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Sample records for personal injury claims

  1. 25 CFR 1000.279 - Is FTCA the exclusive remedy for a tort claim, including a claim concerning personal injury or...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... a claim concerning personal injury or death, resulting from the performance of a self-governance AFA... AFA? Yes, except as explained in § 1000.272(b). No claim may be filed against a self-governance Tribe/Consortium or employee based upon performance of functions under a self-governance AFA. All claims shall...

  2. 25 CFR 1000.279 - Is FTCA the exclusive remedy for a tort claim, including a claim concerning personal injury or...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... a claim concerning personal injury or death, resulting from the performance of a self-governance AFA... AFA? Yes, except as explained in § 1000.272(b). No claim may be filed against a self-governance Tribe/Consortium or employee based upon performance of functions under a self-governance AFA. All claims shall...

  3. 25 CFR 1000.279 - Is FTCA the exclusive remedy for a tort claim, including a claim concerning personal injury or...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... a claim concerning personal injury or death, resulting from the performance of a self-governance AFA... AFA? Yes, except as explained in § 1000.272(b). No claim may be filed against a self-governance Tribe/Consortium or employee based upon performance of functions under a self-governance AFA. All claims shall...

  4. 25 CFR 1000.279 - Is FTCA the exclusive remedy for a tort claim, including a claim concerning personal injury or...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... a claim concerning personal injury or death, resulting from the performance of a self-governance AFA... AFA? Yes, except as explained in § 1000.272(b). No claim may be filed against a self-governance Tribe/Consortium or employee based upon performance of functions under a self-governance AFA. All claims shall...

  5. 25 CFR 1000.279 - Is FTCA the exclusive remedy for a tort claim, including a claim concerning personal injury or...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... a claim concerning personal injury or death, resulting from the performance of a self-governance AFA... AFA? Yes, except as explained in § 1000.272(b). No claim may be filed against a self-governance Tribe/Consortium or employee based upon performance of functions under a self-governance AFA. All claims shall...

  6. 25 CFR 900.190 - Is FTCA the exclusive remedy for a tort claim for personal injury or death resulting from the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Is FTCA the exclusive remedy for a tort claim for... ASSISTANCE ACT Federal Tort Claims Act Coverage General Provisions Medical-Related Claims § 900.190 Is FTCA the exclusive remedy for a tort claim for personal injury or death resulting from the performance of a...

  7. 29 CFR 100.401 - Claims under the Federal Tort Claims Act for loss of or damage to property or for personal injury...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Claims under the Federal Tort Claims Act for loss of or... Labor NATIONAL LABOR RELATIONS BOARD ADMINISTRATIVE REGULATIONS Claims Under the Federal Tort Claims Act § 100.401 Claims under the Federal Tort Claims Act for loss of or damage to property or for personal...

  8. 78 FR 47153 - Claims Under the Federal Tort Claims Act for Loss of or Damage to Property or for Personal Injury...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-05

    ... Part 1076 Claims Under the Federal Tort Claims Act for Loss of or Damage to Property or for Personal... unless it displays a currently valid OMB control number. List of Subjects in 12 CFR Part 1076 Claims... part 1076 to read as follows: CHAPTER X--BUREAU OF CONSUMER FINANCIAL PROTECTION PART 1076--CLAIMS...

  9. 25 CFR 900.190 - Is FTCA the exclusive remedy for a tort claim for personal injury or death resulting from the...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... personal injury or death resulting from the performance of a self-determination contract? 900.190 Section..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION... self-determination contract? Yes, except as explained in § 900.183(b). No claim may be filed against...

  10. 46 CFR 327.27 - Proof of amount claimed for personal injury.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... bears the costs thereof. (c) All hospital records or other medical documents from either this injury or... pay or weekly salary; (5) Time lost from work as a result of the incident; and (6) Claimant's actual...

  11. 76 FR 52580 - Procedures To Adjudicate Claims for Personal Injury or Property Damage Arising Out of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... Operation of the U.S. Postal Service AGENCY: Postal Service. ACTION: Final rule. SUMMARY: This rule amends the Postal Service's regulations concerning tort claims to update the mailing address of the National... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE 39 CFR Part...

  12. Women's rugby league injury claims and costs in New Zealand.

    PubMed

    King, D A; Hume, P A; Milburn, P; Gianotti, S

    2010-11-01

    There is scarce information on rugby league injuries in female players. This paper provides an overview of the epidemiology of women's rugby league injuries requiring medical treatment and associated costs in New Zealand. New Zealand Accident Compensation Corporation injury data for the period 1999-2007 were searched for rugby league injury cases occurring in females. Data were analysed by demographics, body region, nature/severity of injury, and medical procedure and costs. There were 320 moderate to serious injury claims recorded for females participating in rugby league activities over the study period. There was a mean (SD) of 37.9 (9.5) injury claims per year. The mean cost per year for the study period was $196 514 ($99,133) (£76,066 (£38,374)) with half of the injury claims occurring in New Zealand Maori. Concussion/brain injuries accounted for 3.8% of total female moderate to serious injury claims but accounted for 5.4% of female injury costs ($84,399 (£32,688)) with the highest mean cost per claim ($7033 (£2724)). The lower limb accounted for 65% of the total female injury claims and 58.7% of total injury costs ($922,296 (£356,968)). The mean cost per claim was higher for the lower limb ($4434 (£1714)) than the upper ($3331 (£1288)) limb. Clerks recorded 16.3% of the total injury claims, 20.3% of total injury costs ($319,474 (£123,211)) and had the highest mean cost per claim ($6144 (£2370)). The 25-29 age group recorded 31.9% of injury claims and 33.8% of injury costs. The 35-39 age group recorded the highest mean cost per claim ($6200 (£2392)) but only 10.9% of total claims and 13.8% of total costs. When compared with other studies in rugby league injuries, it appears that females incur substantially fewer injuries (5.7%) than males (94.3%). Although no participation data by sex are available, it is likely that participation percentages are reflected in the injury percentages. The high frequency (65%) and cost proportion (58.7%) for lower limb

  13. 19 CFR 191.28 - Person entitled to claim drawback.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Person entitled to claim drawback. 191.28 Section... OF THE TREASURY (CONTINUED) DRAWBACK Manufacturing Drawback § 191.28 Person entitled to claim drawback. The exporter (or destroyer) shall be entitled to claim drawback, unless the exporter (or...

  14. 46 CFR 310.9 - Medical attention and injury claims.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Medical attention and injury claims. 310.9 Section 310.9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRAINING MERCHANT MARINE TRAINING... Medical attention and injury claims. (a) Medical attention and hospitalization. The school shall be...

  15. 19 CFR 191.186 - Person entitled to claim drawback.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Person entitled to claim drawback. 191.186 Section... OF THE TREASURY (CONTINUED) DRAWBACK Merchandise Transferred to a Foreign Trade Zone From Customs Territory § 191.186 Person entitled to claim drawback. The person named in the foreign trade zone operator's...

  16. PERSONALITY CHANGES IN BRAIN INJURY

    PubMed Central

    Garcia, Patricia Gracia; Mielke, Michelle M.; Rosenberg, Paul; Bergey, Alyssa; Rao, Vani

    2011-01-01

    Traumatic brain injury (TBI) is frequently complicated by alterations in mood and behaviour and changes in personality. We report mild personality changes post-TBI as a possible indicator of traumatic brain injury, but not of injury severity or psychiatric complications. PMID:21677207

  17. 19 CFR 191.82 - Person entitled to claim drawback.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Person entitled to claim drawback. 191.82 Section... OF THE TREASURY (CONTINUED) DRAWBACK Liquidation and Protest of Drawback Entries § 191.82 Person entitled to claim drawback. Unless otherwise provided in this part (see §§ 191.42(b), 191.162, 191.175(a...

  18. 19 CFR 191.33 - Person entitled to claim drawback.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Person entitled to claim drawback. 191.33 Section... OF THE TREASURY (CONTINUED) DRAWBACK Unused Merchandise Drawback § 191.33 Person entitled to claim drawback. (a) Direct identification. (1) Under 19 U.S.C. 1313(j)(1), the exporter (or destroyer) shall be...

  19. 25 CFR 900.190 - Is FTCA the exclusive remedy for a tort claim for personal injury or death resulting from the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 900.190 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION... psychologists and social workers. All such claims shall be filed against the United States and are subject...

  20. The Assessment of Emotional Distress in Personal Injury Litigation.

    ERIC Educational Resources Information Center

    Smith, Brent Roderick

    This document asserts that civil litigation of personal injury claims involving emotional distress is commonplace in American society today. It recognizes that expert witness testimony often plays a key role in the rewarding or denial of damages in such claims and that the psychologist's role as an expert witness in such matters entails unique…

  1. Effects of injury severity and cognitive exaggeration on olfactory deficits in head injury compensation claims.

    PubMed

    Green, P; Iverson, G L

    2001-01-01

    The purpose of this study was to examine the relationship between exaggeration and scores on a test of olfactory discrimination in patients being assessed in connection with a claim for financial benefits. Participants were 448 patients referred to a private practice in Edmonton, Alberta, Canada for psychological or neuropsychological assessment, related to evaluation of impairment and disability resulting from a work-related or non-work related accident. All patients were involved in some form of compensation claim at the time of their evaluation. All patients completed two tests designed to detect exaggerated cognitive deficits, the Computerized Assessment of Response Bias (CARB) and the Word Memory Test (WMT) as part of their evaluation. The diagnostic groups included 322 head injury cases, varying from very minor to very severe. Normative data for the smell test were derived from 126 patients with orthopedic injuries who passed both the CARB and the WMT. Patients with more severe traumatic brain injuries were 10-12 times more likely to have olfactory deficits than persons with trivial to mild head injuries. In a subgroup of patients who failed either the CARB or the WMT, there was no relationship between injury severity and total scores on the smell test. Therefore, the dose-response relationship between brain injury severity and olfactory deficits is severely attenuated when patients who are probably exaggerating their cognitive deficits are included in the analyses. Those patients with trivial to mild head injuries who demonstrated adequate effort on both the CARB and the WMT were no more likely to show olfactory deficits than the non-head-injured orthopedic control subjects. Therefore, anosmia following mild traumatic brain injury should not be concluded from self-reports or from tests of smell unless tests of effort have been passed. Effort should also be controlled in group studies of olfaction.

  2. 45 CFR 505.1 - Persons eligible to file claims.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED PROVISIONS OF GENERAL APPLICATION § 505.1 Persons... sections 5(i) and 6(f) of the War Claims Act of 1948, as amended, are: (a) Civilian American citizens... the Act; and (b) Members of the Armed Forces of the United States held as prisoners of war during...

  3. 45 CFR 505.1 - Persons eligible to file claims.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED PROVISIONS OF GENERAL APPLICATION § 505.1 Persons... sections 5(i) and 6(f) of the War Claims Act of 1948, as amended, are: (a) Civilian American citizens... the Act; and (b) Members of the Armed Forces of the United States held as prisoners of war during...

  4. 45 CFR 505.1 - Persons eligible to file claims.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED PROVISIONS OF GENERAL APPLICATION § 505.1 Persons... sections 5(i) and 6(f) of the War Claims Act of 1948, as amended, are: (a) Civilian American citizens... the Act; and (b) Members of the Armed Forces of the United States held as prisoners of war during...

  5. 45 CFR 505.1 - Persons eligible to file claims.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED PROVISIONS OF GENERAL APPLICATION § 505.1 Persons... sections 5(i) and 6(f) of the War Claims Act of 1948, as amended, are: (a) Civilian American citizens... the Act; and (b) Members of the Armed Forces of the United States held as prisoners of war during...

  6. 45 CFR 505.1 - Persons eligible to file claims.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED PROVISIONS OF GENERAL APPLICATION § 505.1 Persons... sections 5(i) and 6(f) of the War Claims Act of 1948, as amended, are: (a) Civilian American citizens... the Act; and (b) Members of the Armed Forces of the United States held as prisoners of war during...

  7. Injury Scheme Claims in Gaelic Games: A Review of 2007-2014.

    PubMed

    Roe, Mark; Blake, Catherine; Gissane, Conor; Collins, Kieran

    2016-04-01

    Gaelic games (Gaelic football and hurling) are indigenous Irish sports with increasing global participation in recent years. Limited information is available on longitudinal injury trends. Reviews of insurance claims can reveal the economic burden of injury and guide cost-effective injury-prevention programs. To review Gaelic games injury claims from 2007-2014 for male players to identify the costs and frequencies of claims. Particular attention was devoted to lower limb injuries due to findings from previous epidemiologic investigations of Gaelic games. Descriptive epidemiology study. Open-access Gaelic Athletic Association Annual Reports from 2007-2014 were reviewed to obtain annual injury-claim data. Gaelic Athletic Association players. Player age (youth or adult) and relationships between lower limb injury-claim rates and claim values, Gaelic football claims, hurling claims, youth claims, and adult claims. Between 2007 and 2014, €64 733 597.00 was allocated to 58 038 claims. Registered teams had annual claim frequencies of 0.36 with average claim values of €1158.4 ± 192.81. Between 2007 and 2014, average adult claims were always greater than youth claims (6217.88 versus 1036.88), while Gaelic football claims were always greater than hurling claims (5395.38 versus 1859.38). Lower limb injuries represented 60% of all claims. The number of lower limb injury claims was significantly correlated with annual injury-claim expenses (r = 0.85, P = .01) and adult claims (r = 0.96, P = .01) but not with youth claims (r = 0.69, P = .06). Reducing lower limb injuries will likely reduce injury-claim expenses. Effective injury interventions have been validated in soccer, but whether such changes can be replicated in Gaelic games remains to be investigated. Injury-claim data should be integrated into current elite injury-surveillance databases to monitor the cost effectiveness of current programs.

  8. Evaluation of a complex, population-based injury claims management intervention for improving injury outcomes: study protocol

    PubMed Central

    Collie, Alex; Gabbe, Belinda; Fitzharris, Michael

    2015-01-01

    Introduction Injuries resulting from road traffic crashes are a substantial cause of disability and death worldwide. Injured persons receiving compensation have poorer recovery and return to work than those with non-compensable injury. Case or claims management is a critical component of injury compensation systems, and there is now evidence that claims management can have powerful positive impacts on recovery, but can also impede recovery or exacerbate mental health concerns in some injured people. This study seeks to evaluate the impact of a population-based injury claims management intervention in the State of Victoria, Australia, on the health of those injured in motor vehicle crashes, their experience of the compensation process, and the financial viability of the compensation system. Methods and analysis Evaluation of this complex intervention involves a series of linked but stand-alone research projects to assess the anticipated process changes, impacts and outcomes of the intervention over a 5-year time frame. Linkage and analysis of routine administrative and health system data is supplemented with a series of primary studies collecting new information. Additionally, a series of ‘action’ research projects will be undertaken to inform the implementation of the intervention. A program logic model designed by the state government Transport Accident Commission in conjunction with the research team provides the evaluation framework. Ethics and dissemination Relatively few studies have comprehensively examined the impact of compensation system processes on the health of injured persons, their satisfaction with systems processes, and impacts on the financial performance of the compensation scheme itself. The wholesale, population-based transformation of an injury claims management model is a rare opportunity to document impacts of system-level policy change on outcomes of injured persons. Findings will contribute to the evidence base of information on the

  9. 14 CFR 1261.302 - Claim.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.302 Claim. Unless the context otherwise requires, claim means... injury or loss of property, or personal injury or death. A claim “arises” at the place where the...

  10. 14 CFR 1261.302 - Claim.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.302 Claim. Unless the context otherwise requires, claim means... injury or loss of property, or personal injury or death. A claim “arises” at the place where the...

  11. 14 CFR 1261.302 - Claim.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.302 Claim. Unless the context otherwise requires, claim means... injury or loss of property, or personal injury or death. A claim “arises” at the place where the...

  12. 14 CFR 1261.302 - Claim.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.302 Claim. Unless the context otherwise requires, claim means a claim for... property, or personal injury or death. A claim “arises” at the place where the injury, loss, or...

  13. 14 CFR § 1261.302 - Claim.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.302 Claim. Unless the context otherwise requires, claim means... injury or loss of property, or personal injury or death. A claim “arises” at the place where the...

  14. 76 FR 73021 - Agency Information Collection (Report of Accidental Injury in Support of Claim for Compensation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... Injury in Support of Claim for Compensation or Pension/Statement of Witness to Accident, VA Form 21- 4176...: VA Form 21-4176 is used to support a claim for disability benefits based on an accidental injury that... AFFAIRS Agency Information Collection (Report of Accidental Injury in Support of Claim for Compensation or...

  15. Claims of psychiatric injury after alleged false arrest.

    PubMed

    Perr, I N

    1988-01-01

    Litigation has increased rapidly in the United States; those who feel aggrieved sue readily for damages. Police officers and security people may be sued after arrests or detention followed by unsuccessful prosecution or dropping of criminal charges. Claims of psychiatric injury may be made where there are no discernible damages otherwise. Examiners must keep in mind that physical abuse or grossly inappropriate police behavior may be factors in the ultimate results. This paper reviews 13 cases of claimed psychiatric injury after arrest. Almost all were settled, some for significant amounts. Appropriateness of evaluation, the value of nuisance suits in this type of litigation, the role of attorneys' fees, and the effect of Federal suits as opposed to state suits are discussed.

  16. Trends in Personal Injury Suits.

    ERIC Educational Resources Information Center

    van der Smissen, Betty

    1985-01-01

    Professional competence becomes more important as personal injury suits against recreation enterprises and parks focus increasingly on the professional responsible for facility safety. All professionals should be aware of and educated in risk management. Trends in liability awards and providers' legal responsibilities in various situations are…

  17. Trends in Personal Injury Suits.

    ERIC Educational Resources Information Center

    van der Smissen, Betty

    1985-01-01

    Professional competence becomes more important as personal injury suits against recreation enterprises and parks focus increasingly on the professional responsible for facility safety. All professionals should be aware of and educated in risk management. Trends in liability awards and providers' legal responsibilities in various situations are…

  18. Injury Scheme Claims in Gaelic Games: A Review of 2007–2014

    PubMed Central

    Roe, Mark; Blake, Catherine; Gissane, Conor; Collins, Kieran

    2016-01-01

    Context:  Gaelic games (Gaelic football and hurling) are indigenous Irish sports with increasing global participation in recent years. Limited information is available on longitudinal injury trends. Reviews of insurance claims can reveal the economic burden of injury and guide cost-effective injury-prevention programs. Objective:  To review Gaelic games injury claims from 2007–2014 for male players to identify the costs and frequencies of claims. Particular attention was devoted to lower limb injuries due to findings from previous epidemiologic investigations of Gaelic games. Design:  Descriptive epidemiology study. Setting:  Open-access Gaelic Athletic Association Annual Reports from 2007–2014 were reviewed to obtain annual injury-claim data. Patients or Other Participants:  Gaelic Athletic Association players. Main Outcome Measure(s):  Player age (youth or adult) and relationships between lower limb injury-claim rates and claim values, Gaelic football claims, hurling claims, youth claims, and adult claims. Results:  Between 2007 and 2014, €64 733 597.00 was allocated to 58 038 claims. Registered teams had annual claim frequencies of 0.36 with average claim values of €1158.4 ± 192.81. Between 2007 and 2014, average adult claims were always greater than youth claims (6217.88 versus 1036.88), while Gaelic football claims were always greater than hurling claims (5395.38 versus 1859.38). Lower limb injuries represented 60% of all claims. The number of lower limb injury claims was significantly correlated with annual injury-claim expenses (r = 0.85, P = .01) and adult claims (r = 0.96, P = .01) but not with youth claims (r = 0.69, P = .06). Conclusions:  Reducing lower limb injuries will likely reduce injury-claim expenses. Effective injury interventions have been validated in soccer, but whether such changes can be replicated in Gaelic games remains to be investigated. Injury-claim data should be integrated into current elite injury

  19. Nature of Injury and Risk of Multiple Claims Among Workers in Manitoba Health Care.

    PubMed

    Oranye, Nelson Ositadimma

    2017-09-01

    In industrial societies, work-related musculoskeletal disorders are common among workers, frequently resulting in recurrent injuries, work disability, and multiple compensation claims. The risk of idiopathic musculoskeletal injuries is thought to be more than twice the risk of any other health problem among workers in the health care sector. This risk is highly prevalent particularly among workers whose job involves frequent physical tasks, such as patient lifting and transfer. Workers with recurrent occupational injuries are likely to submit multiple work disability claims and progress to long-term disability. The objective of this study was to explore the influence of injury type and worker characteristics on multiple compensation claims, using workers' compensation claims data. This retrospective study analyzed 11 years of secondary claims data for health care workers. Workers' occupational groups were classified based on the nature of physical tasks associated with their jobs, and the nature of work injuries was categorized into non-musculoskeletal, and traumatic and idiopathic musculoskeletal injuries. The result shows that risk of multiple injury claims increased with age, and the odds were highest for older workers aged 55 to 64 (odds ratio [OR] = 3.5). A large proportion of those who made an injury claim made multiple claims that resulted in more lost time than single injury claims. The study conclusion is that the nature of injury and work tasks are probably more significant risk factors for multiple claims than worker characteristics.

  20. 76 FR 58566 - Proposed Information Collection (Report of Accidental Injury in Support of Claim for Compensation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... techniques or the use of other forms of information technology. Title: Report of Accidental Injury in Support... AFFAIRS Proposed Information Collection (Report of Accidental Injury in Support of Claim for Compensation... needed to support a claim for disability benefits based on an accidental injury. DATES: Written comments...

  1. Distribution and characteristics of occupational injuries and diseases among farmers: a retrospective analysis of workers' compensation claims.

    PubMed

    Karttunen, Janne P; Rautiainen, Risto H

    2013-08-01

    Research indicates occupational injuries and diseases are not evenly distributed among workers. We investigated the distribution and characteristics of compensated occupational injuries and diseases requiring medical care in the Finnish farming population. The study population consisted of 93,564 Finnish farmers, spouses, and salaried family members who were covered by the mandatory workers' compensation insurance in 2002. This population had a total of 133,207 occupational injuries and 9,148 occupational diseases over a 26-year period (1982-2008). Clustering of claims was observed. Nearly half (47.1%) of the population had no compensated claims while 52.9% had at least one; 50.9% of farmers had one or more injuries and 8.1% had one or more diseases. Ten percent of the population had half of injury cases, and 3% of the population had half of occupational disease cases. Claims frequently involved work tasks related to animal husbandry and repair and maintenance of farm machinery. Injury and disease characteristics (work activity, cause, ICD-10 code) differed between individuals with high and low personal claim rate. Injuries and diseases of the musculoskeletal system had a tendency to reoccur among those with high claim rate. These outcomes were often related to strenuous working motions and postures in labor-intensive animal husbandry. Analyses of longitudinal insurance data contributes to better understanding of the long-term risk of occupational injury and disease among farmers. We suggest focusing on recurrent health outcomes and their causes among high risk populations could help design more effective interventions in agriculture and other industries. Copyright © 2013 Wiley Periodicals, Inc.

  2. Rugby league injuries in New Zealand: a review of 8 years of Accident Compensation Corporation injury entitlement claims and costs.

    PubMed

    King, D A; Hume, P A; Milburn, P; Gianotti, S

    2009-08-01

    This paper provides an overview of the epidemiology of rugby league injuries and associated costs in New Zealand requiring medical treatment. New Zealand national Accident Compensation Corporation injury data for the period 1999 to 2007 were searched for rugby league injury cases. Data were analysed by demographics, body region, nature/severity of injury, and medical procedure and costs. A total of 5941 injury entitlement claims were recorded over the study period with a significant decrease observed in the injury rate between the 1999-2000 and 2002-2003 reporting years. The total cost of the injuries for the study period was $42,822,048 (equivalent to pound15,916,072). The mean (SD) number of injury entitlement claims per year was 743 (271) and yearly cost was $5,352,760 (pound1,989,880) ($2,485,535 (pound923,994)). The knee was the most commonly reported injury site (225 per 1000 entitlement claims; $8,750,147 (pound3,252,020)) and soft tissue injuries were the most common injury types (474 per 1000 entitlement claims; $17,324,214 (pound6,438,599)). Accounting for only 1.8% of total injury entitlement claims, concussion/brain injuries accounted for 6.3% of injury entitlement costs and had the highest mean cost per claim ($25 347 (pound9420)). The upper and lower arm recorded the highest mean injury site claim cost of $43,096 (pound16,016) per claim. The 25-29 age group recorded 27.7% of total injury entitlement claims and 29.6% of total injury entitlement costs, which was slightly more than the 20-24 age group (27.3% claims; 24.7% costs). Nearly 15% of total moderate to serious injury entitlement claims and 20% of total costs were recorded from participants 35 years or older. This study identified that the knee was the most common injury site and soft tissue injuries were the most common injury type requiring medical treatment, which is consistent with other international studies on rugby league epidemiology. This study also highlights that the rate of injury and

  3. Severe and fatal obstetric injury claims in relation to labor unit volume.

    PubMed

    Milland, Maria; Mikkelsen, Kim L; Christoffersen, Jens K; Hedegaard, Morten

    2015-05-01

    To assess possible association between the incidence of approved claims for severe and fatal obstetric injuries and delivery volume in Denmark. A nationwide panel study of labor units. Claimants seeking financial compensation due to injuries occurring in labor units in 1995-2012. Exposure information regarding the annual number of deliveries per labor unit was retrieved from the Danish National Birth Register. Outcome information was retrieved from the Danish Patient Compensation Association. Exposure was categorized in delivery volume quintiles as annual volume per labor unit: (10-1377), (1378-2016), (2017-2801), (2802-3861), (3862-6659). Five primary measures of outcome were used. Incidence rate ratios of (A) Submitted claims, (B) Approved claims, (C) Approved severe injury claims (120% degree of disability), (D) Approved fatal injury claims, and (C+D) Combined. 1 151 734 deliveries in 51 labor units and 1872 submitted claims were included. The incidence rate ratios of approved claims overall, of approved fatal injury claims, and of approved severe and fatal injuries combined increased significantly with decreasing annual delivery volume. Face value incidence rate ratios of approved severe injuries increased with decreasing labor unit volume, but the association did not reach statistical significance. High volume labor units appear associated with fewer approved and fewer fatal injury claims compared with units with less volume. The findings support the development towards consolidation of units in Denmark. A suggested option would be to tailor obstetric patient safety initiatives according to the delivery volume of individual labor units. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Patient injuries from anesthesia gas delivery equipment: a closed claims update.

