners of war (POWs) have not been previously described. The objective of this project was to identify aspects of POW incarceration which are associated with later life disability status. Cross-sectional retrospective study of 328 former U.S. military personnel held as POWs (World War II and Korean and Vietnam Wars) who presented for evaluations at a Veterans Affairs medical center between January 1, 1997 and December 31, 2004 outcome measures were: (1) total number of later life disability conditions attributable to incarceration and (2) cumulative percentage later life disability attributable to these conditions. We found significant associations between later life disability and POW experiences, including experiencing or witnessing torture, solitary confinement, forced marches, dysentry, pellagra, vitamin deficiencies, scabies, depression, and suicidal thoughts. Conditions of captivity and health concerns or emotional distress during captivity may contribute to long-term adverse health outcomes as measured by later life disabilities in individuals incarcerated as POWs.

Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities.

PubMed

Furuta, Michiko; Komiya-Nonaka, Manae; Akifusa, Sumio; Shimazaki, Yoshihiro; Adachi, Munehisa; Kinoshita, Toshinori; Kikutani, Takeshi; Yamashita, Yoshihisa

2013-04-01

Malnutrition and cognitive impairment lead to declines in activities of daily living (ADL). Nutritional status and cognitive ability have been shown to correlate with oral health status and swallowing function. However, the complex relationship among the factors that affect decline in ADL is not understood. We examined direct and indirect relationships among oral health status, swallowing function, nutritional status, cognitive ability, and ADL in Japanese elderly people living at home and receiving home care services because of physical disabilities. Participants were 286 subjects aged 60 years and older (mean age, 84.5±7.9 years) living at home and receiving home care services. Oral health status (the number of teeth and wearing dentures) was assessed, and swallowing function was examined using cervical auscultation. Additionally, ADL, cognitive ability, and nutritional status were assessed using the Barthel Index, the Clinical Dementia Rating Scale, and the Mini Nutritional Assessment-Short Form, respectively. Path analysis was used to test pathways from these factors to ADL. The mean number of teeth present in the participants was 8.6±9.9 (edentates, 40.6%). Dysphagia, malnutrition, and severe cognitive impairment were found in 31.1%, 14.0%, and 21.3% of the participants, respectively. Path analysis indicated that poor oral health status and cognitive impairment had a direct effect on denture wearing, and the consequent dysphagia, in addition to cognitive impairment, was positively associated with malnutrition. Malnutrition as well as dysphagia and cognitive impairment directly limited ADL. A lower number of teeth are positively related to swallowing dysfunction, whereas denture wearing contributes to recovery of swallowing function. Dysphagia, cognitive impairment, and malnutrition directly and indirectly decreased ADL in elderly people living at home and receiving home nursing care. The findings suggest that preventing tooth loss and encouraging denture wearing when teeth are lost may indirectly contribute to maintaining or improving ADL, mediated by recovery of swallowing function and nutritional status. © 2012 John Wiley & Sons A/S.

Venous thromboembolism and subsequent permanent work-related disability

PubMed Central

Brækkan, Sigrid K.; Grosse, Scott D.; Okoroh, Ekwutosi M.; Tsai, James; Cannegieter, Suzanne C.; Næss, Inger Anne; Krokstad, Steinar; Hansen, John-Bjarne; Skjeldestad, Finn Egil

2016-01-01

Background The burden of venous thromboembolism (VTE) related to permanent work-related disability has never been assessed among a general population. Therefore, we aimed to estimate the risk of work-related disability in subjects with incident VTE compared with those without VTE in a population-based cohort. Methods From the Tromsø Study and the Nord-Trøndelag Health Study (HUNT), Norway, 66005 individuals aged 20–65 years were enrolled in 1994–1997 and followed to December 31, 2008. Incident VTE events among the study participants were identified and validated, and information on work-related disability was obtained from the Norwegian National Insurance Administration database. Cox-regression models using age as time-scale and VTE as time-varying exposure were used to estimate hazard ratios (HR) with 95% confidence intervals (CI) adjusted for sex, BMI, smoking, education level, marital status, history of cancer, diabetes, cardiovascular disease and self-rated general health. Results During follow-up, 384 subjects had a first VTE and 9862 participants were granted disability pension. The crude incidence rate of work-related disability after VTE was 37.5 (95%CI: 29.7–47.3) per 1000 person-years, versus 13.5 (13.2–13.7) per 1000 person-years among those without VTE. Subjects with unprovoked VTE had a 52% higher risk of work-related disability than those without VTE (HR 1.52, 95%CI 1.09–2.14) after multivariable adjustment, and the association appeared to be driven by deep vein thrombosis. Conclusion VTE was associated with subsequent work-related disability in a cohort recruited from the general working-age population. Our findings suggest that indirect costs due to loss of work time may add to the economic burden of VTE. PMID:27411161

Disability-Specific Atlases of Gray Matter Loss in Relapsing-Remitting Multiple Sclerosis.

PubMed

MacKenzie-Graham, Allan; Kurth, Florian; Itoh, Yuichiro; Wang, He-Jing; Montag, Michael J; Elashoff, Robert; Voskuhl, Rhonda R

2016-08-01

Multiple sclerosis (MS) is characterized by progressive gray matter (GM) atrophy that strongly correlates with clinical disability. However, whether localized GM atrophy correlates with specific disabilities in patients with MS remains unknown. To understand the association between localized GM atrophy and clinical disability in a biology-driven analysis of MS. In this cross-sectional study, magnetic resonance images were acquired from 133 women with relapsing-remitting MS and analyzed using voxel-based morphometry and volumetry. A regression analysis was used to determine whether voxelwise GM atrophy was associated with specific clinical deficits. Data were collected from June 28, 2007, to January 9, 2014. Voxelwise correlation of GM change with clinical outcome measures (Expanded Disability Status Scale and Multiple Sclerosis Functional Composite scores). Among the 133 female patients (mean [SD] age, 37.4 [7.5] years), worse performance on the Multiple Sclerosis Functional Composite correlated with voxelwise GM volume loss in the middle cingulate cortex (P < .001) and a cluster in the precentral gyrus bilaterally (P = .004). In addition, worse performance on the Paced Auditory Serial Addition Test correlated with volume loss in the auditory and premotor cortices (P < .001), whereas worse performance on the 9-Hole Peg Test correlated with GM volume loss in Brodmann area 44 (Broca area; P = .02). Finally, voxelwise GM loss in the right paracentral lobulus correlated with bowel and bladder disability (P = .03). Thus, deficits in specific clinical test results were directly associated with localized GM loss in clinically eloquent locations. These biology-driven data indicate that specific disabilities in MS are associated with voxelwise GM loss in distinct locations. This approach may be used to develop disability-specific biomarkers for use in future clinical trials of neuroprotective treatments in MS.

Stability of cognitive performance in children with mild intellectual disability.

PubMed

Jenni, Oskar G; Fintelmann, Sylvia; Caflisch, Jon; Latal, Beatrice; Rousson, Valentin; Chaouch, Aziz

2015-05-01

Longitudinal studies that have examined cognitive performance in children with intellectual disability more than twice over the course of their development are scarce. We assessed population and individual stability of cognitive performance in a clinical sample of children with borderline to mild non-syndromic intellectual disability. Thirty-six children (28 males, eight females; age range 3-19y) with borderline to mild intellectual disability (Full-scale IQ [FSIQ] 50-85) of unknown origin were examined in a retrospective clinical case series using linear mixed models including at least three assessments with standardized intelligence tests. Average cognitive performance remained remarkably stable over time (high population stability, drop of only 0.38 IQ points per year, standard error=0.39, p=0.325) whereas individual stability was at best moderate (intraclass correlation of 0.58), indicating that about 60% of the residual variation in FSIQ scores can be attributed to between-child variability. Neither sex nor socio-economic status had a statistically significant impact on FSIQ. Although intellectual disability during childhood is a relatively stable phenomenon, individual stability of IQ is only moderate, likely to be caused by test-to-test reliability (e.g. level of child's cooperation, motivation, and attention). Therefore, clinical decisions and predictions should not rely on single IQ assessments, but should also consider adaptive functioning and previous developmental history. © 2014 Mac Keith Press.

Multi-task functional MRI in multiple sclerosis patients without clinical disability.

PubMed

Colorado, René A; Shukla, Karan; Zhou, Yuxiang; Wolinsky, Jerry S; Narayana, Ponnada A

2012-01-02

While the majority of individuals with multiple sclerosis (MS) develop significant clinical disability, a subset experiences a disease course with minimal impairment even in the presence of significant apparent tissue damage on magnetic resonance imaging (MRI). Functional magnetic resonance imaging (fMRI) in MS patients with low disability suggests that increased use of the cognitive control system may limit the clinical manifestation of the disease. The current fMRI studies tested the hypothesis that nondisabled MS patients show increased recruitment of cognitive control regions while performing sensory, motor and cognitive tasks. Twenty two patients with relapsing-remitting MS and an Expanded Disability Status Scale (EDSS) score of ≤1.5 and 23 matched healthy controls were recruited. Subjects underwent fMRI while observing flashing checkerboards, performing right or left hand movements, or executing the 2-back working memory task. Compared to control subjects, patients demonstrated increased activation of the right dorsolateral prefrontal cortex and anterior cingulate cortex during the performance of the working memory task. This pattern of functional recruitment also was observed during the performance of non-dominant hand movements. These results support the mounting evidence of increased functional recruitment of cognitive control regions in the working memory system of MS patients with low disability and provide new evidence for the role of increased cognitive control recruitment in the motor system. Copyright © 2011 Elsevier Inc. All rights reserved.

Progression in disability and regional grey matter atrophy in relapsing-remitting multiple sclerosis.

PubMed

Hofstetter, Louis; Naegelin, Yvonne; Filli, Lukas; Kuster, Pascal; Traud, Stefan; Smieskova, Renata; Mueller-Lenke, Nicole; Kappos, Ludwig; Gass, Achim; Sprenger, Till; Penner, Iris-Katharina; Nichols, Thomas E; Vrenken, Hugo; Barkhof, Frederik; Polman, Chris; Radue, Ernst-Wilhelm; Borgwardt, Stefan J; Bendfeldt, Kerstin

2014-02-01

In multiple sclerosis (MS) regional grey matter (GM) atrophy has been associated with disability progression. The aim of this study was to compare regional GM volume changes in relapsing-remitting MS (RRMS) patients with progressive and stable disability, using voxel-based morphometry (VBM). We acquired baseline and 1-year follow-up 3-dimensional (3D) T1-weighted magnetic resonance imaging (MRI) data of RRMS patients, using two 1.5-Tesla scanners. Patients were matched pair-wise with respect to age, gender, disease duration, medication, scanner and baseline Expanded Disability Status Scale (EDSS) into 13 pairs, with either progressive EDSS (≥ 1 point change y(-1)) or stable EDSS, as well as into 29 pairs with either progressive Multiple Sclerosis Functional Composite (MSFC) at ≥ 0.25% decrease in y(-1) in any component, or stable MSFC. We analysed longitudinal regional differences in GM volumes in the progressive and stable EDSS and MSFC groups, respectively, using VBM. Significant GM volume reductions occurred in the right precuneus, in the progressive EDSS group. Differential between-group effects occurred in the right precuneus and in the postcentral gyrus. Further longitudinal GM volume reductions occurred in the right orbicular gyrus, in the progressive MSFC group, but no between-group differences were observed (non-stationary cluster-wise inference, all P(corrected) < 0.05). These results suggested a direct association of disability progression and regional GM atrophy in RRMS.

The oral health of people with learning disabilities - a user-friendly questionnaire survey.

PubMed

Owens, J; Jones, K; Marshman, Z

2017-03-01

To conduct a user-friendly questionnaire survey of the oral health and service needs of adults with learning disabilities. Researchers collaborated with local self-advocacy services to develop a questionnaire adapted from one used in a regional postal survey. The questionnaire, which covered dental status, oral health and dental services use, was sent to a random sample of people from the learning disability case register. Of 2,000 questionnaires mailed, 117 were returned undelivered and 625 were completed (response rate 31.3%). The self-reported dental status of people with learning disabilities appeared similar to that of the 2008 postal survey of the general population in Sheffield. The major difference in dental status was 11.5% of people with learning disabilities wore upper dentures and 7.2% wore lower dentures, compared to 21.2% and 12.1% of the general population in Sheffield. Using the case register as a recruitment instrument may have excluded people with learning disabilities not registered. Time and finances only permitted one mailing. Analysis on the basis of deprivation could not be conducted. Contrary to current practice, it is possible to include people with learning disabilities in oral health surveys. A multidisciplinary team was essential for enabling the progression and implementation of inclusive research and for people with learning disabilities and their supporters to engage meaningfully. This level of collaboration appears necessary if we are committed to ensuring that people with learning disabilities and their supporters are made visible to policy and decision-makers. Copyright© 2017 Dennis Barber Ltd

The difference a word makes: responding to questions on 'disability' and 'difficulty' in South Africa.

PubMed

Schneider, Marguerite

2009-01-01

This article discusses the current efforts to measure disability in a comparable manner internationally, the effects of using different types of wording in questions, and the implications of the approach of asking about 'difficulties' rather than 'disability' on the use of disability statistics. The study design was qualitative. Twenty-one focus groups were run with adults responding for themselves. Nine groups were classified a priori by the author as 'disabled', six as 'unsure', and the last six as 'non-disabled'. The participants completed a questionnaire using the Washington Group on Disability Statistics (WG) Short Set, the South African Census 2001 question, and the question 'Are you disabled?'. This was followed by group discussion on these questions and on how the concept of disability is understood by group participants. Participants understand disability as being a permanent, unchangeable state, mostly physical, and where a person is unable to do anything. The participants in the three groups of allocated disability status (disabled, unsure and non-disabled) provided quite different responses on the three questions. All participants in the 'disabled' and 'unsure' groups reported having 'difficulty' on the WG questions, but the 'unsure' groups did not identify as being 'disabled' on either of the two other questions. Using questions that ask about 'difficulty' rather than 'disability' provides a more comprehensive and inclusive measure of disability with a clearer understanding of what is being measured. Asking about 'difficulty' provides an improved measure of disability status for effective data collection and analysis to promote development, implementation and monitoring of disability-inclusive policies.

77 FR 43335 - Administration on Intellectual and Developmental Disabilities; Agency Information Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Community Living Administration on Intellectual and Developmental Disabilities; Agency Information Collection Activities; Proposed Collection; Comment Request; Financial Status Reporting Form for State Councils on Developmental Disabilities AGENCY...

Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: a randomized clinical trial.

PubMed

Inani, Sumit B; Selkar, Sohan P

2013-01-01

Low Back Pain (LBP) results in significant level of disability, producing significant restriction on usual activity such as an inability to work. Nearly two third of the adults are affected by non-specific low back pain at some point in their lives. The purpose of the study was to determine the effect of core stabilization exercises in comparison with conventional exercises on pain, functional status in patients with non-specific LBP. Thirty patients diagnosed with non-specific LBP participated with age group between 20-50 years and divided in to 2 groups, one with core stabilization exercises and other conventional exercises, 15 subjects each. Three months study, pre and post treatment outcome measures used were VAS for pain intensity and Modified Oswestry Low Back Pain Disability Index for functional status (disability). Data were analyzed using student 't' test (paired and unpaired). Whereas both groups improved significantly from the initiation of treatment, a between-group comparison revealed significantly greater (p<0.001) improvements regarding pain and functional status for experimental group compared to control group. Core stabilization exercises were found to be more effective in reducing pain and improving functional status by decreasing disability of patients with non-specific low back pain in comparison with conventional exercises.

Vision in a phase 3 trial of natalizumab for multiple sclerosis: relation to disability and quality of life.

PubMed

Chahin, Salim; Balcer, Laura J; Miller, Deborah M; Zhang, Annie; Galetta, Steven L

2015-03-01

Low-contrast visual acuity (LCVA), a sensitive measure of visual function in multiple sclerosis (MS), demonstrated treatment effects as a secondary outcome measure in the Phase 3 trial of natalizumab, AFFIRM. In these posttrial analyses, we studied the relation of visual function to quality of life (QOL), magnetic resonance imaging (MRI) measures, and Expanded Disability Status Scale (EDSS) scores. At baseline and at 52 and 104 weeks in AFFIRM, patients underwent binocular testing of LCVA (1.25% and 2.5% contrast) and high-contrast visual acuity (HCVA). Vision-specific QOL was assessed by the Impact of Visual Impairment Scale (IVIS), whereas the SF-36 Health Survey and Visual Analog Scale were administered as generic QOL measures and the EDSS as a measure of neurologic impairment. Among QOL measures, IVIS scores showed the most significant correlations with visual dysfunction at all time points in the trial (r= -0.25 to -0.45, P < 0.0001 for LCVA and HCVA). Higher MRI T1- and T2-lesion volumes were also associated with worse vision scores at all time points (P < 0.0001). Clinically meaningful worsening (progression) of LCVA was noted in substantial proportions of patients in AFFIRM and was prevalent even among those without EDSS progression over 2 years (21.9% with LCVA progression at 2.5% contrast; 26.2% at 1.25% contrast). HCVA worsened in only 3.7% of patients without EDSS progression. Loss of visual function, particularly as measured by LCVA, was common in AFFIRM, occurring in >20% of patients. Both LCVA and HCVA scores reflect vision-specific aspects of QOL, but LCVA provides information about disability progression not entirely captured by the EDSS. Vision represents a key dimension of outcome assessment for MS and adds valuable information on disability and QOL that can be useful to clinicians.

Employment and choice-making for adults with intellectual disability, autism, and down syndrome.

PubMed

Bush, Kelsey L; Tassé, Marc J

2017-06-01

Adults with disabilities are employed at a significantly lower rate than adults without disabilities. Of adults with disabilities in the workforce, more individuals work in a facility setting rather than a community setting, despite efforts to improve community inclusion. Choice-making has been proposed as a predictive factor for employment for individuals with disabilities. The purpose of this research was to examine the current state of employment for three groups of adults with intellectual disability (ID): individuals with autism spectrum disorder (ASD), individuals with Down syndrome (DS), and individuals with idiopathic ID. Choice-making and its relation to improved employment outcomes was explored. This study used National Core Indicator's Adult Consumer Survey datasets from years 2011-2012 and 2012-2013. Factor analyses revealed latent variables from six choice-making questions in the Adult Consumer Survey. Ordinal logistic regression was used to identify factors related to employment status. Adults with DS had the highest rates of paid community jobs, but adults with ID had the highest rates of choice-making. ID severity level and short-term choice-making had the greatest effects on employment status in all three groups. Employment rates remain low despite national efforts to find jobs for people with disabilities. Choice-making is a unique factor that was found to be associated with employment status and provides a target for interventions to increase employability. Copyright © 2017 Elsevier Ltd. All rights reserved.

48 CFR 19.307 - Protesting a firm's status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2012 CFR

2012-10-01

... as a service-disabled veteran-owned small business concern. 19.307 Section 19.307 Federal Acquisition...-disabled veteran-owned small business concern. (a) For sole source acquisitions, the SBA or the contracting officer may protest the apparently successful offeror's service-disabled veteran-owned small business...

48 CFR 19.307 - Protesting a firm's status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2011 CFR

2011-10-01

... as a service-disabled veteran-owned small business concern. 19.307 Section 19.307 Federal Acquisition...-disabled veteran-owned small business concern. (a) For sole source acquisitions, the SBA or the contracting officer may protest the apparently successful offeror's service-disabled veteran-owned small business...

48 CFR 19.307 - Protesting a firm's status as a service-disabled veteran-owned small business concern.

Code of Federal Regulations, 2013 CFR

2013-10-01

... as a service-disabled veteran-owned small business concern. 19.307 Section 19.307 Federal Acquisition...-disabled veteran-owned small business concern. (a) For sole source acquisitions, the SBA or the contracting officer may protest the apparently successful offeror's service-disabled veteran-owned small business...

Longitudinal Perspectives of Child Positive Impact on Families: Relationship to Disability and Culture

ERIC Educational Resources Information Center

Blacher, Jan; Begum, Gazi F.; Marcoulides, George A.; Baker, Bruce L.

2013-01-01

This study examined mothers' perceptions of the positive impact of having a child with an intellectual disability. Trajectories of positive impact from 7 time points were developed using latent growth modeling and 2 predictors: culture (Anglo, Latino) and child disability status (intellectual disability, typical development). Data were from 219…

Social Experiences of Children with Disabilities in Inclusive Portuguese Preschool Settings

ERIC Educational Resources Information Center

Ferreira, Milene; Aguiar, Cecília; Correia, Nadine; Fialho, Margarida; Pimentel, Júlia Serpa

2017-01-01

Based on peer sociometric reports, we examined how number of friendships, social acceptance, and characteristics of social networks vary as a function of disability profile. We also investigated teachers' awareness of the sociometric status of young children with disabilities. Participants were 86 children with disabilities (63 boys) enrolled in…

Academic Library Service to Disabled Students: Today and Tomorrow.

ERIC Educational Resources Information Center

Stone, Elizabeth W.