    PubMed

    Mehta, Sonya P; Eisenkraft, James B; Posner, Karen L; Domino, Karen B

    2013-10-01

    Improvements in anesthesia gas delivery equipment and provider training may increase patient safety. The authors analyzed patient injuries related to gas delivery equipment claims from the American Society of Anesthesiologists Closed Claims Project database over the decades from 1970s to the 2000s. After the Institutional Review Board approval, the authors reviewed the Closed Claims Project database of 9,806 total claims. Inclusion criteria were general anesthesia for surgical or obstetric anesthesia care (n = 6,022). Anesthesia gas delivery equipment was defined as any device used to convey gas to or from (but not involving) the airway management device. Claims related to anesthesia gas delivery equipment were compared between time periods by chi-square test, Fisher exact test, and Mann-Whitney U test. Anesthesia gas delivery claims decreased over the decades (P < 0.001) to 1% of claims in the 2000s. Outcomes in claims from 1990 to 2011 (n = 40) were less severe, with a greater proportion of awareness (n = 9, 23%; P = 0.003) and pneumothorax (n = 7, 18%; P = 0.047). Severe injuries (death/permanent brain damage) occurred in supplemental oxygen supply events outside the operating room, breathing circuit events, or ventilator mishaps. The majority (85%) of claims involved provider error with (n = 7) or without (n = 27) equipment failure. Thirty-five percent of claims were judged as preventable by preanesthesia machine check. Gas delivery equipment claims in the Closed Claims Project database decreased in 1990-2011 compared with earlier decades. Provider error contributed to severe injury, especially with inadequate alarms, improvised oxygen delivery systems, and misdiagnosis or treatment of breathing circuit events.

  5. 27 CFR 70.505 - Requirements on persons intending to file claim.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... on Distilled Spirits, Wines, and Beer General § 70.505 Requirements on persons intending to file... claim, as provided in § 70.506, and (b) Comply with any other provisions of law or regulations which...

  6. 27 CFR 70.505 - Requirements on persons intending to file claim.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... on Distilled Spirits, Wines, and Beer General § 70.505 Requirements on persons intending to file... claim, as provided in § 70.506, and (b) Comply with any other provisions of law or regulations which...

  7. 27 CFR 70.505 - Requirements on persons intending to file claim.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... on Distilled Spirits, Wines, and Beer General § 70.505 Requirements on persons intending to file... claim, as provided in § 70.506, and (b) Comply with any other provisions of law or regulations which...

  8. 27 CFR 70.505 - Requirements on persons intending to file claim.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... on Distilled Spirits, Wines, and Beer General § 70.505 Requirements on persons intending to file... claim, as provided in § 70.506, and (b) Comply with any other provisions of law or regulations which...

  9. 27 CFR 70.505 - Requirements on persons intending to file claim.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... on Distilled Spirits, Wines, and Beer General § 70.505 Requirements on persons intending to file... claim, as provided in § 70.506, and (b) Comply with any other provisions of law or regulations which...

  10. 46 CFR 310.9 - Medical attention and injury claims.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... responsible for arranging that a medical officer shall be attached or on call to the school. During the cruise, the School shall assign a medical officer to the Training Ship. (b) Compensation claims of Cadets or... the Training Ship may avail themselves of any medical facilities furnished by the State or...

  11. 46 CFR 310.9 - Medical attention and injury claims.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... responsible for arranging that a medical officer shall be attached or on call to the school. During the cruise, the School shall assign a medical officer to the Training Ship. (b) Compensation claims of Cadets or... the Training Ship may avail themselves of any medical facilities furnished by the State or...

  12. 46 CFR 310.9 - Medical attention and injury claims.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... responsible for arranging that a medical officer shall be attached or on call to the school. During the cruise, the School shall assign a medical officer to the Training Ship. (b) Compensation claims of Cadets or... the Training Ship may avail themselves of any medical facilities furnished by the State or...

  13. Risk factors for injuries associated with damage claims following groin hernia repair.

    PubMed

    Nordin, P; Ahlberg, J; Johansson, H; Holmberg, H; Hafström, L

    2017-04-01

    Surgical repair of groin hernia should be carried out with minimal complication rates, and it is important to have regular quality control and accurate means of assessment. The Swedish healthcare system has a mutual insurance company (LÖF) that receives claims from patients who have suffered healthcare-related damage or malpractice. The Swedish Hernia Register (SHR) currently covers around 98% of all Swedish groin hernia operations. The aim of this study was to analyse damage claims following groin hernia repair surgery and link these with entries in the SHR, in order to identify risk factors and causes of injuries and malpractice associated with hernia repair. Data on all 48,574 groin hernia operations registered in the SHR between 2008 and 2010 were compared and linked with data on claims made to the Swedish National Patient Injury Insurance (LÖF). Of the 130 damage claims received by LÖF, 26 dealt with bleeding, 20 with testicular injury and 7 with intestinal lesions. Eighty (62%) of the complications were considered malpractice according to the Swedish Patient Injury Act. Acute and recurrent surgery, sutured repair and general anaesthesia were associated with a significantly increased risk for a damage claim independently the patients were compensated or not. Females filed claims in greater proportion than males. There was no significant difference in background factors between claims accepted by LÖF and compensated and those who were rejected compensation. Risk factors for filing a damage claim included acute surgery, operation for recurrence, sutured repair and general anaesthesia, whereas local anaesthesia reduced the risk.

  14. Unreported workers’ compensation claims to the BLS Survey of Occupational Injuries and Illnesses: Establishment factors

    PubMed Central

    Adams, Darrin A.; Bonauto, David K.

    2016-01-01

    Background Studies suggest employers underreport injuries to the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII); less is known about reporting differences by establishment characteristics. Methods We linked SOII data to Washington State workers’ compensation claims data, using unemployment insurance data to improve linking accuracy. We used multivariable regression models to estimate incidence ratios (IR) of unreported workers’ compensation claims for establishment characteristics. Results An estimated 70% of workers’ compensation claims were reported in SOII. Claims among state and local government establishments were most likely to be reported. Compared to large manufacturing establishments, unreported claims were most common among small educational services establishments (IR = 2.47, 95%CI: 1.52–4.01) and large construction establishments (IR = 2.05, 95%CI: 1.77–2.37). Conclusions Underreporting of workers’ compensation claims to SOII varies by establishment characteristics, obscuring true differences in work injury incidence. Findings may differ from previous research due to differences in study methods. Am. J. Ind. Med. 59:274–289, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26792563

  15. 32 CFR 842.18 - Claims not payable.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ADMINISTRATIVE CLAIMS Claims Under Article 139, Uniform Code of Military Justice (UCMJ) (10 U.S.C. 939) § 842.18...) Claims for personal injury or death. (c) Claims resulting from acts or omissions of Air Force military... private indebtedness. (f) Claims for reimbursement for bad checks....

  16. 32 CFR 842.18 - Claims not payable.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ADMINISTRATIVE CLAIMS Claims Under Article 139, Uniform Code of Military Justice (UCMJ) (10 U.S.C. 939) § 842.18...) Claims for personal injury or death. (c) Claims resulting from acts or omissions of Air Force military... private indebtedness. (f) Claims for reimbursement for bad checks....

  17. 25 CFR 900.200 - May persons who are not Indians or Alaska Natives assert claims under FTCA?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false May persons who are not Indians or Alaska Natives assert claims under FTCA? 900.200 Section 900.200 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR... Claims § 900.200 May persons who are not Indians or Alaska Natives assert claims under FTCA? Yes. Non...

  18. Consumer understanding, interpretation and perceived levels of personal responsibility in relation to satiety-related claims.

    PubMed

    Bilman, Els M; Kleef, Ellen van; Mela, David J; Hulshof, Toine; van Trijp, Hans C M

    2012-12-01

    The aim of this study was to explore (a) whether and how consumers may (over-) interpret satiety claims, and (b) whether and to what extent consumers recognize that personal efforts are required to realize possible satiety-related or weight loss benefits. Following means-end chain theory, we explored for a number of satiety claims the extent of inference-making to higher-level benefits than actually stated in the claim, using internet-based questions and tasks. Respondents (N=1504) in U.K., France, Italy and Germany participated in the study. The majority of these respondents correctly interpret satiety-related claims; i.e. they largely limit their interpretation to what was actually stated. They do not expect a "magic bullet" effect, but understand that personal efforts are required to translate product attributes into potential weight control benefits. Less-restrained eaters were at lower risk for over-interpreting satiety-related claims, whilst respondents with a stronger belief that their weight is something that they can control accept more personal responsibility, and better understand that personal efforts are required to be effective in weight control. Overall, these results indicate there is likely to be a relatively low level of consumer misinterpretation of satiety-related claims on food products.

  19. 45 CFR 35.2 - Administrative claim; when presented; place of filing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... a claim for money damages in a sum certain for damage to or loss of property, for personal injury... claim, the Department shall have 6 months in which to make a final disposition of the claim as amended...

  20. An analysis of injury claims from low-seam coal mines

    SciTech Connect

    Gallagher, S.; Moore, S.; Dempsey, P.G.

    2009-07-01

    The restricted workspace present in low-seam coal mines forces workers to adopt awkward working postures (kneeling and stooping), which place high physical demands on the knee and lower back. This article provides an analysis of injury claims for eight mining companies operating low-seam coal mines during calendar years 1996-2008. All cost data were normalized using data on the cost of medical care (MPI) as provided by the U.S. Bureau of Labor Statistics. Results of the analysis indicate that the knee was the body part that led in terms of claim cost ($4.2 million), followed by injuries to the lower back ($2.7 million). While the average cost per injury for these body parts was $13,100 and $14,400, respectively (close to the average cost of an injury overall), the high frequency of these injuries resulted in their pre-eminence in terms of cost. Analysis of data from individual mining companies suggest that knee and lower back injuries were a consistent problem across companies, as these injuries were each among the top five most costly part of body for seven out of eight companies studied. Results of this investigation suggest that efforts to reduce the frequency of knee and low back injuries in low-seam mines have the potential to create substantial cost savings.

  1. Predictors of sustained return to work after work-related injury or disease: insights from workers' compensation claims records.

    PubMed

    Berecki-Gisolf, Janneke; Clay, Fiona J; Collie, Alex; McClure, Roderick J

    2012-09-01

    After work-related injury or disease, multiple spells of work absences and unsuccessful return to work (RTW) are common. The purpose of this study was to identify predictors of sustained RTW and work disability recurrences. Australian WorkSafe Victoria claims containing income compensation payments starting between January 1st, 2001 and December 31st, 2004 (n = 59,526) were analysed over a 2-year observation window. Time until first RTW and final RTW, and 'recurrences' (cessations of payments of >7 days), were derived from claims payments data. Regression models were used relating demographic, occupational, workplace and injury characteristics to RTW outcomes. Although 94% of claimants had at least one RTW, only 79% achieved sustained RTW during follow-up. Median time until first RTW was 50 days; median time until final RTW was 91 days. Independent predictors of delayed final RTW were older age, afflictions involving the neck or multiple locations, and working in manufacturing. Of those who returned to work, 37% had at least one recurrence: risk factors were ages 35-55, female sex, working as a labourer, working in manufacturing, traumatic joint/ligament or muscle/tendon injury and musculoskeletal and connective tissue diseases, and afflictions involving the neck or multiple locations. Work disability recurrences are common and have considerable impact on sustained RTW outcomes. A policy focus on education about secondary prevention may help improve long-term RTW outcomes, particularly for persons with musculoskeletal disorders and those working in manufacturing.

  2. Etiology of work-related electrical injuries: a narrative analysis of workers' compensation claims.

    PubMed

    Lombardi, David A; Matz, Simon; Brennan, Melanye J; Smith, Gordon S; Courtney, Theodore K

    2009-10-01

    The purpose of this study was to provide new insight into the etiology of primarily nonfatal, work-related electrical injuries. We developed a multistage, case-selection algorithm to identify electrical-related injuries from workers' compensation claims and a customized coding taxonomy to identify pre-injury circumstances. Workers' compensation claims routinely collected over a 1-year period from a large U.S. insurance provider were used to identify electrical-related injuries using an algorithm that evaluated: coded injury cause information, nature of injury, "accident" description, and injury description narratives. Concurrently, a customized coding taxonomy for these narratives was developed to abstract the activity, source, initiating process, mechanism, vector, and voltage. Among the 586,567 reported claims during 2002, electrical-related injuries accounted for 1283 (0.22%) of nonfatal claims and 15 fatalities (1.2% of electrical). Most (72.3%) were male, average age of 36, working in services (33.4%), manufacturing (24.7%), retail trade (17.3%), and construction (7.2%). Body part(s) injured most often were the hands, fingers, or wrist (34.9%); multiple body parts/systems (25.0%); lower/upper arm; elbow; shoulder, and upper extremities (19.2%). The leading activities were conducting manual tasks (55.1%); working with machinery, appliances, or equipment; working with electrical wire; and operating powered or nonpowered hand tools. Primary injury sources were appliances and office equipment (24.4%); wires, cables/cords (18.0%); machines and other equipment (11.8%); fixtures, bulbs, and switches (10.4%); and lightning (4.3%). No vector was identified in 85% of cases. and the work process was initiated by others in less than 1% of cases. Injury narratives provide valuable information to overcome some of the limitations of precoded data, more specially for identifying additional injury cases and in supplementing traditional epidemiologic data for further

  3. Injuries to New Zealanders participating in adventure tourism and adventure sports: an analysis of Accident Compensation Corporation (ACC) claims.

    PubMed

    Bentley, Tim; Macky, Keith; Edwards, Jo

    2006-12-15

    The aim of this study was to examine the involvement of adventure tourism and adventure sports activity in injury claims made to the Accident Compensation Corporation (ACC). Epidemiological analysis of ACC claims for the period, July 2004 to June 2005, where adventure activities were involved in the injury. 18,697 adventure tourism and adventure sports injury claims were identified from the data, representing 28 activity sectors. Injuries were most common during the summer months, and were most frequently located in the major population centres. The majority of injuries were incurred by claimants in the 20-50 years age groups, although claimants over 50 years of age had highest claims costs. Males incurred 60% of all claims. Four activities (horse riding, mountain biking, tramping/hiking, and surfing) were responsible for approximately 60% of all adventure tourism and adventure sports-related injuries. Slips, trips, and falls were the most common injury initiating events, and injuries were most often to the back/spine, shoulder, and knee. These findings suggest the need to investigate whether regulatory intervention in the form of codes of practice for high injury count activities such as horse riding and mountain biking may be necessary. Health promotion messages and education programs should focus on these and other high-injury risk areas. Improved risk management practices are required for commercial adventure tourism and adventure sports operators in New Zealand if safety is to be improved across this sector.

  4. Translating and Transforming Care: People With Brain Injury and Caregivers Filling in a Disability Claim Form.

    PubMed

    Gillespie, Alex; Moore, Helen

    2016-03-01

    This article examines how the Disability Living Allowance claim form, used in the United Kingdom to allocate £13 billion of disability benefits, translates and transforms disability and care. Twenty-two people with acquired brain injury and their main informal caregivers (n = 44) were video-recorded filling in the disability claim form. Participants disagreed on 26% of the questions, revealing two types of problems. Translation problems arose as participants struggled to provide categorical responses to ambiguous questions and were unable to report contextual variability in care needs or divergences of perception. Transformation problems arose as participants resisted the way in which the form positioned them, forcing them to conceptualize their relationship in terms of dependency and burden. The disability claim form co-opts claimants to translate care and disability into bureaucratically predefined categories, and it transforms the care relationship that it purports to document. © The Author(s) 2015.

  5. Frequency and cost of claims by injury type from a state workers' compensation fund from 1998 through 2008.

    PubMed

    Mroz, Tracy M; Carlini, Anthony R; Archer, Kristin R; Wegener, Stephen T; Hoolachan, Jordan I; Stiers, William; Shore, Rebecca A; Castillo, Renan C

    2014-06-01

    To determine which work-related injuries are the most frequent and costly. Secondary analysis of workers' compensation claims data. Data were provided by a large, Maryland workers' compensation insurer from 1998 through 2008. Not applicable. None. For 45 injury types, the number of claims and compensation amount was calculated for total compensation and for medical and indemnity compensation separately. Back and knee injuries were the most frequently occurring single injury types, whereas heart attack and occupational disease were the most expensive in terms of mean compensation. When taking into account both the frequency and cost of injury (mean cost × number occurrences), back, knee, and shoulder injuries were the most expensive single injury types. Successful prevention and management of back, knee, and shoulder injuries could lead to a substantial reduction in the burden associated with work-related injuries. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. 39 CFR 912.1 - Claims responsibility.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Claims responsibility. 912.1 Section 912.1 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURES TO ADJUDICATE CLAIMS FOR PERSONAL INJURY OR PROPERTY DAMAGE ARISING OUT OF THE OPERATION OF THE U.S. POSTAL SERVICE § 912.1 Claims responsibility....

  7. 32 CFR 536.28 - Claims acknowledgment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... years from the date of accrual. See § 536.122. In any claim for personal injury or wrongful death, an... authorizing the use of medical information, including medical records, in order to use sources other than claims personnel to evaluate the claim as required by the Health Care Portability and Accountability Act...

  8. 32 CFR 536.28 - Claims acknowledgment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... years from the date of accrual. See § 536.122. In any claim for personal injury or wrongful death, an... authorizing the use of medical information, including medical records, in order to use sources other than claims personnel to evaluate the claim as required by the Health Care Portability and Accountability Act...

  9. 14 CFR § 1261.304 - Place of filing claim.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.304 Place of filing claim. A claim... activities are believed to have given rise to the claimed injury, loss, or death. If the identity of...

  10. 33 CFR 25.113 - Contents of claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Standard Form 95, Claim for Damage, Injury, or Death. (b) A claim under any other Act may be presented using Standard Form 95. Any claim which is not presented using Standard Form 95 shall include: (1) The..., personal injury, or death, as applicable; (5) A detailed description of the incident giving rise to the...

  11. 76 FR 16039 - Agency Information Collection (Statement of Person Claiming To Have Stood in Relation of a Parent...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (Statement of Person Claiming To Have Stood in Relation of a Parent.... 2900-0059.'' SUPPLEMENTARY INFORMATION: Title: Statement of Person Claiming to Have Stood in...

  12. How to Help a Person with a Serious Burn Injury

    MedlinePlus

    ... With A Serious Burn Injury How To Help A Person With A Serious Burn Injury Wellness For Parents Professionals Caregivers ... doubt, volunteer to help out! Kathy Edwards is a burn survivor and professor in the Department of ...

  13. A probabilistic method for computing quantitative risk indexes from medical injuries compensation claims.

    PubMed

    Dalle Carbonare, S; Folli, F; Patrini, E; Giudici, P; Bellazzi, R

    2013-01-01

    The increasing demand of health care services and the complexity of health care delivery require Health Care Organizations (HCOs) to approach clinical risk management through proper methods and tools. An important aspect of risk management is to exploit the analysis of medical injuries compensation claims in order to reduce adverse events and, at the same time, to optimize the costs of health insurance policies. This work provides a probabilistic method to estimate the risk level of a HCO by computing quantitative risk indexes from medical injury compensation claims. Our method is based on the estimate of a loss probability distribution from compensation claims data through parametric and non-parametric modeling and Monte Carlo simulations. The loss distribution can be estimated both on the whole dataset and, thanks to the application of a Bayesian hierarchical model, on stratified data. The approach allows to quantitatively assessing the risk structure of the HCO by analyzing the loss distribution and deriving its expected value and percentiles. We applied the proposed method to 206 cases of injuries with compensation requests collected from 1999 to the first semester of 2007 by the HCO of Lodi, in the Northern part of Italy. We computed the risk indexes taking into account the different clinical departments and the different hospitals involved. The approach proved to be useful to understand the HCO risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.

  14. Factors predisposing to claims and compensations for patient injuries following total hip and knee arthroplasty

    PubMed Central

    2012-01-01

    Background and purpose Factors associated with malpractice claims are poorly understood. Knowledge of these factors could help to improve patient safety. We investigated whether patient characteristics and hospital volume affect claims and compensations following total hip arthroplasty (THA) and knee arthroplasty (TKA) in a no-fault scheme. Methods A retrospective registry-based study was done on 16,646 THAs and 17,535 TKAs performed in Finland from 1998 through 2003. First, the association between patient characteristics—e.g., age, sex, comorbidity, prosthesis type—and annual hospital volume with filing of a claim was analyzed by logistic regression. Then, multinomial logistic regression was applied to analyze the association between these same factors and receipt of compensation. Results For THA and TKA, patients over 65 years of age were less likely to file a claim than patients under 65 (OR = 0.57, 95% CI: 0.46–0.72 and OR = 0.65, CI: 0.53–0.80, respectively), while patients with increased comorbidity were more likely to file a claim (OR = 1.17, CI: 1.04–1.31 and OR = 1.14, CI: 1.03-1.26, respectively). Following THA, male sex and cemented prosthesis reduced the odds of a claim (OR = 0.74, CI: 0.60–0.91 and OR = 0.77, CI: 0.60–0.99, respectively) and volume of between 200 and 300 operations increased the odds of a claim (OR = 1.29, CI: 1.01–1.64). Following TKA, a volume of over 300 operations reduced the probability of compensation for certain injury types (RRR = 0.24, CI: 0.08–0.72). Interpretation Centralization of TKA to hospitals with higher volume may reduce the rate of compensable patient injuries. Furthermore, more attention should be paid to equal opportunities for patients to file a claim and obtain compensation. PMID:22401679

  15. Rehabilitation of persons with traumatic brain injury.

    PubMed

    The objective of this NIH Consensus Statement is to inform the biomedical research and clinical practice communities of the results of the NIH Consensus Development Conference on Rehabilitation of Persons with Traumatic Brain Injury. The statement provides state-of-the-art information regarding effective rehabilitation measures for persons who have suffered a traumatic brain injury (TBI) and presents the conclusions and recommendations of the consensus panel regarding these issues. In addition, the statement identifies those areas that deserve further investigation. Upon completion of this educational activity, the reader should possess a clear working clinical knowledge of the state of the art regarding this topic. The target audience for this statement includes, but is not limited to, pediatricians, family practitioners, internists, neurologists, physiatrists, psychologists, and behavioral medicine specialists. Participants were a non-Federal, nonadvocate, 16-member panel representing the fields of neuropsychology, neurology, psychiatry, behavioral medicine, family medicine, pediatrics, physical medicine and rehabilitation, speech and hearing, occupational therapy, nursing, epidemiology, biostatistics and the public. In addition, 23 experts from these same fields presented data to the panel and a conference audience of 883. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. A compendium of evidence was prepared by the panel which included a contribution from a patient with TBI, a report from an Evidence Based Practice Center of the Agency for Health Care Policy and Research, and a report from the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined

  16. The assessment of performance and self-report validity in persons claiming pain-related disability.

    PubMed

    Greve, Kevin W; Bianchini, Kevin J; Brewer, Steve T

    2013-01-01

    One third of all people will experience spinal pain in their lifetime and half of these will experience chronic pain. Pain often occurs in the context of a legally compensable event with back pain being the most common reason for filing a Workers Compensation claim in the United States. When financial incentives to appear disabled exist, malingered pain-related disability is a potential problem. Malingering may take the form of exaggerated physical, emotional, or cognitive symptoms and/or under-performance on measures of cognitive and physical capacity. Essential to the accurate detection of Malingered Pain-related Disability is the understanding that malingering is an act of will, the goal of which is to increase the appearance of disability beyond that which would naturally arise from the injury in question. This paper will review a number of Symptom Validity Tests (SVTs) that have been developed to detect malingering in patients claiming pain-related disability and will conclude with a review of studies showing the diagnostic benefit of combining SVT findings from a comprehensive malingering assessment. The utilization of a variety of tools sensitive to the multiple manifestations of malingering increases the odds of detecting invalid claims while reducing the risk of rejecting a valid claim.

  17. Occupational injuries to Oregon workers 24 years and younger: An analysis of workers' compensation claims, 2000-2007.

    PubMed

    Walters, Jaime K; Christensen, Kari A; Green, Mandy K; Karam, Lauren E; Kincl, Laurel D

    2010-10-01

    Occupational injuries to adolescents and young adults are a known public health problem. We sought to describe and estimate rates of occupational injuries to workers younger than 25 years of age in Oregon during an 8-year period. Oregon workers' compensation disabling claims data (n = 23,325) and one commercial insurance carrier's non-disabling claims data (n = 16,153) were analyzed. Total employment from the Local Employment Dynamics of the U.S. Census Bureau and the Oregon Labor Market Information System was used as a denominator for rates. Injuries were more frequent among 22-24 year olds and among males, though females accounted for a higher proportion of claims in the youngest age group. The most common injury type was a sprain or strain, but lacerations and burns were more frequently reported in the 14-18 year olds. When non-disabling claims were included, the rate of injury for 14-18 year olds doubled. The overall rate of injury was 122.7/10,000 workers, but was higher in the construction, manufacturing, and transportation sectors, and in the agriculture, forestry, fishing, and hunting sector for older teens and young adults. Young workers continue to be at risk for occupational injuries. Our results show that specific interventions may be needed for older teen and young adult workers to reduce their rate of injury. © 2010 Wiley-Liss, Inc.

  18. Neck back and spine injuries in amateur rugby league: a review of nine years of Accident Compensation Corporation injury entitlement claims and costs.

    PubMed

    King, Doug A; Hume, Patria A; Gianotti, Simon; Clark, Trevor

    2011-03-01

    Rugby league is a popular participation sport, but there have been concerns raised regarding the possible high number of severe neck, back and spine injuries. Therefore an epidemiological overview of rugby league neck, back and spine injuries and associated costs of these injuries was undertaken in one country over nine years. The New Zealand national Accident Compensation Corporation data for moderate to serious injury entitlement claims (MSC) over nine years were analysed for the number, type and cost of neck, back and spine rugby league injuries resulting in medical treatment. There were 206 (3%) neck, back and spine MSC claims totalling NZD$1,585,927 (4%) of the total injury entitlement costs for rugby league over the nine-year period. The rate of MSC neck, back and spine rugby league injuries was 26 per 1000 total rugby league claims. Although the rate of neck, back and spine injuries varied over the nine years from 22 to 40 per 1000 injury claims, there was a significant increase over the duration of the study in the number of neck, back and spine MSC claims (χ2=849, df=8, p<0.001), and the cost per MSC injury claim (χ2=19,054, df=8, p<0.001). The frequency, severity and first 12 months cost of neck, back and spine injuries in rugby league is an issue that needs to be addressed. Unfortunately the ACC data base does not provide information on how or why the injuries occurred. A prospective injury epidemiology study needs to be conducted that will allow collection of information surrounding the mechanisms of injury and possible causative risk factors such as tackling technique. In the meantime it is suggested that coaches should ensure tackling technique is correctly taught to all rugby league players to reduce the risk of neck, back and spine injury. Team medical personnel should be trained in dealing with neck and spine injuries as well as head related injuries, and emergency procedures in dealing with players with a suspected neck or back injury should be

  19. 22 CFR 304.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... (a) Personal injury. In support of a claim for personal injury, including pain and suffering, the... expenses. (7) If damages for pain and suffering prior to death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for...