The presentation focuses on the status of disabled persons in the world, notes progress made in improved living conditions for the disabled, and considers implications for libraries serving disabled clients. Services currently offered in academic libraries are described, as are goals related to four aims specified by the United Nations during the…

Physical Disability, Stigma, and Physical Activity in Children

ERIC Educational Resources Information Center

Barg, Carolyn J.; Armstrong, Brittany D.; Hetz, Samuel P.; Latimer, Amy E.

2010-01-01

Using the stereotype content model as a guiding framework, this study explored whether the stigma that able-bodied adults have towards children with a physical disability is reduced when the child is portrayed as being active. In a 2 (physical activity status) x 2 (ability status) study design, 178 university students rated a child described in…

Exclusionary Discipline Practices across Students' Racial/Ethnic Backgrounds and Disability Status: Findings from the Pacific Northwest

ERIC Educational Resources Information Center

Vincent, Claudia G.; Sprague, Jeffrey R.; Tobin, Tary J.

2012-01-01

We examined 2009-2010 data on exclusionary discipline practices from one state in the Pacific Northwest of the United States across students' racial/ethnic backgrounds and disability status. Our focus was on proportionate representation in exclusionary discipline actions and in the duration of those disciplinary actions. Descriptive outcomes…

20 CFR 404.1588 - Your responsibility to tell us of events that may change your disability status.

Code of Federal Regulations, 2013 CFR

2013-04-01

... may change your disability status. 404.1588 Section 404.1588 Employees' Benefits SOCIAL SECURITY... issue a receipt to you or your representative at least until a centralized computer file that records... centralized computer file is in place, we will continue to issue receipts to you or your representative if you...

20 CFR 404.1588 - Your responsibility to tell us of events that may change your disability status.

Code of Federal Regulations, 2012 CFR

2012-04-01

... may change your disability status. 404.1588 Section 404.1588 Employees' Benefits SOCIAL SECURITY... issue a receipt to you or your representative at least until a centralized computer file that records... centralized computer file is in place, we will continue to issue receipts to you or your representative if you...

20 CFR 404.1588 - Your responsibility to tell us of events that may change your disability status.

Code of Federal Regulations, 2011 CFR

2011-04-01

... may change your disability status. 404.1588 Section 404.1588 Employees' Benefits SOCIAL SECURITY... issue a receipt to you or your representative at least until a centralized computer file that records... centralized computer file is in place, we will continue to issue receipts to you or your representative if you...

20 CFR 404.1588 - Your responsibility to tell us of events that may change your disability status.

Code of Federal Regulations, 2014 CFR

2014-04-01

... may change your disability status. 404.1588 Section 404.1588 Employees' Benefits SOCIAL SECURITY... issue a receipt to you or your representative at least until a centralized computer file that records... centralized computer file is in place, we will continue to issue receipts to you or your representative if you...

Overweight Status, Obesity, and Risk Factors for Coronary Heart Disease in Adults with Intellectual Disability

ERIC Educational Resources Information Center

Henderson, C. Michael; Robinson, Laura M.; Davidson, Philip W.; Haveman, Meindert; Janicki, Matthew P.; Albertini, Giorgio

2008-01-01

Research indicates that adults with intellectual disabilities (ID) have high rates of overweight status/obesity (OSO). OSO is associated with several important risk factors for coronary heart disease (CHD). This study focused on assessing whether such risk factors are being identified in adults with ID who are receiving their healthcare in…

Health Profile of Aging Family Caregivers Supporting Adults with Intellectual and Developmental Disabilities at Home

ERIC Educational Resources Information Center

Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar

2009-01-01

The health status of 206 female caregivers supporting adults with intellectual and developmental disabilities at home was investigated using objective (i.e., presence of chronic health conditions and activity limitations) and subjective (i.e., self-perceived health status) health measures compared with those of women in the general population in 2…

Vitamin D Status and Optimal Supplementation in Institutionalized Adults with Intellectual Disability

ERIC Educational Resources Information Center

Kilpinen-Loisa, P.; Arvio, M.; Ilvesmaki, V.; Makitie, O.

2009-01-01

Background: Adults with intellectual disability (ID) have several risk factors for osteoporosis. Feeding problems with consequent nutritive deficiencies, and lack of sunshine exposure may lead to vitamin D deficiency. The purpose of this study was to evaluate vitamin D status in adults with ID living in nursing homes and to compare two different…

Lost in the Margins? Intersections between Disability and Other Nondominant Statuses with Regard to Peer Victimization

ERIC Educational Resources Information Center

McGee, Marjorie G.

2014-01-01

This study examined the extent to which disability status, alone and in combination with other social identities, was associated with differential levels of exposure to peer victimization. Logistic analyses of survey responses from eleventh graders completing the 2008 Oregon Healthy Teen survey (N = 7,091) utilized an intersectional,…

Perceptions towards disability among social work students in Israel: Development and validation of a new scale.

PubMed

Holler, Roni; Werner, Shirli

2018-05-01

Over the last decades, the disability movement has been advocating for a paradigmatic shift in how disability is perceived and managed: from a medical or individual perspective focusing on the person's body and mind to a social perspective emphasizing the context and barriers of disability. However, we still know little about the perceptions of helping professionals, particularly social workers who work closely with disabled people. Thus, the aim of the current study is to develop and validate a scale-Perceptions Toward Disability Scale (PTDS)-to measure how social workers view disability: as an individual or social category. This paper describes the three phases of the scale's construction. First, scale items were formulated and its content validity was examined. Next, a pilot of 30 social workers completed a questionnaire and an initial exploratory factor analysis was conducted. In the third and main phase, the final draft was completed in 2016 by 565 Israeli social work students to assess its psychometric properties. Both exploratory and confirmatory factorial validity and discriminant validity analyses were conducted. The results of a confirmatory factor analysis revealed two distinct factors: an individual perspective of disability comprised of eight items (α = 0.77) and a social perspective of disability comprised of ten (α = 0.66). Subsequent analyses supported the scale's discriminant validity as indicated by the lack of an association between the Attitude Toward Disabled Persons Scale (ATDP) and the social model subscale (r = .13, p = .19) and by the weak negative relation with the individual model subscale (r = -.25, p = .01). These findings show that the PTDS possesses promising construct validity and provide support for its utility. This easy-to-administer instrument offers several practical benefits and can serve as a framework for further empirical research regarding social work practice with disabled people. © 2018 John Wiley & Sons Ltd.

Validating the Learning Disability Screening Questionnaire against the Weschler Adult Intelligence Scale, Fourth Edition

ERIC Educational Resources Information Center

McKenzie, Karen; Sharples, Phil; Murray, Aja L.

2015-01-01

The Learning Disability Screening Questionnaire (LDSQ), a brief screening tool for intellectual disability, was originally validated against the Weschler Adult Intelligence Scale, Third Edition (WAIS-III), which was superseded by the Weschler Adult Intelligence Scale, Fourth Edition (WAIS-IV) in the United Kingdom in 2010. This study examines the…

Health disparities among adults with developmental disabilities, adults with other disabilities, and adults not reporting disability in North Carolina.

PubMed

Havercamp, Susan M; Scandlin, Donna; Roth, Marcia

2004-01-01

The purposes of this study were (1) to identify disparities between adults with developmental disabilities and non-disabled adults in health and medical care, and (2) to compare this pattern of disparities to the pattern of disparities between adults with other disabilities and adults without disabilities. The authors compared data on health status, health risk behaviors, chronic health conditions, and utilization of medical care across three groups of adults: No Disability, Disability, and Developmental Disability. Data sources were the 2001 North Carolina Behavioral Risk Factor Surveillance System and the North Carolina National Core Indicators survey. Adults with developmental disabilities were more likely to lead sedentary lifestyles and seven times as likely to report inadequate emotional support, compared with adults without disabilities. Adults with disabilities and developmental disabilities were significantly more likely to report being in fair or poor health than adults without disabilities. Similar rates of tobacco use and overweight/obesity were reported. Adults with developmental disabilities had a similar or greater risk of having four of five chronic health conditions compared with non-disabled adults. Significant medical care utilization disparities were found for breast and cervical cancer screening as well as for oral health care. Adults with developmental disabilities presented a unique risk for inadequate emotional support and low utilization of breast and cervical cancer screenings. Significant disparities in health and medical care utilization were found for adults with developmental disabilities relative to non-disabled adults. The National Core Indicators protocol offers a sound methodology to gather much-needed surveillance information on the health status, health risk behaviors, and medical care utilization of adults with developmental disabilities. Health promotion efforts must be specifically designed for this population.

The Status of Long-Term Disability Plans in Higher Education.

ERIC Educational Resources Information Center

Cook, Thomas J.

1981-01-01

Long-term disability income coverage is seen as the most rapidly growing staff benefit in recent years. A Teachers Insurance and Annuity Association's survey of existing long-term disability plans, which provide adequate income replacement, is discussed. (MLW)

The International Disability Rights Movement and the ICF.

PubMed

Hurst, Rachel

To outline the thinking of disabled people about their situation and status before the formulation of the ICIDH (International Classification of Impairment, Disability and Handicap) in 1980, the growth of the international disability rights movement since 1980, its subsequent involvement in the revision process and then its hopes as to the effectiveness of the ICF (the International Classification of Functioning, Disability and Health-the revised ICIDH) in the future. This is a personal analysis based on the author's experience as a disability rights activist and as a member of the World Council of Disabled Peoples' International (DPI), elected in 1987 to represent DPI in the revision process and who later became Chair of the Environmental Task Force. These are shown to be a major shift from the medical model of disability to the adoption of the interactive model and the impacts of environmental factors in all aspects of health and functioning. That proper use of the environmental factors within the ICF will ensure appropriate policies, systems and services for health care and support, provide measurable indicators for health status and sustainable development and underpin the recognition that disability is a human rights issue.

The Cumulative Probability of Arrest by Age 28 Years in the United States by Disability Status, Race/Ethnicity, and Gender.

PubMed

McCauley, Erin J

2017-12-01

To estimate the cumulative probability (c) of arrest by age 28 years in the United States by disability status, race/ethnicity, and gender. I estimated cumulative probabilities through birth cohort life tables with data from the National Longitudinal Survey of Youth, 1997. Estimates demonstrated that those with disabilities have a higher cumulative probability of arrest (c = 42.65) than those without (c = 29.68). The risk was disproportionately spread across races/ethnicities, with Blacks with disabilities experiencing the highest cumulative probability of arrest (c = 55.17) and Whites without disabilities experiencing the lowest (c = 27.55). Racial/ethnic differences existed by gender as well. There was a similar distribution of disability types across race/ethnicity, suggesting that the racial/ethnic differences in arrest may stem from racial/ethnic inequalities as opposed to differential distribution of disability types. The experience of arrest for those with disabilities was higher than expected. Police officers should understand how disabilities may affect compliance and other behaviors, and likewise how implicit bias and structural racism may affect reactions and actions of officers and the systems they work within in ways that create inequities.

Functioning and disability analysis by using WHO Disability Assessment Schedule 2.0 in older adults Taiwanese patients with dementia.

PubMed

Huang, Shih-Wei; Chang, Kwang-Hwa; Escorpizo, Reuben; Chi, Wen-Chou; Yen, Chia-Feng; Liao, Hua-Fang; Chang, Feng-Hang; Chiu, Wen-Ta; Lin, Jia-Wei; Liou, Tsan-Hon

2016-08-01

To analyse the disability status of elderly Taiwanese dementia patients by using the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). We enrolled 12 126 disabled elderly (>65 years) patients with dementia during July 2012-January 2014 from the Taiwan Data Bank of Persons with Disability. Trained interviewers evaluated the standardised scores in the six WHODAS 2.0 domains. Student's t test was used for comparing WHODAS 2.0 scores of male and female dementia patients with different age groups. The study population comprised 12 126 patients; 7612 were women and 4514 were men. The WHODAS 2.0 scores showed that the dementia patients had global activity limitation and participation restriction in all domains. Dementia-induced disability was prominent in male patients in all of the domains of the WHODAS 2.0. The domains of life activities, getting along with people and cognition were more strongly affected than the other domains. However, women experienced more rapid functional decline than men did as they aged. The data analysed in this large-scale, population-based study revealed crucial information on dementia-induced disability in elderly patients on the basis of the WHODAS 2.0 framework. Implications for rehabilitation Dementia patients have global functional disability in all domains of WHODAS 2.0 and multidisciplinary team is needed for rehabilitation programme intervention for these patients. When considering the rehabilitation resource and strategy, the domains of cognition, activities of daily living and life activities should be focussed. When dementia patients aged 65-75 years old, male patients got more restriction of function than female and more medical resource allocation for disabled male patients is recommended. With ageing, female dementia patients exhibited more rapid functional decline than male patients did and more budget about rehabilitation for maintain functional and dementia progression is crucial for female patients.

Neuro-ophthalmologic evaluation, quality of life, and functional disability in patients with MS.

PubMed

Garcia-Martin, Elena; Rodriguez-Mena, Diego; Herrero, Raquel; Almarcegui, Carmen; Dolz, Isabel; Martin, Jesus; Ara, Jose R; Larrosa, Jose M; Polo, Vicente; Fernández, Javier; Pablo, Luis E

2013-07-02

To evaluate correlations between longitudinal changes in neuro-ophthalmologic measures and quality of life (QOL) and disability in patients with multiple sclerosis (MS), using optical coherence tomography (OCT), visual evoked potentials (VEP), and visual field examination. Fifty-four patients with relapsing-remitting MS were enrolled in this study and underwent Multiple Sclerosis Quality of Life questionnaire (54 items) (MSQOL-54) and Expanded Disability Status Scale (EDSS) evaluation, as well as complete neuro-ophthalmologic examination including visual field testing and retinal nerve fiber layer (RNFL) measurements using Cirrus and Spectralis OCT and VEP. All patients were re-evaluated at 12, 24, and 36 months. Logistical regression was performed to analyze which measures, if any, could predict QOL. Overall, RNFL thickness results at the baseline evaluation were significantly different from those at 3 years (p ≤ 0.05), but there were no differences in functional measures (visual acuity, contrast sensitivity, color vision, visual field, and VEP). A reduced MSQOL-54 score was associated with an increase in EDSS score and a decrease in both functional and structural parameters. Patients with longer MS duration presented with a lower MSQOL-54 score (reduction in QOL). Patients with progressive axonal loss as seen in RNFL results had a lower QOL and more functional disability.

The shoulder pain and disability index: the construct validity and responsiveness of a region-specific disability measure.

PubMed

Heald, S L; Riddle, D L; Lamb, R L

1997-10-01

The purposes of this study were (1) to assess the construct validity of the Shoulder Pain and Disability Index (SPADI) and (2) to determine whether the SPADI is more responsive than the Sickness Impact Profile (SIP), a generic health status measure. The sample consisted of 94 patients who were diagnosed with a shoulder problem and referred to six outpatient physical therapy clinics. Clinically meaningful change was determined by use of an ordinal rating scale designed to determine whether the patient's shoulder function was improved, the same, or worse following treatment. Spearman rho correlations were calculated for the initial visit SPADI and SIP scores. The standardized response mean (SRM) was used to measure responsiveness for the patients who were judged to be improved. One-tailed paired t tests (alpha = .01) were used to determine whether differences existed among SRM values. Correlations between the SPADI and SIP scores ranged from r = .01 to r = .57. The SRM value was higher for the SPADI total score (SRM = 1.38) than for the SIP total score (SRM = 0.79). Most correlations between SPADI and SIP scores provided support for the construct validity of the SPADI. The SPADI does not appear to strongly reflect occupational and recreational disability and is more responsive than the SIP.

Physical, Cognitive, and Psychosocial Variables from the Disablement Process Model Predict Patterns of Independence and the Transition into Disability for the Oldest-Old

ERIC Educational Resources Information Center

Fauth, Elizabeth Braungart; Zarit, Steven H.; Malmberg, Bo; Johansson, Boo

2007-01-01

Purpose: This study used the Disablement Process Model to predict whether a sample of the oldest-old maintained their disability or disability-free status over a 2- and 4-year follow-up, or whether they transitioned into a state of disability during this time. Design and Methods: We followed a sample of 149 Swedish adults who were 86 years of age…

The Effects of Selected Variables on Problems Facing Handicapped in the United Arab Emirates.

ERIC Educational Resources Information Center

Sartawi, A. A. M.

1996-01-01

Individuals (n=125, ages 15 to 25) with disabilities in the United Arab Emirates were surveyed concerning gender, disability type and cause, parental status, and level of family income. Results indicated that: (1) individuals with acquired disabilities had more problems than those with congenital disabilities, and (2) people with physical…

Awareness Workshop Resource Packet. Serving Persons With Disabilities Through Camping. Camp Administration Series.

ERIC Educational Resources Information Center

Stein, Cindy, Ed.

The resource packet is an aid for coordinators organizing an awareness workshop on camping for the disabled or for camp directors in orienting staff to camping for persons with physical or mental handicaps. Section I covers the status of camping for the disabled, different types of disabilities, serving campers with certain handicapping…

"A Frog in a Well": The Exclusion of Disabled People from Work in Cambodia

ERIC Educational Resources Information Center

Gartrell, Alexandra

2010-01-01

Based on ethnographic research conducted in north-west Cambodia in 2000-2001, this paper examines why disabled people experience systematic marginalisation in the labour market. Although there are no official data on the relationship between disability and employment status in Cambodia, this research suggests that disabled people are more likely…

Monitoring for Accessibility and University Websites: Meeting the Needs of People with Disabilities

ERIC Educational Resources Information Center

Solovieva, Tatiana I.; Bock, Jeremy M.

2014-01-01

Under the Americans with Disabilities Act (ADA), people with disabilities are guaranteed access to all postsecondary programs and services. The purpose of this study, conducted by the Center for Excellence in Disabilities, was to evaluate the current status of a major university's web accessibility. The results indicated that in 2011 only 51% of…

Suspension Rates of Students with Autism or Intellectual Disabilities in Maryland from 2004 to 2015

ERIC Educational Resources Information Center

Krezmien, M. P.; Travers, J. C.; Camacho, K.

2017-01-01

Background: Little research exists on suspension of students with autism or intellectual disabilities. We examined suspension rates of students with autism or intellectual disability in Maryland from 2004 to 2015 to understand whether race and disability status predicted the odds of being suspended. Method: We used school enrollment data and…

The Social Status of Children with Disabilities and Their Families as Determined by Census Data

ERIC Educational Resources Information Center

Tyndik, A. O.; Vasin, S. A.

2016-01-01

Russia's ratification of the UN Convention on the Rights of Persons with Disabilities (CRPD) has necessitated that regular monitoring studies of the social situation of people with disabilities and families with disabled members be conducted. These studies have exacerbated the issue of obtaining accessible data that is suitable for these purposes.…

The Effects of Aging on Employment of People with and without Disabilities

ERIC Educational Resources Information Center

Mitchell, Judith M.; Adkins, Rodney H.; Kemp, Bryan J.

2006-01-01

A cross-sectional study investigated the role of both aging and disability on employment status over the life span. Current employment rates of 262 people with a disability and 115 people without a disability were compared. Impairments were polio, cerebral palsy, spinal cord injury, rheumatoid arthritis, stroke, and miscellaneous. Ages ranged from…

Disability inclusion in higher education in Uganda: Status and strategies

PubMed Central

Emong, Paul

2016-01-01

Background Uganda has embraced inclusive education and evidently committed itself to bringing about disability inclusion at every level of education. Both legal and non-legal frameworks have been adopted and arguably are in line with the intent of the Convention on the Rights of Persons with Disabilities (CRPD) on education. The CRPD, in Article 24, requires states to attain a right to education for persons with disabilities without discrimination and on the basis of equal opportunities at all levels of education. Objectives Despite Uganda’s robust disability legal and policy framework on education, there is evidence of exclusion and discrimination of students with disabilities in the higher education institutions. The main objective of this article is to explore the status of disability inclusion in higher education and strategies for its realisation, using evidence from Emong’s study, workshop proceedings where the authors facilitated and additional individual interviews with four students with disabilities by the authors. Results The results show that there are discrimination and exclusion tendencies in matters related to admissions, access to lectures, assessment and examinations, access to library services, halls of residence and other disability support services. Conclusion The article recommends that institutional policies and guidelines on support services for students with disabilities and special needs in higher education be developed, data on students with disabilities collected to help planning, collaboration between Disabled Peoples Organisations (DPO’s) strengthened to ensure disability inclusion and the establishment of disability support centres. PMID:28730044

Long-term health and work outcomes of renal transplantation and patterns of work status during the end-stage renal disease trajectory.

PubMed

van der Mei, Sijrike F; Kuiper, Daphne; Groothoff, Johan W; van den Heuvel, Wim J A; van Son, Willem J; Brouwer, Sandra

2011-09-01

The aim of this study was to examine the health- and work outcomes of renal transplant recipients long-term after transplantation as well as the pattern of work status, work ability and disability benefits during the end-stage renal disease (ESRD) trajectory that precedes transplantation. 34 transplant recipients completed interviews 3, 13 months and >6 years posttransplantation. Health status (SF-36), work ability (WAI), and fatigue (CIS) were assessed by questionnaires, clinical data were derived from medical charts, and data on functional limitations were extracted from the social security system database. The work status trajectory preceding transplantation was examined retrospectively. Of the 34 third wave transplant recipients, 29% were severely fatigued. Compared with the general working population, recipients experienced worse general health and less vitality. Non-working recipients had worse renal function and general health, and more limitations in physical functioning compared to working recipients. The WAI score indicated moderate work ability for 60% of the employed recipients. Although 67% were employed (45% parttime), 30% of those working still received some disability benefits. Social insurance physicians found variable levels of functional limitations. The mean work status trajectory showed more sickness absence and less work ability during dialysis, but after transplantation, both work status and work ability generally improved. Transplant recipients have a compromised health status which leads to functional limitations and disability. Although work status improved after transplantation, a substantial number of the transplant recipients received disability benefits. The negative health consequences of anti-rejection medications may play an important role in long-term work ability. These results indicate that a 'new' kidney has advantages over dialysis with respect to work, but does not necessarily leads to 'normal' work outcomes.

An Operational Definition of Learning Disabilities (Cognitive Domain) Using WISC Full Scale IQ and Peabody Individual Achievement Test Scores

ERIC Educational Resources Information Center

Brenton, Beatrice White; Gilmore, Doug

1976-01-01

An operational index of discrepancy to assist in identifying learning disabilities was derived using the Full Scale IQ, Wechsler Intelligence Scale for Children, and relevant subtest scores on the Peabody Individual Achievement Test. Considerable caution should be exercised when classifying children, especially females, as learning disabled.…

Social Shyness among Mothers of Children with Disabilities Based on Some Variables in Riyadh, Saudi Arabia

ERIC Educational Resources Information Center

Allala, Saeb; Alzubairi, Sharefa

2016-01-01

The current study is an attempt to identify social shyness among mothers of children with disabilities based on (Disability type, mother's academic qualification, and family's economic level) in Riyadh. Thus, Social Shyness Scale was prepared of (28) paragraphs according to five-point Likert Scale. The reliability coefficient of the scale rated…

Social Effects of Integrated Classrooms and Resource Room/ Regular Class Placements on Elementary Students with Learning Disabilities.

ERIC Educational Resources Information Center

Madge, Sally; And Others

1990-01-01

Social status of learning-disabled (LD) elementary students served by the Integrated Classroom Model was compared to that of LD elementary students in a regular class with resource room support. Results suggest that, although both groups had lower social status than nondisabled peers, ICM students blended into the classroom better. (Author/PB)

Examining Agreement and Longitudinal Stability among Traditional and RTI-Based Definitions of Reading Disability Using the Affected-Status Agreement Statistic

ERIC Educational Resources Information Center

Waesche, Jessica S. Brown; Schatschneider, Christopher; Maner, Jon K.; Ahmed, Yusra; Wagner, Richard K.

2011-01-01

Rates of agreement among alternative definitions of reading disability and their 1- and 2-year stabilities were examined using a new measure of agreement, the affected-status agreement statistic. Participants were 288,114 first through third grade students. Reading measures were "Dynamic Indicators of Basic Early Literacy Skills" Oral…

Current Status of Evidence-Based Practice for Students with Intellectual Disability and Autism Spectrum Disorders

ERIC Educational Resources Information Center

West, Elizabeth A.; McCollow, Meaghan; Umbarger, Gardner; Kidwell, James; Cote, Debra L.

2013-01-01

The purpose of this paper is to provide a current look at the status of evidence-based practice (EBP) for students with intellectual disability and autism spectrum disorders. Specifically, this paper will (1) provide an introduction to the history and evolution of the use of levels of evidence, (2) discuss the importance of EBPs, (3) identify…

Weighting the Weights: Agreement among Anthropometric Indicators Identifying the Weight Status of People with Intellectual Disabilities

ERIC Educational Resources Information Center

Verstraelen, C. J. F.; Maaskant, M. A.; van Knijff-Raeven, A. G. M.; Curfs, L. M. G.; van Schrojenstein Lantman-de Valk, H. M. J.

2009-01-01

Background: The aims of this study were (1) to determine to what extent body mass index (BMI), waist circumference, fat free mass index (FFMI) and skinfold thickness are feasible measurement options in people with intellectual disabilities (ID) to measure their weight status, and (2) to assess the level of agreement among these methods. Methods:…

Carer Reports of Health Status among Adults with Intellectual/Developmental Disabilities in Taiwan Living at Home and in Institutions

ERIC Educational Resources Information Center

Wang, K.-Y.; Hsieh, K.; Heller, T.; Davidson, P. W.; Janicki, M. P.

2007-01-01

Background: The aim of the present study was to assess the health status of a cohort of adults with intellectual/developmental disabilities (I/DD) residing in family homes or institutions in Taiwan and to examine whether morbidity varied with age, sex, existing diagnosis [Down syndrome (DS), seizures, cerebral palsy (CP), intellectual disability…

Self-Reported Functional Status among the Old-Old: A Comparison of Two Israeli Cohorts

PubMed Central

Litwin, Howard; Shrira, Amit; Shmotkin, Dov

2012-01-01

OBJECTIVES To examine differences in functional status among two successive cohorts. METHODS The study was a comparative analysis of Jewish respondents aged 75–94 from two nationwide random samples: the Cross-Sectional and Longitudinal Aging Study (1989–1992; N =1200) and the Survey of Health, Ageing, and Retirement in Europe (2005–2006; N =379). Self-reported functional limitation and disability were compared by means of logistic regressions and MANCOVA, controlling for age, gender, origin, education, marital status, income, self-rated health, and home care receipt. RESULTS Reported functional limitation decreased in the later cohort (SHARE-Israel), but ADL- and IADL-disability increased. Receipt of home care moderated these effects. ADL- and IADL-disability increased among home-care-receiving respondents in the later cohort whereas functional limitation decreased among respondents not in receipt of home care. DISCUSSION The findings suggest that different measures used to assess the disablement process capture different aspects, and that contextual factors influence how older people rate their own functional capacity. PMID:22422761

Does socioeconomic inequality in health persist among older people living in resource-poor urban slums?

PubMed

Falkingham, Jane C; Chepngeno-Langat, Gloria; Kyobutungi, Catherine; Ezeh, Alex; Evandrou, Maria

2011-06-01

Using self-reported health that assesses functionality or disability status, this paper investigates whether there are any differences in health status among older people living in a deprived area of Nairobi, Kenya. Data from a cross-sectional survey of 2,037 men and women aged 50 years and older are used to examine the association between socioeconomic position and self-reported health status across 6 health domains. Education, occupation, a wealth index, and main source of livelihood are used to assess the presence of a socioeconomic gradient in health. All the indicators showed the expected negative association with health across some, but not all, of the disability domains. Nonetheless, differences based on occupation, the most commonly used indicators to examine health inequalities, were not statistically significant. Primary level of education was a significant factor for women but not for men; conversely, wealth status was associated with lower disability for both men and women. Older people dependent on their own sources of livelihood were also less likely to report a disability. The results suggest the need for further research to identify an appropriate socioeconomic classification that is sensitive in identifying poverty and deprivation among older people living in slums.

REPEAT MAMMOGRAPHY SCREENING AMONG UNMARRIED WOMEN WITH AND WITHOUT A DISABILITY

PubMed Central

Clark, Melissa A.; Rogers, Michelle L.; Wen, Xiaozhong; Wilcox, Victoria; McCarthy-Barnett, Kate; Panarace, Jeanne; Manning, Carol; Allen, Susan; Rakowski, William

2009-01-01

Objectives Unmarried women with disabilities may be a particularly vulnerable group for underutilization of repeat mammography screening. Our goal was to compare the breast cancer screening experiences of unmarried women with disabilities (WWD) versus women with no disabilities (WND), and determine whether these experiences are associated with adherence to repeat screening. Methods We conducted a matched cohort study of 93 WWD and 93 WND to compare mammography experiences by disability status, examine rates of repeat mammography by disability status, and identify factors that are associated with repeat mammography. Results WWD were less likely to be on-schedule than WND in univariable (54.8% vs. 71.0%; relative risk = 0.77, 95% CL = 0.61, 0.97), but not multivariable, analyses. In multivariable analyses, there was a significant interaction between disability status and positive experiences as the reasons for returning to the same mammography facility. Among WND, repeat screening ranged from 59% to 86%, depending on the number of positive experiences endorsed (range=1–5). In contrast, among WWD, screening rates were only 37% among those who did not report any positive experiences and increased to a maximum of 60% regardless of whether women endorsed one to four or all five positive experiences. Severity and type of disability were not associated with repeat screening. Conclusions WWD may be less likely than WND to remain on-schedule for mammography. WWD who do not report any positive experiences as reasons for returning to a mammography facility may be at particularly high risk of underutilization of screening. PMID:19775912

Income differentials in functional disability in old age: relative risks of onset, recovery, decline, attrition and mortality.

PubMed

Broese van Groenou, Marjolein I; Deeg, Dorly J H; Penninx, Brenda W J H

2003-04-01

Socioeconomic status (SES) differences in health decline in late life may be underestimated, because the relatively higher risks of attrition of lower-SES persons are seldom taken into account. This longitudinal study aimed at comparing income differences in the course of disability, non-mortality attrition and mortality in older adults. A sample population of 3107 older adults who participated in the 1992/1993 baseline of the Longitudinal Aging Study Amsterdam was examined regarding changes in functional disability in 1998/1999. SES was indicated by household income. Multinomial regression analyses revealed that, for men without disability at baseline, the relative rate for attrition was four times higher and the mortality rate was twice as high for low-income vs high-income persons. For non-disabled women, the relative risk for the onset of disability was nearly twice as high for low-income vs high-income persons. For both men and women, these risks decreased only slightly when behavioral and psychosocial risk factors were taken into account. Among persons with disability at baseline, the relative risks for attrition (for women) and mortality (for men) were twice as high for low-income persons, but no income differences were found with respect to recovery and decline. Adjustment for risk factors decreased the relative risks for attrition and mortality to a non-significant level. Income inequality in health in late life is to a large degree explained by the higher incidence of disability among lower-status women and by the higher attrition and mortality risks among lower-status men.

Identity, difference and the ethical politics of prenatal testing.

PubMed

Stainton, T

2003-10-01

This paper explores the role of identity in relation to the ethics of prenatal testing for conditions that cause intellectual disabilities. Specifically, it considers the question of identity and the moral status of the fetus. It argues that both the arguments in favour and opposed to prenatal testing mistakenly presuppose that there is no moral status attached to the fetus. That status is grounded in an identity-constituting characteristic, such as 'intellectual disability', which is brought about by the purpose of genetic testing, and the meaning of which is culturally constructed. This paper examines the implications this has for the debate around both prenatal testing and termination in general and considers the nature of the ethical politics which follows from this position with regard to prenatal testing related to intellectual disability.

Determinants of Quality of Life in the Acute Stage Following Stroke

PubMed Central

Jeong, Bo-Ok; Kang, Hee-Ju; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Kim, Joon-Tae; Park, Man-Seok; Cho, Ki-Hyun; Yoon, Jin-Sang

2012-01-01

Objective This study aimed to investigate the factors influence the quality of life (QOL) of survivors of an acute stroke. Methods For 422 stroke patients, assessments were made within two weeks of the index event. QOL was measured using the World Health Organization Quality of Life-Abbreviated form (WHOQOL-BREF), which has four domains related to physical factors, psychological factors, social relationships, and environmental context. Associations of each four WHOQOL-BREF domain score with socio-demographic characteristics (age, sex, education, marital status, religion, and occupation), stroke severity (National Institutes of Health Stroke Scale), physical disability (Barthel Index), cognitive function (Mini-Mental Status Examination: MMSE), grip strength, and psychological distress (Hospital Anxiety and Depression Scale depression and anxiety subscale: HADS-D and HADS-A) were investigated using the linear regression models. Results Higher physical domain scores were independently associated with higher MMSE scores, stronger hand-grip strength, and lower HADS-D and HADS-A scores; higher psychological domain scores were independently associated with higher educational level, higher MMSE scores, and lower HADS-D and HADS-A scores; higher social relationships domain scores were independently associated with lower HADS-D and HADS-A scores; and higher environmental domain scores were independently associated with higher educational level, higher MMSE scores, and lower HADS-D scores. Conclusion Psychological distress and impaired cognitive function were independently associated with lower QOL in patients with acute stroke. However, stroke severity, physical disability and other socio-demographic factors were less significantly associated with QOL. These findings underscore the importance of psychological interventions for improving QOL during the acute phase following stroke. PMID:22707962

Longitudinal follow-up of employment status in patients with chronic fatigue syndrome after mononucleosis.

PubMed

Nyland, Morten; Naess, Halvor; Birkeland, Jon Steinar; Nyland, Harald

2014-11-26

To examine the effect of early clinical and demographic factors on occupational outcome, return to work or awarded permanent disability pension in young patients with chronic fatigue syndrome (CFS). Longitudinal cohort study. A written self-management programme including a description of active coping strategies for daily life was provided. Patients with CFS after mononucleosis were evaluated at Department of Neurology, Haukeland University Hospital during 1996-2006 (contact 1). In 2009 self-report questionnaires were sent to all patients (contact 2). Primary measure was employment status at contact 2. Secondary measures included clinical symptoms, and Fatigue Severity Scale (FSS) scores on both contacts, and Work and Social Adjustment Scale (WSAS) at contact 2. Of 111 patients at contact 1, 92 (83%) patients returned the questionnaire at contact 2. Mean disease duration at contact 1 was 4.7 years and at contact 2 11.4 years. At contact 1, 9 (10%) were part-time or full-time employed. At contact 2, 49 (55%) were part-time or full-time employed. Logical regression analysis showed that FSS≥5 at contact 2 was associated with depression, arthralgia and long disease duration (all at contact 1). About half of younger patients with CFS with long-term incapacity for work experienced marked improvement including full-time or part-time employment showing better outcomes than expected. Risk factors for transition to permanent disability were depression, arthralgia and disease duration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The indirect costs of multiple sclerosis: systematic review and meta-analysis.

PubMed

Stawowczyk, Ewa; Malinowski, Krzysztof Piotr; Kawalec, Paweł; Moćko, Paweł

2015-01-01

The aim of this systematic review is to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with multiple sclerosis. Searches were conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2014 prices US$ using the consumer price index and purchasing power parity (scenario 1) and expressed as proportion of specific gross domestic product in current local currency unit to adjust for country's development (scenario 2). Identified studies were then analyzed in order to assess their possible inclusion in the meta-analysis. The authors identified 63 records, of which 23 were eligible for meta-analysis. Overall indirect cost per patient calculated in scenario 1 was as high as US$20,167 with US$22,197 in Europe, US$17,382 in North America and US$153 in Asia. Overall indirect cost per patient calculated in scenario 2 was equal to US$16,939, with US$19,612 in Europe, US$11,592 in North America and US$899 in Asia. Overall indirect costs varied from US$3726 for patients with EDSS score less than 3 to US$19,264 for patients with Expanded Disability Status Scale score grater that 7. This review revealed the great economic burden of multiple sclerosis on society. The authors observed a great variety of the considered components of indirect costs and their definitions. Costs were higher for Europe than for other continents and were also higher for patients with a higher Expanded Disability Status Scale score.

Medicaid Managed Care and Individuals with Disabilities: Status Report.

ERIC Educational Resources Information Center

Hemp, Richard; Braddock, David

1998-01-01

Summarizes information presented in the American Association on Mental Retardation's 1998 publication, "State of the States in Developmental Disabilities" (Braddock, Hemp, Parish, and Westrich), which reports data on the implementation of managed care for persons with developmental disabilities. A table summarizes information about…

The siblings relationship of adolescents with and without intellectual disabilities.

PubMed

Begum, Gazi; Blacher, Jan

2011-01-01

The sibling relationship of adolescents with and without intellectual disabilities was examined. Participants were 70 sibling dyads--each dyad was comprised of one 12-year old adolescent with (N=23) or without intellectual disabilities (N=47). Sibling relationships, behavior problems, and social skills were assessed using mother reports. Results revealed three findings. First, for typically developing adolescents, mothers reported more warmth in the sibling relationship for opposite sex dyads. For adolescents with intellectual disabilities, mothers reported more warmth in the sibling relationship for same-sex dyads. Second, for typically developing adolescents, mothers reported more status/power differences when the sibling was younger than when the sibling was older. For adolescents with intellectual disabilities, birth order did not affect status/power in the sibling relationship. Third, for typically developing adolescents, conflict was related to internalizing behavior problems. For adolescents with intellectual disabilities, conflict was related to externalizing behavior problems. Implications, limitations, and future directions are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Quantitative measures detect sensory and motor impairments in multiple sclerosis.

PubMed

Newsome, Scott D; Wang, Joseph I; Kang, Jonathan Y; Calabresi, Peter A; Zackowski, Kathleen M

2011-06-15

Sensory and motor dysfunction in multiple sclerosis (MS) is often assessed with rating scales which rely heavily on clinical judgment. Quantitative devices may be more precise than rating scales. To quantify lower extremity sensorimotor measures in individuals with MS, evaluate the extent to which they can detect functional systems impairments, and determine their relationship to global disability measures. We tested 145 MS subjects and 58 controls. Vibration thresholds were quantified using a Vibratron-II device. Strength was quantified by a hand-held dynamometer. We also recorded Expanded Disability Status Scale (EDSS) and Timed 25-Foot Walk (T25FW). t-tests and Wilcoxon-rank sum were used to compare group data. Spearman correlations were used to assess relationships between each measure. We also used a step-wise linear regression model to determine how much the quantitative measures explain the variance in the respective functional systems scores (FSS). EDSS scores ranged from 0-7.5, mean disease duration was 10.4 ± 9.6 years, and 66% were female. In relapsing-remitting MS, but not progressive MS, poorer vibration sensation correlated with a worse EDSS score, whereas progressive groups' ankle/hip strength changed significantly with EDSS progression. Interestingly, not only did sensorimotor measures significantly correlate with global disability measures (i.e., EDSS), but they had improved sensitivity, as they detected impairments in up to 32% of MS subjects with normal sensory and pyramidal FSS. Sensory and motor deficits in MS can be quantified using clinically accessible tools and distinguish differences among MS subtypes. We show that quantitative sensorimotor measures are more sensitive than FSS from the EDSS. These tools have the potential to be used as clinical outcome measures in practice and for future MS clinical trials of neurorehabilitative and neuroreparative interventions. Copyright © 2011 Elsevier B.V. All rights reserved.

The JAGUAR Score Predicts 1-Month Disability/Death in Ischemic Stroke Patient Ineligible for Recanalization Therapy.

PubMed

Widhi Nugroho, Aryandhito; Arima, Hisatomi; Takashima, Naoyuki; Fujii, Takako; Shitara, Satoshi; Miyamatsu, Naomi; Sugimoto, Yoshihisa; Nagata, Satoru; Komori, Masaru; Kita, Yoshikuni; Miura, Katsuyuki; Nozaki, Kazuhiko

2018-06-22

Most available scoring system to predict outcome after acute ischemic stroke (AIS) were established in Western countries. We aimed to develop a simple prediction score of 1-month severe disability/death after onset in AIS patients ineligible for recanalization therapy based on readily and widely obtainable on-admission clinical, laboratory and radiological examinations in Asian developing countries. Using the Shiga Stroke Registry, a large population-based registry in Japan, multivariable logistic regression analysis was conducted in 1617 AIS patients ineligible for recanalization therapy to yield ß-coefficients of significant predictors of 1-month modified Rankin Scale score of 5-6, which were then multiplied by a specific constant and rounded to nearest integer to develop 0-10 points system. Model discrimination and calibration were evaluated in the original and bootstrapped population. Japan Coma Scale score (J), age (A), random glucose (G), untimely onset-to-arrival time (U), atrial fibrillation (A), and preadmission dependency status according to the modified Rankin Scale score (R), were recognized as independent predictors of outcome. Each of their β-coefficients was multiplied by 1.3 creating the JAGUAR score. Its area under the curve (95% confidence interval) was .901 (.880- .922) and .901 (.900- .901) in the original and bootstrapped population, respectively. It was found to have good calibration in both study population (P = .27). The JAGUAR score can be an important prediction tool of severe disability/death in AIS patients ineligible for recanalization therapy that can be applied on admission with no complicated calculation and multimodal neuroimaging necessary, thus suitable for Asian developing countries. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Quantitative measures detect sensory and motor impairments in multiple sclerosis

PubMed Central

Newsome, Scott D.; Wang, Joseph I.; Kang, Jonathan Y.; Calabresi, Peter A.; Zackowski, Kathleen M.