  20. 45 CFR 35.4 - Administrative claims; evidence and information to be submitted.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... pain and suffering prior to death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for pain and the decedent's physical...) Personal injury. In support of a claim for personal injury, including pain and suffering, the claimant...

  1. 22 CFR 304.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... (a) Personal injury. In support of a claim for personal injury, including pain and suffering, the... expenses. (7) If damages for pain and suffering prior to death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for...

  2. 22 CFR 304.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... (a) Personal injury. In support of a claim for personal injury, including pain and suffering, the... expenses. (7) If damages for pain and suffering prior to death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for...

  3. 25 CFR 1000.282 - May persons who are not Indians or Alaska Natives assert claims under FTCA?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false May persons who are not Indians or Alaska Natives assert claims under FTCA? 1000.282 Section 1000.282 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN AFFAIRS... Indians or Alaska Natives assert claims under FTCA? Yes, non-Indian individuals served under the self...

  4. Factors Associated with Word Memory Test Performance in Persons with Medically Documented Traumatic Brain Injury.

    PubMed

    Sherer, Mark; Davis, Lynne C; Sander, Angelle M; Nick, Todd G; Luo, Chunqiao; Pastorek, Nicholas; Hanks, Robin

    2015-01-01

    (1) To examine the rate of poor performance validity in a large, multicenter, prospectively accrued cohort of community dwelling persons with medically documented traumatic brain injury (TBI), (2) to identify factors associated with Word Memory Test (WMT) performance in persons with TBI. This was a prospective cohort, observational study of 491 persons with medically documented TBI. Participants were administered a battery of cognitive tests, questionnaires on emotional distress and post-concussive symptoms, and a performance validity test (WMT). Additional data were collected by interview and review of medical records. One hundred and seventeen participants showed poor performance validity using the standard cutoff. Variable cluster analysis was conducted as a data reduction strategy. Findings revealed that the 10 cognitive tests and questionnaires could be summarized as 4 indices of emotional distress, speed of cognitive processing, verbal memory, and verbal fluency. Regression models revealed that verbal memory, emotional distress, age, and injury severity (time to follow commands) made unique contribution to prediction of poor performance validity. Poor performance validity was common in a research sample of persons with medically documented TBI who were not evaluated in conjunction with litigation, compensation claims, or current report of symptoms. Poor performance validity was associated with poor performance on cognitive tests, greater emotional distress, lower injury severity, and greater age. Many participants expected to have residual deficits based on initial injury severity showed poor performance validity.

  5. Employer reasons for failing to report eligible workers’ compensation claims in the BLS survey of occupational injuries and illnesses

    PubMed Central

    Wuellner, Sara E.; Bonauto, David K.

    2016-01-01

    Background Little research has been done to identify reasons employers fail to report some injuries and illnesses in the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII). Methods We interviewed the 2012 Washington SOII respondents from establishments that had failed to report one or more eligible workers’ compensation claims in the SOII about their reasons for not reporting specific claims. Qualitative content analysis methods were used to identify themes and patterns in the responses. Results Non‐compliance with OSHA recordkeeping or SOII reporting instructions and data entry errors led to unreported claims. Some employers refused to include claims because they did not consider the injury to be work‐related, despite workers’ compensation eligibility. Participant responses brought the SOII eligibility of some claims into question. Conclusion Systematic and non‐systematic errors lead to SOII underreporting. Insufficient recordkeeping systems and limited knowledge of reporting requirements are barriers to accurate workplace injury records. Am. J. Ind. Med. 59:343–356, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26970051

  6. Employer reasons for failing to report eligible workers' compensation claims in the BLS survey of occupational injuries and illnesses.

    PubMed

    Rappin, Christina L; Wuellner, Sara E; Bonauto, David K

    2016-05-01

    Little research has been done to identify reasons employers fail to report some injuries and illnesses in the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII). We interviewed the 2012 Washington SOII respondents from establishments that had failed to report one or more eligible workers' compensation claims in the SOII about their reasons for not reporting specific claims. Qualitative content analysis methods were used to identify themes and patterns in the responses. Non-compliance with OSHA recordkeeping or SOII reporting instructions and data entry errors led to unreported claims. Some employers refused to include claims because they did not consider the injury to be work-related, despite workers' compensation eligibility. Participant responses brought the SOII eligibility of some claims into question. Systematic and non-systematic errors lead to SOII underreporting. Insufficient recordkeeping systems and limited knowledge of reporting requirements are barriers to accurate workplace injury records. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

  7. Insurance claims data: a possible solution for a national sports injury surveillance system? An evaluation of data information against ASIDD and consensus statements on sports injury surveillance

    PubMed Central

    Åman, Malin; Forssblad, Magnus; Henriksson-Larsén, Karin

    2014-01-01

    Background Before preventive actions can be suggested for sports injuries at the national level, a solid surveillance system is required in order to study their epidemiology, risk factors and mechanisms. There are guidelines for sports injury data collection and classifications in the literature for that purpose. In Sweden, 90% of all athletes (57/70 sports federations) are insured with the same insurance company and data from their database could be a foundation for studies on acute sports injuries at the national level. Objective To evaluate the usefulness of sports injury insurance claims data in sports injury surveillance at the national level. Method A database with 27 947 injuries was exported to an Excel file. Access to the corresponding text files was also obtained. Data were reviewed on available information, missing information and dropouts. Comparison with ASIDD (Australian Sports Injury Data Dictionary) and existing consensus statements in the literature (football (soccer), rugby union, tennis, cricket and thoroughbred horse racing) was performed in a structured manner. Result Comparison with ASIDD showed that 93% of the suggested data items were present in the database to at least some extent. Compliance with the consensus statements was generally high (13/18). Almost all claims (83%) contained text information concerning the injury. Conclusions Relatively high-quality sports injury data can be obtained from a specific insurance company at the national level in Sweden. The database has the potential to be a solid base for research on acute sports injuries in different sports at the national level. PMID:24928588

  8. Administrative "health courts" for medical injury claims: the federal constitutional issues.

    PubMed

    Elliott, E Donald; Narayan, Sanjay A; Nasmith, Moneen S

    2008-08-01

    Our article analyzes whether the federal government may constitutionally supplant a traditional system of common-law trials before state judges and juries with new federal institutions designed by statute for compensating victims of medical injuries. Specifically, this article examines the federal constitutional issues raised by various proposals to replace traditional medical malpractice litigation in state courts with a federal system of administrative "health courts." In doing so, we address the following constitutional issues: 1. Is there federal authority to preempt state law (the commerce clause and spending clause issues)? 2. May jurisdiction be created in non-article 3 tribunals, and may claims be decided without trial by jury (the separation of powers and Seventh Amendment issues)? 3. Would pilot programs that require some claims to be pursued in a federal administrative forum while other claimants are left to pursue traditional state tort law remedies be constitutional (the equal protection issue)? The article concludes that a federal compensation system through administrative health courts should be constitutional provided the statute is appropriately drafted and that appropriate factual findings are made concerning the benefits to patients and the public as well as to doctors and their insurers.

  9. Time series forecasting of future claims amount of SOCSO's employment injury scheme (EIS)

    NASA Astrophysics Data System (ADS)

    Zulkifli, Faiz; Ismail, Isma Liana; Chek, Mohd Zaki Awang; Jamal, Nur Faezah; Ridzwan, Ahmad Nur Azam Ahmad; Jelas, Imran Md; Noor, Syamsul Ikram Mohd; Ahmad, Abu Bakar

    2012-09-01

    The Employment Injury Scheme (EIS) provides protection to employees who are injured due to accidents whilst working, commuting from home to the work place or during employee takes a break during an authorized recess time or while travelling that is related with his work. The main purpose of this study is to forecast value on claims amount of EIS for the year 2011 until 2015 by using appropriate models. These models were tested on the actual EIS data from year 1972 until year 2010. Three different forecasting models are chosen for comparisons. These are the Naïve with Trend Model, Average Percent Change Model and Double Exponential Smoothing Model. The best model is selected based on the smallest value of error measures using the Mean Squared Error (MSE) and Mean Absolute Percentage Error (MAPE). From the result, the best model that best fit the forecast for the EIS is the Average Percent Change Model. Furthermore, the result also shows the claims amount of EIS for the year 2011 to year 2015 continue to trend upwards from year 2010.

  10. Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries

    PubMed Central

    Waryasz, Gregory R.; Daniels, Alan H.; Gil, Joseph A.; Suric, Vladimir; Eberson, Craig P.

    2016-01-01

    Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness. PMID:27761219

  11. Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries.

    PubMed

    Waryasz, Gregory R; Daniels, Alan H; Gil, Joseph A; Suric, Vladimir; Eberson, Craig P

    2016-09-19

    Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor's degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor's degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness.

  12. 14 CFR 1261.305 - Form of claim.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.305 Form of claim. (a) The official designated in § 1261.308... for Damage, Injury or Death.” (b) NASA installations will furnish copies of Standard Form 95...

  13. 14 CFR 1261.305 - Form of claim.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.305 Form of claim. (a) The official designated in § 1261.308... for Damage, Injury or Death.” (b) NASA installations will furnish copies of Standard Form 95...

  14. 14 CFR 1261.305 - Form of claim.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.305 Form of claim. (a) The official designated in § 1261.308... for Damage, Injury or Death.” (b) NASA installations will furnish copies of Standard Form 95...

  15. 14 CFR 1261.305 - Form of claim.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... for Damage, Injury or Death.” (b) NASA installations will furnish copies of Standard Form 95 upon... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Form of claim. 1261.305 Section 1261.305...) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death...

  16. Prevalence and predictors of personality change after severe brain injury.

    PubMed

    Norup, Anne; Mortensen, Erik Lykke

    2015-01-01

    To investigate the prevalence of personality change after severe brain injury; to identify predictors of personality change; and to investigate whether personality change is associated with distress in family members. A longitudinal study of personality change. Rehabilitation unit. The study sample was composed of 22 pairs of patients with traumatic brain injury or nontraumatic brain injury (N=22) and their significant others (SOs). Not applicable. An SO completed the observer version of the NEO Five Factor Inventory rating the patient at discharge from hospital and 1 year after injury. The SOs were also asked to complete the anxiety and depression scales of the Symptom Checklist-90-Revised, rating their own emotional condition and health-related quality of life (HRQOL) as assessed by the 4 mental scales of the Medical Outcomes Study 36-Item Short-Form Health Survey. Of the sample, 59.1% experienced personality change after acquired brain injury, and the most dominant changes were observed in the personality traits of neuroticism, extraversion, and conscientiousness. Changes in neuroticism were most often observed in patients with frontal or temporal lesions. Generally, personality changes in patients were not associated with more distress and lower HRQOL in family members; however, change in patient agreeableness was associated with lower HRQOL on the role limitations-emotional scale. Personality change was observed in most patients with severe brain injury. Change in neuroticism was associated with frontal and temporal lesions. Generally, personality change was not associated with more distress and lower HRQOL in SOs. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. 29 CFR 15.303 - How does a Job Corps student file a claim for loss of or damages to personal property under the WIA?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false How does a Job Corps student file a claim for loss of or damages to personal property under the WIA? 15.303 Section 15.303 Labor Office of the Secretary of Labor ADMINISTRATIVE CLAIMS UNDER THE FEDERAL TORT CLAIMS ACT AND RELATED CLAIMS STATUTES Claims Arising Out of the Operation of the Job Corps §...

  18. Prioritizing industries for occupational injury and illness prevention and research, Washington State Workers' compensation claims, 1999-2003.

    PubMed

    Bonauto, David; Silverstein, Barbara; Adams, Darrin; Foley, Michael

    2006-08-01

    The objective of this study was to identify high-risk industry groups for effective allocation of occupational safety and health prevention and research resources. We used all compensable Washington state workers' compensation claims to rank North American Industry Classification System (NAICS) industry groups by a "prevention index" (PI). The PI is the average of the rank orders of each industry group's claim count and claim incidence rate. Of the 274 industry groups ranked by PI for all compensable workers' compensation claims, the following industry groups ranked the highest: NAICS 2381 Foundation, Structure, and Building Exterior Contractors, NAICS 4841 General Freight Trucking, and NAICS 2361 Residential Building Construction. Industry group PI rankings are reported for the seven most common costly occupational injury types. Use of a PI can focus prevention and research resources where they can be of most benefit.

  19. Assessment of the impact of lifting device use on low back pain and musculoskeletal injury claims among nurses.

    PubMed

    Burdorf, Alex; Koppelaar, Elin; Evanoff, Bradley

    2013-07-01

    The aims of this study were: (1) to evaluate the effect of manually lifting patients on the occurrence of low back pain (LBP) among nurses, and (2) to estimate the impact of lifting device use on the prevention of LBP and musculoskeletal disorder (MSD) injury claims. A literature search of PubMed, Embase and Web of Science identified studies with a quantitative assessment of the effect of manually lifting patients on LBP occurrence and studies on the impact of introducing lifting devices on LBP and MSD injury claims. A Markov decision analysis model was constructed for a health impact assessment of patient lifting device use in healthcare settings. The best scenario, based on observational and experimental studies, showed a maximum reduction in LBP prevalence from 41.9% to 40.5% and in MSD injury claims from 5.8 to 5.6 per 100 work-years. Complete elimination of manually lifting patients would reduce the LBP prevalence to 31.4% and MSD injury claims to 4.3 per 100 work-years. These results were sensitive to the strengths of the association between manually patient lifting and LBP as well as the prevalence of manual lifting of patients. A realistic variant of the baseline scenario requires well over 25 000 healthcare workers to demonstrate effectiveness. This study indicates that good implementation of lifting devices is required to noticeably reduce LBP and injury claims. This health impact assessment may guide intervention studies as well as implementation of programmes to reduce manual lifting of patients in healthcare settings.

  20. STUDIES IN WORKMEN'S COMPENSATION AND RADIATION INJURY. VOLUME II, THE INCIDENCE, NATURE AND ADJUDICATION OF WORKMEN'S COMPENSATION CLAIMS INVOLVING RADIATION EXPOSURE AND DELAYED INJURY.

    ERIC Educational Resources Information Center

    O'TOOLE, THOMAS J.

    THE PURPOSE OF THE STUDY WAS TO PROVIDE A FACTUAL BACKGROUND AGAINST WHICH JUDGMENTS CAN BE MADE CONCERNING THE MAGNITUDE OF THE PROBLEM OF INJURY APPEARING SOME TIME AFTER THE EXPOSURE TO IONIZING RADIATION AND DETERMINE WHETHER EXISTING LAWS PERMIT A JUST AND EQUITABLE ADJUDICATION OF RADIATION COMPENSATION CLAIMS. THE STUDY WAS BASED UPON THE…

  1. 29 CFR 15.5 - Administrative claim; evidence or information to substantiate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... injury. In support of a claim for personal injury, including pain and suffering, the claimant is required... of payment for such expenses. (7) If damages for pain and suffering prior to death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any...

  2. Traumatic Brain Injury and Personality Change

    ERIC Educational Resources Information Center

    Fowler, Marc; McCabe, Paul C.

    2011-01-01

    Traumatic brain injury (TBI) is the leading cause of death and lifelong disability in the United States for individuals below the age of 45. Current estimates from the Center for Disease Control (CDC) indicate that at least 1.4 million Americans sustain a TBI annually. TBI affects 475,000 children under age 14 each year in the United States alone.…

  3. Traumatic Brain Injury and Personality Change

    ERIC Educational Resources Information Center

    Fowler, Marc; McCabe, Paul C.

    2011-01-01

    Traumatic brain injury (TBI) is the leading cause of death and lifelong disability in the United States for individuals below the age of 45. Current estimates from the Center for Disease Control (CDC) indicate that at least 1.4 million Americans sustain a TBI annually. TBI affects 475,000 children under age 14 each year in the United States alone.…

  4. Liability for Personal Injury Caused by Defective Medical Computer Programs

    PubMed Central

    Brannigan, Vincent M.

    1980-01-01

    Defective medical computer programs can cause personal injury. Financial responsibility for the injury under tort law will turn on several factors: whether the program is a product or a service, what types of defect exist in the product, and who produced the program. The factors involved in making these decisions are complex, but knowledge of the relevant issues can assist computer personnel in avoiding liability.

  5. Insurance claims data: a possible solution for a national sports injury surveillance system? An evaluation of data information against ASIDD and consensus statements on sports injury surveillance.

    PubMed

    Aman, Malin; Forssblad, Magnus; Henriksson-Larsén, Karin

    2014-06-12

    Before preventive actions can be suggested for sports injuries at the national level, a solid surveillance system is required in order to study their epidemiology, risk factors and mechanisms. There are guidelines for sports injury data collection and classifications in the literature for that purpose. In Sweden, 90% of all athletes (57/70 sports federations) are insured with the same insurance company and data from their database could be a foundation for studies on acute sports injuries at the national level. To evaluate the usefulness of sports injury insurance claims data in sports injury surveillance at the national level. A database with 27 947 injuries was exported to an Excel file. Access to the corresponding text files was also obtained. Data were reviewed on available information, missing information and dropouts. Comparison with ASIDD (Australian Sports Injury Data Dictionary) and existing consensus statements in the literature (football (soccer), rugby union, tennis, cricket and thoroughbred horse racing) was performed in a structured manner. Comparison with ASIDD showed that 93% of the suggested data items were present in the database to at least some extent. Compliance with the consensus statements was generally high (13/18). Almost all claims (83%) contained text information concerning the injury. Relatively high-quality sports injury data can be obtained from a specific insurance company at the national level in Sweden. The database has the potential to be a solid base for research on acute sports injuries in different sports at the national level. 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.

  6. Contraction induced muscle injury: towards personalized training and recovery programs.

    PubMed

    Givli, Sefi

    2015-02-01

    Skeletal muscles can be injured by their own contractions. Such contraction-induced injury, often accompanied by delayed onset of muscle soreness, is a leading cause of the loss of mobility in the rapidly increasing population of elderly people. Unlike other types of muscle injuries which hurt almost exclusively those who are subjected to intensive exercise such as professional athletes and soldiers in training, contraction induced injury is a phenomenon which may be experienced by people of all ages while performing a variety of daily-life activities. Subjects that experience contraction induced injury report on soreness that usually increases in intensity in the first 24 h after the activity, peaks from 24 to 72 h, and then subsides and disappears in a few days. Despite their clinical importance and wide influence, there are almost no studies, clinical, experimental or computational, that quantitatively relate between the extent of contraction induced injury and activity factors, such as number of repetitions, their frequency and magnitude. The lack of such quantitative information is even more emphasized by the fact that contraction induced injury can be used, if moderate and controlled, to improve muscle performance in the long term. Thus, if properly understood and carefully implemented, contraction induced injury can be used for the purpose of personalized training and recovery programs. In this paper, we review experimental, clinical, and theoretical works, attempting towards drawing a more quantitative description of contraction induced injury and related phenomena.

  7. Applying Personal Genetic Data to Injury Risk Assessment in Athletes

    PubMed Central

    Goodlin, Gabrielle T.; Roos, Andrew K.; Roos, Thomas R.; Hawkins, Claire; Beache, Sydney; Baur, Stephen; Kim, Stuart K.

    2015-01-01

    Recent studies have identified genetic markers associated with risk for certain sports-related injuries and performance-related conditions, with the hope that these markers could be used by individual athletes to personalize their training and diet regimens. We found that we could greatly expand the knowledge base of sports genetic information by using published data originally found in health and disease studies. For example, the results from large genome-wide association studies for low bone mineral density in elderly women can be re-purposed for low bone mineral density in young endurance athletes. In total, we found 124 single-nucleotide polymorphisms associated with: anterior cruciate ligament tear, Achilles tendon injury, low bone mineral density and stress fracture, osteoarthritis, vitamin/mineral deficiencies, and sickle cell trait. Of these single nucleotide polymorphisms, 91% have not previously been used in sports genetics. We conducted a pilot program on fourteen triathletes using this expanded knowledge base of genetic variants associated with sports injury. These athletes were genotyped and educated about how their individual genetic make-up affected their personal risk profile during an hour-long personal consultation. Overall, participants were favorable of the program, found it informative, and most acted upon their genetic results. This pilot program shows that recent genetic research provides valuable information to help reduce sports injuries and to optimize nutrition. There are many genetic studies for health and disease that can be mined to provide useful information to athletes about their individual risk for relevant injuries. PMID:25919592

  8. 49 CFR 238.117 - Protection against personal injury.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Protection against personal injury. 238.117 Section 238.117 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... voltage equipment, electrical conductors and switches, and pipes carrying hot fluids or gases on...

  9. 49 CFR 238.117 - Protection against personal injury.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Protection against personal injury. 238.117 Section 238.117 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... voltage equipment, electrical conductors and switches, and pipes carrying hot fluids or gases on...

  10. Substance Use by Persons with Recent Spinal Cord Injuries.

    ERIC Educational Resources Information Center

    Heinemann, Allen W.; And Others

    Substance use histories were obtained from 103 persons (16 to 63 years of age) with recent spinal cord injuries (SCI). Lifetime exposure to and current use of substances with abuse potential were substantially greater in this sample compared to a like-age national sample. Exposure to and recent use of substances with abuse potential was…

  11. Acute kidney injury in elderly persons.

    PubMed

    Coca, Steven G

    2010-07-01

    The incidence rate of acute kidney injury (AKI) is highest in elderly patients, who make up an ever-growing segment of the population at large. AKI in these patients is associated with an increased risk of short- and long-term death and chronic kidney disease, including end-stage renal disease. Whether AKI in older individuals carries a larger relative risk for these outcomes compared with younger individuals is unclear at this time. Other domains, such as health-related quality of life, may be mildly impacted on after an episode of AKI. No effective therapies for AKI currently are available for widespread use. However, because the incidence of AKI is highest in the elderly and the phenotype is not discernibly different from AKI in all populations, future randomized controlled trials of interventions for AKI should be performed in the elderly population.

  12. Acute Kidney Injury in Elderly Persons

    PubMed Central

    Coca, Steven G.

    2010-01-01

    The incidence rate of acute kidney injury (AKI) is highest in elderly patients, who comprise an ever-growing segment of the population at large. AKI in these patients is associated with an increased risk of short-term and long-term death and chronic kidney disease, including end-stage renal disease. Whether AKI in older individuals carries a larger relative risk for these outcomes compared to younger individuals in unclear at this time. Other domains such as health-related quality of life may be mildly impacted after an episode of AKI. No effective therapies for AKI are currently available for wide-spread use. However, since the incidence of AKI is highest in the elderly and the phenotype is not discernibly different from AKI in all populations, future randomized controlled trials of interventions for AKI should be performed in the elderly population. PMID:20346560

  13. Empowerment of personal injury victims through the internet: design of a randomized controlled trial

    PubMed Central

    2011-01-01

    Background Research has shown that current claims settlement process can have a negative impact on psychological and physical recovery of personal injury (PI) victims. One of the explanations for the negative impact on health is that the claims settlement process is a stressful experience and victims suffer from renewed victimization caused by the claims settlement process. PI victims can experience a lack of information, lack of involvement, lack of 'voice', and poor communication. We present the first study that aims to empower PI victims with respect to the negative impact of the claims settlement process by means of an internet intervention. Methods/design The study is a two armed, randomized controlled trial (RCT), in which 170 PI victims are randomized to either the intervention or control group. The intervention group will get access to a website providing 1) an information module, so participants learn what is happening and what to expect during the claims settlement process, and 2) an e-coach module, so participants learn to cope with problems they experience during the claims settlement process. The control group will get access to a website with hyperlinks to commonly available information only. Participants will be recruited via a PI claims settlement office. Participants are included if they have been involved in a traffic accident which happened less than two years ago, and are at least 18 years old. The main study parameter is the increase of empowerment within the intervention group compared to the control group. Empowerment will be measured by the mastery scale and a self-efficacy scale. The secondary outcomes are perceived justice, burden, well being, work ability, knowledge, amount of damages, and lawyer-client communication. Data are collected at baseline (T0 measurement before randomization), at three months, six months, and twelve months after baseline. Analyses will be conducted according to the intention-to-treat principle. Discussion This

  14. Personality, stress, and injuries in professional ballet dancers.

    PubMed

    Hamilton, L H; Hamilton, W G; Meltzer, J D; Marshall, P; Molnar, M

    1989-01-01

    Twenty-nine soloist and principal dancers (mean age, 29.08 years) from America's two most celebrated ballet companies were administered questionnaires measuring personality (API), occupational stress (OES), strain (PSQ), and coping mechanisms (PRQ), and injury patterns. The results revealed that male dancers demonstrated significantly more negative personality traits and psychological distress than female dancers or men in the general population. In addition, physical stress and personality traits, characteristic of the "overachiever," distinguished injured dancers. It is suggested that classical ballet's emphasis on the ballerina may be at odds with a masculine identity in male dancers. Furthermore, the qualities that lead to success in this profession may contribute to injuries if carried to an extreme.

  15. The incidence and impact of recurrent workplace injury and disease: a cohort study of WorkSafe Victoria, Australia compensation claims

    PubMed Central

    Ruseckaite, Rasa; Collie, Alex

    2013-01-01

    Objective To determine the incidence and impact of recurrent workplace injury and disease over the period 1995–2008. Design Population-based cohort study using data from the state workers’ compensation system database. Setting State of Victoria, Australia. Participants A total of 448 868 workers with an accepted workers’ compensation claim between 1 January 1995 and 31 December 2008 were included into this study. Of them, 135 349 had at least one subsequent claim accepted for a recurrent injury or disease during this period. Main outcome measures Incidence of initial and recurrent injury and disease claims and time lost from work for initial and recurrent injury and disease. Results Over the study period, 448 868 workers lodged 972 281 claims for discrete occurrences of work-related injury or disease. 53.4% of these claims were for recurrent injury or disease. On average, the rates of initial claims dropped by 5.6%, 95% CI (−5.8% to −5.7%) per annum, while the rates of recurrent injuries decreased by 4.1%, 95% CI (−4.2% to −0.4%). In total, workplace injury and disease resulted in 188 978 years of loss in full-time work, with 104 556 of them being for the recurrent injury. Conclusions Recurrent work-related injury and disease is associated with a substantial social and economic impact. There is an opportunity to reduce the social, health and economic burden of workplace injury by enacting secondary prevention programmes targeted at workers who have incurred an initial occupational injury or disease. PMID:23457329

  16. Insurance coverage for employment-related claims

    SciTech Connect

    Scheuermann, J.E.

    1993-12-31

    This article analyzes the principal coverage issues arising under CGL policies for employment-related claims. Section I discusses the bases of the duty to defend and the duty to idemnify in the key CGL policy provisions at issue, including the bodily injury and personal injury coverages. Section II examines the three provisions in CGL policies typically raised as defenses to coverage for employment-related claims and two public policy considerations that may affect claims for coverage. The duty to defend is given closer crutiny in section III. Finally, in section IV the effects of settlement on coverage are discussed. 106 refs.

  17. Do zero-cost workers' compensation medical claims really have zero costs? The impact of workplace injury on group health insurance utilization and costs.

    PubMed

    Asfaw, Abay; Rosa, Roger; Mao, Rebecca

    2013-12-01

    Previous research suggests that non-workers' compensation (WC) insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This study further examined GHI utilization and costs. Using two-part model, we compared those outcomes immediately after injuries for which accepted WC medical claims made zero or positive medical payments. Controlling for pre-injury GHI utilization and costs and other covariates, our results indicated that post-injury GHI utilization and costs increased regardless of whether a WC medical claim was zero or positive. The increases were highest for zero-cost WC medical claims. Our national estimates showed that zero-cost WC medical claims alone could cost the GHI $212 million per year.

  18. Tradeoffs of Using Administrative Claims and Medical Records to Identify the Use of Personalized Medicine for Patients with Breast Cancer

    PubMed Central

    Liang, Su-Ying; Phillips, Kathryn A.; Wang, Grace; Keohane, Carol; Armstrong, Joanne; Morris, William M.; Haas, Jennifer S.

    2012-01-01

    Background Administrative claims and medical records are important data sources to examine healthcare utilization and outcomes. Little is known about identifying personalized medicine technologies in these sources. Objectives To describe agreement, sensitivity, and specificity of administrative claims compared to medical records for two pairs of targeted tests and treatments for breast cancer. Research Design Retrospective analysis of medical records linked to administrative claims from a large health plan. We examined whether agreement varied by factors that facilitate tracking in claims (coding and cost) and that enhance medical record completeness (records from multiple providers). Subjects Women (35 – 65 years) with incident breast cancer diagnosed in 2006–2007 (n=775). Measures Use of human epidermal growth factor receptor 2 (HER2) and gene expression profiling (GEP) testing, trastuzumab and adjuvant chemotherapy in claims and medical records. Results Agreement between claims and records was substantial for GEP, trastuzumab, and chemotherapy, and lowest for HER2 tests. GEP, an expensive test with unique billing codes, had higher agreement (91.6% vs. 75.2%), sensitivity (94.9% vs. 76.7%), and specificity (90.1% vs. 29.2%) than HER2, a test without unique billing codes. Trastuzumab, a treatment with unique billing codes, had slightly higher agreement (95.1% vs. 90%) and sensitivity (98.1% vs. 87.9%) than adjuvant chemotherapy. Conclusions Higher agreement and specificity were associated with services that had unique billing codes and high cost. Administrative claims may be sufficient for examining services with unique billing codes. Medical records provide better data for identifying tests lacking specific codes and for research requiring detailed clinical information. PMID:21422962

  19. Acute respiratory infections in persons with spinal cord injury.

    PubMed

    Burns, Stephen P

    2007-05-01

    Respiratory disorders are the leading cause of death for persons with both acute and chronic spinal cord injury (SCI), and much of the morbidity and mortality associated with respiratory disorders is related to acute respiratory infections. Pneumonia is the best recognized respiratory infection associated with mortality in this population. Recent evidence supports some management strategies that differ from those recommended for the general population. Upper respiratory tract infections and acute bronchitis may be precipitating factors in the development of pneumonia or ventilatory failure in patients with chronic SCI. This review emphasizes management principles for treatment and prevention of respiratory infections in persons with SCI.

  20. Repeat workers' compensation claims: risk factors, costs and work disability

    PubMed Central

    2011-01-01

    Background The objective of our study was to describe factors associated with repeat workers' compensation claims and to compare the work disability arising in workers with single and multiple compensation claims. Methods All initial injury claims lodged by persons of working age during a five year period (1996 to 2000) and any repeat claims were extracted from workers' compensation administrative data in the state of Victoria, Australia. Groups of workers with single and multiple claims were identified. Descriptive analysis of claims by affliction, bodily location, industry segment, occupation, employer and workplace was undertaken. Survival analysis determined the impact of these variables on the time between the claims. The economic impact and duration of work incapacity associated with initial and repeat claims was compared between groups. Results 37% of persons with an initial claim lodged a second claim. This group contained a significantly greater proportion of males, were younger and more likely to be employed in manual occupations and high-risk industries than those with single claims. 78% of repeat claims were for a second injury. Duration between the claims was shortest when the working conditions had not changed. The initial claims of repeat claimants resulted in significantly (p < 0.001) lower costs and work disability than the repeat claims. Conclusions A substantial proportion of injured workers experience a second occupational injury or disease. These workers pose a greater economic burden than those with single claims, and also experience a substantially greater cumulative period of work disability. There is potential to reduce the social, health and economic burden of workplace injury by enacting prevention programs targeted at these workers. PMID:21696637

  1. 14 CFR 1261.308 - NASA officials authorized to act upon claims.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true NASA officials authorized to act upon claims... PROCESSING OF MONETARY CLAIMS (GENERAL) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.308 NASA officials...

  2. Sport-related dental injury claims to the New Zealand Accident Rehabilitation & Compensation Insurance Corporation, 1993-1996: analysis of the 10 most common sports, excluding rugby union.

    PubMed

    Love, R M; Carman, N; Carmichael, S; MacFadyen, E

    1998-12-01

    A large number of New Zealanders participate in sport, either formally or informally; sporting injuries are common. In New Zealand, the Accident Rehabilitation & Compensation Insurance Corporation (ACC) is the main organisation that covers sports-related dental claims. Rugby union claims are the most common. The ACC's national data from 1993 to 1996 relating to dental claims for sports injuries (excluding rugby union) were analysed. This study identified 45 other sports in which participants are also at risk for dental injuries. Total claims per sport for each year were determined, and the "top 10" sports for claims per year were identified and compared for any change over the years studied. The top 10 sports for 1993 and 1994 were, in descending order: swimming, rugby league, basketball, cricket, hockey, soccer, netball, squash, softball-baseball, and tennis. Data for 1995 and 1996 revealed a similar trend, except that touch rugby displaced tennis as the tenth-ranked sport. The most common age group for claims was the age group 10-19 years, with a male:female ratio of approximately 2:1. Many sports, in addition to rugby union, place their participants at risk of dental injury. Awareness of prevention of dental injuries should be more widely promoted for all sports.

  3. 40 CFR 1620.5 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... expenses. (7) If damages for pain and suffering before death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for pain, and the... support of a claim for personal injury, including pain and suffering, the claimant may be required...

  4. 40 CFR 1620.5 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... expenses. (7) If damages for pain and suffering before death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for pain, and the... support of a claim for personal injury, including pain and suffering, the claimant may be required...

  5. 29 CFR 15.5 - Administrative claim; evidence or information to substantiate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of a claim for personal injury, including pain and suffering, the claimant is required to submit the... for such expenses. (7) If damages for pain and suffering prior to death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs...

  6. 40 CFR 1620.5 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... expenses. (7) If damages for pain and suffering before death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for pain, and the... support of a claim for personal injury, including pain and suffering, the claimant may be required...

  7. 40 CFR 1620.5 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... expenses. (7) If damages for pain and suffering before death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for pain, and the... support of a claim for personal injury, including pain and suffering, the claimant may be required...

  8. 20 CFR 429.104 - What evidence do I need to submit with my claim?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... claim for personal injury, including pain and suffering, you may be required to submit the following...) If damages for pain and suffering prior to death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for pain and...

  9. ACCIDENTAL INJURIES TO WOMEN—Obstetrical and Gynecological Problems Associated with Damage Claims

    PubMed Central

    McNeil, Robert J.

    1955-01-01

    Women who have been injured should be examined for possible gynecological injury within 24 hours of the accident. Injuries to pregnant women do not usually cause an obstetrical crisis. When such an event does occur, there is positive evidence which relates it to the accident if there was such relationship. Metrorrhagia and menorrhagia are common sequelae of physical and psychological injury, but they are of temporary nature in cases in which there is no demonstrable pathologic change upon pelvic examination. Uterine prolapse, cystocele and rectocele are not caused by a single injury except in extremely rare instances. When vaginal vault injury has occurred as a result of a single injury, there is plentiful evidence of severe tissue damage. PMID:14390007

  10. Patient dignity in persons with spinal cord injury.

    PubMed

    Belanger, Heather G; Nelson, Audrey L; McMillan, Susan; Gavin-Dreschnack, Deborah; Holley, Sandra; Rosenberg, Deborah

    2003-01-01

    Technology is changing the way nurses provide patient care in spinal cord injury. A key nursing concern is the impact of technology-assisted caregiving tasks (TACT) on the patients' sense of dignity. Despite frequent use of the term dignity in discussing treatment of persons with disabilities, there is a dearth of empirical research related to this topic. In particular, there have been few attempts to define the construct for the purposes of valid measurement. The purpose of this article is, therefore, to critically review the relevant literature on patient dignity with an aim toward eventual development and validation of a Dignity Assessment Tool.

  11. The Personality Assessment Inventory in individuals with traumatic brain injury.

    PubMed

    Demakis, George J; Hammond, Flora; Knotts, Allison; Cooper, Douglas B; Clement, Pamelia; Kennedy, Jan; Sawyer, Tom

    2007-01-01

    This study examined the Personality Assessment Inventory (PAI) in 95 individuals who had suffered a traumatic brain injury (TBI). Participants were recruited from a rehabilitation hospital (n=60) and a military hospital (n=35); despite differences in demographics and injury characteristics groups did not differ on any of the clinical scales and were thus combined. In the combined group, the highest mean clinical scale elevations were on Somatic Complaints, Depression, and Borderline Features and the most common configural profiles, based on cluster analysis, were Cluster 1 (no prominent elevations), Cluster 6 (social isolation and confused thinking), and Cluster 2 (depression and withdrawal). Factor analysis indicated a robust three-factor solution that accounted for 74.86 percent of the variance and was similar to findings from the psychiatric and non-psychiatric populations in the standardization sample. The above findings are compared with the previous literature on psychopathology in TBI, particularly in regards to the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), as well as previous psychometric research on the PAI.

  12. 31 CFR 3.2 - Filing of claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... claimant, his duly authorized agent or legal representative of an executed Standard Form 95 or other written notification of an incident, accompanied by a claim for money damages in a sum certain for injury to or loss of property, or personal injury, or death alleged to have occurred by reason of the...

  13. The Claim of the Personal: Narratives and Reflections in a Time of Exposition

    ERIC Educational Resources Information Center

    Weber, David

    2014-01-01

    In this article, the author describes the benefits of a program where he has taught for many years. It is a program that emphasizes personal narratives drawn from memory--and that also celebrates the personal essay, which usually incorporates narrative content. The article begins by addressing concerns expressed about this form of writing. It then…

  14. The Claim of the Personal: Narratives and Reflections in a Time of Exposition

    ERIC Educational Resources Information Center

    Weber, David

    2014-01-01

    In this article, the author describes the benefits of a program where he has taught for many years. It is a program that emphasizes personal narratives drawn from memory--and that also celebrates the personal essay, which usually incorporates narrative content. The article begins by addressing concerns expressed about this form of writing. It then…

  15. A qualitative study on the use of personal information technology by persons with spinal cord injury.

    PubMed

    Mattar, Andrew A G; Hitzig, Sander L; McGillivray, Colleen F

    2015-01-01

    Previous work has shown that information technology (IT), such as personal computers and other digital devices (e.g. tablets, laptops, etc.), software, online resources and hand-held communication tools (e.g. cellphones), has benefits for health and well-being for persons with chronic health conditions. To date, the ways that persons with spinal cord injury (SCI) use IT in their daily activities has not been fully explored. Thus, the purpose of the study was to obtain an in-depth perspective of how people with SCI regularly use IT to gain insight on ways IT can be used to support health and well-being in the community for this population. Semi-structured interviews were conducted with community-dwelling persons with SCI (N = 10) who identified themselves as frequent-or-daily-users of IT. Qualitative content analysis was used to identify the ways that persons with SCI use personal IT. Ten themes related to IT use were identified: (1) Modifications allowing access to IT; (2) Convenience of IT and its perceived value; (3) IT as a scheduler/planner; (4) Challenges; (5) Contributions of IT to participation; (6) Access to information; (7) Influence of IT on well-being; (8) IT as a connector; (9) Issues of IT acquisition; and (10) Desires for future devices/technology. The findings suggest that IT use by people with SCI contributes to general health and well-being, by increasing access to SCI-related health information and opportunity for social participation. Despite the benefits offered by IT, persons with SCI have identified a degree of skepticism about the reliability and applicability of the health information they find online. Future work on developing and implementing IT for health and well-being post-SCI should take into account consumers' perspectives to facilitate uptake. Implications for Rehabilitation There is a need for a more refined understanding of how people with spinal cord injury (SCI) use information technology (IT) in their daily lives in order to

  16. Who's Missing the Point? A Commentary on Claims that Autistic Persons Have a Specific Deficit in Figurative Language Comprehension.

    PubMed

    Gernsbacher, Morton Ann; Pripas-Kapit, Sarah R

    2012-01-01

    It's become a caricature of autistic persons that they don't understand figurative language. Despite empirical evidence to the contrary, three of the four contributions to this special issue endorse this stereotype without question. And all four contributions attribute this supposed deficit to even shakier fallacies, such as the controversial claim that autistic people lack empathy or a 'theory of mind.' In this commentary, we begin by reviewing the literature more exhaustively than the other contributions, and we highlight a point that they missed: Autistic persons are likely to have difficulty comprehending figurative language if they also have difficulty comprehending language in general. There doesn't seem to be a specific deficit in figurative language unique to autism. We also tackle the claim that autistic people lack empathy. And we question the existence of a 'theory of mind area,' while demonstrating the pitfalls that ensnarl researchers when they strain to interpret differences between autistic and non-autistic brain activity as solely autistic deficits.

  17. The Grin Without the Cat: Claims for Damages From Toxic Exposure Without Present Injury

    DTIC Science & Technology

    1993-07-06

    testimony). See, Eagle-Picher Industries Inc. v. Cox, 481 So.2d 517,526N(Fla. App. 3 Dist. 1985); Devlin v. Johns - Manville Sales Corp., 495 A.2d 495...34); Herber v. Johns - Manville Corp., 785 F.2d 79 (3rd Cir. 1986). 164 Ball v. Joy Technologies, Inc. 958 F.2d 36(4th Cir. 1991)( "A claim for medical...in common a fibrous structure and a potential to be woven. A Physician’s Guide to Asbestos Related Diseases, supra. 223 Herber v. Johns - Manville Corp

  18. 28 CFR 14.4 - Administrative claims; evidence and information to be submitted.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the incident causing death, or itemized receipts of payment for such expenses. (7) If damages for pain... suffered, duration of pain and suffering, any drugs administered for pain, and the decedent's physical...) Personal injury. In support of a claim for personal injury, including pain and suffering, the claimant...

  19. Resilient, Undercontrolled, and Overcontrolled Personality Prototypes Among Persons With Spinal Cord Injury

    PubMed Central

    Berry, Jack W.; Elliott, Timothy R.; Rivera, Patricia

    2008-01-01

    A sample of 199 persons with spinal cord injury (SCI) were assessed on Big Five personality dimensions using the NEO Five-Factor Inventory (NEO–FFI; Costa & McCrae, 1992) at admission to an inpatient medical rehabilitation program. A cluster analysis of the baseline NEO–FFI yielded 3 cluster prototypes that resemble resilient, undercontrolled, and overcontrolled prototypes identified in many previous studies of children and adult community samples. Compared with normative samples, this sample had significantly fewer resilient prototypes and significantly more overcontrolled and undercontrolled prototypes. Undercontrolled individuals were the modal prototype. The resilient and undercontrolled types were better adjusted than the overcontrolled types, showing lower levels of depression at admission and higher acceptance of disability at discharge. The resilient type at admission predicted the most effective reports of social problem-solving abilities at discharge and the overcontrolled type the least. We discuss the implications of these results for assessment and interventions in rehabilitation settings. PMID:18001229

  20. Predictors of Personality Change Due to Traumatic Brain Injury in Children and Adolescents in the First Six Months after Injury.

    ERIC Educational Resources Information Center

    Max, Jeffrey E.; Levin, Harvey S.; Landis, Julie; Schachar, Russell; Saunders, Ann; Ewing-Cobbs, Linda; Chapman, Sandra B.; Dennis, Maureen

    2005-01-01

    Objective: To assess the phenomenology and predictive factors of personality change due to traumatic brain injury. Method: Children (N = 177), aged 5 to 14 years with traumatic brain injury from consecutive admissions to five trauma centers, were followed prospectively at baseline and 6 months with semistructured psychiatric interviews. Injury…

  1. Predictors of Personality Change Due to Traumatic Brain Injury in Children and Adolescents in the First Six Months after Injury.

    ERIC Educational Resources Information Center

    Max, Jeffrey E.; Levin, Harvey S.; Landis, Julie; Schachar, Russell; Saunders, Ann; Ewing-Cobbs, Linda; Chapman, Sandra B.; Dennis, Maureen

    2005-01-01

    Objective: To assess the phenomenology and predictive factors of personality change due to traumatic brain injury. Method: Children (N = 177), aged 5 to 14 years with traumatic brain injury from consecutive admissions to five trauma centers, were followed prospectively at baseline and 6 months with semistructured psychiatric interviews. Injury…

  2. Relationship of Personality and Locus of Control With Employment Outcomes among Participants with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Krause, James S.; Broderick, Lynne

    2006-01-01

    We investigated relationships among personality, locus of control, and current post-injury employment status for 1,391 participants with spinal cord injury. Participants with higher internality locus-of-control scores and activity scores (personality) reported more favorable employment outcomes. Higher scores on chance and powerful others (locus…

  3. Temporal patterns of moose-vehicle collisions with and without personal injuries.

    PubMed

    Niemi, Milla; Rolandsen, Christer M; Neumann, Wiebke; Kukko, Tuomas; Tiilikainen, Raisa; Pusenius, Jyrki; Solberg, Erling J; Ericsson, Göran

    2017-01-01

    Collisions with wild ungulates are an increasing traffic safety issue in boreal regions. Crashes involving smaller-bodied deer species usually lead to vehicle damage only, whereas collisions with a large animal, such as the moose, increase the risk of personal injuries. It is therefore important to understand both the factors affecting the number of moose-vehicle collisions (MVCs) and the underlying causes that turn an MVC into an accident involving personal injuries or fatalities. As a basis for temporal mitigation measures, we examined the annual and monthly variation of MVCs with and without personal injuries. Using a 22-year-long (1990-2011) time series from Finland, we tested the effect of moose population density and traffic volume on the yearly number of all MVCs and those leading to personal injuries. We also examined the monthly distribution of MVCs with and without personal injuries, and contrasted the Finnish findings with collision data from Sweden (years 2008-2010) and Norway (years 2008-2011). Both moose population abundance indices and traffic volume were positively related to the yearly variation in the number of MVCs in Finland. The proportion of MVCs involving personal injuries decreased during our 22-year study period. The monthly distribution of all MVCs peaked during the autumn or winter depending on country, while MVCs involving personal injury peaked in summer. Our study indicates that efforts to reduce MVCs involving personal injuries need to address driver awareness and attitudes during summer, despite most MVCs occurring in autumn or winter.

  4. Relationship of Personality and Locus of Control With Employment Outcomes among Participants with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Krause, James S.; Broderick, Lynne

    2006-01-01

    We investigated relationships among personality, locus of control, and current post-injury employment status for 1,391 participants with spinal cord injury. Participants with higher internality locus-of-control scores and activity scores (personality) reported more favorable employment outcomes. Higher scores on chance and powerful others (locus…

  5. 77 FR 3106 - Damages Received on Account of Personal Physical Injuries or Physical Sickness

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-23

    ... 9573] RIN 1545-BF81 Damages Received on Account of Personal Physical Injuries or Physical Sickness... damages on account of personal physical injuries or physical sickness and taxpayers paying these damages..., damages received from a legal suit, action, or settlement agreement must be based upon ``tort or tort type...

  6. 48 CFR 52.247-21 - Contractor Liability for Personal Injury and/or Property Damage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Personal Injury and/or Property Damage. 52.247-21 Section 52.247-21 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.247-21 Contractor Liability for Personal Injury and/or Property...

  7. An investigation of mediums who claim to give information about deceased persons.

    PubMed

    Kelly, Emily Williams; Arcangel, Dianne

    2011-01-01

    Growing public interest in the phenomenon of mediumship, particularly among bereaved persons, suggests the need for renewed controlled studies of mediums, both to provide potential clients with criteria for judging mediums and to help researchers learn whether they can produce specific and accurate information to which they have had no normal access and, if so, under what conditions. Two research studies were conducted in which mediums provided readings about particular deceased persons to a proxy sitter. The real sitters then blindly rated the reading that was intended for them along with several control readings. In the first study, the results were not significant. In the second, much larger study the results were highly significant (z = -3.89, p < 0.0001, 2-tailed). The authors discuss 2 possible weaknesses of the successful study and indicate some directions for further research.

  8. Functional and symptomatic assessment of medico-legal claims after upper limb injuries.

    PubMed

    Belcher, Hjcr

    2016-10-04

    A consecutive group of 250 patients underwent medico-legal assessment at a mean of 24 (±13) months following upper limb injuries. Each had completed questionnaires to assess function (Quick-DASH) and cold intolerance (CIQ36) before clinical assessment following which their whole limb impairment percentage was calculated. The mean(±SD) whole limb impairment, QDASH and CIQ36 scores were 9(±14)%, 43(±24) and 17(±10), respectively. There was a significant correlation between whole limb impairment and QDASH, although some patients reported surprisingly high disability levels despite minimal or no objective functional impairment. Whilst useful qualitative information can be obtained from questionnaires, the correlation between subjective and objective scores is weak albeit statistically significant. Individual patients can show marked discrepancies between objective and subjective functional scores. The results of questionnaires in individual medico-legal patients should be treated with caution.

  9. Towards personalized care for persons with spinal cord injury: a study on patients' perceptions

    PubMed Central

    Garrino, Lorenza; Curto, Natascia; Decorte, Rita; Felisi, Nadia; Matta, Ebe; Gregorino, Silvano; Actis, M. Vittoria; Marchisio, Cecilia; Carone, Roberto

    2011-01-01

    Objective/background A newly designed Spinal Cord Unit (SCU) was set up at the Orthopedic Traumatology Center (OTC), Turin, Italy, in July 2007. With the relocation of the SCU came the need to reorganize and improve the delivery of its services. The study reported here is a preliminary part of a project entitled ‘Experimentation and evaluation of personalized healthcare for patients with spinal cord injury’, which is a component of an overarching program of targeted research into healthcare funded by the Piedmont Region in 2006. The aim of this study was to assess the perception of care by patients with spinal cord injury (SCI) by collecting important data in order to determine whether an integrated and personalized care pathway could be effective both in hospital and in a rehabilitation setting. Design Qualitative research study. The interview format was based on a narrative approach. Methods Qualitative in-depth semi-structured interviews were conducted with 21 patients with SCI. Qualitative content analysis was used to identify categories and themes arising from the data. Results Six main categories emerged from the perspectives of patients: expectations of rehabilitation care, impact and welcome, relationship with nurses and their involvement in treatment, relationship with physical therapists and participation in rehabilitation programs, relationship with physicians and their availability and attendance, and imparting of information on injury and rehabilitation outcomes. Care was the aspect new patients admitted to the SCU found most important. When closer relationships with staff formed, the healthcare professionals became an essential support. Patients with SCI commonly stated that receiving explicit information was necessary for accepting their condition. Conclusions Analysis of the patients' perceptions revealed a wealth of details on their experience in the SCU and the need for flexible planning of care time in particular. Incorporating the patients

  10. Cognitive performance in hypotensive persons with spinal cord injury

    PubMed Central

    Jegede, Adejoke B.; Rosado-Rivera, Dwindally; Bauman, William A.; Cardozo, Christopher P.; Sano, Mary; Moyer, Jeremy M.; Brooks, Monifa; Wecht, Jill Maria

    2010-01-01

    Background Due to sympathetic de-centralization, individuals with spinal cord injury (SCI), especially those with tetraplegia, often present with hypotension, worsened with upright posture. Several investigations in the non-SCI population have noted a relationship between chronic hypotension and deficits in memory, attention and processing speed and delayed reaction times. Objective To determine cognitive function in persons with SCI who were normotensive or hypotensive over a 24-h observation period while maintaining their routine activities. Methods Subjects included 20 individuals with chronic SCI (2–39 years), 13 with tetraplegia (C4–8) and 7 with paraplegia (T2–11). Individuals with hypotension were defined as having a mean 24-h systolic blood pressure (SBP) below 110 mmHg for males and 100 mmHg for females, and having spent ≥50% of the total time below these gender-specific thresholds. The cognitive battery used included assessment of memory (CVLT), attention and processing speed (Digit Span, Stroop word and color and Oral Trails A), language (COWAT) and executive function (Oral Trails B and Stroop color–word). Results Demographic parameters did not differ among the hypotensive and normotensive groups; the proportion of individuals with tetraplegia (82%) was higher in the hypotensive group. Memory was significantly impaired (P<0.05) and there was a trend toward slowed attention and processing speed (P<0.06) in the hypotensive compared to the normotensive group. Interpretation These preliminary data suggest that chronic hypotension in persons with SCI is associated with deficits in memory and possibly attention and processing speed, as previously reported in the non-SCI population. PMID:19842013

  11. Cognitive performance in hypotensive persons with spinal cord injury.

    PubMed

    Jegede, Adejoke B; Rosado-Rivera, Dwindally; Bauman, William A; Cardozo, Christopher P; Sano, Mary; Moyer, Jeremy M; Brooks, Monifa; Wecht, Jill Maria

    2010-02-01

    Due to sympathetic de-centralization, individuals with spinal cord injury (SCI), especially those with tetraplegia, often present with hypotension, worsened with upright posture. Several investigations in the non-SCI population have noted a relationship between chronic hypotension and deficits in memory, attention and processing speed and delayed reaction times. To determine cognitive function in persons with SCI who were normotensive or hypotensive over a 24-h observation period while maintaining their routine activities. Subjects included 20 individuals with chronic SCI (2-39 years), 13 with tetraplegia (C4-8) and 7 with paraplegia (T2-11). Individuals with hypotension were defined as having a mean 24-h systolic blood pressure (SBP) below 110 mmHg for males and 100 mmHg for females, and having spent >or=50% of the total time below these gender-specific thresholds. The cognitive battery used included assessment of memory (CVLT), attention and processing speed (Digit Span, Stroop word and color and Oral Trails A), language (COWAT) and executive function (Oral Trails B and Stroop color-word). Demographic parameters did not differ among the hypotensive and normotensive groups; the proportion of individuals with tetraplegia (82%) was higher in the hypotensive group. Memory was significantly impaired (P < 0.05) and there was a trend toward slowed attention and processing speed (P < 0.06) in the hypotensive compared to the normotensive group. These preliminary data suggest that chronic hypotension in persons with SCI is associated with deficits in memory and possibly attention and processing speed, as previously reported in the non-SCI population.