2011-01-01

Background Sensory and motor dysfunction in multiple sclerosis (MS) is often assessed with rating scales which rely heavily on clinical judgment. Quantitative devices may be more precise than rating scales. Objective To quantify lower extremity sensorimotor measures in individuals with MS, evaluate the extent to which they can detect functional systems impairments, and determine their relationship to global disability measures. Methods We tested 145 MS subjects and 58 controls. Vibration thresholds were quantified using a Vibratron-II device. Strength was quantified by a hand-held dynamometer. We also recorded Expanded Disability Status Scale (EDSS) and timed 25-foot walk (T25FW). T-tests and Wilcoxon-rank sum were used to compare group data. Spearman correlations were used to assess relationships between each measure. We also used a step-wise linear regression model to determine how much the quantitative measures explain the variance in the respective functional systems scores (FSS). Results EDSS scores ranged from 0-7.5, mean disease duration was 10.4±9.6 years, and 66% were female. In RRMS, but not progressive MS, poorer vibration sensation correlated with a worse EDSS score, whereas progressive groups’ ankle/hip strength changed significantly with EDSS progression. Interestingly, not only did sensorimotor measures significantly correlate with global disability measures (EDSS), but they had improved sensitivity, as they detected impairments in up to 32% of MS subjects with normal sensory FSS. Conclusions Sensory and motor deficits can be quantified using clinically accessible tools and distinguish differences among MS subtypes. We show that quantitative sensorimotor measures are more sensitive than FSS from the EDSS. These tools have the potential to be used as clinical outcome measures in practice and for future MS clinical trials of neurorehabilitative and neuroreparative interventions. PMID:21458828

Educational achievement and chronic pain disability: mediating role of pain-related cognitions.

PubMed

Roth, Randy S; Geisser, Michael E

2002-01-01

This study examined the relation between level of educational achievement (LOE) and the clinical morbidity associated with chronic pain. a multidisciplinary pain rehabilitation program located within a university hospital. Two hundred ninety-nine consecutive patients with chronic spinal pain, average age 39.6 years (SD = 10.7) and with an average duration of pain of 41.9 months (SD = 51.6). Age, duration of pain, sex, and compensation and litigation status were controlled for in the statistical analysis because each was found to be significantly associated with LOE. Pain intensity was assessed by the McGill Pain Questionnaire. Affective distress was assessed by the Global Severity Index from the Brief Symptom Inventory. Severity of depressive symptoms was derived from scores from the Center for Epidemiological Studies-Depression Scale. Pain beliefs and pain coping strategies were assessed by the Survey of Pain Attitudes and the Coping Strategies Questionnaire, respectively. Finally, self-report of pain-related disability was assessed by the Pain Disability Index. After controlling for relevant covariates, LOE was unrelated to pain intensity, severity of depressive symptoms, or affective distress, but was inversely related to self-reported disability. Persons with lower LOEs possessed a greater belief that pain is a "signal of harm," unrelated to emotional experience, disabling and uncontrollable. They also endorsed more passive and maladaptive coping strategies, including a tendency to catastrophize about their pain. Path analysis indicated that, after controlling for the influence of both the belief that pain is a "signal of harm" and catastrophizing on the association between LOE and disability, this relation loses statistical significance. These results suggest that pain-related cognitions mediate the relation between LOE and pain disability and that persons with lower LOEs are more likely to develop maladaptive pain beliefs and coping strategies.

[Shoulder disability questionnaires: a systematic review].

PubMed

Fayad, F; Mace, Y; Lefevre-Colau, M M

2005-07-01

To identify all available shoulder disability questionnaires designed to measure physical functioning and to examine those with satisfactory clinimetric quality. We used the Medline database and the "Guide des outils de mesure de l'évaluation en médecine physique et de réadaptation" textbook to search for questionnaires. Analysis took into account the development methodology, clinimetric quality of the instruments and frequency of their utilization. We classified the instruments according to the International Classification of Functioning, Disability and Health. Thirty-eight instruments have been developed to measure disease-, shoulder- or upper extremity-specific outcome. Four scales assess upper-extremity disability and 3 others shoulder disability. We found 6 scales evaluating disability and shoulder pain, 7 scales measuring the quality of life in patients with various conditions of the shoulder, 14 scales combining objective and subjective measures, 2 pain scales and 2 unclassified scales. Older instruments developed before the advent of modern measurement development methodology usually combine objective and subjective measures. Recent instruments were designed with appropriate methodology. Most are self-administered questionnaires. Numerous shoulder outcome measure instruments are available. There is no "gold standard" for assessing shoulder function outcome in the general population.

Young People with Intellectual Disability Transitioning to Adulthood: Do Behaviour Trajectories Differ in Those with and without Down Syndrome?

PubMed Central

Foley, Kitty-Rose; Taffe, John; Bourke, Jenny; Einfeld, Stewart L.; Tonge, Bruce J.; Trollor, Julian; Leonard, Helen

2016-01-01

Background Young people with intellectual disability exhibit substantial and persistent problem behaviours compared with their non-disabled peers. The aim of this study was to compare changes in emotional and behavioural problems for young people with intellectual disability with and without Down syndrome as they transition into adulthood in two different Australian cohorts. Methods Emotional and behavioural problems were measured over three time points using the Developmental Behaviour Checklist (DBC) for those with Down syndrome (n = 323 at wave one) and compared to those with intellectual disability of another cause (n = 466 at wave one). Outcome scores were modelled using random effects regression as linear functions of age, Down syndrome status, ability to speak and gender. Results DBC scores of those with Down syndrome were lower than those of people without Down syndrome indicating fewer behavioural problems on all scales except communication disturbance. For both groups disruptive, communication disturbance, anxiety and self-absorbed DBC subscales all declined on average over time. There were two important differences between changes in behaviours for these two cohorts. Depressive symptoms did not significantly decline for those with Down syndrome compared to those without Down syndrome. The trajectory of the social relating behaviours subscale differed between these two cohorts, where those with Down syndrome remained relatively steady and, for those with intellectual disability from another cause, the behaviours increased over time. Conclusions These results have implications for needed supports and opportunities for engagement in society to buffer against these emotional and behavioural challenges. PMID:27391326

Untangling therapeutic ingredients of a personalized intervention for patients with depression and severe COPD.

PubMed

Alexopoulos, George S; Kiosses, Dimitris N; Sirey, Jo Anne; Kanellopoulos, Dora; Seirup, Joanna K; Novitch, Richard S; Ghosh, Samiran; Banerjee, Samprit; Raue, Patrick J

2014-11-01

We developed a personalized intervention for depressed patients with COPD (PID-C) aimed to mobilize patients to participate in the care of both conditions. We showed that PID-C reduced depressive symptoms and dyspnea-related disability more than usual care over 28 weeks. This study focused on untangling key therapeutic ingredients of PID-C. Randomized controlled trial. Community. 138 patients who received the diagnoses of COPD and major depression after screening 898 consecutive admissions for acute inpatient pulmonary rehabilitation. Nine sessions of PID-C compared with usual care over 28 weeks. Primary outcome measures were the 17-item Hamilton Depression Rating Scale and the Pulmonary Functional Status and Dyspnea Questionnaire-Modified. Other measures were adherence to rehabilitation exercise (≥2 hours per week) and adherence to adequate antidepressant prescriptions. Low severity of dyspnea-related disability and adherence to antidepressants predicted subsequent improvement of depression. Exercise and low depression severity predicted improvement of dyspnea-related disability. PID-C led to an interacting spiral of improvement in both depression and disability in a gravely medically ill population with a 17% mortality rate over 28 weeks and an expected deterioration in disability. The interrelationship of the course of depression and dyspnea-related disability underscores the need to target adherence to both antidepressants and chronic obstructive pulmonary disease rehabilitation. PID-C may serve as a care management model for depressed persons suffering from medical illnesses with a deteriorating course. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Does disability status modify the association between psychosocial job quality and mental health? A longitudinal fixed-effects analysis.

PubMed

Milner, A; Krnjacki, L; Butterworth, P; Kavanagh, A; LaMontagne, Anthony D

2015-11-01

People with disabilities have difficulties in obtaining work. However, evidence suggests that those with disabilities derive substantial mental health benefits from employment. This paper assesses how the relationship between work and mental health is influenced by psychosocial job quality for people working with a disability. The study design was a longitudinal cohort with 13 annual waves of data collection, yielding a sample of 122,883 observations from 21,848 people. Fixed-effects within-person regression was used to control for time invariant confounding. The Mental Component Summary (MCS) of the Short Form 36 (SF-36) measure was used as the primary outcome measure. The main exposure was a six-category measure of psychosocial job quality and employment status (including 'not in the labour force' [NILF] and unemployment). Disability status ('no waves of disability reported' and 'all contributed waves with reported disability') was assessed as an effect modifier. We also conducted a secondary analysis on respondents contributing both disability and non-disability waves. For those with no disability, the greatest difference in mental health (compared to optimal employment) occurs when people have the poorest quality jobs (-2.12, 95% CI -2.48, -1.75, p < 0.001). The relative difference in mental health was less in relation to NILF and unemployment (-0.39 and -0.66 respectively). For those with consistent disability, the difference in mental health when employed in an optimal job was similar between the poorest quality jobs (-2.25, 95% CI -3.84, -0.65, p = 0.006), NILF (-2.84, 95% CI -4.49, -1.20, p = 0.001) or unemployment (-2.56, 95% CI -4.32, -0.80, p = 0.004). These results were confirmed by the secondary analysis. Efforts to improve psychosocial job quality may have significant mental health benefits for people with disabilities. This will contribute to the economic viability of disability employment insurance schemes in Australia and other high-income countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

A preliminary report on the medical profile of disabled persons living in Zhabei District, Shanghai, Mainland China.

PubMed

Chen, Gang; Tan, B-K; Sun, Xiaoxiao; Meng, Xingqiong; Jiwa, Moyez

2011-01-01

The prevalence of chronic diseases and their risk factors in different general populations are well documented, but little is known about disabled populations in China. The purpose of this study is to report available data on the medical profile of disabled persons living in Zhabei District, Shanghai, Mainland China. It also aimed to explore the association between any medical conditions, types and severity of disabilities and socio-demographic factors. Nine hundred and sixty-one disabled persons underwent physical medical examination to identify predisposing conditions for chronic diseases (hypertension and elevated glucose, lipids and triglyceride levels) and to diagnose two common chronic diseases - heart disease and diabetes. Logistic regression was used to assess the influence of age, gender, disability type, disability severity, education level, employment status, socio-economic status or marital status on chronic diseases and predisposing factors. The mean age of the participants was 53 (±12.5) years. The most prevalent types of disability were physical disability (44.9%), visual impairment (28.8%) and intellectual disability (12.5%). Hyperlipidemia was most prevalent (17.1%), followed by hypertension (15.3%), heart disease (7.2%) and diabetes (6.0%). These conditions were not associated with the type or the severity of disability in this sample. Males were more likely to have hypertension (OR=1.75; 95% CI: 1.05, 2.93) and elevated triglycerides (OR=1.84; 95% CI: 1.05, 3.20). The unemployed (OR=4.80, 95% CI: 1.45, 15.76) and older participants (OR=1.04, 95% CI: 1.02, 1.07) were more likely to have elevated blood glucose levels. Divorced individuals were more likely to be diagnosed with heart disease (OR=3.72; 95% CI: 1.37, 10.09) and those with better socio-economic backgrounds (OR=3.09; 95% CI: 1.05, 9.15) and the older disabled (OR=1.08, 95% CI: 1.04, 1.12) were more likely to have diabetes. This preliminary study found that abnormal clinical findings were not related to the type or the severity of disability. Most abnormal findings were, however, related to increasing age, consistent with previous findings in the general Chinese population.

32 CFR 901.11 - Children of deceased or disabled veterans and children of military or civilian personnel in a...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Children of deceased or disabled veterans and... deceased or disabled veterans and children of military or civilian personnel in a missing status category... of a deceased or disabled member of the Armed Forces of the United States is eligible for nomination...

32 CFR 901.11 - Children of deceased or disabled veterans and children of military or civilian personnel in a...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Children of deceased or disabled veterans and... deceased or disabled veterans and children of military or civilian personnel in a missing status category... of a deceased or disabled member of the Armed Forces of the United States is eligible for nomination...

32 CFR 901.11 - Children of deceased or disabled veterans and children of military or civilian personnel in a...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Children of deceased or disabled veterans and... deceased or disabled veterans and children of military or civilian personnel in a missing status category... of a deceased or disabled member of the Armed Forces of the United States is eligible for nomination...

32 CFR 901.11 - Children of deceased or disabled veterans and children of military or civilian personnel in a...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Children of deceased or disabled veterans and... deceased or disabled veterans and children of military or civilian personnel in a missing status category... of a deceased or disabled member of the Armed Forces of the United States is eligible for nomination...

32 CFR 901.11 - Children of deceased or disabled veterans and children of military or civilian personnel in a...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Children of deceased or disabled veterans and... deceased or disabled veterans and children of military or civilian personnel in a missing status category... of a deceased or disabled member of the Armed Forces of the United States is eligible for nomination...

The First Sexual Experience Among Adolescent Girls With and Without Disabilities

PubMed Central

Shandra, Carrie L.; Chowdhury, Afra R.

2014-01-01

First sexual intercourse is an important experience in the young adult life course. While previous research has examined racial, gender, and socioeconomic differences in the characteristics of first sexual intercourse, less is known about differences by disability status. Using a racially diverse (27% Black, 20% Hispanic, and 53% non-Hispanic white) sample of 2,729 adolescent girls aged 12–24 at first sexual intercourse from the National Longitudinal Survey of Youth 1997, this article examines the association between disability and type of first sexual relationship, degree of discussion about birth control, and pregnancy wantedness. Regression analyses indicate that girls with mild or learning or emotional disabilities experience first sexual intercourse in different types of relationships than girls without disabilities. Adolescents with learning or emotional conditions have greater levels of discussion about birth control with their first sexual partners than those without disabilities. In addition, among those who do not use birth control at first sexual intercourse, girls with multiple or seriously limiting conditions are more likely to want a pregnancy—versus not want a pregnancy—at first sexual intercourse. Findings indicate that disability status is important to consider when examining adolescent sexuality; however, not all youth with disabilities have equal experiences. PMID:21559882

Screening for disability in the inner city.

PubMed Central

Patrick, D L; Darby, S C; Green, S; Horton, G; Locker, D; Wiggins, R D

1981-01-01

A 10% sample of private households on the electoral register of the London borough of Lambeth was screened for disable persons aged 16 and over, using a postal questionnaire. After three mailings and individual follow-up of non-responders, 87% of the sample households returned questionnaires. Disability was defined in the screening questionnaire as functional limitations or activity restrictions consequent upon disease or impairment. The overall point prevalence of disability was estimated at 15.4% and the most frequently reported impairments were those of the sense organs, bones, central nervous, circulatory, and respiratory systems. Hearing difficulties were the single most frequently reported functional limitation. A log-linear modelling procedure identified age, marital status, and working status as the factors most strongly associated with disability for both men and women. In addition, men aged 50-64 and not working, and men in manual occupations and living alone, were more likely to report disability. These findings indicate that some population groups are disable by functional limitations and activity restrictions not included in office criteria of identification and assessment. These criteria might be broadened, and serves planned for those population groups with higher rates of reported disability. PMID:6455485

Measuring health and disability: supporting policy development. The European MHADIE project.

PubMed

Leonardi, Matilde

2010-01-01

Disability is a multi-dimensional phenomenon arising out of an interaction between the individual's health status and his environment: disability data must reflect this bio-psychosocial model. WHO's International Classification of Functioning, Disability and Health (ICF) provides the framework for documenting the interaction between health status and environmental features. MHADIE, a 3-year project supported by a EC 6th Framework Programme Grant, aimed at demonstrating the feasibility and utility of the ICF model in the measurement and description of disability. The ICF model was used as the structure for analysing existing population health surveys and education statistics data. ICF-based tools were used to describe disability in selected health conditions. MHADIE researchers showed that the ICF model is adequate for describing and measuring patterns of disability in clinical samples from different countries cross-sectionally and over time as well as feasible and useful in educational sectors. Valid and reliable information are essential to design, implement or evaluate policies to combat discrimination, promote integration and enhance opportunities. Results made it possible to produce a definition of disability as well as policy recommendations concerning how, in Europe and internationally, the existing sources of data can be harmonized with the ICF model.

Assessment of outcome after severe brain damage.

PubMed

Jennett, B; Bond, M

1975-03-01

Persisting disability after brain damage usually comprises both mental and physical handicap. The mental component is often the more important in contributing to overall social disability. Lack of an objective scale leads to vague and over-optimistic estimates of outcome, which obscure the ultimate results of early management. A five-point scale is described--death, persistent vegetative state, severe disability, moderate disability, and good recovery. Duration as well as intensity of disability should be included in an index of ill-health; this applies particularly after head injury, because many disabled survivors are young.

[Cormorbidity in multiple sclerosis and its therapeutic approach].

PubMed

Estruch, Bonaventura Casanova

2014-12-01

Multiple sclerosis (MS) is a long-term chronic disease, in which intercurrent processes develop three times more frequently in affected individuals than in persons without MS. Knowledge of the comorbidity of MS, its definition and measurement (Charlson index) improves patient management. Acting on comorbid conditions delays the progression of disability, which is intimately linked to the number of concurrent processes and with health states and habits. Moreover, the presence of comorbidities delays the diagnosis of MS, which in turn delays the start of treatment. The main comorbidity found in MS includes other autoimmune diseases (thyroiditis, systemic lupus erythematosus, or pemphigus) but can also include general diseases, such as asthma or osteomuscular alterations, and, in particular, psychiatric disturbances. All these alterations should be evaluated with multidimensional scales (Disability Expectancy Table, DET), which allow more accurate determination of the patient's real clinical course and quality of life. These scales also allow identification of how MS, concurrent and intercurrent processes occurring during the clinical course, and the treatment provided affect patients with MS. An overall approach to patients' health status helps to improve quality of life. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Restoring function in major depressive disorder: A systematic review.

PubMed

Sheehan, David V; Nakagome, Kazuyuki; Asami, Yuko; Pappadopulos, Elizabeth A; Boucher, Matthieu

2017-06-01

Functional impairment contributes to significant disability and economic burden in major depressive disorder (MDD). Treatment response is measured by improvement in depressive symptoms, but functional improvement often lags behind symptomatic improvement. Residual deficits are associated with relapse of depressive symptoms. A literature search was conducted using the following terms: "major depressive disorder," "functional impairment," "functional outcomes," "recovery of function," "treatment outcome," "outcome assessment," "social functioning," "presenteeism," "absenteeism," "psychiatric status rating scales," and "quality of life." Search limits included publication date (January 1, 1995 to August 31, 2016), English language, and human clinical trials. Controlled, acute-phase, nonrecurrent MDD treatment studies in adults were included if a functional outcome was measured at baseline and endpoint. The qualitative analysis included 35 controlled studies. The Sheehan Disability Scale was the most commonly used functional assessment. Antidepressant treatments significantly improved functional outcomes. Early treatment response predicted functional improvement, while baseline disease severity did not. Clinical studies utilized various methodologies and assessments for functional impairment, and were not standardized or adequately powered. The lack of synchronicity between symptomatic and functional improvement highlights an unmet need for MDD. Treatment guided by routine monitoring of symptoms and functionality may minimize residual functional impairments. Copyright © 2017. Published by Elsevier B.V.

T1- Thresholds in Black Holes Increase Clinical-Radiological Correlation in Multiple Sclerosis Patients.

PubMed

Thaler, Christian; Faizy, Tobias; Sedlacik, Jan; Holst, Brigitte; Stellmann, Jan-Patrick; Young, Kim Lea; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

2015-01-01

Magnetic Resonance Imaging (MRI) is an established tool in diagnosing and evaluating disease activity in Multiple Sclerosis (MS). While clinical-radiological correlations are limited in general, hypointense T1 lesions (also known as Black Holes (BH)) have shown some promising results. The definition of BHs is very heterogeneous and depends on subjective visual evaluation. We aimed to improve clinical-radiological correlations by defining BHs using T1 relaxation time (T1-RT) thresholds to achieve best possible correlation between BH lesion volume and clinical disability. 40 patients with mainly relapsing-remitting MS underwent MRI including 3-dimensional fluid attenuated inversion recovery (FLAIR), magnetization-prepared rapid gradient echo (MPRAGE) before and after Gadolinium (GD) injection and double inversion-contrast magnetization-prepared rapid gradient echo (MP2RAGE) sequences. BHs (BHvis) were marked by two raters on native T1-weighted (T1w)-MPRAGE, contrast-enhancing lesions (CE lesions) on T1w-MPRAGE after GD and FLAIR lesions (total-FLAIR lesions) were detected separately. BHvis and total-FLAIR lesion maps were registered to MP2RAGE images, and the mean T1-RT were calculated for all lesion ROIs. Mean T1 values of the cortex (CTX) were calculated for each patient. Subsequently, Spearman rank correlations between clinical scores (Expanded Disability Status Scale and Multiple Sclerosis Functional Composite) and lesion volume were determined for different T1-RT thresholds. Significant differences in T1-RT were obtained between all different lesion types with highest T1 values in visually marked BHs (BHvis: 1453.3±213.4 ms, total-FLAIR lesions: 1394.33±187.38 ms, CTX: 1305.6±35.8 ms; p<0.05). Significant correlations between BHvis/total-FLAIR lesion volume and clinical disability were obtained for a wide range of T1-RT thresholds. The highest correlation for BHvis and total-FLAIR lesion masks were found at T1-RT>1500 ms (Expanded Disability Status Scale vs. lesion volume: rBHvis = 0.442 and rtotal-FLAIR = 0.497, p<0.05; Multiple Sclerosis Functional Composite vs. lesion volume: rBHvis = -0.53 and rtotal-FLAIR = -0.627, p<0.05). Clinical-radiological correlations in MS patients are increased by application of T1-RT thresholds. With the short acquisition time of the MP2RAGE sequences, quantitative T1 maps could be easily established in clinical studies.