  12. Societal Duty and Resource Allocation for Persons with Severe Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    DeJong, Gerben; Batavia, Andrew I.

    1989-01-01

    The article considers eight values and factors that enter into decisions regarding resource allocation for persons with brain injury including the quality of life, moral culpability of the brain-injured person, the social contribution of the person, allocation of family and societal responsibilities, justice, the nature of health care, and…

  13. Societal Duty and Resource Allocation for Persons with Severe Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    DeJong, Gerben; Batavia, Andrew I.

    1989-01-01

    The article considers eight values and factors that enter into decisions regarding resource allocation for persons with brain injury including the quality of life, moral culpability of the brain-injured person, the social contribution of the person, allocation of family and societal responsibilities, justice, the nature of health care, and…

  14. 46 CFR 327.47 - Proof of amount claimed for personal injury.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... earnings. (e) If the claimant is self-employed, written statements, or other evidence showing: (1) The.... (d) If the claimant is employed, a written statement by the claimant's employer certifying...

  15. 46 CFR 327.47 - Proof of amount claimed for personal injury.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... earnings. (e) If the claimant is self-employed, written statements, or other evidence showing: (1) The.... (d) If the claimant is employed, a written statement by the claimant's employer certifying...

  16. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... earnings. (e) If the claimant is self-employed, written statements, or other evidence showing: (1) The.... (d) If the claimant is employed, a written statement by the claimant's employer certifying...

  17. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... earnings. (e) If the claimant is self-employed, written statements, or other evidence showing: (1) The.... (d) If the claimant is employed, a written statement by the claimant's employer certifying...

  18. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... earnings. (e) If the claimant is self-employed, written statements, or other evidence showing: (1) The.... (d) If the claimant is employed, a written statement by the claimant's employer certifying...

  19. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... earnings. (e) If the claimant is self-employed, written statements, or other evidence showing: (1) The.... (d) If the claimant is employed, a written statement by the claimant's employer certifying...

  20. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... earnings. (e) If the claimant is self-employed, written statements, or other evidence showing: (1) The.... (d) If the claimant is employed, a written statement by the claimant's employer certifying...

  1. Self-Esteem Differences among Persons with Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Marini, Irmo; And Others

    1995-01-01

    Surveyed 63 people with spinal cord injury (SCI) in either their first, second, or fifth year post-injury. Results indicated that perceived levels of self-esteem decreased following the SCI. Found that self-esteem was lowest in the second year of injury. Self-esteem may be connected to loss of employment. (RJM)

  2. 10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... pollutant or contaminant attributable to DOE? 770.9 Section 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF... 10 Energy 4 2010-01-01 2010-01-01 false What conditions apply to DOE indemnification of claims... transfer of real property for economic development contains an indemnification provision, the person or...

  3. 14 CFR 1261.308 - NASA officials authorized to act upon claims.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false NASA officials authorized to act upon... PROCESSING OF MONETARY CLAIMS (GENERAL) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.308 NASA officials...

  4. 14 CFR 1261.308 - NASA officials authorized to act upon claims.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false NASA officials authorized to act upon... PROCESSING OF MONETARY CLAIMS (GENERAL) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.308 NASA officials...

  5. 14 CFR § 1261.308 - NASA officials authorized to act upon claims.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false NASA officials authorized to act upon... ADMINISTRATION PROCESSING OF MONETARY CLAIMS (GENERAL) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.308 NASA...

  6. 14 CFR 1261.308 - NASA officials authorized to act upon claims.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false NASA officials authorized to act upon... PROCESSING OF MONETARY CLAIMS (GENERAL) Claims Against NASA or Its Employees for Damage to or Loss of Property or Personal Injury or Death-Accruing On or After January 18, 1967 § 1261.308 NASA officials...

  7. 77 FR 73051 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Claims of U.S...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Agency Information Collection Activities; Proposed Collection; Comments Requested: Claims of U.S. Nationals for Compensation for Serious Personal Injuries Against the Government of Iraq and Referred to the Foreign Claims Settlement Commission by...

  8. 78 FR 9428 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Claims of U.S...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-08

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF JUSTICE Agency Information Collection Activities; Proposed Collection; Comments Requested: Claims of U.S. Nationals for Compensation for Serious Personal Injuries Against the Government of Iraq and Referred to the Foreign Claims Settlement Commission by...

  9. Personal injury recovery cost of pedestrian-vehicle collisions in New South Wales, Australia.

    PubMed

    Mitchell, Rebecca J; Bambach, Mike R

    2016-07-03

    There is a need for routine estimates of injury recovery costs from pedestrian collisions using hospital separation records for economic evaluations. To estimate the cost of injury recovery following pedestrian-vehicle collisions using the personal injury recover cost (PIRC) equation using key demographic and injury characteristics. An estimation of the costs of on-road pedestrian-vehicle collisions involving individuals who were injured and hospitalized in New South Wales (NSW), Australia, from 2002 to 2011 using the PIRC equation. The PIRC estimates individual injury recovery costs and does not include costs associated with property damage, vehicle repair, or rescue services. Individual recovery costs associated with severe traumatic brain injury (TBI) were estimated. The injured individual's mean, median, and total injury recovery costs are described for key demographic, injury, and crash characteristics. There were 9,781 pedestrians who were injured, costing an estimated total of $2.4 billion in personal injury recovery costs, an annual cost of $243 million. Males had a total injury recovery cost 1.7 times higher than females. The median injury recovery cost decreased with increasing age. TBI ($248,491) and spinal cord and vertebral column injuries ($264,103) had the highest median injury recovery costs for the body region of the most severe injury. TBI accounted for 22.6% of the total injury recovery costs for the most severe injury sustained. Just over one third of pedestrians sustained 4 or more injuries, with a median cost of $243,992, which was 1.6 times higher than the cost for a pedestrian who sustained a single injury ($153,682). Personal injury recovery costs following pedestrian-vehicle collisions where a pedestrian is injured are substantial in NSW. The PIRC equation enables the economic cost burden of road traffic injury to be calculated using hospital separation data. The PIRC enables comprehensive personal injury recovery costs to be estimated

  10. Rehabilitation of a person with severe traumatic brain injury.

    PubMed

    Burke, D; Alexander, K; Baxter, M; Baker, F; Connell, K; Diggles, S; Feldman, K; Horny, A; Kokinos, M; Moloney, D; Withers, J

    2000-05-01

    A case study report of a long and intensive rehabilitation programme for a young woman after she sustained a severe diffuse axonal injury in a motor vehicle accident is described in detail. The purpose of this paper is to encourage specialist brain injury rehabilitation services to offer extended rehabilitation programmes to patients, even with very severe injuries. Significant functional improvements and enhanced quality of life frequently reward the high cost and hard work involved.

  11. High Rate of Awarding Compensation for Claims of Injuries Related to Clinical Trials by Pharmaceutical Companies in Japan: A Questionnaire Survey

    PubMed Central

    Kurihara, Chieko; Kusuoka, Hideo; Ono, Shunsuke; Kakee, Naoko; Saito, Kazuyuki; Takehara, Kenji; Tsujide, Kiyokazu; Nabeoka, Yuzo; Sakuhiro, Takuya; Aoki, Hiroshi; Morishita, Noriko; Suzuki, Chieko; Kachi, Shigeo; Kondo, Emiko; Komori, Yukiko; Isobe, Tetsu; Kageyama, Shigeru; Watanabe, Hiroshi

    2014-01-01

    Introduction International norms and ethical standards have suggested that compensation for research-related injury should be provided to injured research volunteers. However, statistical data of incidence of compensation claims and the rate of awarding them have been rarely reported. Method Questionnaire surveys were sent to pharmaceutical companies and medical institutions, focusing on industry-initiated clinical trials aiming at new drug applications (NDAs) on patient volunteers in Japan. Results With the answers from pharmaceutical companies, the incidence of compensation was 0.8%, including 0.06% of monetary compensation. Of the cases of compensation claims, 99% were awarded. In turn, with the answers from medical institutions, the incidence of compensation was 0.6%, including 0.4% of serious but not death cases, and 0.04% of death cases. Furthermore, most claims for compensation were initiated by medical institutions, rather than by the patients. On the other hand, with the answers from clinical trial volunteers, 3% of respondents received compensations. These compensated cases were 25% of the injuries which cannot be ruled out from the scope of compensation. Conclusion Our study results demonstrated that Japanese pharmaceutical companies have provided a high rate of compensation for clinical trial-related injuries despite the possibility of overestimation. In the era of global clinical development, our study indicates the importance of further surveys to find each country's compensation policy by determining how it is being implemented based on a survey of the actual status of compensation coming from statistical data. PMID:24416332

  12. High rate of awarding compensation for claims of injuries related to clinical trials by pharmaceutical companies in Japan: a questionnaire survey.

    PubMed

    Kurihara, Chieko; Kusuoka, Hideo; Ono, Shunsuke; Kakee, Naoko; Saito, Kazuyuki; Takehara, Kenji; Tsujide, Kiyokazu; Nabeoka, Yuzo; Sakuhiro, Takuya; Aoki, Hiroshi; Morishita, Noriko; Suzuki, Chieko; Kachi, Shigeo; Kondo, Emiko; Komori, Yukiko; Isobe, Tetsu; Kageyama, Shigeru; Watanabe, Hiroshi

    2014-01-01

    International norms and ethical standards have suggested that compensation for research-related injury should be provided to injured research volunteers. However, statistical data of incidence of compensation claims and the rate of awarding them have been rarely reported. Questionnaire surveys were sent to pharmaceutical companies and medical institutions, focusing on industry-initiated clinical trials aiming at new drug applications (NDAs) on patient volunteers in Japan. With the answers from pharmaceutical companies, the incidence of compensation was 0.8%, including 0.06% of monetary compensation. Of the cases of compensation claims, 99% were awarded. In turn, with the answers from medical institutions, the incidence of compensation was 0.6%, including 0.4% of serious but not death cases, and 0.04% of death cases. Furthermore, most claims for compensation were initiated by medical institutions, rather than by the patients. On the other hand, with the answers from clinical trial volunteers, 3% of respondents received compensations. These compensated cases were 25% of the injuries which cannot be ruled out from the scope of compensation. Our study results demonstrated that Japanese pharmaceutical companies have provided a high rate of compensation for clinical trial-related injuries despite the possibility of overestimation. In the era of global clinical development, our study indicates the importance of further surveys to find each country's compensation policy by determining how it is being implemented based on a survey of the actual status of compensation coming from statistical data.

  13. Religiosity and Spirituality among Persons with Spinal Cord Injury: Attitudes, Beliefs, and Practices

    ERIC Educational Resources Information Center

    Marini, Irmo; Glover-Graf, Noreen M.

    2011-01-01

    A total of 157 persons with spinal cord injury completed the "Spirituality and Spinal Cord Injury Survey" in relation to their spiritual and/or religious attitudes, beliefs, and practices in terms of adapting to their disability. Factor analysis accounting for 69% of the variance revealed four factors related to Spiritual Help and Improvement…

  14. Religiosity and Spirituality among Persons with Spinal Cord Injury: Attitudes, Beliefs, and Practices

    ERIC Educational Resources Information Center

    Marini, Irmo; Glover-Graf, Noreen M.

    2011-01-01

    A total of 157 persons with spinal cord injury completed the "Spirituality and Spinal Cord Injury Survey" in relation to their spiritual and/or religious attitudes, beliefs, and practices in terms of adapting to their disability. Factor analysis accounting for 69% of the variance revealed four factors related to Spiritual Help and Improvement…

  15. Second workers' compensation claims: who is at risk? Analysis of WorkSafe Victoria, Australia compensation claims.

    PubMed

    Ruseckaite, Rasa; Clay, Fiona J; Collie, Alex

    2012-05-24

    To determine the risk factors associated with early repeat workers' compensation claims in Victoria, Australia and to compare our findings with those of a study on the Alberta's Workers' Compensation Board (WCB) in Canada. We reviewed and described 178,630 claims from 1996-2009. Both persons with single and persons with multiple claims were included. Survival analysis was used to determine the impact of socio-demographic factors on the time between claims. A total of 37% of persons with an initial claim lodged a second claim. A reduced time to a second claim was observed in younger males in the manufacturing industry. Earlier second claims were more common in workers exposed to mental stress, sound and pressure, or chemical and other substances. These findings are similar to those of WCB Alberta. There is a potential to reduce the socio-economic burden of workplace injury in both jurisdictions by enacting prevention programs targeted at workers with an increased risk of repeat claims.

  16. Cognitive error as the most frequent contributory factor in cases of medical injury: a study on verdict's judgment among closed claims in Japan.

    PubMed

    Tokuda, Yasuharu; Kishida, Naoki; Konishi, Ryota; Koizumi, Shunzo

    2011-03-01

    Cognitive errors in the course of clinical decision-making are prevalent in many cases of medical injury. We used information on verdict's judgment from closed claims files to determine the important cognitive factors associated with cases of medical injury. Data were collected from claims closed between 2001 to 2005 at district courts in Tokyo and Osaka, Japan. In each case, we recorded all the contributory cognitive, systemic, and patient-related factors judged in the verdicts to be causally related to the medical injury. We also analyzed the association between cognitive factors and cases involving paid compensation using a multivariable logistic regression model. Among 274 cases (mean age 49 years old; 45% women), there were 122 (45%) deaths and 67 (24%) major injuries (incomplete recovery within a year). In 103 cases (38%), the verdicts ordered hospitals to pay compensation (median; 8,000,000 Japanese Yen). An error in judgment (199/274, 73%) and failure of vigilance (177/274, 65%) were the most prevalent causative cognitive factors, and error in judgment was also significantly associated with paid compensation (odds ratio, 1.9; 95% confidence interval [CI], 1.0-3.4). Systemic causative factors including poor teamwork (11/274, 4%) and technology failure (5/274, 2%) were less common. The closed claims analysis based on verdict's judgment showed that cognitive errors were common in cases of medical injury, with an error in judgment being most prevalent and closely associated with compensation payment. Reduction of this type of error is required to produce safer healthcare. 2010 Society of Hospital Medicine.

  17. Compensation for medical injury in New Zealand: does "'no-fault" increase the level of claims making and reduce social and clinical selectivity?

    PubMed

    Davis, Peter; Lay-Yee, Roy; Fitzjohn, Julie; Hider, Phil; Briant, Robin; Schug, Stephan

    2002-10-01

    The issues of patient safety and quality of care have gained policy attention with a growing appreciation of the scale and impact of medical injury in health systems. While the focus is clearly on the prevention of iatrogenic injury, the question of patient compensation is now also considered important, if only because in fault-based tort systems the fear of litigation may itself be a barrier to the disclosure and open discussion of medical error. No-fault systems, by contrast, do not require proof of culpability, and thus may both reduce barriers to compensation and increase disclosure of error. Little evidence, however, is available on the performance of such systems. This article reports on the analysis of two data sources-a sample of hospital admissions and a complete set of compensation claims for medical injury. Both are for the same year and region of New Zealand, a country that has maintained a no-fault system of accident compensation for a quarter of a century. Just over 2 percent of hospital admissions were associated with an adverse event that was potentially compensable under scheme criteria. While the claims process was well targeted, the level of claims making and receipt was low, with the ratio of successful claims to potentially compensable events being approximately 1:30. Comparison of social and clinical characteristics of the two data sets revealed a degree of selectivity. Compared with the hospital events, the typical successful claimant was younger and female and was much more likely to have experienced a surgical adverse event that, while unexpected, was not due to substandard care. It is concluded that, in interpreting these results, account needs to be taken of a number of features unique to the New Zealand system. These include: the limited payoff for a compensation claim (no pain and suffering or lump sum, free hospital care); the relative complexity of the grounds for claim (either rarity and severity or practitioner error); and a history

  18. Telerehabilitation needs: a survey of persons with acquired brain injury.

    PubMed

    Ricker, Joseph H; Rosenthal, Mitchell; Garay, Edward; DeLuca, John; Germain, Anneliese; Abraham-Fuchs, Klaus; Schmidt, Kai-Uwe

    2002-06-01

    To survey individuals with acquired brain injury to assess multiple facets of interest, access, and familiarity necessary to implement new telerehabilitation technologies. Anonymous mail survey. Community. Seventy-one respondents to a survey. These individuals had experienced acquired brain injury (predominantly severe traumatic brain injury [TBI]) and were living in the community. Surveys were mailed by a state chapter of the Brain Injury Association to a random selection of members with acquired brain injury. Survey designed specifically for this investigation. The survey responses indicate that there is great interest in the possibility of accessing telerehabilitative services among individuals with acquired brain injury. In particular, there was strong interest expressed in services that could be used to assist with problems in memory, attention, problem-solving, and activities of daily living. Telemedicine, and more specifically telerehabilitation, holds great promise as an adjunct to traditional clinical service delivery. Little research in this area has been applied, however, to individuals with acquired brain injuries. Although on the surface, telerehabilitation seems to be an appropriate assessment and treatment modality for individuals with brain injury, it will only succeed if those individuals have the interest-and the access-necessary to use new and evolving technologies.

  19. Substance abuse and crime patterns among persons with traumatic brain injury referred for supported employment.

    PubMed

    Kreutzer, J S; Wehman, P H; Harris, J A; Burns, C T; Young, H F

    1991-01-01

    The present investigation examined the incidence of alcohol use, drug use and criminal behaviour among persons with traumatic brain injury referred for supported employment services. Primary caretakers of 74 consecutive referrals completed the General Health and History Questionnaire, the brief version of the Michigan Alcohol Screening Test, and the Quantity-Frequency-Variability Index. Pre-injury, a fifth of the sample were abstinent from alcohol and 66% were labelled as moderate or heavy drinkers. Post-injury alcohol use declined. Half of the sample were abstinent and 28% were moderate or heavy drinkers. Thirty-six percent reported illicit drug use pre-injury. Reportedly, post-injury drug use declined to an incidence of 4%. Nearly 20% of the sample had been arrested pre-injury and 10% were arrested post-injury. Implications for further research and programme development are discussed.

  20. Does the Relationship of the Proxy to the Target Person Affect the Concordance between Survey Reports and Medicare Claims Measures of Health Services Use?

    PubMed

    Wehby, George L; Jones, Michael P; Ullrich, Fred; Lou, Yiyue; Wolinsky, Fredric D

    2016-02-01

    To compare concordance of survey reports of health service use versus claims data between self respondents and spousal and nonspousal relative proxies. 1995-2010 data from the Survey on Assets and Health Dynamics among the Oldest Old and 1993-2010 Medicare claims for 3,229 individuals (13,488 person-years). Regression models with individual fixed effects were estimated for discordance of any hospitalizations and outpatient surgery and for the numbers of under- and over-reported physician visits. Spousal proxies were similar to self respondents on discordance. Nonspousal proxies, particularly daughters/daughters-in-law and sons/sons-in-law, had less discordance, mainly due to reduced under-reporting. Survey reports of health services use from nonspousal relatives are more consistent with Medicare claims than spousal proxies and self respondents. © Health Research and Educational Trust.

  1. 14 CFR 1261.304 - Place of filing claim.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Injury or Death-Accruing On or After January 18, 1967 § 1261.304 Place of filing claim. A claim arising... activities are believed to have given rise to the claimed injury, loss, or death. If the identity of...

  2. 14 CFR 1261.304 - Place of filing claim.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Injury or Death-Accruing On or After January 18, 1967 § 1261.304 Place of filing claim. A claim arising... activities are believed to have given rise to the claimed injury, loss, or death. If the identity of...

  3. 14 CFR 1261.304 - Place of filing claim.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Injury or Death-Accruing On or After January 18, 1967 § 1261.304 Place of filing claim. A claim arising... activities are believed to have given rise to the claimed injury, loss, or death. If the identity of...

  4. Linguistic Factors Associated with Self-Inflicted Injury in Borderline Personality Disorder

    ERIC Educational Resources Information Center

    Birdwell, Benjamin Park

    2009-01-01

    The present study builds on previous research, which demonstrated higher levels of depressive and interpersonal conflict language in first-person narrative accounts of nonsuicidal self-injury (NSSI) and suicide attempt (SA) in borderline personality disorder. The present study was designed to examine the semantic similarity of time-sequences…

  5. Linguistic Factors Associated with Self-Inflicted Injury in Borderline Personality Disorder

    ERIC Educational Resources Information Center

    Birdwell, Benjamin Park

    2009-01-01

    The present study builds on previous research, which demonstrated higher levels of depressive and interpersonal conflict language in first-person narrative accounts of nonsuicidal self-injury (NSSI) and suicide attempt (SA) in borderline personality disorder. The present study was designed to examine the semantic similarity of time-sequences…

  6. Focus on Clinical Research: Supported Employment for Persons with Traumatic Brain Injury: A Preliminary Report.

    ERIC Educational Resources Information Center

    Wehman, Paul; And Others

    1988-01-01

    Described is an individual-placement supported-employment program for persons with traumatic brain injury. A referral pool of 32 persons is analyzed in terms of demographics, neuropsychological test performance, occupational history, occupational status, etc. Also described are program procedures, data management systems, and the role of…

  7. 34 CFR 35.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... incident causing death, or itemized receipts of payments for such expenses. (7) If damages for pain and..., duration of pain and suffering, any drugs administered for pain and the decedent's physical condition in... injury. In support of a claim for personal injury, including pain and suffering, the claimant may...

  8. 44 CFR 11.14 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... causing death, or itemized receipts of payment for such expenses. (7) If damages for pain and suffering... pain and suffering, any drugs administered for pain, and the decedent's physical condition in the... injury. In support of a claim for personal injury, including pain and suffering, the claimant may...

  9. Differences in Affect, Life Satisfaction, and Depression between Successfully and Unsuccessfully Rehabilitated Persons with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Chapin, Martha H.; Holbert, Donald

    2009-01-01

    This study assessed whether persons with spinal cord injuries who were successfully rehabilitated differed from those who were not with regard to positive and negative affect, life satisfaction, and depression. An ex post facto research design compared persons with spinal cord injuries who were previously employed with persons with spinal cord…

  10. Differences in Affect, Life Satisfaction, and Depression between Successfully and Unsuccessfully Rehabilitated Persons with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Chapin, Martha H.; Holbert, Donald

    2009-01-01

    This study assessed whether persons with spinal cord injuries who were successfully rehabilitated differed from those who were not with regard to positive and negative affect, life satisfaction, and depression. An ex post facto research design compared persons with spinal cord injuries who were previously employed with persons with spinal cord…

  11. [Childhood traumatization, dissociation and nonsuicidal self-injurious behavior in borderline personality disorder].

    PubMed

    Merza, Katalin; Harmatta, János; Papp, Gábor; Kuritárné Szabó, Ildikó

    2017-05-01

    Childhood traumatization plays a significant role in the etiology of borderline personality disorder. Studies found a significant association between childhood traumatization, dissociation, and nonsuicidal self-injurious behavior. The aim of our study was to assess dissociation and nonsuicidal self-injury among borderline inpatients and to reveal the association between childhood traumatization, dissociation, and self-injurious behavior. The sample consisted of 80 borderline inpatients and 73 depressed control patients. Childhood traumatization, dissociation and self-injurious behavior were assessed by questionnaires. Borderline patients reported severe and multiplex childhood traumatization. Cumulative trauma score and sexual abuse were the strongest predictors of dissociation. Furthermore, we have found that cumulative trauma score and dissociation were highly predictive of self-injurious behavior. Our results suggest that self-injurious behavior and dissociation in borderline patients can be regarded as indicators of childhood traumatization. Orv Hetil. 2017; 158(19): 740-747.

  12. Work-related injuries in minors.

    PubMed

    Schober, S E; Handke, J L; Halperin, W E; Moll, M B; Thun, M J

    1988-01-01

    Since 1938, federal child labor laws have restricted employment of persons under 18 years old, in part to protect them from hazardous occupations. Workers' compensation claims reported to the Supplementary Data System of the Bureau of Labor Statistics were examined to define the current status of occupational injuries among minors. Data tapes from 1980 to 1983 were searched to identify all current claims for injuries and illnesses occurring in 1980 in persons under age 18. Injury rates were calculated using information about employment in 1979 available from the 1980 census. In the 24 states included in this study, 23,823 claims were reported for persons less than 18 years old. Of these claims, approximately 10% were from persons under age 16. Rates of injuries in 16- and 17 year olds were 12.6 per 100 full-time male workers and 6.6 per 100 full-time female workers. Serious injuries included fractures, dislocations, and amputations, accounting for 5.8%, 0.7%, and 0.6% of cases, respectively. California, the only state that coded whether injuries resulted in fatalities, reported 12 deaths in this age group. Machines and vehicles, many of which are restricted under child labor laws, accounted for 8.3% and 5.8% of claims. These data suggest that persons under age 18 years are not adequately protected from occupational injury. Further attention and, possibly, new preventive strategies are needed.

  13. Personalized Medicine in Veterans with Traumatic Brain Injuries

    DTIC Science & Technology

    2013-05-01

    between peripheral blood mononuclear cell production of BDNF , TNF-alpha, IL-6, IL-10 and cognitive perform- ances in multiple sclerosis patients. J Neuro...2010; 33: 893-904. [31] Archer T, Svensson K, and Alricsson M. Physi- cal exercise ameliorates deficits induced by traumatic brain injury. Acta

  14. Personalized Medicine in Veterans with Traumatic Brain Injuries

    DTIC Science & Technology

    2012-05-01

    of BDNF , TNF-alpha, IL-6, IL-10 and cognitive perform- ances in multiple sclerosis patients. J Neuro- sci Res 2010; 88: 1106-1112. [15] van Heerden...and Alricsson M. Physi- cal exercise ameliorates deficits induced by traumatic brain injury. Acta Neurol Scand 2012; (in press). [32] Qu C, Mahmood

  15. Vocational Rehabilitation of Persons with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Poor, Charles R.

    1975-01-01

    Reviews historical development of organized vocational rehabilitation programming for the spinal cord injured in the United States. Significant factors that affect vocational rehabilitation outcomes with spinal cord injured persons are listed and discussed. (Author)

  16. Threefold increased bile duct injury rate is associated with less surgeon experience in an insurance claims database: more rigorous training in biliary surgery may be needed.