An Examination of the Impact of the IEP Team Composition and Transition Planning upon the Success of Students with Disabilities in Urban Districts

ERIC Educational Resources Information Center

Hill, Petrina D.

2010-01-01

The primary purpose of this correlational study was to examine the impact of IEP team composition (team member attendance) and transition planning (types of transition outcomes) upon the success (graduation) of students with disabilities in urban districts. Other factors also included gender, academic status of school, socioeconomic status of the…

A bill to amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel in connection with certain special disabilities rehabilitation, and for other purposes.

THOMAS, 113th Congress

Sen. Tester, Jon [D-MT

2013-03-21

Senate - 05/09/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-203. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A bill to amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes.

THOMAS, 112th Congress

Sen. Tester, Jon [D-MT

2011-10-20

Senate - 06/27/2012 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 112-668. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Health Status and ADL Functioning of Older Persons with Intellectual Disability: Community Residence versus Residential Care Centers

ERIC Educational Resources Information Center

Lifshitz, Hefziba; Merrick, Joav; Morad, Mohammed

2008-01-01

The objective of the study was to study differences in aging phenomena among adults with intellectual disability (ID), who live in community residence versus their peers in residential care centers and to determine the contribution of health status, age, gender, etiology and level of ID to the decline in ADL function with age. Our study was based…

Problems Accompanied Individuals with Learning Disability and Its Relationship to Gender and Family Economic Status Variables in a Jordanian Sample

ERIC Educational Resources Information Center

Al-Oweidi, Alia M.

2015-01-01

The purpose of this study is to investigate the relationship between problems that accompany individuals with learning disability and the variables of gender and family economic status for a selected sample of Jordanians. The sample of the study, which consisted of (239) male and female students, was chosen randomly. To achieve this aim, the…

End-of-Life Care and Dying: Issues Raised by Staff Supporting Older People with Intellectual Disability in Community Living Services

ERIC Educational Resources Information Center

Wiese, Michele; Stancliffe, Roger J.; Balandin, Susan; Howarth, Glennys; Dew, Angela

2012-01-01

Background: The aim of this study was to explore the current status of end-of-life care and dying of people with intellectual disability based on the experiences of staff in community living services. Materials and Methods: Focus groups and individual interviews were conducted, guided by grounded theory methodology. Results: The current status of…

To amend the Americans with Disabilities Act to require that the same access to transportation and public accommodations be afforded to certified trainers of service animals as is afforded under such Act to individuals with disabilities who use such service animals.

THOMAS, 111th Congress

Rep. Kissell, Larry [D-NC-8

2009-12-16

House - 03/01/2010 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

International Visions of Excellence for Children with Disabilities.

ERIC Educational Resources Information Center

Mittler, Peter

1992-01-01

This paper reviews the status of children with disabilities throughout the world. It summarizes United Nations information on the prevalence of disability and on prevention efforts. Progress is noted in the areas of immunization, increased early intervention services, community-based rehabilitation, and increased recognition of governmental…

Employability Skills for Individuals with Intellectual Disabilities: Supervisors' versus Teachers' Perspectives

ERIC Educational Resources Information Center

Bonner, Vint K. H.

2017-01-01

Employability skills are important for employment access, success, and excellence, regardless of disability status. Importantly, employability skills are essential to the employment success of individuals with intellectual disabilities. Unfortunately, there are differences between the employability skills valued by employers, and the employability…

Dimensions of Parenting in Families Having Children with Disabilities.

ERIC Educational Resources Information Center

Bradley, Robert H.; And Others

1991-01-01

This study examined relationships between parenting, severity of disability, and 5 aspects of family ecology for 83 preschool and 69 elementary school children with disabilities. Family ecology variables included socioeconomic status, coping styles, social support, stressful life events, and marital quality. Results showed positive correlations…

Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis.

PubMed

Ji, Juan; Zhang, Lijuan; Zhang, Qiuxiang; Yin, Rulan; Fu, Ting; Li, Liren; Gu, Zhifeng

2017-05-02

As an important outcome measure among rheumatoid arthritis (RA) patients, functional disability may contribute to unemployment, loss of work productivity, and impaired quality of life. However, little is known about the risk factors of functional disability in Chinese RA patients. This study aimed (1) to examine the prevalence of functional disability in Chinese RA patients; (2) to explore factors associated with the health assessment questionnaire-disability index (HAQ-DI). A total of 101 RA patients in this cross-sectional study underwent standardized laboratory examinations and responded to the questionnaire for demographic data, the HAQ-DI for functional disability, the Compliance Questionnaire on Rheumatology (CQR) for medication adherence, the Hospital Anxiety and Depression Scale (HADS) for psychological status, and the Short Form 36 health survey (SF-36) for quality of life. Pain, grip/pinch strength, disease activity, and large joint mobility were recorded. Independent samples t-tests, chi-square analyses, and logistic regression modeling were used to analyze the data. The mean ± SD age of RA patients was 54.9 ± 11.9 years. Approximately 15.8% RA patients in mainland China experience functional disability (defined as a HAQ-DI score ≥ 1). Long disease duration, pain, high disease activity, a larger number of tender and swollen joints, high C-reactive protein (CRP) level, decreased grip strength, and limitation of shoulder, elbow, wrist, knee, and ankle motion were associated with the HAQ-DI. Participants with functional disability tended to have more severe depressive symptoms and a lower quality of life compared with individuals without functional disability. Stepwise logistic regression analyses found that limitation of wrist extension (P = 0.001) and lower body pain (BP) score (P = 0.001) explained higher HAQ-DI score. The present study reported that functional disability was common in Chinese RA patients. A low quality of life and limitation of joint mobility had great impacts on functional disability in Chinese RA patients. Targeted and culturally sensitive interventions should be strengthened to delay the onset of disabilities of this population.

Prevalence of Metabolic Syndrome and Its Association with Physical Capacity, Disability, and Self-Rated Health among Lifestyle Interventions and Independence for Elders (LIFE) Study Participants

PubMed Central

Botoseneanu, Anda; Ambrosius, Walter T.; Beavers, Daniel P.; de Rekeneire, Nathalie; Anton, Stephen; Church, Timothy; Folta, Sara C.; Goodpaster, Bret H.; King, Abby C.; Nicklas, Barbara J.; Spring, Bonnie; Wang, Xuewen; Gill, Thomas M.

2014-01-01

Objectives To evaluate the prevalence of metabolic syndrome (MetS) and its association with physical capacity, disability, and self-rated health among older adults at high risk for mobility disability, including those with and without diabetes. Design Cross-sectional analysis. Setting Lifestyle Interventions and Independence for Elders (LIFE) Study. Participants 1,535 community-dwelling sedentary adults aged 70–89 years old at high risk for mobility disability [short physical performance battery (SPPB) score ≤ 9; mean (SD) = 7.4 (1.6)]. Measurements MetS was defined according to the 2009 multi-agency harmonized criteria; outcomes were physical capacity (400m walk time, grip strength, and SPPB score), disability (composite 19-item score), and self-rated health (5-point scale ranging from “excellent” to “poor”). Results The prevalence of MetS was 49.8% in the overall sample, and 83.2% and 38.1% among diabetics and non-diabetics, respectively. MetS was associated with greater grip strength [mean difference (kilograms) Δ = 1.2, p = .01] in the overall sample and among participants without diabetes, and with poorer self-rated health (Δ = 0.1, p < .001) in the overall sample only. No significant differences were found in the 400m walk time, SPPB score, and disability score between participants with and without MetS, in either the overall sample or diabetes subgroups. Conclusion Metabolic dysfunction is highly prevalent among older adults at risk for mobility disability, yet consistent associations were not observed between MetS and walking speed, lower extremity function, and self-reported disability after adjusting for known and potential confounders. Longitudinal studies are needed to investigate whether MetS accelerates declines in functional status in high-risk older adults and to inform clinical and public health interventions aimed at preventing or delaying disability in this group. PMID:25645664

Utility of the Community Integration Questionnaire in a sample of adults with neurological and neuropsychiatric disorders receiving prevocational training.

PubMed

Tomaszewski, Robert; Mitrushina, Maura

2016-01-01

To investigate utility of the Community Integration Questionnaire (CIQ) in a mixed sample of adults with neurological and neuropsychiatric disorders. Cross-sectional, interview-based study. Participants were community-dwelling adults with disabilities resulting from neurological and neuropsychiatric disorders (N = 54), who participated in a pre-vocational readiness and social skills training program. Psychometric properties of the Community Integration Questionnaire (CIQ) were assessed and validated against Mayo-Portland Adaptability Inventory (MPAI) and The Problem Checklist from the New York University Head Injury Family Interview (PCL). Based on the revised scoring procedures, psychometric properties of the CIQ Home Competency scale were excellent, followed by the Total score and Social Integration scale. Productive Activity scale had low content validity and a weak association with the total score. Convergent and discriminant validity of the CIQ were demonstrated by correlation patterns with MPAI scales in the expected direction. Significant relationship was found with PCL Physical/Dependency scale. Significant associations were found with sex, living status, and record of subsequent employment. The results provide support for the use of the CIQ as a measure of participation in individuals with neurological and neuropsychiatric diagnoses and resulting disabilities. An important goal of rehabilitation and training programs for individuals with dysfunction of the central nervous system is to promote their participation in social, vocational, and domestic activities. The Community Integration Questionnaire (CIQ) is a brief and efficient instrument for measuring these participation domains. This study demonstrated good psychometric properties and high utility of the CIQ in a sample of 54 individuals participating in a prevocational training program.

Is Obesity More Than a Double Burden among People with Mobility Disability? The Effect of Obesity on HRQoL and Participation in Society

PubMed Central

de Munter, Jeroen; Rasmussen, Finn

2017-01-01

Obesity is more common in individuals with mobility disability than in those without this condition. Individuals with mobility disability also have lower health-related quality of life (HRQoL) and are limited in their participation in society. Therefore, this study aimed to investigate the body mass index (BMI) status and the association of overweight or obesity on HRQoL and participation in society among those with mobility disability in comparison to those without mobility disability. This cross-sectional study was based on a health survey conducted in Sweden in 2012 (n = 18,322; age, 18–64 years). Logistic regression with and without interaction analysis was applied. Effect modification by overweight status was significant for, moderate pain. For obesity, effect modification was seen for low general health, pain (moderate and severe), and not participating in work. BMI was higher among those with mobility disability, but no associations between overweight or obesity and HRQoL or participation in society were observed for those with mobility disability. Overweight and obesity did not add an additional burden to mobility disability, probably because mobility disability is associated with low HRQoL and low participation in society. Despite these results, population obesity prevention strategies are still needed. PMID:29064394

Mobility disability and the pattern of accelerometer-derived sedentary and physical activity behaviors in people with multiple sclerosis.

PubMed

Ezeugwu, Victor; Klaren, Rachel E; A Hubbard, Elizabeth; Manns, Patricia Trish; Motl, Robert W

2015-01-01

Low physical activity and high sedentary behavior levels are major concerns in persons with multiple sclerosis (MS) and these differ depending on the level of mobility disability. However, the manner in which daily activity is accumulated is currently unknown in this population. A secondary analysis was performed on a combined data set of persons with MS from two previous investigations of physical activity and symptomatic or quality of life outcomes in the United States over a two year period (2007-2009). Mobility disability status was determined using the Patient Determined Disease Steps (PDDS) while activity behavior was objectively monitored using an ActiGraph accelerometer for 7 days. Persons with MS who have mobility disability were involved in sedentary behavior, light and moderate intensity activity for 65%, 34% and 1% of the day, respectively compared to 60%, 37%, and 3%, respectively in those without mobility disability (p < 0.05). Breaks in sedentary time did not differ by mobility disability status. Compared to those without mobility disability, the average number of sedentary bouts longer than 30 min was greater in those with mobility disability (p = 0.016). Persons with MS with mobility disability are less active, engage in more sedentary behavior and accumulate prolonged sedentary bouts.

Relationship of race and poverty to lower extremity function and decline: findings from the Women's Health and Aging Study.

PubMed

Thorpe, Roland James; Kasper, Judith D; Szanton, Sarah L; Frick, Kevin D; Fried, Linda P; Simonsick, Eleanor M

2008-02-01

Race- and poverty-related disparities in physical function are well documented, though little is known about effects of race and poverty on functional decline and the progression of disability. We examined cross-sectional and longitudinal relationships between race, poverty and lower extremity function using data from moderately to severely disabled women in the U.S. Women's Health and Aging Study. Severity of lower extremity functional limitation was determined from scaled responses of reported difficulty walking (1/4) mile, walking across a room, climbing stairs, and stooping, crouching or kneeling. Usual walking speed assessed over 4m was our objective measure of function. Of the 996 women who described themselves as black or white, 284 (29%) were black and 367 (37%) were living at or below 100% of the federal poverty level. Independent of demographic and health-related factors, among white women, the poor exhibited consistently worse lower extremity function than the non-poor; this association, however, was not observed in black women. Among the non-poor, black women had slower walking speeds, and reported more limitation in lower extremity function than their non-poor white counterparts, even after adjusting for demographic variables and health-related characteristics. After 3 years, accounting for baseline function, demographic and health-related factors, race and poverty status were unrelated to functional decline. Thus, while race and poverty status were associated with functional deficits in old age, they do not appear to impact the rate of functional decline or progression of disability over 3 years.

Somatization is associated with worse outcome in a chiropractic patient population with neck pain and low back pain.

PubMed

Ailliet, L; Rubinstein, S M; Knol, D; van Tulder, M W; de Vet, H C W

2016-02-01

To determine if psychosocial factors are associated with outcome in patients with neck pain or low back pain. In a prospective, multi-center chiropractic practice-based cohort study in Belgium and The Netherlands, 917 patients, of which 326 with neck pain and 591 with low back pain, completed self-administered questionnaires at baseline, following the second visit, and at 1, 3, 6 and 12 months. Psychosocial factors assessed at baseline were: distress, depression, anxiety and somatization via the Four Dimensional Symptom Questionnaire, patient's beliefs regarding the effect of physical activity and work on their complaint via the Fear Avoidance Beliefs Questionnaire, and social support via the Feij social support scale. Primary outcome measures were perceived recovery, pain intensity, and functional status which was measured with the Neck Disability Index and Oswestry Disability Index. A univariable regression analysis to estimate the relation between each psychological variable and outcome was followed by a multivariable multilevel regression analysis. There were no differences in baseline patient characteristics between the patient population from Belgium and the Netherlands. Somatization scores are consistently associated with perceived recovery, functional status and pain for both neck pain and low-back pain. Depression was associated with poorer functioning in patients with LBP. There was a small association between fear and function and pain for patients with neck pain or low-back pain. Somatization was the only variable consistently found to be associated with diminished perceived recovery, higher degree of neck or low back disability, and increased neck or low back pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

76 FR 14439 - No FEAR Act Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... basis of race, color, religion, sex, national origin, age, disability, marital status or political..., religion, sex, national origin or disability, you must contact an Equal Employment Opportunity (EEO...

No relevant impact of ambient temperature on disability measurements in a large cohort of patients with multiple sclerosis.

PubMed

Stellmann, J-P; Young, K L; Vettorazzi, E; Pöttgen, J; Heesen, C

2017-06-01

Many patients with multiple sclerosis (MS) report a worsening of symptoms due to high ambient temperatures, but objective data about this association are rare and contradictory. The aim of this study was to investigate the influence of ambient temperature on standard clinical tests. We extracted the Symbol Digit Modality Test, Nine Hole Peg Test, Timed 25 Foot Walk (T25FW), Timed Tandem Walk, Expanded Disability Status Scale (EDSS) and quality-of-life items on cognition, fatigue and depression from our clinical database and matched them to historical temperatures. We used linear mixed-effect models to investigate the association between temperature and outcomes. A total of 1254 patients with MS (mean age, 42.7 years; 69.9% females; 52.1% relapsing-remitting MS, mean EDSS, 3.8) had 5751 assessments between 1996 and 2012. We observed a worsening in the T25FW with higher ambient temperatures in moderately disabled patients (EDSS ≥ 4) but not in less disabled patients. However, an increase of 10°C prolonged the T25FW by just 0.4 s. Other outcomes were not associated with ambient temperatures. Higher ambient temperature might compromise walking capabilities in patients with MS with a manifest walking impairment. However, effects are small and not detectable in mildly disabled patients. Hand function, cognition, mood and fatigue do not appear to be correlated with ambient temperature. © 2017 EAN.

Relationship between lower extremity isometric muscle strength and standing balance in patients with multiple sclerosis.

PubMed

Citaker, Seyit; Guclu-Gunduz, Arzu; Yazici, Gokhan; Bayraktar, Deniz; Nazliel, Bijen; Irkec, Ceyla

2013-01-01

Muscle strength and standing balance decrease in patients with Multiple Sclerosis (MS). The aim of the present study was to investigate the relationship between the lower extremity isometric muscle strength and standing balance in patients with MS. Forty-seven patients with MS and 10 healthy volunteers were included. Neurological disability level was assessed using Expanded Disability Status Scale (EDSS). Isometric strength of seven lower extremity muscles (hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor) was assessed using hand-held dynamometer. Duration of static one-leg standing balance was measured using digital chronometer. Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength, and duration of one-leg standing balance were decreased in patients with MS when compared with controls (p < 0.05). All assessed lower extremity isometric muscle strength and EDSS level was related duration of one-leg standing balance in patients with MS. All assessed lower extremity isometric muscle strength (except ankle dorsal flexor) was related with EDSS. Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength decreases in ambulatory MS patients. Lower extremity muscle weakness and neurological disability level are related with imbalance in MS population. Hip and knee region muscles weakness increases the neurological disability level. For the better balance and decrease neurological disability level whole lower extremity muscle strengthening should be included in rehabilitation programs.

Development of a New Attention Rating Scale for Children with Intellectual Disability: The Scale of Attention in Intellectual Disability (SAID)

ERIC Educational Resources Information Center

Freeman, Nerelie C.; Gray, Kylie M.; Taffe, John R.; Cornish, Kim M.

2015-01-01

Difficulties with attention, impulsivity, and hyperactivity are thought to be as common among children with intellectual disability (ID) as they are in children without ID. Despite this, there is a lack of scales to specifically assess ADHD symptomatology in children and adolescents with ID. This article describes the development and evaluation of…

Frailty among rural elderly adults

PubMed Central

2014-01-01

Background This study aimed to estimate the prevalence and associated factors related to frailty, by Fried criteria, in the elderly population in a rural area in the Andes Mountains, and to analyze the relationship of these with comorbidity and disability. Methods A cross-sectional study was undertaken involving 1878 participants 60 years of age and older. The frailty syndrome was diagnosed based on the Fried criteria (weakness, low speed, low physical activity, exhaustion, and weight loss). Variables were grouped as theoretical domains and, along with other potential confounders, were placed into five categories: (a) demographic and socioeconomic status, (b) health status, (c) self-reported functional status, (d) physical performance-based measures, and (e) psychosocial factors. Chi-square, ANOVA, and multinomial logistic regression analyses were used to test the prognostic value of frailty for the outcomes of interest. Results The prevalence of frailty was 12.2%. Factors associated with frailty were age, gender, health status variables that included self-perceived health and number of chronic conditions, functional covariate variables that included disability in activities in daily living (ADL), disabilities in instrumental ADL, chair stand time, and psychosocial variables that included depressive symptoms and cognitive impairment. Higher comorbidity and disability was found in frail elderly people. Only a subset of frail elderly people (10%) reported no disease or disability. Conclusions A relevant number of elderly persons living in rural areas in the Andes Mountains are frail. The prevalence of frailty is similar to that reported in other populations in the Latin American region. Our results support the use of modified Cardiovascular Health Study criteria to measure frailty in communities other than urban settings. Frailty in this study was strongly associated with comorbidities, and frailty and comorbidity predicted disability. PMID:24405584

Brain atrophy and lesion load measures over 1 year relate to clinical status after 6 years in patients with clinically isolated syndromes.

PubMed

Di Filippo, M; Anderson, V M; Altmann, D R; Swanton, J K; Plant, G T; Thompson, A J; Miller, D H

2010-02-01

Conventional MRI lesion measures modestly predict long term disability in some clinically isolated syndrome (CIS) studies. Brain atrophy suggests neuroaxonal loss in multiple sclerosis (MS) with the potential to reflect disease progression to a greater extent than lesion measures. To investigate whether brain atrophy and lesion load, during the first year in patients presenting with CIS, independently predict clinical outcome (development of MS and disability at 6 years). 99 patients presenting with CIS were included in the study. T1 gadolinium enhanced and T2 weighted brain MRI was acquired at baseline and approximately 1 year later. Percentage brain atrophy rate between baseline and follow-up scans was analysed using SIENA. Mean annual brain atrophy rates were -0.38% for all patients, -0.50% in patients who had developed MS at 6 years and -0.26% in those who had not. Brain atrophy rate (p = 0.005) and baseline T2 lesion load (p<0.001) were independent predictors of clinically definite MS. While brain atrophy rate was a predictor of Expanded Disability Status Scale (EDSS) score in a univariate analysis, only 1 year T2 lesion load change (p = 0.007) and baseline gadolinium enhancing lesion number (p = 0.03) were independent predictors of EDSS score at the 6 year follow-up. T1 lesion load was the only MRI parameter which predicted Multiple Sclerosis Functional Composite score at the 6 year follow-up. The findings confirm that brain atrophy occurs during the earliest phases of MS and suggest that 1 year longitudinal measures of MRI change, if considered together with baseline MRI variables, might help to predict clinical status 6 years after the first demyelinating event in CIS patients, better than measurements such as lesion or brain volumes on baseline MRI alone.

Digital divide among people with disabilities: Analysis of data from a nationwide study for determinants of Internet use and activities performed online.

PubMed

Duplaga, Mariusz

2017-01-01

The Internet is both an opportunity as well as a challenge for people with disabilities. However, this segment of the population is usually indicated among social groups experiencing digital divide. The study is focused on the analysis of factors determining Internet usage and undertaking specific activities online among people with disabilities based on a nationwide study performed in 2013 in Poland. Secondary analysis was performed on the data of persons who declared disability status in 2013 "Social Diagnosis" study. Multivariate logistic regression models were developed for the use of the Internet and performing three types of activities online. Among 3,556 respondents with disability 51.02% were females, 25.19% 65 years of age and over and 33.05% were Internet users. The predictors of Internet usage included the degree of disability, place of residence, level of education, marital status, occupational status, net income, use of health care service and the use of mobile phone. The odds ratio that a person with disability belonging to the oldest category will use the Internet was only 0.04 (95% CI 0.02-0.09), when compared to the youngest category. The odds that a person with disability from the highest category of education will use the Internet were 18 times higher than in the case of persons with only basic education (OR 18.17, 95% CI 11.70-28.21). Common predictors of online activities (accessing websites of public institutions, checking and sending emails, publishing own content on the Internet) included age category and net income. People with disabilities in Poland are facing a significant digital divide. The factors determining the use of the Internet in this group are similar to those of the general population. On the other hand, people with disabilities who are active online, access diversified types of services including presentation of their own content online.

Digital divide among people with disabilities: Analysis of data from a nationwide study for determinants of Internet use and activities performed online

PubMed Central

2017-01-01

Introduction The Internet is both an opportunity as well as a challenge for people with disabilities. However, this segment of the population is usually indicated among social groups experiencing digital divide. The study is focused on the analysis of factors determining Internet usage and undertaking specific activities online among people with disabilities based on a nationwide study performed in 2013 in Poland. Methods Secondary analysis was performed on the data of persons who declared disability status in 2013 “Social Diagnosis” study. Multivariate logistic regression models were developed for the use of the Internet and performing three types of activities online. Results Among 3,556 respondents with disability 51.02% were females, 25.19% 65 years of age and over and 33.05% were Internet users. The predictors of Internet usage included the degree of disability, place of residence, level of education, marital status, occupational status, net income, use of health care service and the use of mobile phone. The odds ratio that a person with disability belonging to the oldest category will use the Internet was only 0.04 (95% CI 0.02–0.09), when compared to the youngest category. The odds that a person with disability from the highest category of education will use the Internet were 18 times higher than in the case of persons with only basic education (OR 18.17, 95% CI 11.70–28.21). Common predictors of online activities (accessing websites of public institutions, checking and sending emails, publishing own content on the Internet) included age category and net income. Conclusions People with disabilities in Poland are facing a significant digital divide. The factors determining the use of the Internet in this group are similar to those of the general population. On the other hand, people with disabilities who are active online, access diversified types of services including presentation of their own content online. PMID:28662125

Mobility measures differentiate falls risk status in persons with multiple sclerosis: An exploratory study.

PubMed

Sebastião, Emerson; Learmonth, Yvonne C; Motl, Robert W

2017-01-01

Falls are of great concern among persons with multiple sclerosis (MS). To examine differences in metrics of mobility, postural control, and cognition in persons with MS with distinct fall risk status; and to investigate predictors of fall risk group membership using discriminant analysis. Forty-seven persons with MS completed the Activities-Balance Confidence (ABC) Scale and underwent a battery of assessments of mobility, balance, and cognition. Participants further wore an accelerometer for 7 days as an assessment of steps/day. Participants were allocated into fall risk groups based on ABC scale scores (increased fall risk (IFR); and normal fall risk (NFR)). We examined univariate differences between groups using ANOVA, and discriminant function analysis (DFA) identified the significant multivariate predictors of FR status. After controlling for disability level, the IFR group had significantly (p < 0.05) worse scores on measures of mobility (i.e., MSWS-12, 6 MW, and steps/day) compared to the NFR group. DFA identified MSWS-12 and 6 MW scores as significant (p < 0.05) predictors of fall risk group membership. Those two variables collectively explained 55% of variance in fall risk grouping. The findings suggest that mobility should be the focus of rehabilitation programs in persons with MS, especially for those at IFR.

Federal Employment of People with Disabilities

ERIC Educational Resources Information Center

Domzal, Christine

2009-01-01

The purpose of this paper is to examine the status of employment of people with disabilities in the Federal Government and to make recommendations for improving federal hiring and advancement of employees with disabilities. The paper summarizes the legal authorities and policy guidance, the responsibilities of various federal agencies charged with…

Inclusive Higher Education for Students with Disabilities in Taiwan

ERIC Educational Resources Information Center

Ho, Hua-Kuo

2004-01-01

The purpose of this paper was intended to present the current status of inclusive higher education for students with disabilities in Taiwan. Literature review, documentary analysis, and field observation were used to collect the needed information. The history for educating students with disabilities in higher education institutions in Taiwan has…

Snacking Smarts for the New Year

ERIC Educational Resources Information Center

Bissex, Janice Newell

2008-01-01

Poor nutritional status is a primary concern for people with disabilities. Inadequate diets can contribute to and hasten the development of degenerative diseases and delay recovery from illnesses. Individuals who have disabilities are more at risk for malnutrition, as their disability may affect food intake and nutrient requirements. Because of…

Qualitative Study of Malnutrition in People with Intellectual Disabilities

ERIC Educational Resources Information Center

Franssen, Janine J. L.; Maaskant, Marian A.; van Schrojenstein Lantman-de Valk, Henny M. J.

2011-01-01

The prevalence of underweight status is relatively high in persons with intellectual disabilities. However, it is not clear whether this is due to malnourishment. The authors sought to examine the awareness and knowledge of physicians, dieticians, and direct care staff regarding malnutrition in people with intellectual disabilities. They also…

Teaching about Psychosocial Aspects of Disability: Emphasizing Person-Environment Relations

ERIC Educational Resources Information Center

Dunn, Dana S.

2016-01-01

This article presents some psychosocial aspects of disability linked to the person--environment relation that teachers should share in the psychology classroom. Disability is an often-overlooked form of diversity, one that teachers should discuss alongside race, gender, sexual orientation, social class/socioeconomic status (SES), religiosity, and…

When Average Is Not Good Enough: Students with Learning Disabilities at Selective, Private Colleges

ERIC Educational Resources Information Center

Weis, Robert; Erickson, Celeste P.; Till, Christina H.

2017-01-01

Adolescents with learning disabilities disproportionately come from lower socioeconomic status backgrounds, show normative deficits in academic skills, and attend 2-year, public colleges instead of 4-year institutions. However, students with learning disabilities are well represented at the United States' most expensive and selective postsecondary…

Oral health status of autistic children in India.

PubMed

Subramaniam, P; Gupta, M

2011-01-01

Autism is one of the most severe childhood neuropsychiatric disorders. Autistic individuals are characterized by impairment in social interaction with a restricted range of interests and often, stereotyped repetitive behaviors. Studies on oral health conditions in children with autism are sparse. The complicated disability itself makes clinical research difficult. The need for baseline information regarding the oral health status of children with autism is essential. The present study assessed the oral health status of 106 autistic children aged 4 to 15 years in Bangalore city, India. The dental caries was recorded according to the WHO criteria; oral hygiene was assessed using the oral hygiene index-simplified (OHI-S) and its modification for deciduous dentition. The behavior of children towards dental treatment was also assessed using the Frankel's behavior rating scale. Data obtained was subjected to statistical analysis. showed that caries experience among autistic children was lower; however they were found to have more debris and calculus deposits. Negative behavior towards dental treatment was seen in autistic children.

Associations of perceived neighborhood environment on health status outcomes in persons with arthritis.

PubMed

Martin, Kathryn Remmes; Shreffler, Jack; Schoster, Britta; Callahan, Leigh F

2010-11-01

To examine the association between 4 aspects of perceived neighborhood environment (aesthetics, walkability, safety, and social cohesion) and health status outcomes in a cohort of North Carolinians with self-reported arthritis after adjustment for individual and neighborhood socioeconomic status covariates. In a telephone survey, 696 participants self-reported ≥1 types of arthritis or rheumatic conditions. Outcomes measured were physical and mental functioning (Short Form 12 health survey version 2 physical component and mental component summary [MCS]), functional disability (Health Assessment Questionnaire), and depressive symptomatology (Center for Epidemiologic Studies Depression Scale scores <16 versus ≥16). Multivariate regression and multivariate logistic regression analyses were conducted using Stata, version 11. Results from separate adjusted models indicated that measures of associations for perceived neighborhood characteristics were statistically significant (P ≤ 0.001 to P = 0.017) for each health status outcome (except walkability and MCS) after adjusting for covariates. Final adjusted models included all 4 perceived neighborhood characteristics simultaneously. A 1-point increase in perceiving worse neighborhood aesthetics predicted lower mental health (B = -1.81, P = 0.034). Individuals had increased odds of depressive symptoms if they perceived lower neighborhood safety (odds ratio [OR] 1.36, 95% confidence interval [95% CI] 1.04-1.78; P = 0.023) and lower neighborhood social cohesion (OR 1.42, 95% CI 1.03-1.96; P = 0.030). Study findings indicate that an individual's perception of neighborhood environment characteristics, especially aesthetics, safety, and social cohesion, is predictive of health outcomes among adults with self-reported arthritis, even after adjusting for key variables. Future studies interested in examining the role that community characteristics play on disability and mental health in individuals with arthritis might consider further examination of perceived neighborhood environment. Copyright © 2010 by the American College of Rheumatology.

Correlation of thermal deficit with clinical parameters and functional status in patients with unilateral lumbosacral radiculopathy.

PubMed

Dimitrijevic, I M; Kocic, M N; Lazovic, M P; Mancic, D D; Marinkovic, O K; Zlatanovic, D S

2016-08-01

Lumbosacral radiculopathy is a pathological process that refers to the dysfunction of one or more spinal nerve roots in the lumbosacral region of the spine. Some studies have shown that infrared thermography can estimate the severity of the clinical manifestation of unilateral lumbosacral radiculopathy. This study aimed to examine the correlation of the regional thermal deficit of the affected lower extremity with pain intensity, mobility of the lumbar spine, and functional status in patients with unilateral lumbosacral radiculopathy. This cross-sectional study was conducted at the Clinic for Physical Medicine and Rehabilitation of the Clinical Center Niš, Serbia. A total of 69 patients with unilateral lumbosacral radiculopathy of discogenic origin were recruited, with the following clinical parameters evaluated: (1) pain intensity by using a visual analogue scale, separately at rest and during active movement; (2) mobility of the lumbar spine by Schober test and the fingertip-to-floor test; and (3) functional status by the Oswestry Disability Index. Temperature differences between the symmetrical regions of the lower extremities were detected by infrared thermography. A quantitative analysis of thermograms determined the regions of interest with maximum thermal deficit. Correlation of maximum thermal deficit with each tested parameter was then determined. A significant and strong positive correlation was found between the regional thermal deficit and pain intensity at rest, as well as pain during active movements (rVAS - rest=0.887, rVAS - activity=0.890; P<0.001). The regional thermal deficit significantly and strongly correlated with the Oswestry Disability Index score and limited mobility of the lumbar spine (P<0.001). In patients with unilateral lumbosacral radiculopathy, the values of regional thermal deficit of the affected lower extremity are correlated with pain intensity, mobility of the lumbar spine, and functional status of the patient.

Examining the role of communication on sibling relationship quality and interaction for sibling pairs with and without a developmental disability.

PubMed

Smith, Ashlyn L; Romski, Maryann; Sevcik, Rose A

2013-09-01

This study examined communication interaction patterns when one sibling had a developmental disability as well as the role of communication skills in sibling relationship quality. Thirty sibling dyads were categorized into one of three communication status groups: emerging, context-dependent, and independent communicators. Independent communicators and their siblings did not differ in terms of syntactic complexity but typically developing siblings dominated the interaction and exhibited greater lexical diversity regardless of communication status. Communication status did not impact the warmth/closeness, rivalry, or conflict in the sibling relationship, but siblings of independent communicators engaged in the greatest amount of helping and managing behaviors. These results represent a first step in understanding the role of communication skills in the sibling relationship for families of children with disabilities.

The experience of stress and personal growth among grandparents of children with and without intellectual disability.

PubMed

Findler, Liora

2014-02-01

The aim of this research was to examine the contribution of internal and external resources to stress and personal growth among grandparents of children with and without an intellectual disability. Ninety-four grandparents of children with intellectual disability and 105 grandparents of children without intellectual disability completed the following scales: Multidimensional Experience of Grandparenthood; Multidimensional Scale for Perceived Social Support, Level of Differentiation of Self Scale, Family Adaptability and Cohesion Evaluation Scale, Perceived Stress Scale, and Posttraumatic Growth Inventory. Results indicate that group differences are reflected in higher negative emotions among grandparents of children without intellectual disability. In addition, both stress and growth are related to better health, lower level of education, family cohesiveness, and negative emotions. However, whereas stress is associated with the internal resource of self-differentiation, the external resource of social support, and the cost of grandparenthood, growth is associated with gender and the symbolic and behavioral aspects of the grandparenting role. This study aimed to correct the nearly exclusive focus in the literature on negativity, stress, and the burden of grandparenting children with intellectual disability, as well as to test the pervasive assumption that the absence of disability results in an almost entirely positive grandparenting experience with nearly no negative affect.

Responsiveness of pain and disability measures for chronic whiplash.

PubMed

Stewart, Mark; Maher, Christopher G; Refshauge, Kathryn M; Bogduk, Nikolai; Nicholas, Michael

2007-03-01

Cohort study. To evaluate the responsiveness of common pain and disability measures in a cohort of patients with chronic whiplash. Pain and disability are routinely measured in clinical practice and clinical research. However, to date, a head-to-head comparison of competing measures for whiplash patients has not been performed. Pain (pain intensity, bothersomeness, and SF-36 bodily pain score) and disability (Patient Specific Functional Scale, Neck Disability Index, Functional Rating Index, Copenhagen Scale, and SF-36 physical summary) measures were completed by 132 patients with chronic whiplash at baseline and then again after 6 weeks together with an 11-point global perceived effect scale. Internal responsiveness was evaluated by calculating effect sizes and standardized response means, and external responsiveness by correlating change scores with global perceived effect scores and by ROC curves. The ranking of responsiveness was consistent across the different analyses. Pain bothersomeness was more responsive than pain intensity, which was more responsive than the SF-36 pain measure. The Patient Specific Functional Scale was the most responsive disability measure, followed by the spine-specific measures, with the SF-36 physical summary measure the least responsive. Pain bothersomeness and the Patient Specific Functional Scale provide the most responsive measures of pain and disability, respectively, in patients with chronic whiplash.

Disability in Indian patients with haemophilia.

PubMed

Kar, A; Mirkazemi, R; Singh, P; Potnis-Lele, M; Lohade, S; Lalwani, A; Saha, A S

2007-07-01

Chronic shortage of clotting factor concentrates, exorbitant treatment costs and the poor economic status of patients makes disability an inevitable consequence of haemophilia in India. The prevalence and risk factors for disability were studied in 148 patients with severe haemophilia A registered at five haemophilia clinics in the country. Disability was measured using a scoring method that used a compilation of functional ability, mobility and range-of-motion scores for each patient. Patients ranged in age from 5 to 55 years. Only nine of 148 patients were free of disability. The proportion of disability free patients in the 5-12, 13-24 and 25+ age groups were 14.3%, 4.4% and 0% respectively. The risk factors significantly associated with disability were patients age, socio-economic status, number of persons in the family, family history of haemophilia, frequency of physiotherapy exercises, home use of coagulation factor concentrate and type of blood product(s) used, that is clotting factor concentrate or cryoprecipitate. The study highlights the need to provide coagulation factor concentrates in sufficient amounts to prevent disability, the beneficial role of physiotherapy exercises and the advantage of older patients as peer educators for younger patients. The most important utility of the data is to demonstrate the widespread prevalence of disability amongst patients, its social costs in terms of incomplete education and unemployment, which justifies the need to include haemophilia as one of the conditions under the Disability Act of India.

Prevalence and risk of violence against people with and without disabilities: findings from an Australian population-based study.

PubMed

Krnjacki, Lauren; Emerson, Eric; Llewellyn, Gwynnyth; Kavanagh, Anne M

2016-02-01

There are no population-based estimates of the prevalence of interpersonal violence among people with disabilities in Australia. The project aimed to: 1) estimate the prevalence of violence for men and women according to disability status; 2) compare the risk of violence among women and men with disabilities to their same-sex non-disabled counterparts and; 3) compare the risk of violence between women and men with disabilities. We analysed the 2012 Australian Bureau of Statistics Survey on Personal Safety of more than 17,000 adults and estimated the population-weighted prevalence of violence (physical, sexual and intimate partner violence and stalking/harassment) in the past 12 months and since the age of 15. Population-weighted, age-adjusted, logistic regression was used to estimate the odds of violence by disability status and gender. People with disabilities were significantly more likely to experience all types of violence, both in the past 12 months and since the age of 15. Women with disabilities were more likely to experience sexual and partner violence and men were more likely to experience physical violence. These results underscore the need to understand risk factors for violence, raise awareness about violence and to target policies and services to reduce violence against people with disabilities in Australia. © 2015 Public Health Association of Australia.

Availability of state-based obesity surveillance data on high school students with disabilities in the United States.

PubMed

Yamaki, Kiyoshi; Lowry, Brienne Davis; Buscaj, Emilie; Zisko, Leigh; Rimmer, James H

2015-05-01

The aim of this study was to assess the availability of public health surveillance data on obesity among American children with disabilities in state-based surveillance programs. We reviewed annual cross-sectional datasets in state-level surveillance programs for high school students, implemented 2001-2011, for the inclusion of weight and height and disability screening questions. When datasets included a disability screen, its content and consistency of use across years were examined. We identified 54 surveillance programs with 261 annual datasets containing obesity data. Twelve surveillance programs in 11 states included a disability screening question that could be used to extract obesity data for high school students with disabilities, leaving the other 39 states with no state-level obesity data for students with disabilities. A total of 43 annual datasets, 16.5 % of the available datasets, could be used to estimate the obesity status of students with disabilities. The frequency of use of disability questions varied across states, and the content of the questions often changed across years and within a state. We concluded that state surveillance programs rarely contained questions that could be used to identify high school students with disabilities. This limits the availability of data that can be used to monitor obesity and related health statuses among this population in the majority of states.

Health Status, Social Support, and Quality of Life among Family Carers of Adults with Profound Intellectual and Multiple Disabilities (PIMD) in Taiwan

ERIC Educational Resources Information Center

Chou, Yueh-Ching; Chiao, Chi; Fu, Li-Yeh

2011-01-01

Background: Primary family carers of adults with profound intellectual and multiple disabilities (PIMD) experience a range of considerable demands. Method: A census survey was conducted in a city of Taiwan; 796 family carers of adults (aged 18 or older) diagnosed with intellectual disability and/or with multiple disabilities living with the family…

Task Force on Returning Global War on Terror Heroes

DTIC Science & Technology

2007-04-19

assigning disability ratings used to determine fitness for military retention, level of disability for retirement, and VA disability compensation...process. DoD and VA agreed to develop a joint process of assigning disability ratings used to determine fitness for military retention, level of...charged with deciding fit /unfit status. Servicemembers obviously endeavor to reach the threshold because it results in lifelong benefits such as health

Life expectancy and life expectancy with disability of normal weight, overweight, and obese smokers and nonsmokers in Europe.

PubMed

Majer, Istvan M; Nusselder, Wilma J; Mackenbach, Johan P; Kunst, Anton E

2011-07-01

The goal of this study was to estimate life expectancy (LE) and LE with disability (LwD) among normal weight, overweight, and obese smokers and nonsmokers in Western Europe. Data from four waves (1998-2001) of the European Community Household Panel (ECHP) were used; a standardized multipurpose annual longitudinal survey. Self-reported health and socioeconomic information was collected repeatedly using uniform questionnaires for 66,331 individuals in nine countries. Health status was measured in terms of disability in daily activities. Multistate Markov (MSM) models were applied to obtain hazard ratios (HRs) and age-specific transition rates according to BMI and smoking status. Multistate life tables were computed using the predicted transition probabilities to estimate LE and LwD. Significant associations were observed between disability incidence and BMI (HR = 1.15 for overweight, HR = 1.64 for obese, compared to normal weight). The risk of mortality was negatively associated with overweight status among disabled (HR = 0.77). Overweight people had higher LE than people with normal-weight and obesity. Among women, overweight and obese nonsmokers expect 3.6 and 6.1 more years of LwD than normal weight persons, respectively. In contrast, daily smokers expect lower LE but a similar LwD. The same patterns were observed among people with high education and those with low education. To conclude, daily smoking is associated with mortality more than with disability, whereas obesity is associated with disability more than with mortality. The findings suggest that further tobacco control would contribute to increasing LE, while tackling the obesity epidemic is necessary to prevent an expansion of disability.