    PubMed

    Schwaitzberg, Steven D; Scott, Daniel J; Jones, Daniel B; McKinley, Sophia K; Castrillion, Johanna; Hunter, Tina D; Michael Brunt, L

    2014-11-01

    Bile duct injury (BDI) remains the dreaded complication of laparoscopic cholecystectomy (LC) over the last two decades. Although the Fundamentals of Laparoscopic Surgery (FLS) certification is now required for new applicants by the American Board of Surgery, the impact of FLS on procedure-specific outcomes is unknown. Moreover, the FLS content centers on fundamental education and not procedure-specific complication reduction such as BDI, magnifying the importance of understanding the educational impact of FLS on specific case types. This study reviewed the impact of FLS certification and other factors on the incidence of bile duct injury in a large insurance claims database. In total, 53,632 LCs were reviewed from July 2009 to December 2010 from a large private payer claims database. Surgeon National Provider Identifier (NPI), FLS certification status, International Classification of Diseases, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) were available for each event. Each record was analyzed for evidence of any bile duct injury based on associated CPT or ICD-9 data in the claim record. Characteristics of the FLS+ and FLS- surgeon groups were analyzed by a separate reviewer blinded to clinical outcome on a large scale. A total of 53,632 LCs were reviewed; 1748 LC were performed by 441 FLS+ surgeons; and 58,870 LCs by 10,851 FLS- surgeons. (Some procedures involved more than one surgeon). Eighty-two BDIs were identified: 8 in the FLS+ and 74 in the FLS- group. The FLS+ group had a higher rate of BDI than the FLS- group (0.47 vs. 0.14 %, p = 0.0013); however, the FLS+ group was also younger (mean age 38.2 FLS+ vs. 50.4 years) and had significantly fewer years in practice (FLS+ = 6.1 vs. FLS- = 20.7, p = 0.0012). No other complications showed differences between the groups. NPI can be used as a linking intermediary between skills certification and outcomes on claims databases. FLS certification was not associated with a reduction in bile duct injury

  17. Claims and Appeals (Medicare)

    MedlinePlus

    ... gov Medicare forms Advance directives & long-term care Electronic prescribing Electronic Health Records (EHRs) Download claims with Medicare’s Blue ... to Disclose Personal Health Information form Access an electronic form so that someone who helps you with ...

  18. On matters of causation in personal injury cases: Considerations in forensic examination

    PubMed Central

    Ferrari, Robert; Klar, Lewis

    2014-01-01

    Rheumatologists are often called to be independent examiners of injured claimants and to address the question: “What is causing the injured person’s symptoms?” This article deals with the legal principles that arise in these cases, including causation, convenient focus, secondary gain, and thin skull rules. We shall first set out two hypothetical scenarios of personal injury cases that set the scene for a discussion of legal principles in personal injury law. With the same two scenarios of personal injury in mind, we shall review the legal principles and the biopsychosocial models of the illnesses concerned and consider the importance of examiners going beyond diagnostic labels towards a more in-depth analysis of illness factors and mechanisms that in turn assist the trier of facts. PMID:27708902

  19. Community-based training and employment: an effective program for persons with traumatic brain injury.

    PubMed

    Wall, J R; Niemczura, J G; Rosenthal, M

    1998-01-01

    Occupational entry is an important issue for persons with disabilities, as many become or remain unemployed after their injury. After traumatic brain injury (TBI), individuals exhibit high unemployment rates, especially those persons with injuries of greater severity, a limited premorbid work history and/or persons from economically disadvantaged backgrounds. Vocational rehabilitation programs have been developed to improve employability. Traditional vocational rehabilitation approaches, based on integrating work skills with cognitive rehabilitation models have proven only minimally effective with TBI. The supported employment model has been demonstrated to be much more effective with this group, as has an approach that combines vocational and psychosocial skills training along with job support. Even with these generally successful approaches, the literature on vocational rehabilitation in clients from economically disadvantaged environments who are diagnosed with TBI is limited. An approach for the economically disadvantaged, which combines work skills training in a real work community along with supported employment is presented.

  20. Long-term outcome from childhood traumatic brain injury: intellectual ability, personality, and quality of life.

    PubMed

    Anderson, Vicki; Brown, Sandra; Newitt, Heidi; Hoile, Hannah

    2011-03-01

    Only a handful of studies have attempted to explore very long-term outcomes from childhood traumatic brain injury (TBI). These studies have generally failed to fully consider the impact of injury severity or employ measures sensitive to the survivor's day-to-day function. This study examined outcomes in adulthood, with a focus on functional abilities including education, employment, and quality of life (QOL), and employed predictors including injury severity, age at injury, socioeconomic factors, intelligence, and personality. The study was retrospective and cross-sectional and included 50 adult survivors of child TBI (31 males), aged 19-30 years at evaluation (M = 24.2, SD = 3.6), with injury on average 13.3 years prior to evaluation. Participants were divided according to injury severity-mild (n = 20), moderate (n = 12), and severe (n = 18)-completed an intellectual evaluation and questionnaires regarding educational and employment status, personality, and quality of life. Intellectual and personality measures indicated good outcomes, with mean scores for all groups in the average range and few severity-based findings. In contrast, those with more severe TBI were more likely to have educational and employment problems. QOL was significantly reduced in the context of severe insult, with lower IQ and personality factors most predictive of outcome in this domain. Mild and moderate TBI were generally more benign. Findings suggest that, while TBI is a lifelong problem, its impact is most dramatic in the domain of QOL, where a complex interaction occurs between injury factors, cognition, and personality. (c) 2011 APA, all rights reserved

  1. Leisure repertoire among persons with a spinal cord injury: Interests, performance, and well-being

    PubMed Central

    Lundström, Ulrica; Lilja, Margareta; Petersson, Ingela; Lexell, Jan; Isaksson, Gunilla

    2014-01-01

    Objective To explore and describe the leisure repertoire of persons with traumatic spinal cord injury (SCI) and how the repertoire is related to interest, performance, and well-being. Design Cross-sectional study. Setting A total of 97 persons with traumatic SCI were recruited from the non-profit national organization, RG Active Rehabilitation in Sweden. Outcome measure Data were collected through a two-part postal survey. The first comprised of questions investigating socio-demographic variables and injury characteristics; the second part included an interest checklist with 20 areas of leisure activities. Results The participants were mostly interested in, performed, and experienced well-being from social and culture activities and TV/DVD/movies. The areas of leisure activities in which they had most likely experienced changes after the SCI were outdoor activities, exercise, and gardening. Sex, age, and to some extent, time since injury were related to interest, performance, well-being, and changed performance. Conclusions The results provided an explanation and limited description of a changed leisure repertoire among persons after a traumatic SCI. The study showed that sex, age, and time since injury were more closely related to the choice of leisure activities to include in the leisure repertoire than the level of injury. This knowledge can be of importance when professionals in the field of rehabilitation are planning and implementing interventions concerning leisure activities for persons with SCI. PMID:24090284

  2. Examining the epidemiology of work-related traumatic brain injury through a sex/gender lens: analysis of workers' compensation claims in Victoria, Australia.

    PubMed

    Chang, Vicky C; Ruseckaite, Rasa; Collie, Alex; Colantonio, Angela

    2014-10-01

    To provide an overview of the epidemiology of work-related traumatic brain injury (wrTBI) in the state of Victoria, Australia. Specifically, we investigated sex differences in incidence, demographics, injury characteristics, in addition to outcomes associated with wrTBI. This study involved secondary analysis of administrative workers' compensation claims data obtained from the Victorian WorkCover Authority for the period 2004-2011. Sex-specific and industry-specific rates of wrTBI were calculated using denominators derived from the Australian Bureau of Statistics. A descriptive analysis of all variables was conducted for the total wrTBI population and stratified by sex. Among 4186 wrTBI cases identified, 36.4% were females. The annual incidence of wrTBI was estimated at 19.8/100 000 workers. The rate for males was 1.43 (95% CI 1.35 to 1.53) times that for females, but the gap between the two sexes appeared to have narrowed over time. Compared to males, females were older at time of injury and had lower preinjury income. Males had higher rates than females across most industry sectors, with the exception of education/training (RR 0.77, 95% CI 0.64 to 0.93) and professional/scientific/technical services (RR 0.64, 95% CI 0.44 to 0.93). For both sexes, the most common injury mechanism was struck by/against, followed by falls. WrTBI among males was associated with longer duration of work disability and higher claim costs compared to females. This study found significant sex differences in various risk factors and outcomes of wrTBI. Sex/gender should be taken into consideration in future research and prevention strategies. 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.

  3. Describing functioning and health after spinal cord injury in the light of psychological-personal factors.

    PubMed

    Geyh, Szilvia; Kunz, Simon; Müller, Rachel; Peter, Claudio

    2016-02-01

    To describe and explore functioning and health of persons with spinal cord injury from the perspective of psychological-personal factors in the light of the International Classification of Functioning, Disability and Health (ICF) framework. Data from 511 participants regarding feelings, thoughts and beliefs, motives, and patterns of experience and behaviour were analysed. Measurement instruments included the Mental Health Index-5, Positive and Negative Affect Schedule, Hospital Anxiety and Depression Scale, Appraisal of Life Events Scale, 5 items from the World Health Organization Quality of Life Scale, Purpose in Life Test-Short Form, General Self-Efficacy Scale, Big Five Inventory-21, Social Skills Inventory-SF, Brief COPE. The distribution of the selected psychological-personal factors-indicators was examined using descriptive statistics. Differences between SCI subgroups by sex, age, age at injury, time since injury, aetiology and severity of injury were explored using analysis of variance (ANOVA) and F-tests. Participants who were older and sustained their spinal cord injury more recently experienced more depressed mood, less positive affect, less challenge appraisal, lower life satisfaction, lower purpose in life, and lower self-efficacy. They reported lower social skills, less usage of the coping strategies humour, positive reframing, and acceptance, and more usage of the coping strategies denial and self-distraction. Overall, effect sizes were small. Although study participants appeared to be well adjusted to spinal cord injury, those who sustained their injury at an older age and more recently reported more negative experiences. Quantitative description and exploration of the psychological-personal aspects of health will enable hypotheses to be formulated for further research, and suggest a need for tailored interventions for those at risk of less favourable outcomes.

  4. Rehabilitation Utilization following a Work-Related Traumatic Brain Injury: A Sex-Based Examination of Workers’ Compensation Claims in Victoria, Australia

    PubMed Central

    Guerriero, E. Niki; Smith, Peter M.; Stergiou-Kita, Mary; Colantonio, Angela

    2016-01-01

    Objectives To report on and examine differences in the use of four types of rehabilitation services (occupational therapy, physiotherapy, psychology, and speech therapy) by men and women following a work-related traumatic brain injury in Victoria, Australia; and to examine the importance of demographic, need, work-related and geographic factors in explaining these differences. Methods A retrospective cohort design was used to analyze 1786 work-related traumatic brain injury workers’ compensation claims lodged between 2004 and 2012 in Victoria, Australia. ZINB regressions were conducted for each type of rehabilitation service to examine the relationship between sex and rehabilitation use. Covariates included demographic, need-related, work-related, and geographic factors. Results Out of all claims (63% male, 37% female), 13% used occupational therapy, 23% used physiotherapy, 9% used psychology, and 2% used speech therapy at least once during the first year of service utilization. After controlling for demographic, need-related, work-related, and geographic factors, women were more likely to use physiotherapy compared to men. Men and women were equally likely to use occupational therapy and psychology services. The number of visits in the first year for each type of service did not differ between male and female users. Conclusions Our findings support a sex-based approach to studying rehabilitation utilization in work-related populations. Future research is needed to examine other factors associated with rehabilitation utilization and to determine the implications of different rehabilitation utilization patterns on health and return-to-work outcomes. PMID:26982491

  5. Personal and non-occupational risk factors and occupational injury/illness.

    PubMed

    Craig, Brian N; Congleton, Jerome J; Kerk, Carter J; Amendola, Alfred A; Gaines, William G

    2006-04-01

    The materials handling industry performs is an essential function in the world economy, however, it is plagued with occupationally related injuries and illnesses. Understanding the risk factors may assist this industry in alleviating these injuries and illnesses, as well as their associated costs. Forty-eight personal and non-occupational risk factors were measured and evaluated for statistically significant relationships with occupational injury in 442 volunteer manual material handlers who worked for three different companies, at nine US locations, with 15 different job descriptions. OSHA 200 logs were used to ascertain evidence of occupational injury within this population for 1 year after the testing and measurement was completed. Higher occurrences of injury were significantly associated with six risk factors in the univariate model (odds ratios 1.51-4.00). The significantly (P < 0.05) related risk factors in the univariate model were aerobic power, smoking status, perceived fitness level, fishing/hunting as a hobby, speed limit obeyance, and witnessing or being involved in a violent fight. In the multivariate analysis, five risk factors (aerobic power, smoking status, percent body fat, body mass index, and sit-and-reach measured flexibility) were significantly (P < 0.05) associated with occupational injury. Odds ratios in the multivariate analysis varied from 1.42 to 10.11. Evidence of an association of occupational injury occurrence with certain risk factors presented in personal and non-occupational univariate and multivariate models is shown. In industry, effective injury reduction programs should go beyond traditional methods of job-related ergonomic risk factors and include personal factors such as smoking, weight control, and alcohol abuse. Copyright 2006 Wiley-Liss, Inc.

  6. The epidemiology of injury among surfers, kite surfers and personal watercraft riders: wind and waves.

    PubMed

    Pikora, Terri J; Braham, Rebecca; Mills, Christina

    2012-01-01

    The objective of this review was to summarize the epidemiological literature for surfboard riding (surfing), kite surfing and personal watercraft (PWC) riding injuries and describe the incidence and nature of these injuries, common risk factors, and strategies for prevention. The databases searched for relevant publications included Medline, ScienceDirect, ProQuest International, PubMed, Academic Search Premier as well as Google Scholar to identify additional, non-indexed studies. Overall, there was a lack of good quality descriptive studies for these three sports and many of the studies reviewed involved the use of administrative datasets or case-series designs. Among the few studies to provide incidence estimates, there were inconsistencies in how injury was defined, the inclusion criteria, and the reporting of incidence rates, making comparisons within and between the sports difficult. While the reported incidence rates were generally low, head and lower extremity injuries were common across all three sports. Only two studies reported evidence for postulated risk factors. Bigger waves and surfing over rock or reef sea floor increased the risk of injury among competitive surfers, while older age and having more experience increased the risk of significant injuries among recreational surfers. No evaluations of preventative measures were identified. This review demonstrates the need for well-designed epidemiological research, especially studies that focus on the accurate measurement and description of incidence, nature, severity and circumstances of injuries. Once this has occurred, interventions targeted at reducing the incidence of injuries among these sports can be designed, implemented and evaluated.

  7. Personality Change due to Traumatic Brain Injury in Children and Adolescents: Neurocognitive Correlates

    PubMed Central

    Wilde, Elisabeth A.; Bigler, Erin D.; Hanten, Gerri; Dennis, Maureen; Schachar, Russell J.; Saunders, Ann E.; Ewing-Cobbs, Linda; Chapman, Sandra B.; Thompson, Wesley K.; Yang, Tony T.; Levin, Harvey S.

    2015-01-01

    Personality Change due to traumatic brain injury (PC) in children is an important psychiatric complication of injury and is a form of severe affective dysregulation. The aim of the study was to examine neurocognitive correlates of PC. The sample included children (n=177) aged 5-14 years with traumatic brain injury from consecutive admissions to 5 trauma centers were followed prospectively at baseline and 6 months with semi-structured psychiatric interviews. Injury severity, socioeconomic status, and neurocognitive function (measures of attention, processing speed, verbal memory, IQ, verbal working memory, executive function, naming/reading, expressive language, motor speed, and motor inhibition) were assessed with standardized instruments. Unremitted PC was present in 26/141 (18%) participants assessed at 6 months post-injury. Attention, processing speed, verbal memory, IQ, and executive function, were significantly associated (p < .05) with PC even after socioeconomic status, injury severity, and pre-injury attention-deficit/hyperactivity disorder were controlled. These findings are a first step in characterizing concomitant cognitive impairments associated with PC. The results have implications beyond brain injury to potentially elucidate the neurocognitive symptom complex associated with mood instability regardless of etiology. PMID:26185905

  8. Injury-related visits and comorbid conditions among homeless persons presenting to emergency departments.

    PubMed

    Hammig, Bart; Jozkowski, Kristen; Jones, Ches

    2014-04-01

    The authors examined the clinical characteristics of homeless patients presenting to emergency departments (EDs) in the United States, with a focus on unintentional and intentional injury events and related comorbid conditions. The study included a nationally representative sample of patients presenting to EDs with data obtained from the 2007 through 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS). Descriptive and analytical epidemiologic analyses were employed to examine injuries among homeless patients. Homeless persons made 603,000 visits annually to EDs, 55% of which were for injuries, with the majority related to unintentional (52%) and self-inflicted (23%) injuries. Multivariate logistic regression analyses revealed that homeless patients had a higher odds of presenting with injuries related to unintentional (odds ratio [OR]=1.4. 95% confidence interval [CI]=1.1 to 1.9), self-inflicted (OR=6.0, 95% CI=3.7 to 9.5), and assault (OR=3.0, 95% CI=1.5 to 5.9) injuries. A better understanding of the injuries affecting homeless populations may provide medical and public health professionals insight into more effective ways to intervene and limit further morbidity and mortality related to specific injury outcomes. © 2014 by the Society for Academic Emergency Medicine.

  9. A Supported Relationships Intervention to Increase the Social Integration of Persons with Traumatic Brain Injuries.

    ERIC Educational Resources Information Center

    Johnson, Katherine; Davis, Paula K.

    1998-01-01

    Three persons with traumatic brain injury (TBI) were matched with four community participants for leisure activities. Community participants were trained and were given specific interactions suggestions. Integrated social contacts were measured using a multiple-baseline design across participants. Results suggest that social integration can be…

  10. Correlates of Depression in Adult Siblings of Persons with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Degeneffe, Charles Edmund; Lynch, Ruth Torkelson

    2006-01-01

    Using Pearlin's stress process model, this study examined correlates of depression in 170 adult siblings of persons with traumatic brain injury (TBI). Approximately 39% of adult sibling participants evinced "Center for Epidemiologic Studies-Depression" (CES-D; Radloff, 1977) scores indicating clinically significant depressive symptoms. Background…

  11. Emotional Responses to Self-Injury Imagery among Adults with Borderline Personality Disorder

    ERIC Educational Resources Information Center

    Welch, Stacy Shaw; Linehan, Marsha M.; Sylvers, Patrick; Chittams, Jesse; Rizvi, Shireen L.

    2008-01-01

    Nonsuicidal self-injury (NSSI) and suicide attempts (SAs) are especially prevalent in borderline personality disorder. One proposed mechanism for the maintenance of NSSI and SAs is escape conditioning, whereby immediate reductions in aversive emotional states negatively reinforce the behaviors. Psychophysiological and subjective indicators of…

  12. Differences in Coping Styles among Persons with Spinal Cord Injury: A Cluster-Analytic Approach.

    ERIC Educational Resources Information Center

    Frank, Robert G.; And Others

    1987-01-01

    Identified and validated two subgroups in group of 53 persons with spinal cord injury by applying cluster-analytic procedures to subjects' self-reported coping and health locus of control belief scores. Cluster 1 coped less effectively and tended to be psychologically distressed; Cluster 2 subjects emphasized internal health attributions and…

  13. Family Resiliency, Family Needs, and Community Reintegration in Persons with Brain Injury

    ERIC Educational Resources Information Center

    Frain, Julianne; Dillahunt-Aspillaga, Tina; Frain, Michael; Ehkle, Sarah

    2014-01-01

    Purpose: The purpose of the study was to measure predictors of community reintegration and empirically test the resiliency model of family stress, adjustment, and adaptation in persons with traumatic brain injury (TBI). The study also aimed to measure family needs by surveying caregiving family members through the use of the Family Needs…

  14. Alcohol and Drug Use among Young Persons with Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    Kreutzer, Jeffrey S.; And Others

    1996-01-01

    This study compared the preinjury and postinjury patterns of alcohol and illicit drug use of 87 persons (ages 16 to 20) with traumatic brain injury. Although an initial follow-up indicated decline in alcohol use, second follow-up (at 28 months postinjury) suggested that drinking quantity and frequency increased over time. Postinjury illicit drug…

  15. Emotional Responses to Self-Injury Imagery among Adults with Borderline Personality Disorder

    ERIC Educational Resources Information Center

    Welch, Stacy Shaw; Linehan, Marsha M.; Sylvers, Patrick; Chittams, Jesse; Rizvi, Shireen L.

    2008-01-01

    Nonsuicidal self-injury (NSSI) and suicide attempts (SAs) are especially prevalent in borderline personality disorder. One proposed mechanism for the maintenance of NSSI and SAs is escape conditioning, whereby immediate reductions in aversive emotional states negatively reinforce the behaviors. Psychophysiological and subjective indicators of…

  16. Future Concerns of Adult Siblings of Persons with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Degeneffe, Charles Edmund; Olney, Marjorie F.

    2008-01-01

    This study examined future concerns conveyed by adult siblings who provided regular caregiving support to their brothers and sisters with traumatic brain injury (TBI). The authors surveyed a national sample of 280 adult siblings of persons with TBI. Using a constant comparative approach to text analysis, the authors analyzed responses to the…

  17. Family Resiliency, Family Needs, and Community Reintegration in Persons with Brain Injury

    ERIC Educational Resources Information Center

    Frain, Julianne; Dillahunt-Aspillaga, Tina; Frain, Michael; Ehkle, Sarah

    2014-01-01

    Purpose: The purpose of the study was to measure predictors of community reintegration and empirically test the resiliency model of family stress, adjustment, and adaptation in persons with traumatic brain injury (TBI). The study also aimed to measure family needs by surveying caregiving family members through the use of the Family Needs…

  18. Beta Adrenergic Blocking Medications for Aggressive or Self-Injurious Mentally Retarded Persons.

    ERIC Educational Resources Information Center

    Ruedrich, Stephen L.; And Others

    1990-01-01

    Literature is reviewed and a case report is presented concerning blockers of the beta-adrenergic function of the sympathetic nervous system, postulated to have efficacy in treatment of aggressive or self-injurious syndromes in persons with mental retardation. Concerns are raised regarding endorsement of beta-blocking medications before they have…

  19. A Supported Relationships Intervention to Increase the Social Integration of Persons with Traumatic Brain Injuries.

    ERIC Educational Resources Information Center

    Johnson, Katherine; Davis, Paula K.

    1998-01-01

    Three persons with traumatic brain injury (TBI) were matched with four community participants for leisure activities. Community participants were trained and were given specific interactions suggestions. Integrated social contacts were measured using a multiple-baseline design across participants. Results suggest that social integration can be…

  20. 75 FR 1301 - Damages Received on Account of Personal Physical Injuries or Physical Sickness; Hearing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 RIN 1545-BF81 Damages Received on Account of Personal Physical Injuries or Physical Sickness; Hearing AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of...

  1. [Harmonisation of personal injury compensation in the European Union. Application to medical liability case law].

    PubMed

    Hureau, Jacques

    2006-03-01

    Harmonisation of personal injury compensation in the European Union (EU) is crucial. Continuing on from the work begun by the European Federation of Medical Academies, a working party of the XVth Committee of the French National Academy of Medicine has sought to go beyond the restrictive framework of automobile accident compensation in order to address more universal concerns, regardless of the causes and effects of bodily injury. The specific situation of injuries resulting from medical acts was considered, both for its medicolegal complexity and its potential human consequences. After recalling relevant European legislation, the authors consider the different philosophies of medical liability and health care systems in Europe. Methodological convergence is required to achieve harmonisation of personal injury compensation regimes, and especially for the classification of different types of bodily injury, the role of social services, and the establishment of a reference for medical evaluation of injury with built-in compensation levels. The doctrines and concepts of all EU member states (civil law, common law, Nordic medical liability regimes, etc.) are discussed, together with means of facilitating their harmonisation.

  2. Long-bone fractures in persons with spinal cord injury.

    PubMed

    Frotzler, A; Cheikh-Sarraf, B; Pourtehrani, M; Krebs, J; Lippuner, K

    2015-09-01

    Retrospective data analysis. To document fracture characteristics, management and related complications in individuals with traumatic spinal cord injury (SCI). Rehabilitation centre for SCI individuals. Patients' records were reviewed. Patients with traumatic SCI and extremity fractures that had occurred after SCI were included. Patient characteristics, fractured bone, fracture localisation, severity and management (operative/conservative), and fracture-related complications were extracted. A total of 156 long-bone fractures in 107 SCI patients (34 women and 73 men) were identified. The majority of patients were paraplegics (77.6%) and classified as American Spinal Injury Association Impairment Scale A (86.0%). Only the lower extremities were affected, whereby the femur (60.9% of all fractures) was fractured more frequently than the lower leg (39.1%). A total of 70 patients (65.4%) had one fracture, whereas 37 patients (34.6%) had two or more fractures. Simple or extraarticular fractures were most common (75.0%). Overall, 130 (83.3%) fractures were managed operatively. Approximately half of the femur fractures (48.2%) were treated with locking compression plates. In the lower leg, fractures were mainly managed with external fixation (48.8%). Conservative fracture management was applied in 16.7% of the cases and consisted of braces or a well-padded soft cast. Fracture-associated complications were present in 13.5% of the cases but did not differ significantly between operative (13.1%) and conservative (15.4%) fracture management. SCI was associated with simple or extraarticular fractures of the distal femur and the lower leg. Fractures were mainly managed operatively with a low complication rate.

  3. Mobility, continence, and life expectancy in persons with Asia Impairment Scale Grade D spinal cord injuries.

    PubMed

    Shavelle, Robert M; Paculdo, David R; Tran, Linh M; Strauss, David J; Brooks, Jordan C; DeVivo, Michael J

    2015-03-01

    Previous research on the life expectancy of persons with American Spinal Injury Association (ASIA) Impairment Scale Grade D spinal cord injury has considered them as a large homogenous group, making no functional or medical distinctions. This study sought to (1) determine how survival in this group depends on ambulatory function and the extent of bowel or bladder dysfunction, (2) compute life expectancies for various subgroups, and (3) examine whether survival has improved over time. Data were from 8,206 adults with ASIA Impairment Scale Grade D spinal cord injury in the Spinal Cord Injury Model Systems database who were not ventilator dependent and who survived more than 1 yr after injury. There were a total of 114,739 person-years of follow-up and 1,730 deaths during the 1970-2011 study period. Empirical age- and sex-specific mortality rates were computed. Regression analysis of survival data with time-dependent covariates was used to determine the effect of risk factors, to test for a time trend, and to estimate mortality rates for subgroups. Life expectancies were obtained from life tables constructed for each subgroup. The ability to walk, whether independently or with an assistive device, was associated with longer survival than wheelchair dependence. The need for an indwelling catheter, and to a lesser extent intermittent catheterization, was associated with increased mortality risk. Persons who walked unaided and who did not require catheterization had life expectancies roughly 90% of normal. Those who required a wheelchair for locomotion had life expectancies comparable with that in paraplegia, less than 75% of normal. No time trend in survival was found. Life expectancy of persons with ASIA Impairment Scale D spinal cord injury depends strongly on the ability to walk and the need for catheterization.