A 15-year prospective study of shift work and disability pension

PubMed Central

Tüchsen, F; Christensen, K B; Lund, T; Feveile, H

2008-01-01

Objective: To estimate the hazard ratio for disability pension associated with shift work. Methods: Cohorts of shift and day workers were identified in three waves of the Danish Work Environment Cohort Study and followed up for incidence of disability pension in a national register of social transfer payment. A total of 3980 female and 4025 male employees were included in the cohorts. Information about shift work status, age, smoking habits, body mass index and ergonomic work environment were updated according to responses in subsequent waves of the survey when possible. Respondents reporting shift work were classified as shift workers in the following waves as well. Respondents were followed in the register from the time of first interview and were censored at the time of their 60th birthday, emigration, death or end of follow-up (18 June 2006). The authors used the Cox proportional hazards model to estimate hazard ratios for incidence of disability pension and 95% confidence intervals. Results: The authors observed 253 new disability pensions among women and 173 among men during 56 903 and 57 886 person-years at risk respectively, Among women, shift work predicted disability after adjustment for age, general health and socioeconomic status HR 1.39 (95% CI 1.07 to 1.82). After further adjustment for body mass index, smoking habits, socioeconomic status and ergonomic exposures the association remained statistically significant HR 1.34 (95% CI 1.02 to 1.75). Shift work was not associated with disability among men. Conclusion: Shift work might be moderately associated with disability pension among women; however, more powerful studies are needed to establish the possible association. PMID:18198201

Stimulated peripheral production of interferon-gamma is related to fatigue and depression in multiple sclerosis.

PubMed

Pokryszko-Dragan, A; Frydecka, I; Kosmaczewska, A; Ciszak, L; Bilińska, M; Gruszka, E; Podemski, R; Frydecka, D

2012-10-01

The aim of the study was to evaluate the stimulated production of interferon-gamma (IFNγ) by peripheral CD3+CD4+ T lymphocytes in patients with multiple sclerosis (MS) with regard to the degree of fatigue, and to investigate relationships between immunological parameters, level of depression and clinical variables. Forty MS patients (30 women, 10 men, aged 22-60 years): 20 fatigued and 20 non-fatigued were involved in the study. Fatigue was evaluated using the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS), depression level - using Beck Depression Inventory (BDI). Production of IFNγ by stimulated peripheral blood CD3+CD4+ T lymphocytes, assessed using flow cytometry, was compared between MS patients with different levels of fatigue and controls. Correlations were searched out between immunological findings and BDI, age, duration and course of MS, relapse rate, disability (assessed in Expanded Disability Status Scale - EDSS) and its progression. Stimulated production of IFNγ by CD3+CD4+ T lymphocytes was higher in severely fatigued patients in comparison with non-fatigued ones and controls, tended to correlate with FSS and MFIS, and correlated with BDI. No relationships were found between immunological findings and disease-related variables. Stimulated production of IFNγ by peripheral CD3+CD4+ T lymphocytes is related to fatigue and depression in MS patients. Copyright © 2012 Elsevier B.V. All rights reserved.

Dynamometer-based measure of spasticity confirms limited association between plantarflexor spasticity and walking function in persons with multiple sclerosis

PubMed Central

Kremer, Theodore R.; Van Dillen, Linda R.; Wagner, Joanne M.

2017-01-01

The literature shows inconsistent evidence regarding the association between clinically assessed plantarflexor (PF) spasticity and walking function in ambulatory persons with multiple sclerosis (pwMS). The use of a dynamometer-based spasticity measure (DSM) may help to clarify this association. Our cohort included 42 pwMS (27 female, 15 male; age: 42.9 +/− 10.2 yr) with mild clinical disability (Expanded Disability Status Scale score: 3.6 +/− 1.6). PF spasticity was assessed using a clinical measure, the modified Ashworth Scale (MAS), and an instrumented measure, the DSM. Walking function was assessed by the timed 25-foot walk test (T25FWT), the 6-minute walk test (6MWT), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Spearman rho correlations were used to evaluate relationships between spasticity measures, measures of walking speed and endurance, and self-perceived limitations in walking. The correlation was small between PF spasticity and the T25FWT (PF maximum [Max] MAS rho = 0.27, PF Max DSM rho = 0.26), the 6MWT (PF Max MAS rho = −0.20, PF Max DSM rho = −0.21), and the MSWS-12 (PF Max MAS rho = 0.11, PF Max DSM rho = 0.26). Our results are similar to reports in other neurologic clinical populations, wherein spasticity has a limited association with walking dysfunction. PMID:25356797

Balance exercise in patients with chronic sensory ataxic neuropathy: a pilot study.

PubMed

Riva, Nilo; Faccendini, Simone; Lopez, Ignazio D; Fratelli, Annamaria; Velardo, Daniele; Quattrini, Angelo; Gatti, Roberto; Comi, Giancarlo; Comola, Mauro; Fazio, Raffaella

2014-06-01

Although exercise therapy is considered part of the treatment of neuropathic patients, and somatosensory input is essential for motor learning, performance and neural plasticity, rehabilitation of patients with sensory ataxia has received little attention so far. The aim of this prospective pilot study was to explore the short- and medium-term efficacy of a 3-week intensive balance and treadmill exercise program in chronic ataxic neuropathy patients; 20 consecutive patients with leg overall disability sum score (ODSS-leg) ≥2, absent/mild motor signs, clinical and therapeutic stability ≥4 months were enrolled. Evaluations were done at baseline, at the end of treatment and at 3- and 6-month follow-up. Outcome measurements included: ODSS-leg, Berg balance scale, 6-min walk distance, and the functional independence measure (FIM) scale. The short-form-36 health status scale (SF-36) was used to measure health-related quality of life (HRQoL). ODSS-leg improved significantly compared with baseline, 3 weeks, 3 months (primary outcome), and 6 months follow-up. A significant improvement in all functional secondary outcome measurements and in some SF-36 subscales was also observed. This pilot study suggests that balance exercise is safe and well tolerated and might be effective in ameliorating disability and HRQoL in patients with chronic peripheral sensory ataxia. © 2014 Peripheral Nerve Society.

The influence of coping styles on long-term employment in multiple sclerosis: A prospective study.

PubMed

Grytten, Nina; Skår, Anne Br; Aarseth, Jan Harald; Assmus, Jorg; Farbu, Elisabeth; Lode, Kirsten; Nyland, Harald I; Smedal, Tori; Myhr, Kjell Morten

2017-06-01

The aim was to investigate predictive values of coping styles, clinical and demographic factors on time to unemployment in patients diagnosed with multiple sclerosis (MS) during 1998-2002 in Norway. All patients ( N = 108) diagnosed with MS 1998-2002 in Hordaland and Rogaland counties, Western Norway, were invited to participate in the long-term follow-up study in 2002. Baseline recordings included disability scoring (Expanded Disability Status Scale (EDSS)), fatigue (Fatigue Severity Scale (FSS)), depression (Beck Depression Inventory (BDI)), and questionnaire assessing coping (the Dispositional Coping Styles Scale (COPE)). Logistic regression analysis was used to identify factors associated with unemployed at baseline, and Cox regression analysis to identify factors at baseline associated with time to unemployment during follow-up. In all, 41 (44%) were employed at baseline. After 13 years follow-up in 2015, mean disease duration of 22 years, 16 (17%) were still employed. Median time from baseline to unemployment was 6 years (±5). Older age at diagnosis, female gender, and depression were associated with patients being unemployed at baseline. Female gender, long disease duration, and denial as avoidant coping strategy at baseline predicted shorter time to unemployment. Avoidant coping style, female gender, and longer disease duration were associated with shorter time to unemployment. These factors should be considered when advising patients on MS and future employment.

Predictors of informal care burden 1 year after a severe traumatic brain injury: results from the PariS-TBI study.

PubMed

Bayen, Eleonore; Pradat-Diehl, Pascale; Jourdan, Claire; Ghout, Idir; Bosserelle, Vanessa; Azerad, Sylvie; Weiss, Jean-Jacques; Joël, Marie-Eve; Aegerter, Philippe; Azouvi, Philippe

2013-01-01

To investigate predictors of informal care burden 1 year after a severe traumatic brain injury (TBI). Patients (N = 66) aged 15 years or older with severe TBI (Glasgow Coma Scale score of 8 or less) and their primary informal caregivers. Multicenter inception cohort study over 22 months in Paris and the surrounding area (PariS-TBI study). Patients' preinjury characteristics; injury severity data; outcome measures at discharge from intensive care and 1 year after the injury; Dysexecutive Questionnaire; Medical Outcome Study Short Form-36; Zarit Burden Inventory. Among the 257 survivors at discharge from acute care, 66 patient-caregiver couples were included. Primary informal caregivers were predominantly women (73%), of middle age (age, 50 years), supporting male patients (79%), of mean age of 38 years. The majority (56%) of caregivers experienced significant burden, and 44% were at risk of depression. Caregivers' impaired health status and perceived burden significantly correlated with patients' global disability (as assessed with the Glasgow Outcome Scale-Extended) and impairments of executive functions (as assessed with the Dysexecutive Questionnaire). A focused principal component analysis suggested that disability and executive dysfunctions were independent predictors of perceived burden, whereas demographics, injury severity, and Glasgow Outcome Scale at discharge from acute care did not significantly correlate with caregiver's burden. Global handicap and impairments of executive functions are independent significant predictors of caregiver burden 1 year after TBI.

Posttraumatic stress disorder and associated risk factors in Canadian peacekeeping veterans with health-related disabilities.

PubMed

Richardson, J Don; Naifeh, James A; Elhai, Jon D

2007-08-01

This study investigates posttraumatic stress disorder (PTSD) and its associated risk factors in a random, national, Canadian sample of United Nations peacekeeping veterans with service-related disabilities. Participants included 1016 male veterans (age < 65 years) who served in the Canadian Forces from 1990 to 1999 and were selected from a larger random sample of 1968 veterans who voluntarily and anonymously completed a general health survey conducted by Veterans Affairs Canada in 1999. Survey instruments included the PTSD Checklist-Military Version (PCL-M), Center for Epidemiological Studies-Depression Scale (CES-D), and questionnaires regarding life events during the past year, current stressors, sociodemographic characteristics, and military history. We found that rates of probable PTSD (PCL-M score > 50) among veterans were 10.92% for veterans deployed once and 14.84% for those deployed more than once. The rates of probable clinical depression (CES-D score > 16) were 30.35% for veterans deployed once and 32.62% for those deployed more than once. We found that, in multivariate analyses, probable PTSD rates and PTSD severity were associated with younger age, single marital status, and deployment frequency. PTSD is an important health concern in the veteran population. Understanding such risk factors as younger age and unmarried status can help predict morbidity among trauma-exposed veterans.

Quantitative measures of walking and strength provide insight into brain corticospinal tract pathology in multiple sclerosis.

PubMed

Fritz, Nora E; Keller, Jennifer; Calabresi, Peter A; Zackowski, Kathleen M

2017-01-01

At least 85% of individuals with multiple sclerosis report walking dysfunction as their primary complaint. Walking and strength measures are common clinical measures to mark increasing disability or improvement with rehabilitation. Previous studies have shown an association between strength or walking ability and spinal cord MRI measures, and strength measures with brainstem corticospinal tract magnetization transfer ratio. However, the relationship between walking performance and brain corticospinal tract magnetization transfer imaging measures and the contribution of clinical measurements of walking and strength to the underlying integrity of the corticospinal tract has not been explored in multiple sclerosis. The objectives of this study were explore the relationship of quantitative measures of walking and strength to whole-brain corticospinal tract-specific MRI measures and to determine the contribution of quantitative measures of function in addition to basic clinical measures (age, gender, symptom duration and Expanded Disability Status Scale) to structural imaging measures of the corticospinal tract. We hypothesized that quantitative walking and strength measures would be related to brain corticospinal tract-specific measures, and would provide insight into the heterogeneity of brain pathology. Twenty-nine individuals with relapsing-remitting multiple sclerosis (mean(SD) age 48.7 (11.5) years; symptom duration 11.9(8.7); 17 females; median[range] Expanded Disability Status Scale 4.0 [1.0-6.5]) and 29 age and gender-matched healthy controls (age 50.8(11.6) years; 20 females) participated in clinical tests of strength and walking (Timed Up and Go, Timed 25 Foot Walk, Two Minute Walk Test ) as well as 3 T imaging including diffusion tensor imaging and magnetization transfer imaging. Individuals with multiple sclerosis were weaker (p = 0.0024) and walked slower (p = 0.0013) compared to controls. Quantitative measures of walking and strength were significantly related to corticospinal tract fractional anisotropy (r > 0.26; p < 0.04) and magnetization transfer ratio (r > 0.29; p < 0.03) measures. Although the Expanded Disability Status Scale was highly correlated with walking measures, it was not significantly related to either corticospinal tract fractional anisotropy or magnetization transfer ratio (p > 0.05). Walk velocity was a significant contributor to magnetization transfer ratio (p = 0.006) and fractional anisotropy (p = 0.011) in regression modeling that included both quantitative measures of function and basic clinical information. Quantitative measures of strength and walking are associated with brain corticospinal tract pathology. The addition of these quantitative measures to basic clinical information explains more of the variance in corticospinal tract fractional anisotropy and magnetization transfer ratio than the basic clinical information alone. Outcome measurement for multiple sclerosis clinical trials has been notoriously challenging; the use of quantitative measures of strength and walking along with tract-specific imaging methods may improve our ability to monitor disease change over time, with intervention, and provide needed guidelines for developing more effective targeted rehabilitation strategies.

[Predicting gainful employment in a population sample of 4225 statutory pension insurance members covering a prognostic period of five years using a brief subjective prognostic employment scale (SPE Scale)].

PubMed

Mittag, O; Meyer, T; Glaser-Möller, N; Matthis, C; Raspe, H

2006-05-01

Vocational (dis-)ability is a key concept in social medicine. It plays a major role in the realm of statutory pension funds (e. g. appraisal of applications for early retirement) as well as in epidemiologic or rehabilitation research. In a former population-based survey reliability of a short scale assessing the subjective prognosis of gainful employment (SPE-Scale, range = 0 - 3) had been tested. We now wanted to explore whether the SPE-Scale allows a prediction of vocational outcomes (early retirement) in the population sample over longer periods of time. Statutory pension insurees from Luebeck and surroundings aged between 40 and 55 were surveyed by questionnaire in 1999/2000. For 4225 subjects (= 95% of the original cohort) we obtained the following outcome data from pension fund records: dates of any applications for early retirement and beginning of retirement, date of death. The follow-up period covers 4.75 years on average. During this period 323 applications for early retirement (= 7.6%) were filed, and 200 subjects (= 4.7%) actually retired. First analysis including age and sex as covariates showed a threefold (SPE = 2) and eightfold (SPE = 3) risk of early retirement. Multivariate analysis (covariates: overall health status, number of chronic conditions, approved disability, subjective vocational ability, and length of sick leave measured at study onset) yielded a twofold risk of filing an application for early retirement (SPE = 3). The SPE-Scale is an appropriate screening instrument for hazards regarding gainful employment. It also can be recommended for use in epidemiologic or rehabilitation surveys.

34 CFR 300.328 - Alternative means of meeting participation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... scheduling, exchange of witness lists, and status conferences), the parent of a child with a disability and a... EDUCATION OF CHILDREN WITH DISABILITIES Evaluations, Eligibility Determinations, Individualized Education...

34 CFR 300.328 - Alternative means of meeting participation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... scheduling, exchange of witness lists, and status conferences), the parent of a child with a disability and a... EDUCATION OF CHILDREN WITH DISABILITIES Evaluations, Eligibility Determinations, Individualized Education...

34 CFR 300.328 - Alternative means of meeting participation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... scheduling, exchange of witness lists, and status conferences), the parent of a child with a disability and a... EDUCATION OF CHILDREN WITH DISABILITIES Evaluations, Eligibility Determinations, Individualized Education...

34 CFR 300.328 - Alternative means of meeting participation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... scheduling, exchange of witness lists, and status conferences), the parent of a child with a disability and a... EDUCATION OF CHILDREN WITH DISABILITIES Evaluations, Eligibility Determinations, Individualized Education...

Female sterilization is more common among women with physical and/or sensory disabilities than women without disabilities in the United States.

PubMed

Wu, Justine P; McKee, Michael M; Mckee, Kimberly S; Meade, Michelle A; Plegue, Melissa; Sen, Ananda

2017-07-01

Female sterilization accounts for 50% of all contraceptive use in the U.S. The extent to which U.S. women with physical and/or sensory disabilities have undergone female sterilization is unknown. Our primary objective was to determine the prevalence of sterilization for women with physical/sensory disabilities, and compare this to the prevalence for women without disabilities. We also compared use of long-acting reversible contraceptive (LARC) methods between women with and without disabilities. We conducted a secondary analysis of data from the National Survey of Family Growth 2011-2013, a population-based survey of U.S. women aged 15-44. Bivariate comparisons between women with and without disabilities by female sterilization and LARC use were conducted using chi-square tests. Using logistic regression, we estimated the odds of female sterilization based upon disability status. Women with physical/sensory disabilities accounted for 9.3% of the total sample (N = 4966). Among women with disabilities only, 28.2% had undergone female sterilization, representing 1.2 million women nationally. LARC use was lower among women with disabilities than those without disabilities (5.4%, 9.3%, respectively, p < 0.01). After adjusting for age, race/ethnicity, education, insurance, marital status, parity, and self-reported health, women with disabilities had higher odds of sterilization (OR 1.36, 95% CI 1.03, 1.79). The odds of female sterilization is higher among women with physical/sensory disabilities than those without disabilities. Future research is necessary to understand factors contributing to this finding, including possible underutilization of LARC methods. Copyright © 2016 Elsevier Inc. All rights reserved.

rTMS: A Treatment to Restore Function After Severe TBI

DTIC Science & Technology

2016-10-01

of rTMS-induced neurobehavioral effects measured with the Disability Rating Scale. Aim II will determine the presence, direction and sustainability...Aim IV addresses the need to confirm rTMS safety for severe TBI. 15. SUBJECT TERMS Disability Rating Scale (DRS), Neurobehavioral, Repetitive...rTMS sessions. The Disability Rating Scale (DRS) will be used at four time points to measure neurobehavioral recovery slopes. Net neural effects

Multi-state Markov model for disability: A case of Malaysia Social Security (SOCSO)

NASA Astrophysics Data System (ADS)

Samsuddin, Shamshimah; Ismail, Noriszura

2016-06-01

Studies of SOCSO's contributor outcomes like disability are usually restricted to a single outcome. In this respect, the study has focused on the approach of multi-state Markov model for estimating the transition probabilities among SOCSO's contributor in Malaysia between states: work, temporary disability, permanent disability and death at yearly intervals on age, gender, year and disability category; ignoring duration and past disability experience which is not consider of how or when someone arrived in that category. These outcomes represent different states which depend on health status among the workers.

Development of disability in chronic obstructive pulmonary disease: beyond lung function.

PubMed

Eisner, Mark D; Iribarren, Carlos; Blanc, Paul D; Yelin, Edward H; Ackerson, Lynn; Byl, Nancy; Omachi, Theodore A; Sidney, Stephen; Katz, Patricia P

2011-02-01

COPD is a major cause of disability, but little is known about how disability develops in this condition. The authors analysed data from the Function, Living, Outcomes and Work (FLOW) Study which enrolled 1202 Kaiser Permanente Northern California members with COPD at baseline and re-evaluated 1051 subjects at 2-year follow-up. The authors tested the specific hypothesis that the development of specific non-respiratory impairments (abnormal body composition and muscle strength) and functional limitations (decreased lower extremity function, poor balance, mobility-related dyspnoea, reduced exercise performance and decreased cognitive function) will determine the risk of disability in COPD, after controlling for respiratory impairment (FEV(1) and oxygen saturation). The Valued Life Activities Scale was used to assess disability in terms of a broad range of daily activities. The primary disability outcome measure was defined as an increase in the proportion of activities that cannot be performed of 3.3% or greater from baseline to 2-year follow-up (the estimated minimal important difference). Multivariable logistic regression was used for analysis. Respiratory impairment measures were related to an increased prospective risk of disability (multivariate OR 1.75; 95% CI 1.26 to 2.44 for 1 litre decrement of FEV(1) and OR 1.57 per 5% decrement in oxygen saturation; 95% CI 1.13 to 2.18). Non-respiratory impairment (body composition and lower extremity muscle strength) and functional limitations (lower extremity function, exercise performance, and mobility-related dyspnoea) were all associated with an increased longitudinal risk of disability after controlling for respiratory impairment (p<0.05 in all cases). Non-respiratory impairment and functional limitations were predictive of prospective disability, above-and-beyond sociodemographic characteristics, smoking status and respiratory impairment (area under the receiver operating characteristic curve increased from 0.65 to 0.75; p<0.001). Development of non-respiratory impairment and functional limitations, which reflect the systemic nature of COPD, appear to be critical determinants of disablement. Prevention and treatment of disability require a comprehensive approach to the COPD patient.