  4. Effect of a health claim and personal characteristics on consumer acceptance of fruit juices with different concentrations of açaí (Euterpe oleracea Mart.).

    PubMed

    Sabbe, Sara; Verbeke, Wim; Deliza, Rosires; Matta, Virginia; Van Damme, Patrick

    2009-08-01

    This study evaluates the effect of a health claim and personal characteristics on the acceptance of two unfamiliar açaí fruit juices that have a low (40% açaí) versus a high (4% açaí) a priori overall liking. Hedonic and sensory measures as well as health- and nutrition-related attribute perceptions and purchase intention were rated before and after health information was presented. Differences in information effects due to interactions with juice type, consumer background attitudes and socio-demographics were investigated. Providing health information yielded a positive, though rather small increase, in overall liking, perceived healthiness and perceived nutritional value of both juices, as well as in their purchase intention. Sensory experiences remained predominant in the acceptance of the fruit juices, although the health claim had a stronger effect on the perceived healthiness and nutritional value of the least-liked juice. Background attitudes and socio-demographic characteristics influenced consumers' acceptance of both unfamiliar fruit juices. Health-oriented consumers were more likely to compromise on taste for an eventual health benefit, though they still preferred the best tasting juice. Consumers with a high food neophobia reported a lower liking for both unfamiliar fruit juices. Older respondents and women were more likely to accept fruit juices that claim a particular health benefit.

  5. Precision and improving outcomes in acute kidney injury: Personalizing the approach.

    PubMed

    Forni, Lui G; Chawla, Lakhmir; Ronco, Claudio

    2017-02-01

    It is now well over a decade since attempts at harmonization of acute renal failure into a definable entity termed acute kidney injury. This has led to several landmark studies outlining the epidemiology of acute kidney injury, particularly in the critically ill, as well as providing insights into the long-term effects of the syndrome. Despite the introduction of consensus definitions and improvement in recognition, this has not been translated into outcome benefits as yet. The introduction of novel biomarkers associated with renal damage was primarily aimed at aiding early recognition of acute kidney injury. We argue that, in the future, using biomarkers may not only alert to acute kidney injury but may direct therapy in a personalized fashion rather than a one-size-fits-all approach.

  6. Promoting safer home environments for persons with Alzheimer's disease. The Home Safety/Injury Model.

    PubMed

    Hurley, Ann C; Gauthier, Mary Anne; Horvath, Kathy J; Harvey, Rose; Smith, Sally J; Trudeau, Scott; Cipolloni, P B; Hendricks, Ann; Duffy, Mary

    2004-06-01

    This article describes a Home Safety/Injury Model derived from Social Cognitive Theory. The model's three components are safety platform, the person with dementia, and risky behaviors. The person with dementia is in the center, located on the safety platform composed of the physical environment and caregiver competence. The interaction between the underlying dementia and indicators of frailty can lead to the person with dementia performing risky behaviors that can overcome the safety platform's resources and lead to an accident or injury, and result in negative consequences. Through education and research, the model guides proactive actions to prevent risky behaviors of individuals with dementia by promoting safer home environments and increased caregiver competence.

  7. Who’s Missing the Point? A Commentary on Claims that Autistic Persons Have a Specific Deficit in Figurative Language Comprehension

    PubMed Central

    Gernsbacher, Morton Ann; Pripas-Kapit, Sarah R.

    2014-01-01

    It’s become a caricature of autistic persons that they don’t understand figurative language. Despite empirical evidence to the contrary, three of the four contributions to this special issue endorse this stereotype without question. And all four contributions attribute this supposed deficit to even shakier fallacies, such as the controversial claim that autistic people lack empathy or a ‘theory of mind.’ In this commentary, we begin by reviewing the literature more exhaustively than the other contributions, and we highlight a point that they missed: Autistic persons are likely to have difficulty comprehending figurative language if they also have difficulty comprehending language in general. There doesn’t seem to be a specific deficit in figurative language unique to autism. We also tackle the claim that autistic people lack empathy. And we question the existence of a ‘theory of mind area,’ while demonstrating the pitfalls that ensnarl researchers when they strain to interpret differences between autistic and non-autistic brain activity as solely autistic deficits. PMID:25339845

  8. Risk behaviors related to cigarette smoking among persons with spinal cord injury.

    PubMed

    Saunders, Lee L; Krause, James S; Carpenter, Matthew J; Saladin, Michael

    2014-02-01

    Smoking, while detrimental to health in any population, has greater health implications for those with spinal cord injury (SCI) because of additional risks posed by SCI. The aims of this study were to document smoking status after SCI and to assess relationships between smoking status with injury severity and alcohol/pain medication use. Participants (n = 1,076) were identified from a large rehabilitation hospital in the southeastern part of the United States. Eligibility criteria included (a) traumatic SCI resulting in residual impairment, (b) adult, and (c) 1+ years postinjury. Previous and current cigarette smoking and quitting attempts were assessed. Relationships were assessed between smoking status (current, former, and never), alcohol use, and pain medication use. Of participants (72% male, M age = 49.6 years, M = 16.1 years since SCI), 49.2% had never smoked, 28.2% were former smokers, and 22.6% were current smokers. Of current smokers, 39.2% attempted quitting in the past year and 77.2% had ever tried to quit. Only 29.9% of those who ever tried to quit sought professional help. Ambulatory persons, regardless of injury level, were 2.32 times more likely to be current smokers than nonambulatory persons with a high-level cervical injury. Lower socioeconomic status, binge drinking, and misuse of pain medication all predicted current smoking. Smoking prevalence among persons with SCI is largely consistent with the general population. Additionally, we found smoking to be associated with other risk behaviors (binge drinking and prescription medication misuse) and differs by injury severity. Future studies should assess smoking interventions, which may differ by injury severity.

  9. Postinjury personality and outcome in acquired brain injury: the Millon Behavioral Medicine Diagnostic.

    PubMed

    Beck, Kelley D; Franks, Susan F; Hall, James R

    2010-03-01

    To examine the relationship between postinjury personality and outcome in individuals with acquired brain injury. It was hypothesized that patients with differing levels of Introversive, Dejected, and Oppositional coping styles as described by Millon's Theory of Personality would show different outcomes after completion of a rehabilitation program. A retrospective chart review and completion of an outcome assessment was undertaken to examine study hypotheses. A postacute brain injury rehabilitation program. Fifty patients who completed the rehabilitation program between 2005 and 2008, who were 18 years of age or older, who possessed at least a sixth-grade reading level, and who completed a valid Millon Behavioral Medicine Diagnostic (MBMD) were selected. Rehabilitation therapists who worked with these patients were also recruited to assess patient outcomes. Charts of patients that met inclusion criteria were reviewed. Rehabilitation therapists completed the outcome measure retrospectively. The MBMD was used to predict outcome. The MBMD is a self-report questionnaire designed to assess psychosocial factors that relate to the course of medical treatment in chronic illness. The Mayo-Portland Adaptability Inventory (MPAI-4) was used to assess patient outcome. It is a 29-item assessment designed to evaluate the common physical, cognitive, emotional, behavioral, and social issues after acquired brain injury. Findings supported our hypotheses that patients with differing levels of Introversive and Oppositional Coping Styles would have significantly different outcomes after rehabilitation. Thus, individuals with mild/moderate to moderate/severe limitations had significantly greater scores on the Introversive and Oppositional coping compared with individuals with more successful outcomes. The results of this study support the idea that postinjury personality is an important factor in understanding outcome after completion of a brain-injury rehabilitation program

  10. Overview of impaired facial affect recognition in persons with traumatic brain injury.

    PubMed

    Radice-Neumann, Dawn; Zupan, Barbra; Babbage, Duncan R; Willer, Barry

    2007-07-01

    To review the literature of affect recognition for persons with traumatic brain injury (TBI). It is suggested that impairment of affect recognition could be a significant problem for the TBI population and treatment strategies are recommended based on research for persons with autism. Research demonstrates that persons with TBI often have difficulty determining emotion from facial expressions. Studies show that poor interpersonal skills, which are associated with impaired affect recognition, are linked to a variety of negative outcomes. Theories suggest that facial affect recognition is achieved by interpreting important facial features and processing one's own emotions. These skills are often affected by TBI, depending on the areas damaged. Affect recognition impairments have also been identified in persons with autism. Successful interventions have already been developed for the autism population. Comparable neuroanatomical and behavioural findings between TBI and autism suggest that treatment approaches for autism may also benefit those with TBI. Impaired facial affect recognition appears to be a significant problem for persons with TBI. Theories of affect recognition, strategies used in autism and teaching techniques commonly used in TBI need to be considered when developing treatments to improve affect recognition in persons with brain injury.

  11. Brief report: emotion regulation and coping as moderators in the relationship between personality and self-injury.

    PubMed

    Hasking, Penelope A; Coric, Sarah J; Swannell, Sarah; Martin, Graham; Thompson, Holly Knox; Frost, Aaron D J

    2010-10-01

    Self-injury without conscious suicidal intent is an increasingly prevalent phenomenon particularly among adolescent populations. This pilot study examined the extent and correlates of self-injurious behaviour in a school population sample of 393 adolescents (aged 13-18 years) using a self-report questionnaire. Specifically, we aimed to determine whether personality was related to self-injury and whether this relationship was moderated by emotion regulation or coping strategies. Few personality and coping variables were directly related to self-injury after controlling for age and psychopathology. However the relationship between personality and self-injury was moderated by coping skills and emotion regulation. We suggest future research explore these relationships in order to determine the role of coping skills and emotional regulation training in prevention of self-injury.

  12. Non-fatal workplace violence workers' compensation claims (1993-1996).

    PubMed

    Hashemi, L; Webster, B S

    1998-06-01

    More is known about fatal workplace violence than non-fatal workplace violence (NFWV). This study provides descriptive information on the number and cost of NFWV claims filed with a large workers' compensation carrier. NFWV claims from 51 US jurisdictions were selected either by cause codes or by word search from the accident-description narrative. Claims reported in 1993 through 1996 were analyzed to report the frequency, cost, gender, age, industry, and nature of injury. An analysis of a random sample of 600 claims provided information on perpetrator type, cause of events, and injury mechanism. A total of 28,692 NFWV claims were filed during the study period. No cost was incurred for 32.5% of the claims, and 15.5% received payments for lost work. As a percentage of all claims filed by industry, schools had the highest percentage (11.4%) of NFWV claims, and banking had the highest percentage (11.5%) of cost. The majority of claims in the banking random sample group (93%) were due to stress. In the random sample, 90.3% of claims were caused by criminals (51.8%) or by patients, clients, or customers (38.5%). Only 9.7% were caused by an employee (9.2%) or a personal acquaintance of the employee (0.5%). Employers should acknowledge that NFWV incidents occur, recognize that the majority of perpetrators are criminals or clients rather than employees, and develop appropriate prevention and intervention programs.

  13. Effects of personal and occupational stress on injuries in a young, physically active population: a survey of military personnel.

    PubMed

    Bedno, Sheryl; Hauret, Keith; Loringer, Kelly; Kao, Tzu-Cheg; Mallon, Timothy; Jones, Bruce

    2014-11-01

    The aim of this study was to document risk factors for any injury and sports- and exercise-related injuries, including personal and occupational stress among active duty service members (SMs) in the Air Force, Army, Marine Corps, and Navy. A total of 10,692 SMs completed the April 2008 Status of Forces Survey of Active Duty Members. The survey asked about demographics, personal stress and occupational stress, injuries from any cause, and participation in sports- and exercise- related activities in the past year. The survey used a complex sampling procedure to create a representative sample of SMs. Logistic regression was used to examine the associations of injury outcomes with potential risk factors. 49% of SMs sought medical care for an injury in the past year and 25% sustained a sports- and exercise-related activities injury. Odds of injury were higher for the Army and Marine Corps than for the Air Force or Navy. This survey showed that higher personal and occupational stress was associated with higher risks of injury. SMs who experienced higher levels of personal or occupational stress reported higher risks of injuries. The effects of stress reduction programs on injury risks should be evaluated in military and other young physically active populations.

  14. 78 FR 65450 - Proposed Information Collection (Statement of Person Claiming To Have Stood in Relation of a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... relation of parents to a deceased Veteran eligibility for death benefits. DATES: Written comments and... claimants seeking service-connected death benefits as persons who stood in the relationship of the...

  15. 76 FR 2755 - Proposed Information Collection (Statement of Person Claiming To Have Stood in Relation of a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ... relation of parents to a deceased veteran eligibility for death benefits. DATES: Written comments and... claimants seeking service-connected death benefits as persons who stood in the relationship of the...

  16. [Relationships between low-grade chronic depression, pain and personality traits among community-dwelling persons with traumatic spinal cord injury].

    PubMed

    Nagumo, N

    2000-08-01

    To examine the relationships between low-grade chronic depression, pain and personality traits among community-dwelling persons with traumatic spinal cord injury (TSCI), 111 male and 11 female TSCI persons were administered questionnaires including Self-rating Depression Scale (SDS) and measures of pain and other mental health items, and were followed-up two years later. Nineteen persons (15%) meeting the criteria for low-grade chronic depression (both SDS scores > or = 48) were identified, while 30% of the sample population consistently showed normal mood (both SDS scores < or = 41). Both disabling pain and B type (emotionally labile, socially maladjusted, and extraverted personality characteristic) associated with lower IQ (90 and less) were significantly related to high SDS scores. However, age, sex, time-since-injury, levels of injury and marital status had no relationship with depression.

  17. Personality Change Due to Traumatic Brain Injury in Children and Adolescents: Neurocognitive Correlates.

    PubMed

    Max, Jeffrey E; Wilde, Elisabeth A; Bigler, Erin D; Hanten, Gerri; Dennis, Maureen; Schachar, Russell J; Saunders, Ann E; Ewing-Cobbs, Linda; Chapman, Sandra B; Thompson, Wesley K; Yang, Tony T; Levin, Harvey S

    2015-01-01

    Personality change due to traumatic brain injury (PC) in children is an important psychiatric complication of injury and is a form of severe affective dysregulation. This study aimed to examine neurocognitive correlates of PC. The sample included 177 children 5-14 years old with traumatic brain injury who were enrolled from consecutive admissions to five trauma centers. Patients were followed up prospectively at baseline and at 6 months, and they were assessed with semistructured psychiatric interviews. Injury severity, socioeconomic status, and neurocognitive function (measures of attention, processing speed, verbal memory, IQ, verbal working memory, executive function, naming/reading, expressive language, motor speed, and motor inhibition) were assessed with standardized instruments. Unremitted PC was present in 26 (18%) of 141 participants assessed at 6 months postinjury. Attention, processing speed, verbal memory, IQ, and executive function were significantly associated with PC even after socioeconomic status, injury severity, and preinjury attention deficit hyperactivity disorder were controlled. These findings are a first step in characterizing concomitant cognitive impairments associated with PC. The results have implications beyond brain injury to potentially elucidate the neurocognitive symptom complex associated with mood instability regardless of etiology.

  18. Work safety climate, personal protection use, and injuries among Latino residential roofers.

    PubMed

    Arcury, Thomas A; Summers, Phillip; Rushing, Julia; Grzywacz, Joseph G; Mora, Dana C; Quandt, Sara A; Lang, Wei; Mills, Thomas H

    2015-01-01

    This analysis describes work safety climate, personal protective equipment (PPE) use, and injuries among Latino residential roofers, and examines the associations of work safety climate with PPE use and injuries. Eighty-nine North Carolina residential roofers completed a baseline interview and daily logs about perceptions and use of PPE, occurrence of injuries in last 12 months, and work safety climate. The mean work safety climate score was 26.5 (SD = 5.6). In the baseline interview, participants reported that the majority of employers provided PPE and that they used it most or all of the time; daily log data indicated that PPE was used for half or fewer of hours worked. 39.9% reported any injury in the last 12 months. Work safety climate was significantly correlated with the provision and use of most types of PPE, and was inversely associated with injury. Supervisors promoting safety may increase the PPE use and decrease injuries. © 2014 Wiley Periodicals, Inc.

  19. 14 CFR 1261.304 - Place of filing claim.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Death-Accruing On or After January 18, 1967 § 1261.304 Place of filing claim. A claim arising in the... believed to have given rise to the claimed injury, loss, or death. If the identity of such installation...

  20. Measuring unmet needs and services among persons with traumatic brain injury.

    PubMed

    Heinemann, Allen W; Sokol, Kara; Garvin, Lauree; Bode, Rita K

    2002-08-01

    (1) To develop a comprehensive list of needs and services appropriate for persons with traumatic brain injury (TBI); (2) to determine whether these needs and services formed unidimensional hierarchies from least common to most common; (3) to describe the relationship between unmet needs and services received; and (4) to estimate the extent to which a variety of demographic, injury, and service characteristics predict unmet needs. Statewide mailed survey. Illinois communities. A total of 895 persons who had had a TBI recruited from Brain Injury Association members and rehabilitation service recipients. The median time post-TBI was 7 years; the median age was 37 years. Not applicable. A 27-item instrument assessing service needs and utilization of services, and equal-interval measures of needs and services derived with Rasch analysis. The most prevalent unmet needs were improving memory or problem-solving skills (51.9%), increasing income (50.5%), and improving job skills (46.3%). The instrument defined unidimensional and reliable constructs of needs and services. Persons with greater unmet needs tended to receive fewer services; to report lower life satisfaction and worse medical health and psychologic well-being since injury; to be younger, single, black, dependent in 1 or more daily activities; and to have more recent injuries. The results show the common pattern of unmet needs and services and emphasize the importance of comprehensive, statewide assessment of services and needs in developing policies. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

  1. Environmental Factors Item Development for Persons With Stroke, Traumatic Brain Injury, and Spinal Cord Injury

    PubMed Central

    Heinemann, Allen W.; Magasi, Susan; Hammel, Joy; Carlozzi, Noelle E.; Garcia, Sofia F.; Hahn, Elizabeth A.; Lai, Jin-Shei; Tulsky, David; Gray, David B.; Hollingsworth, Holly; Jerousek, Sara

    2015-01-01

    Objectives To describe methods used in operationalizing environmental factors; to describe the results of a research project to develop measures of environmental factors that affect participation; and to define an initial item set of facilitators and barriers to participation after stroke, traumatic brain injury, and spinal cord injury. Design Instrument development included an extensive literature review, item classification and selection, item writing, and cognitive testing following the approach of the Patient-Reported Outcomes Measurement Information System. Setting Community. Participants Content area and outcome measurement experts (n=10) contributed to instrument development; individuals (n=200) with the target conditions participated in focus groups and in cognitive testing (n=15). Interventions None. Main Outcome Measures Environmental factor items were categorized in 6 domains: assistive technology; built and natural environment; social environment; services, systems, and policies; access to information and technology; and economic quality of life. Results We binned 2273 items across the 6 domains, winnowed this pool to 291 items for cognitive testing, and recommended 274 items for pilot data collection. Conclusions Five of the 6 domains correspond closely to the International Classification of Functioning, Disability and Health taxonomy of environmental factors; the sixth domain, economic quality of life, reflects an important construct that reflects financial resources that affect participation. Testing with a new and larger sample is underway to evaluate reliability, validity, and sensitivity. PMID:24378804

  2. Environmental factors item development for persons with stroke, traumatic brain injury, and spinal cord injury.

    PubMed

    Heinemann, Allen W; Magasi, Susan; Hammel, Joy; Carlozzi, Noelle E; Garcia, Sofia F; Hahn, Elizabeth A; Lai, Jin-Shei; Tulsky, David; Gray, David B; Hollingsworth, Holly; Jerousek, Sara

    2015-04-01

    To describe methods used in operationalizing environmental factors; to describe the results of a research project to develop measures of environmental factors that affect participation; and to define an initial item set of facilitators and barriers to participation after stroke, traumatic brain injury, and spinal cord injury. Instrument development included an extensive literature review, item classification and selection, item writing, and cognitive testing following the approach of the Patient-Reported Outcomes Measurement Information System. Community. Content area and outcome measurement experts (n=10) contributed to instrument development; individuals (n=200) with the target conditions participated in focus groups and in cognitive testing (n=15). None. Environmental factor items were categorized in 6 domains: assistive technology; built and natural environment; social environment; services, systems, and policies; access to information and technology; and economic quality of life. We binned 2273 items across the 6 domains, winnowed this pool to 291 items for cognitive testing, and recommended 274 items for pilot data collection. Five of the 6 domains correspond closely to the International Classification of Functioning, Disability and Health taxonomy of environmental factors; the sixth domain, economic quality of life, reflects an important construct that reflects financial resources that affect participation. Testing with a new and larger sample is underway to evaluate reliability, validity, and sensitivity. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. The use of virtual reality in the assessment of driving performance in persons with brain injury.

    PubMed

    Wald, J; Liu, L; Hirsekorn, L; Taylar, S

    2000-01-01

    In this article, we present the results of a pilot study that examined the driving performance of persons with brain injury using a virtual reality environment, known as the DriVR. Virtual driving performance was examined and compared to on-road, cognitive, visual-perceptual, and driving video test results. The DriVR appeared to be a useful adjunctive screening tool for assessing driving performance. However as with any new assessment tool, will need to undergo further empirical validation.

  4. Cognitive Appraisals and Lived Experiences During Injury Rehabilitation: A Narrative Account Within Personal and Situational Backdrop.

    PubMed

    Roy, Jolly; Mokhtar, Abdul Halim; Abdul Karim, Samihah; Ayathupady Mohanan, Santhosh

    2015-09-01

    The article highlights an athlete's cognitive appraisals form the onset to return to play. The narrative provides how an athlete constructs a sense of self within personal and situational factors and describes the subjective experiences during rehabilitation. The study examined the cognitive appraisal and psychological response within the backdrop of personal and situational factors in an injured athlete. The study is contextualized within the injury rehabilitation experiences of a cycling national athlete aged about 18 years old who was presented with the complaint of right shoulder pain, following a right shoulder dislocation. The 22 page narrative account provided by the athlete offered a holistic and integrated account of his experiences from the onset to return to play. A six step narrative analysis was analyzed by two qualified psychologists and two medical practitioners. The themes are extracted to understand what was important to the participant. The cognitive appraisal and lived experiences are discussed within three dominant themes: 1) Injury and consequences in sporting life. 2) Childhood experiences, emotions, social support. 3) Trusting relationship, behavioral outcome and hopeful future. The study indicates the influence of personal and situational factors in cognitive appraisals leading to emotional and behavioral responses during rehabilitation. The study demonstrates how individual experiences become a dynamic core of psychological response during injury rehabilitation. The study highlights the cognitive appraisals and, emotional upheaval to provide an understanding of how personal and situational factors affect the psychological responses of an injured athlete. Findings suggest the need to develop a holistic approach as an effective strategy in injury rehabilitation.

  5. Cognitive Appraisals and Lived Experiences During Injury Rehabilitation: A Narrative Account Within Personal and Situational Backdrop

    PubMed Central

    Roy, Jolly; Mokhtar, Abdul Halim; Abdul Karim, Samihah; Ayathupady Mohanan, Santhosh

    2015-01-01

    Background: The article highlights an athlete’s cognitive appraisals form the onset to return to play. The narrative provides how an athlete constructs a sense of self within personal and situational factors and describes the subjective experiences during rehabilitation Objectives: The study examined the cognitive appraisal and psychological response within the backdrop of personal and situational factors in an injured athlete. Patients and Methods: The study is contextualized within the injury rehabilitation experiences of a cycling national athlete aged about 18 years old who was presented with the complaint of right shoulder pain, following a right shoulder dislocation. The 22 page narrative account provided by the athlete offered a holistic and integrated account of his experiences from the onset to return to play. A six step narrative analysis was analyzed by two qualified psychologists and two medical practitioners. Results: The themes are extracted to understand what was important to the participant. The cognitive appraisal and lived experiences are discussed within three dominant themes: 1) Injury and consequences in sporting life. 2) Childhood experiences, emotions, social support. 3) Trusting relationship, behavioral outcome and hopeful future. The study indicates the influence of personal and situational factors in cognitive appraisals leading to emotional and behavioral responses during rehabilitation. Conclusions: The study demonstrates how individual experiences become a dynamic core of psychological response during injury rehabilitation. The study highlights the cognitive appraisals and, emotional upheaval to provide an understanding of how personal and situational factors affect the psychological responses of an injured athlete. Findings suggest the need to develop a holistic approach as an effective strategy in injury rehabilitation. PMID:26448849

  6. The effect of pre-existing health conditions on the cost of recovery from road traffic injury: insights from data linkage of medicare and compensable injury claims in Victoria, Australia.