Venous thromboembolism and subsequent permanent work-related disability.

PubMed

Braekkan, S K; Grosse, S D; Okoroh, E M; Tsai, J; Cannegieter, S C; Naess, I A; Krokstad, S; Hansen, J-B; Skjeldestad, F E

2016-10-01

Essentials The burden of venous thromboembolism (VTE) related to permanent work-related disability is unknown. In a cohort of 66 005 individuals, the risk of work-related disability after a VTE was assessed. Unprovoked VTE was associated with 52% increased risk of work-related disability. This suggests that indirect costs due to loss of work time may add to the economic burden of VTE. Background The burden of venous thromboembolism (VTE) related to permanent work-related disability has never been assessed among a general population. Therefore, we aimed to estimate the risk of work-related disability in subjects with incident VTE compared with those without VTE in a population-based cohort. Methods From the Tromsø Study and the Nord-Trøndelag Health Study (HUNT), Norway, 66 005 individuals aged 20-65 years were enrolled in 1994-1997 and followed to 31 December 2008. Incident VTE events among the study participants were identified and validated, and information on work-related disability was obtained from the Norwegian National Insurance Administration database. Cox-regression models using age as time-scale and VTE as time-varying exposure were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for sex, body mass index, smoking, education level, marital status, history of cancer, diabetes, cardiovascular disease and self-rated general health. Results During follow-up, 384 subjects had a first VTE and 9862 participants were granted disability pension. The crude incidence rate of work-related disability after VTE was 37.5 (95% CI, 29.7-47.3) per 1000 person-years, vs. 13.5 (13.2-13.7) per 1000 person-years among those without VTE. Subjects with unprovoked VTE had a 52% higher risk of work-related disability than those without VTE (HR, 1.52; 95% CI, 1.09-2.14) after multivariable adjustment, and the association appeared to be driven by deep vein thrombosis. Conclusion VTE was associated with subsequent work-related disability in a cohort recruited from the general working-age population. Our findings suggest that indirect costs because of loss of work time may add to the economic burden of VTE. © 2016 International Society on Thrombosis and Haemostasis.

Genetic and Environmental Influences on Achievement Outcomes Based on Family History of Learning Disabilities Status.

PubMed

Erbeli, Florina; Hart, Sara A; Taylor, Jeanette

2018-05-01

A risk to develop a learning disability has been shown to run in families. Having a positive family history of learning disability seems to account for mean differences in achievement outcomes (reading, math) in that children with a positive family history score significantly lower compared to their peers with no such family history. However, the role of family history status in explaining etiological (genetic and environmental) differences among these subgroups of children has yet to be established. The present study of 872 twins ( M age = 13.30, SD age = 1.40) from the Florida Twin Project on Reading, Behavior, and Environment utilized a multigroup approach to examine etiological differences on reading, spelling, and math among two subgroups defined by family history status. Results showed significant mean differences on all achievement outcomes, aside from math; however, no significant etiological differences on any achievement outcome were found among the two subgroups. Results support previous literature that the risk for developing a learning disability is transmitted through a family, but this is seemingly not manifested by differential etiology.

Function and disability in late life: comparison of the Late-Life Function and Disability Instrument to the Short-Form-36 and the London Handicap Scale.

PubMed

Dubuc, Nicole; Haley, Stephen; Ni, Pengsheng; Kooyoomjian, Jill; Jette, Alan

2004-03-18

We evaluated the Late-Life Function and Disability Instrument's (LLFDI) concurrent validity, comprehensiveness and precision by comparing it with the Short-Form-36 physical functioning (PF-10) and the London Handicap Scale (LHS). We administered the LLFDI, PF-10 and LHS to 75 community-dwelling adults (> 60 years of age). We used Pearson correlation coefficients to examine concurrent validity and Rasch analysis to compare the item hierarchies, content ranges and precision of the PF-10 and LLFDI function domains, and the LHS and the LLFDI disability domains. LLFDI Function (lower extremity scales) and PF-10 scores were highly correlated (r = 0.74 - 0.86, p > 0.001); moderate correlations were found between the LHS and the LLFDI Disability limitation (r = 0.66, p < 0.0001) and Disability frequency (r = 0.47, p < 0.001) scores. The LLFDI had a wider range of content coverage, less ceiling effects and better relative precision across the spectrum of function and disability than the PF-10 and the LHS. The LHS had slightly more content range and precision in the lower end of the disability scale than the LLFDI. The LLFDI is a more comprehensive and precise instrument compared to the PF-10 and LHS for assessing function and disability in community-dwelling older adults.

Association of low back pain on physical, sociodemographic and lifestyle factors across a general population sample within Greece.

PubMed

Billis, E; Koutsojannis, C; Matzaroglou, C; Gliatis, J; Fousekis, K; Gioftsos, G; Papandreou, M; McCarthy, C; Oldham, J A; Tsepis, E

2017-01-01

Although low back pain (LBP) is a debilitating problem internationally, there is not a lot of research on its impact on physical, psychosocial and lifestyle factors. Especially in mediterranean countries, such as Greece, it is not sufficiently explored whether physical (pain location, activity limitation etc.), sociodemographic (education, smoking etc.) or lifestyle factors (i.e. quality of life or anxiety) are influenced by LBP. To estimate LBP prevalence in the Greek general population and explore its association with particular sociodemographic, physical and lifestyle factors. A sample of 3125 people of the Greek adult population was randomly selected by stratified sampling encompassing rural and urban representation within the Greek mainland. An extended survey form was developed entailing three sections; personal (sociodemographic) information, questions on symptomatology and physical factors (i.e. pain characteristics, recurrence, physical disability etc.) and 3 self-administered questionnaires (including mostly lifestyle factors); Hospital Anxiety and Depression (HAD) scale for anxiety and depression, SF-12 for quality of life (QoL) and Roland-Morris for disability. A total of 471 (15%) people reported LBP (210 males, mean age: 47.04 ± 15.03). Amongst them 60% reported sciatica, 76% suffered recurrent LBP and 70% received specialist care. Low disability levels, moderate to high pain intensity, gender differences and good self-reported QoL and psychosocial status were reported. Sociodemographic characteristics (income, smoking, marital status etc.) were not associated with LBP physical factors, apart from age which correlated with physical disability and wellness (r being 0.446 and 0.405, respectively, p< 0.001). Physical factors (particularly pain intensity and location) correlated with lifestyle factors (QoL) and disability (r ranging between 0.396 and 0.543, p< 0.001). Mental wellness, anxiety and depression (as lifestyle factors) were not associated with sociodemographic or physical factors. Physical parameters were amongst the most prevalent characteristics of the Greek sample, thus offering a direction towards a more targeted treatment and rehabilitation planning. Unlike previous literature, most sociodemographic characteristics were not correlated with any LBP physical or lifestyle factors, thus possibly indicating a different socioeconomic background and aetiology domain to that of the usual non-specific LBP spectrum.

Predicting return to work after low back injury using the Psychosocial Risk for Occupational Disability Instrument: a validation study.

PubMed

Schultz, I Z; Crook, J; Berkowitz, J; Milner, R; Meloche, G R

2005-09-01

This paper reports on the predictive validity of a Psychosocial Risk for Occupational Disability Scale in the workers' compensation environment using a paper and pencil version of a previously validated multimethod instrument on a new, subacute sample of workers with low back pain. A cohort longitudinal study design with a randomly selected cohort off work for 4-6 weeks was applied. The questionnaire was completed by 111 eligible workers at 4-6 weeks following injury. Return to work status data at three months was obtained from 100 workers. Sixty-four workers had returned to work (RTW) and 36 had not (NRTW). Stepwise backward elimination resulted in a model with these predictors: Expectations of Recovery, SF-36 Vitality, SF-36 Mental Health, and Waddell Symptoms. The correct classification of RTW/NRTW was 79%, with sensitivity (NRTW) of 61% and specificity (RTW) of 89%. The area under the ROC curve was 84%. New evidence for predictive validity for the Psychosocial Risk-for-Disability Instrument was provided. The instrument can be useful and practical for prediction of return to work outcomes in the subacute stage after low back injury in the workers' compensation context.

Sunlight exposure and sun sensitivity associated with disability progression in multiple sclerosis.

PubMed

D'hooghe, M B; Haentjens, P; Nagels, G; Garmyn, M; De Keyser, J

2012-04-01

Sunlight and vitamin D have been inversely associated with the risk of multiple sclerosis (MS). We investigated sunlight exposure and sun sensitivity in relation to disability progression in MS. We conducted a survey among persons with MS, registered by the Flemish MS society, Belgium, and stratified data according to relapsing-onset and progressive-onset MS. We used Kaplan-Meier survival and Cox proportional hazard regression analyses with time to Expanded Disability Status Scale (EDSS) 6 as outcome measure. Hazard ratios for the time from onset and from birth were calculated for the potentially predictive variables, adjusting for age at onset, gender and immunomodulatory treatment. 704 (51.3%) of the 1372 respondents had reached EDSS 6. In relapsing-onset MS, respondents reporting equal or higher levels of sun exposure than persons of the same age in the last 10 years had a decreased risk of reaching EDSS 6. In progressive-onset MS, increased sun sensitivity was associated with an increased hazard of reaching EDSS 6. The association of higher sun exposure with a better outcome in relapsing-onset MS may be explained by either a protective effect or reverse causality. Mechanisms underlying sun sensitivity might influence progression in progressive-onset MS.

Outcomes of home-based employment service programs for people with disabilities and their related factors--a preliminary study in Taiwan.

PubMed

Lin, Yi-Jiun; Huang, I-Chun; Wang, Yun-Tung

2014-01-01

The aim of this exploratory study is to gain an understanding of the outcomes of home-based employment service programs for people with disabilities and their related factors in Taiwan. This study used survey method to collect 132 questionnaires. Descriptive and two-variable statistics including chi-square (χ(2)), independent sample t-test and analysis of variance were employed. The results found that 36.5% of the subjects improved their employment status and 75.8% of them improved in employability. Educational level and and vocational categories including "web page production", "e-commerce", "internet marketing", "on-line store" and "website set-up and management" were significantly "positively" associated with either of the two outcome indicators - change of employment status and employability. This study is the first evidence-based study about the outcomes of home-based employment service programs and their related factors for people with disabilities in Taiwan. The outcomes of the home-based employment service programs for people with disabilities were presented. Implications for Rehabilitation Home-based rehabilitation for people with disabilities can be effective. A programme of this kind supports participants in improving or gaining employment status as well as developing employability skills. Further consideration should be given to developing cost-effective home-based programmes and evaluating their effectiveness.

76 FR 41756 - Notice of Funds Availability Under the Rural Business Enterprise Grant Program To Provide...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political...

Comparative Policy Brief: Status of Intellectual Disabilities in Nepal

ERIC Educational Resources Information Center

Crishna, Brinda; Prajapati, Surya Bhakta

2008-01-01

In Nepal, the estimates of the prevalence of disabilities vary, and there is sparse information specifically about people with intellectual disabilities (ID). Existing data suggest higher rates of prevalence of ID in the more remote northern area due to use of non-iodized salt, lack of health facilities, and extreme poverty. Superstitious beliefs…

Comparative Policy Brief: Status of Intellectual Disabilities in the Islamic Republic of Iran

ERIC Educational Resources Information Center

Samadi, Sayyed Ali

2008-01-01

In the Islamic Republic of Iran, considerable stigma is attached to the presence of a family member with intellectual disabilities, and even in Iran's new constitution, a word with traditional, negative connotation has been retained to refer to persons with intellectual disabilities. While two government organizations have recently become involved…

Dietary Intake among U.S. Adults with Disability

ERIC Educational Resources Information Center

An, Ruopeng; Chiu, Chung-Yi

2015-01-01

Purpose: Physical, mental, and financial barriers among individuals with disability may limit their access to fruit and vegetable. In this study, we examined the relationship between disability status and vegetable, fruit, and fruit juice intake among U.S. adults aged 18 years and older using a large nationally representative sample. Methods:…

Two-Year Follow-up of the Competitive Employment Status of Graduates with Developmental Disabilities.

ERIC Educational Resources Information Center

Hoisch, Sharon A.; And Others

1992-01-01

This follow-up study of 54 graduates of a California high school career and vocational services program for students with developmental disabilities or learning disabilities found that only 39 percent were in competitive employment and that jobs were predominantly in the food, building, fabrication, and packaging service occupations. Most…

Associations between Adolescent Risk Behaviors and Injury: The Modifying Role of Disability

ERIC Educational Resources Information Center

Raman, Sudha R.; Boyce, William F.; Pickett, William

2009-01-01

Background: Adolescents with disabilities are at risk for poor health outcomes including injury. The objective of this study was to examine if disability status modifies the association between risk behavior and injury among adolescents. Methods: The cross-sectional Health Behavior in School-Aged Children Survey was administered to a…

Implementing Disability Sports in the General Physical Education Curriculum

ERIC Educational Resources Information Center

Davis, Ronald; Rocco-Dillon, Suzanna; Grenier, Michelle; Martinez, David; Aenchbacker, Amy

2012-01-01

The purpose of this article is to offer a theory-to-practice-based approach to promoting equal status for all students in GPE classes by implementing disability sports in the GPE curriculum. Teaching disability sports is an appropriate means of promoting inclusion and establishing a more differentiated and comprehensive GPE curriculum. This…

76 FR 35787 - Updated Trafficking Definition and Supplemental Nutrition Assistance Program (SNAP)-FDPIR Dual...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

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Cognitive Profiles of Mathematical Problem Solving Learning Disability for Different Definitions of Disability

ERIC Educational Resources Information Center

Tolar, Tammy D.; Fuchs, Lynn; Fletcher, Jack M.; Fuchs, Douglas; Hamlett, Carol L.

2016-01-01

Three cohorts of third-grade students (N = 813) were evaluated on achievement, cognitive abilities, and behavioral attention according to contrasting research traditions in defining math learning disability (LD) status: low achievement versus extremely low achievement and IQ-achievement discrepant versus strictly low-achieving LD. We use methods…

National Disability Policy: A Progress Report

ERIC Educational Resources Information Center

National Council on Disability, 2009

2009-01-01

In recent years, the National Council on Disability (NCD) Progress Report has been a retrospective review and analysis of Federal programs for people with disabilities. For this Progress Report, NCD members have chosen to depart from a retrospective approach, and, instead, will focus on the current status of the quality of life of people with…

Once, Sometimes, or Always in Special Education: Mathematics Growth and Achievement Gaps

ERIC Educational Resources Information Center

Schulte, Ann C.; Stevens, Joseph J.

2015-01-01

This study used a statewide longitudinal sample to examine mathematics achievement gaps and growth in students with and without disabilities and to examine the impact of different methods of determining disability group membership on achievement gaps and growth. When disability status was determined on the basis of special education placement each…

A Study of School Leavers with a Physical Disability.

ERIC Educational Resources Information Center

McAndrew, I.

The retrospective study evaluated the postschool adjustment and status of 172 Australian young adults (ages 18 to 28 years), all with some disability of motor function including cerebral palsy, polio, and results of accidents. Structured interviews with the Ss and their parents were used to obtain information on problems imposed by the disability,…

Predictors of Self-Determination in Postsecondary Education for Students with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Shogren, Karrie A.; Wehmeyer, Michael L.; Shaw, Leslie A.; Grigal, Meg; Hart, Debra; Smith, Frank A.; Khamsi, Sheida

2018-01-01

Given the increasing enrollment of students with intellectual and developmental disabilities in postsecondary education and the potential impact of self-determination on postsecondary outcomes, this study analyzed data on the self-determination status of students with intellectual and developmental disabilities completing their first year of a…

Attitudes towards motherhood of women with physical versus psychiatric disabilities.

PubMed

Hasson-Ohayon, Ilanit; Hason-Shaked, Meiran; Silberg, Tamar; Shpigelman, Carmit-Noa; Roe, David

2018-05-16

Women with disabilities may face social negative attitudes with regard to their being mothers. In addition, attitudes toward different disabilities form a hierarchy, with more positive attitudes being displayed toward persons with physical disabilities than toward persons with psychiatric disabilities. Current observational study examined whether the relationship between a woman's type of disability (psychiatric vs. physical) and the social attitude towards her would be moderated by her being presented as a mother. University students (N = 100) filled out the Multidimensional Attitudes Scale Toward Persons With Disabilities and the Social Distance Scale, after reading one of six randomly assigned fictitious vignettes. The vignettes consisted of a woman with a physical disability/a woman with a psychiatric disability/a woman without a disability, who either was or was not a mother. Type of disability was found to have a main effect in some attitude domains, suggesting that attitudes toward women with physical disabilities were better than attitudes towards women with psychiatric disabilities. An interaction between type of disability and motherhood was found for the interpersonal distress subscale of the attitudes scale. It was found that when women had physical disabilities, there was no change in attitude towards them regardless of whether they were presented as mothers or not; However, when the target woman had a psychiatric disability, and she was presented as a mother, negative attitudes were generated towards her. The study demonstrates the existence of a hierarchy of stigmatization and the effect of being a mother on stigmatization. Copyright © 2018 Elsevier Inc. All rights reserved.

College Graduation to Employment in STEM Careers: The Experience of New Graduates at the Intersection of Underrepresented Racial/Ethnic Minority Status and Disability

ERIC Educational Resources Information Center

Hawley, Carolyn E.; McMahon, Brian T.; Cardoso, Elizabeth D.; Fogg, Neeta P.; Harrington, Paul E.; Barbir, Lara A.

2014-01-01

Purpose: To examine the recent labor market indicators of science, technology, engineering, and mathematics (STEM) versus non-STEM college graduates with disabilities. Method: The sample included bachelor of science (B.S.)/B.S.-level college graduates including 1,567,527 with a disability and 32,512,446 without a disability. Data were derived from…

Explaining Low Subjective Well-Being of Persons with Disabilities in Europe: The Impact of Disability, Personal Resources, Participation and Socio-Economic Status

ERIC Educational Resources Information Center

van Campen, Cretien; van Santvoort, Marc

2013-01-01

Persons with chronic disabilities report the lowest subjective well-being (SWB) in many countries. The gap in SWB compared with the non-disabled population is smaller in some countries than in others. Data from the European Social Survey were analysed in order to: (1) describe the inequality in SWB in 21 European countries; and (2) identify the…

Predictors of Obesity in a US Sample of High School Adolescents With and Without Disabilities.

PubMed

Papas, Mia A; Trabulsi, Jillian C; Axe, Michelle; Rimmer, James H

2016-11-01

Childhood obesity is a major public health concern. Children with disabilities have a higher prevalence of obesity. We examined factors associated with obesity within a cross-sectional study of US adolescents with and without disabilities. Data were obtained from the 2011 Youth Risk Behavior Survey. Logistic regression models were fitted to assess effects of dietary habits, physical activity, and unhealthy weight control behaviors on obesity. Effect modification by disability status was examined. Twenty percent (1986 of 9775 participants) reported a disability. Adolescents with disabilities were more likely to be obese (odds ratio [OR] = 1.7; 95% confidence interval [CI]: 1.3-2.1) and have at least 1 unhealthy weight control behavior (OR = 2.0; 95% CI: 1.6-2.5), and were less likely to be physically active (OR = 0.5; 95% CI: 0.4-0.6). Lack of physical activity, increased television watching/video game playing, and unhealthy weight loss behaviors were significantly associated with obesity regardless of disability status (p-for-interaction >.05). Successful obesity interventions should target diet, physical activity, and weight control among adolescents with disabilities. Understanding barriers to healthier diet and physical activity for this population is critical to developing effective obesity prevention programs and reducing the prevalence of unhealthy weight control behaviors. © 2016, American School Health Association.

Use of Emergency Departments among Working Age Adults with Disabilities: A Problem of Access and Service Needs

PubMed Central

Rasch, Elizabeth K; Gulley, Stephen P; Chan, Leighton

2013-01-01

Objective To examine the relationship between emergency department (ED) use and access to medical care and prescription medications among working age Americans with disabilities. Data Source Pooled data from the 2006–2008 Medical Expenditure Panel Survey (MEPS), a U.S. health survey representative of community-dwelling civilians. Study Design We compared the health and service utilization of two groups of people with disabilities to a contrast group without disability. We modeled ED visits on the basis of disability status, measures of health and health conditions, access to care, and sociodemographics. Data Extraction These variables were aggregated from the household component, the medical condition, and event files to provide average annual estimates for the period spanning 2006–2008. Principal Findings People with disabilities accounted for almost 40 percent of the annual visits made to U.S. EDs each year. Three key factors affect their ED use: access to regular medical care (including prescription medications), disability status, and the complexity of individuals’ health profiles. Conclusions Given the volume of health conditions among people with disabilities, the ED will always play a role in their care. However, some ED visits could potentially be avoided if ongoing care were optimized. PMID:23278461