    PubMed

    Hassani-Mahmooei, Behrooz; Berecki-Gisolf, Janneke; Hahn, Youjin; McClure, Roderick J

    2016-04-29

    Comorbidity is known to affect length of hospital stay and mortality after trauma but less is known about its impact on recovery beyond the immediate post-accident care period. The aim of this study was to investigate the role of pre-existing health conditions in the cost of recovery from road traffic injury using health service use records for 1 year before and after the injury. Individuals who claimed Transport Accident Commission (TAC) compensation for a non-catastrophic injury that occurred between 2010 and 2012 in Victoria, Australia and who provided consent for Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) linkage were included (n = 738) in the analysis. PBS and MBS records dating from 12 months prior to injury were provided by the Department of Human Services (Canberra, Australia). Pre-injury use of health service items and pharmaceuticals were considered to indicate pre-existing health condition. Bayesian Model Averaging techniques were used to identify the items that were most strongly correlated with recovery cost. Multivariate regression models were used to determine the impact of these items on the cost of injury recovery in terms of compensated ambulance, hospital, medical, and overall claim cost. Out of the 738 study participants, 688 used at least one medical item (total of 15,625 items) and 427 used at least one pharmaceutical item (total of 9846). The total health service cost of recovery was $10,115,714. The results show that while pre-existing conditions did not have any significant impact on the total cost of recovery, categorical costs were affected: e.g. on average, for every anaesthetic in the year before the accident, hospital cost of recovery increased by 24 % [95 % CI: 13, 36 %] and for each pathological test related to established diabetes, hospital cost increased by $10,407 [5466.78, 15346.28]. For medical costs, each anaesthetic led to $258 higher cost [174.16, 341.16] and every prescription of drugs

  7. Television viewing and hostile personality trait increase the risk of injuries.

    PubMed

    Fabio, Anthony; Chen, Chung-Yu; Dearwater, Steven; Jacobs, David R; Erickson, Darin; Matthews, Karen A; Iribarren, Carlos; Sidney, Stephen; Pereira, Mark A

    2017-03-01

    Individuals with high levels of hostility may be more susceptible to the influence of television on violence and risk taking behaviors. This study aimed to examine whether hostile personality trait modifies the association between TV viewing and injuries. It is a prospective study of 4,196 black and white adults aged 23 to 35 in 1990/1. Cross-lagged panel models were analyzed at three 5-year time periods to test whether TV viewing predicted injuries. Covariates were gender, race, and education. Individuals who watched more TV (0 hours, 1-3 hours, 4-6 hours, and ≥7 hours) were more likely to have a hospitalization for an injury in the following 5 years across each of the three follow-up periods [OR = 1.5 (95%CI = 1.2, 1.9), 1.5 (1.1, 1.9), and 1.9 (1.3, 2.6)]. The cross-lagged effects of TV viewing to injury were significant in the high hostility group [OR = 1.4 (95%CI = 1.1, 1.8), 1.3 (1.0, 1.8), and 2.0 (1.3, 2.9)] but not in the low hostility group [OR = 1.3 (95%CI = 0.6, 2.2), 1.1 (0.6, 2.1), and 1.4 (0.7, 2.8)]. Additionally, a statistically significant difference between the two models (P < 0.001) suggested that hostility moderated the relationship between TV watching and injury. These findings suggest that individuals who watch more TV and have a hostile personality trait may be at a greater risk for injury.

  8. Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Yaghmanian, Rana; Smedema, Susan Miller; Thompson, Kerry

    2017-01-01

    Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu's (2009) revised World Health Organization's International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were…

  9. Decentralized cardiovascular autonomic control and cognitive deficits in persons with spinal cord injury.

    PubMed

    Wecht, Jill M; Bauman, William A

    2013-03-01

    Spinal cord injury (SCI) results in motor and sensory impairments that can be identified with the American Spinal Injury Association (ASIA) Impairment Scale (AIS). Although, SCI may disrupt autonomic neural transmission, less is understood regarding the clinical impact of decentralized autonomic control. Cardiovascular regulation may be altered following SCI and the degree of impairment may or may not relate to the level of AIS injury classification. In general, persons with lesions above T1 present with bradycardia, hypotension, and orthostatic hypotension; functional changes which may interfere with rehabilitation efforts. Although many individuals with SCI above T1 remain overtly asymptomatic to hypotension, we have documented deficits in memory and attention processing speed in hypotensive individuals with SCI compared to a normotensive SCI cohort. Reduced resting cerebral blood flow (CBF) and diminished CBF responses to cognitive testing relate to test performance in hypotensive non-SCI, and preliminary evidence suggests a similar association in individuals with SCI. Persons with paraplegia below T7 generally present with a normal cardiovascular profile; however, our group and others have documented persistently elevated heart rate and increased arterial stiffness. In the non-SCI literature there is evidence supporting a link between increased arterial stiffness and cognitive deficits. Preliminary evidence suggests increased incidence of cognitive impairment in individuals with paraplegia, which we believe may relate to adverse cardiovascular changes. This report reviews relevant literature and discusses findings related to the possible association between decentralized cardiovascular autonomic control and cognitive dysfunction in persons with SCI.

  10. Therapeutic education in persons with spinal cord injury: a review of the literature.

    PubMed

    Gélis, A; Stéfan, A; Colin, D; Albert, T; Gault, D; Goossens, D; Perrouin-Verbe, B; Fattal, C; Pelissier, J; Coudeyre, E

    2011-05-01

    Therapeutic education is an integrant part of the physical medicine and rehabilitation care of persons with spinal cord injury. It is often conducted in an empirical manner. The objective of this literature review was to evaluate the state of the art regarding the evaluations and therapeutic education programs for persons with spinal cord injury. Systematic review of the literature with Medline and Cochrane Library databases from 1966 to 2009. The main areas of interest, for the evaluations found in the literature, focused on clinical variables, patients' knowledge, health behaviors, functional independence and quality of life but also psychological dimensions such as health locus of control, representations, abilities to resolve problems and self-perceived efficacy. Ten clinical studies were retained for analysis. These clinical studies were built around various health and educational models. An impact was highlighted on clinical variables (pressure ulcer, urinary tract infection), knowledge, quality of life and psychological criteria (depression, self-perceived efficacy, coping and problem solving strategies). The global level of evidence on the effects of therapeutic education in persons with spinal cord injury is low because of the number of studies and their low statistical power and requires additional studies. However, the analysis of the literature allows for discussing the organization of therapeutic education in clinical practice. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  11. Debates to personal conclusion in peripheral nerve injury and reconstruction: A 30-year experience at Chang Gung Memorial Hospital.

    PubMed

    Chuang, David Chwei-Chin

    2016-01-01

    Significant progress has been achieved in the science and management of peripheral nerve injuries over the past 40 years. Yet there are many questions and few answers. The author, with 30 years of experience in treating them at the Chang Gung Memorial Hospital, addresses debates on various issues with personal conclusions. These include: (1) Degree of peripheral nerve injury, (2) Timing of nerve repair, (3)Technique of nerve repair, (4) Level of brachial plexus injury,(5) Level of radial nerve injury,(6) Traction avulsion amputation of major limb, (7) Proximal Vs distal nerve transfers in brachial plexus injuries and (8) Post paralysis facial synkinesis.

  12. Costs of injury in New Zealand: Accident Compensation Corporation spending, personal spending and quality-adjusted life years lost.

    PubMed

    Wilson, Ross; Derrett, Sarah; Hansen, Paul; Langley, John Desmond

    2013-04-01

    New Zealand offers a unique opportunity for cost-of-injury research due to its comprehensive, no-fault injury compensation insurance scheme, which is managed by the government-controlled Accident Compensation Corporation (ACC). To estimate the costs of injury in New Zealand with respect to ACC's spending for entitlement claimants (ie, people with injuries requiring more than 'treatment only'), as well as injured individuals' out-of-pocket personal spending and non-pecuniary costs in terms of effects on health-related quality of life (HRQoL). A prospective cohort study of people injured between June 2007 and May 2009 was followed for 12 months after injury. ACC's spending for each participant (n=2215) was estimated from ACC data. Out-of-pocket personal spending and quality-adjusted life years (QALYs) lost were estimated based on interviews conducted at 3, 5 and 12 months post injury. For the cohort studied, most of the reported financial costs of injury were met by ACC. ACC spending was higher for individuals with more severe injuries and ones admitted to hospital. There was no difference in mean personal spending between people who were hospitalised or not, or between those with minor or moderate injuries, although individuals with more severe injuries reported higher personal spending. Overall, the ACC appears to be performing well supporting injured people financially. Nonetheless, people with more severe injuries incur substantial out-of-pocket expenses. Costs are higher for hospitalised and more severe injuries, but non-hospitalised and less severe cases can still incur substantial costs. The HRQoL effects of injury-naturally, borne by injured individuals themselves-are relatively large on average.

  13. [An analysis of insurance claims of civil responsibility in radiology. The first Italian data].

    PubMed

    Fileni, A; Magnavita, N

    1996-03-01

    The purpose of this study is to provide information to Italian radiologists regarding claims and patient injuries in medical malpractice claims. The assurance claims of Italian radiologists over a two-year period (1994-95) were anonymously analyzed, based on pertinent data provided by the Insurance Company of the Italian Society of Medical Radiology. The incidence risk-rate of claims was 9.1 per thousand person/year. Alleged malpractice accounted for more than 85% of the claims. In nearly one-half of the cases (44.4%), the plaintiff's argument was based on a . The most common misdiagnosis was failure to diagnose fracture or dislocation. The second most common claim category (40.7%) were complications, most commonly occurring during interventional radiology and contrast media injection. The third claim category (14.8%) was patient's accidents occurring during the diagnostic procedure. The most frequent types of injuries experienced by patients were death (6 cases), loss of chance for survival and permanent disability. Claims were more frequent in public health services, and mostly related to emergency examinations and interventional procedures. Misdiagnoses almost exclusively involved public health radiologists. Private health care, on the other hand, had a higher rate of fatal injuries, mostly related to technical complications.

  14. Outcomes of a multicomponent intervention on occupational performance in persons with unilateral acquired brain injury

    PubMed Central

    Hoyas, Elisabet Huertas; Pérez, Eduardo José Pedrero; Águila Maturana, Ana M.; Mota, Gloria Rojo; Piédrola, Rosa Martínez; de Heredia Torres, Marta Pérez

    2016-01-01

    Summary Complications after unilateral acquired brain injury (ABI) can affect various areas of expertise causing (depending on the location of the lesion) impairment in occupational performance. The aim of this study was to analyze and compare the concepts of occupational performance and functional independence, both before and after a multicomponent intervention including occupational therapy, in persons with unilateral brain damage. This was a longitudinal quasi-experimental pretest post-test study in a sample of 58 patients with unilateral brain injury (28 with traumatic brain injury and 30 with ischemic stroke). The patients’ level of independence was measured using the short version of the International Classification of Functioning, Disability and Health. We also measured quality of performance using the Assessment of Motor and Process Skills. The findings of this study showed that patients with injury in the right hemisphere improved more than those with left hemisphere damage (p<0.001). All the patients with ABI, especially those with right-sided injury, derived benefit from the multicomponent intervention, except in the area of motor skills. More research is needed on the specific techniques that might address such skills. PMID:27358224

  15. Outcomes of a multicomponent intervention on occupational performance in persons with unilateral acquired brain injury.

    PubMed

    Huertas Hoyas, E; Pedrero Pérez, E J; Águila Maturana, A M; Rojo Mota, G; Martínez Piédrola, R; Pérez de Heredia Torres, M

    2016-01-01

    Complications after unilateral acquired brain injury (ABI) can affect various areas of expertise causing (depending on the location of the lesion) impairment in occupational performance. The aim of this study was to analyze and compare the concepts of occupational performance and functional independence, both before and after a multicomponent intervention including occupational therapy, in persons with unilateral brain damage. This was a longitudinal quasi-experimental pretest post-test study in a sample of 58 patients with unilateral brain injury (28 with traumatic brain injury and 30 with ischemic stroke). The patients' level of independence was measured using the short version of the International Classification of Functioning, Disability and Health. We also measured quality of performance using the Assessment of Motor and Process Skills. The findings of this study showed that patients with injury in the right hemisphere improved more than those with left hemisphere damage (p<0.001). All the patients with ABI, especially those with right-sided injury, derived benefit from the multicomponent intervention, except in the area of motor skills. More research is needed on the specific techniques that might address such skills.

  16. Personality changes and return to work after severe traumatic brain injury: a prospective study.

    PubMed

    Diaz, Alexandre P; Schwarzbold, Marcelo L; Thais, Maria E; Cavallazzi, Gisele G; Schmoeller, Roseli; Nunes, Jean C; Hohl, Alexandre; Guarnieri, Ricardo; Linhares, Marcelo N; Walz, Roger

    2014-09-01

    To evaluate predictors of non-return to work (nRTW) among social, demographic, clinical, and psychiatric variables after severe traumatic brain injury (TBI) in a cohort of Brazilian patients. Prospective study. Forty-three community-dwelling individuals treated at a Level I trauma center at the time of TBI were evaluated 18 months after trauma. Measures included DSM-IV-TR criteria for personality changes after TBI and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to assess psychiatric diagnosis. Hospitalization variables included Glasgow Coma Scale scores, pupil examination findings, associated limb trauma, Marshall computed tomography classification, and blood glucose levels. After multiple logistic regression analysis, only the diagnosis of personality changes was found to be independently associated with nRTW, with an adjusted odds ratio of 10.92 (p = 0.02, 95% confidence interval 1.41-84.28). In this study, personality changes were an independent predictor of nRTW after severe TBI. Ways to predict risk factors associated with personality changes after severe brain injury could aid in identification of early and effective interventions that might ease the burden associated with this condition.

  17. The Age Related Prevalence of Aggression and Self-Injury in Persons with an Intellectual Disability: A Review

    ERIC Educational Resources Information Center

    Davies, Louise; Oliver, Chris

    2013-01-01

    The aim of this study was to analyse statistically published data regarding the age related prevalence of aggression and self-injury in persons with intellectual disability. Studies including prevalence data for aggression and/or self-injury broken down by age band were identified and relative risk analyses conducted to generate indices of age…

  18. Development of a Personalized Model for Pressure Ulcer Prevention Acutely Following Spinal Cord Injury: Biomarkers of Muscle Composition and Resilience

    DTIC Science & Technology

    2015-10-01

    AWARD NUMBER: W81XWH-14-1-0618 TITLE: Development of a Personalized Model for Pressure Ulcer Prevention Acutely Following Spinal Cord Injury...Model for Pressure Ulcer Prevention Acutely Following Spinal Cord Injury: Biomarkers of Muscle Composition and Resilience 5a. CONTRACT NUMBER...DISTRIBUTION / AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Development of a pressure

  19. The Age Related Prevalence of Aggression and Self-Injury in Persons with an Intellectual Disability: A Review

    ERIC Educational Resources Information Center

    Davies, Louise; Oliver, Chris

    2013-01-01

    The aim of this study was to analyse statistically published data regarding the age related prevalence of aggression and self-injury in persons with intellectual disability. Studies including prevalence data for aggression and/or self-injury broken down by age band were identified and relative risk analyses conducted to generate indices of age…

  20. The Italian version of the Brain Injury Rehabilitation Trust (BIRT) personality questionnaires: five new measures of personality change after acquired brain injury.

    PubMed

    Basagni, Benedetta; Navarrete, Eduardo; Bertoni, Debora; Cattran, Charlotte; Mapelli, Daniela; Oddy, Michael; De Tanti, Antonio

    2015-10-01

    The aim of this study was to describe the translation and adaptation of the BIRT personality questionnaires for the Italian population. This included the replication of validity testing and the collection of normative data. Following translation and adaptation according to cross-cultural guidelines, the questionnaires were administered as a pre-test to a sample of 20 healthy subjects and then to 10 patients. The questionnaires were then administered to 120 healthy subjects equally distributed by sex, education, and age, to collect normative data from an Italian population. The questionnaires were easily administered to both healthy subjects and patients. Statistical analysis on normative data was conducted to find the mean value for each questionnaire. This study lays the foundations for using a new instrument to assess behavioral changes after acquired brain injury on the Italian population.

  1. The role of parental psychopathology and personality in adolescent non-suicidal self-injury.

    PubMed

    Gromatsky, Molly A; Waszczuk, Monika A; Perlman, Greg; Salis, Katie Lee; Klein, Daniel N; Kotov, Roman

    2017-02-01

    Adolescent non-suicidal self-injury (NSSI), a significant risk factor for suicidal behavior, is strongly associated with adolescent psychopathology and personality traits, particularly those characterized by poor self-regulation. Some parental psychopathology and personality traits have also been identified as risk factors for adolescent NSSI, but specific parental characteristics and mechanisms involved in this association have not been systematically examined. The current study comprehensively investigated the contribution of parental psychopathology and personality to adolescent NSSI using data from the baseline wave of the Adolescent Development of Emotion and Personality Traits (ADEPT) study of 550 adolescent girls (mean age = 14.39 years, SD = 0.63) and their biological parents. We first investigated whether parental lifetime psychiatric diagnoses, and personality and clinical (rumination, self-criticism, emotional reliance) traits were associated with adolescent NSSI. We also tested whether adolescent history of psychiatric illness, personality, and clinical traits mediated the associations between parental characteristics and adolescent NSSI. Parental substance use disorder, adult-ADHD symptoms, self-criticism, and lower agreeableness and conscientiousness were associated with offspring's NSSI. These associations were mediated through adolescent characteristics. In contrast, parental mood and anxiety disorders and neuroticism were unrelated to adolescent NSSI. The results suggest that parental traits and disorders characterized by self-regulatory difficulties and lack of support constitute risk factors for self-injury in adolescent girls, acting via adolescent traits. This demonstrates that parental influences play a significant role in the etiology of adolescent NSSI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Functional assessment scales. A study of persons after traumatic brain injury.

    PubMed

    Granger, C V; Divan, N; Fiedler, R C

    1995-01-01

    The purpose of this study was to investigate disability in persons after traumatic brain injury (TBI) by using combinations of functional assessment item, subscale, domain, and full-scale scores to predict (1) the need for assistance in performance of specific physical care tasks measured in minutes of help per day provided by another person in the home and (2) the subject's level of satisfaction with life in general. This study also sought to account for the amount of supervision that persons with TBI may require beyond that needed for physical care tasks. The Functional Independence Measure (FIM) contributed to prediction of subjects' physical care needs. A single-point change in total FIM score was equivalent to an average of about 5 min of help from another person per day. Satisfaction with life in general was predicted mainly by the depression subscale of the Brief Symptom Inventory. However, this latter prediction was only true when subjects who required constant supervision were removed from analysis. Thus, the amount of supervision required by persons with TBI is an important variable to study in this population. Three categories of supervision were identified: constant (all of the time), periodic (daily or weekly), or not at all. The need for supervision and physical assistance from another person and a subject's satisfaction with life in general are important standards by which functional assessment instruments may be compared to reflect, in pragmatic terms, the impact of disability on the lives of individuals and on human and economic resources of the community.

  3. Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour.

    PubMed

    Reitz, Sarah; Kluetsch, Rosemarie; Niedtfeld, Inga; Knorz, Teresa; Lis, Stefanie; Paret, Christian; Kirsch, Peter; Meyer-Lindenberg, Andreas; Treede, Rolf-Detlef; Baumgärtner, Ulf; Bohus, Martin; Schmahl, Christian

    2015-08-01

    Patients with borderline personality disorder frequently show non-suicidal self-injury (NSSI). In these patients, NSSI often serves to reduce high levels of stress. Investigation of neurobiological mechanisms of NSSI in borderline personality disorder. In total, 21 women with borderline personality disorder and 17 healthy controls underwent a stress induction, followed by either an incision into the forearm or a sham treatment. Afterwards participants underwent resting-state functional magnetic resonance imaging while aversive tension, heart rate and heart rate variability were assessed. We found a significant influence of incision on subjective and objective stress levels with a stronger decrease of aversive tension in the borderline personality disorder group following incision than sham. Amygdala activity decreased more and functional connectivity with superior frontal gyrus normalised after incision in the borderline personality disorder group. Decreased stress levels and amygdala activity after incision support the assumption of an influence of NSSI on emotion regulation in individuals with borderline personality disorder and aids in understanding why these patients use self-inflicted pain to reduce inner tension. © The Royal College of Psychiatrists 2015.

  4. 10 CFR 1014.4 - Administrative claims; evidence and information to be submitted.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... incident causing death, or itemized receipts of payment for such expenses. (7) If damages for pain and... duration of pain and suffering, any drugs administered for pain, and the decedent's physical condition... support of a claim for personal injury, including pain and suffering, the claimant may be required...

  5. 10 CFR 1014.4 - Administrative claims; evidence and information to be submitted.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... incident causing death, or itemized receipts of payment for such expenses. (7) If damages for pain and... duration of pain and suffering, any drugs administered for pain, and the decedent's physical condition... support of a claim for personal injury, including pain and suffering, the claimant may be required...

  6. 10 CFR 1014.4 - Administrative claims; evidence and information to be submitted.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... incident causing death, or itemized receipts of payment for such expenses. (7) If damages for pain and... duration of pain and suffering, any drugs administered for pain, and the decedent's physical condition... support of a claim for personal injury, including pain and suffering, the claimant may be required...

  7. 10 CFR 1014.4 - Administrative claims; evidence and information to be submitted.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... incident causing death, or itemized receipts of payment for such expenses. (7) If damages for pain and... duration of pain and suffering, any drugs administered for pain, and the decedent's physical condition... support of a claim for personal injury, including pain and suffering, the claimant may be required...

  8. Participation in activities and secondary health complications among persons aging with traumatic spinal cord injury.

    PubMed

    Lundström, U; Wahman, K; Seiger, Å; Gray, D B; Isaksson, G; Lilja, M

    2017-04-01

    Cross-sectional study. To describe participation in activities and explore the relationship with secondary complications among persons aging with a traumatic spinal cord injury (SCI). A regional SCI outpatient center in Sweden. Data were collected through a phone survey, which included 10 activities from the instrument PARTS/M-v3 (PARTicipation Survey/Mobility version-3) together with data from the participants' medical records. Cross-tabulation and χ(2) were used for data analysis. In this study, 121 persons matched the inclusion criteria and the final study sample comprised 73 participants (60% response rate): 55 men and 18 women. Mean age was 63.7±9.4 years, and mean time since injury was 36.3±9.2 years. Regardless of duration of SCI, all 73 participated in dressing, bathing and leisure activities. Women reported better health than men. Particularly for those who lived 36-55 years after injury; increasing pain, fatigue, spasticity and decreased muscle strength were negatively affecting participation in activities, especially exercise and active recreation. Additionally, a need to save strength/energy was also a reason for not participating in the activities. Perceived future support and concerns in relation to personal assistance, assistive devices and rehabilitation was also reported. Increasing secondary health complications and a need to save strength/energy influenced participation in activities. Laws and/or governmental policies regarding personal assistance and assistive devices did not always support participation in activities. Interventions should aim to create a balance among activities in everyday life.

  9. 22 CFR 304.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Administrative claim; who may file. 304.3 Section 304.3 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.3 Administrative claim; who may file. (a) A claim for injury to or loss of property may be...

  10. 22 CFR 304.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Administrative claim; who may file. 304.3 Section 304.3 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.3 Administrative claim; who may file. (a) A claim for injury to or loss of property may be...

  11. 22 CFR 304.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Administrative claim; who may file. 304.3 Section 304.3 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.3 Administrative claim; who may file. (a) A claim for injury to or loss of property may be...

  12. 22 CFR 304.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Administrative claim; who may file. 304.3 Section 304.3 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.3 Administrative claim; who may file. (a) A claim for injury to or loss of property may be...

  13. 22 CFR 304.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Administrative claim; who may file. 304.3 Section 304.3 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.3 Administrative claim; who may file. (a) A claim for injury to or loss of property may...

  14. Differences in the Community Built Environment Influence Poor Perceived Health Among Persons With Spinal Cord Injury.

    PubMed

    Botticello, Amanda L; Rohrbach, Tanya; Cobbold, Nicolette

    2015-09-01

    To assess the association between characteristics of the built environment and differences in perceived health among persons with spinal cord injury (SCI) using objective measures of the local community derived from Geographic Information Systems data. Secondary analysis of cross-sectional survey data. Community. Persons with chronic SCI enrolled in the Spinal Cord Injury Model Systems database (N=503). All cases were residents of New Jersey, completed an interview during the years 2000 through 2012, had a complete residential address, and were community living at the time of follow-up. Not applicable. Perceived health. Bivariate tests indicated that persons with SCI residing in communities with more (vs less) mixed land use and small (vs large) amounts of open space were more likely to report poor perceived health. No associations were found between perceived health and differences in the residential or destination density of the community. Adjusting for variation in demographic, impairment, quality of life, and community socioeconomic characteristics accounted for the gap in the odds of reporting poor health between persons living in areas with large versus small amounts of open space (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.28-1.02). However, even after accounting for individual background differences, persons living in communities characterized by more heterogeneous land use were twice as likely to report poor health compared with persons living in less mixed areas (OR, 2.14; 95% CI, 1.12-4.08). Differences in the built characteristics of communities may be important to the long-term health and well-being of persons with SCI who may have greater exposure to the features of their local area because of limited mobility. The results of this study suggest living in a community with more heterogeneous land use was not beneficial to the perceived health of persons with chronic SCI living in New Jersey. Further investigation is needed to assess if the

  15. Evidence of Big-Five personality changes following acquired brain injury from a prospective longitudinal investigation.

    PubMed

    Leonhardt, Anne; Schmukle, Stefan C; Exner, Cornelia

    2016-03-01

    Many studies using different assessment methods have reported personality changes after acquired brain injury (ABI). However, to our knowledge, no prospective study has yet been conducted to examine whether previous cross-sectional and retrospective results can be replicated in a longitudinal prospective design. Further, because clinical control groups were only rarely used, it remains debatable if the personality changes found are unique to patients with ABI or if they also affect patients with other disabilities. This study examined personality change in 114 participants with different kinds of ABI, 1321 matched controls (general control, GC), and 746 matched participants with restrictive impairments other than brain injury (clinical control, CC) in a prospective longitudinal design using data from the panel survey Household, Income and Labour Dynamics in Australia (HILDA). Participants with ABI showed significantly larger declines in Extraversion and Conscientiousness compared with the GC group. When the ABI participants were compared with the CC group, only the difference in Conscientiousness remained significant. Our prospective data corroborate evidence from previous cross-sectional studies that patients with ABI experience larger declines in Extraversion and Conscientiousness than the general population. Whereas the effect on Conscientiousness was unique to patients with ABI, the decline in Extraversion was also observed in participants with other impairments. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Usability of a New Writing Assistive Device for Persons with Cervical Spinal Cord Injury.

    PubMed

    Lim, MyungJoon; Park, Jiyoung; Lee, Kuem Ju; Kweon, Hyosun; Kim, Byungchul; Cho, Kyujin; Choi, Hyun

    2015-01-01

    The hand function for persons with cervical spinal cord injury (PCSCI) is most frequently cause difficulties in leading normal lives. The purpose of this study was to test the usability of a new writing assistive device (NWAD) for PCSCI. To access its usability, the authors design usability testing method and test the NWAD to five individuals with cervical spinal cord injury. From the usability testing, we have found number of issues that lead us to key design concept about developing the NWAD. The NWAD will be redesigned based on the result of the present study. We expect that the NWAD will help PCSCI use their affected hand better and improve the level of independence and quality of life.

  17. [Reappropriation of residential space of families with a person with a spinal cord injury].

    PubMed

    Jutras, Sylvie; Coulombe, Simon; Labbé, Delphine; Jutras, Dominique

    2015-06-01

    To date, we do not know how home adaptations transform the residential experience of people with disabilities and their families. This study aimed to describe the residential reappropriation process of people with spinal cord injury and their families. Interviews with 31 people with spinal cord injuries and 31 family members focused on the adaptations, satisfaction with the adaptations, territorial behaviour at home, and family functioning. Adaptations aimed to sustain the disabled person's autonomy and mobility. Participants were satisfied with the physical adaptations, particularly in regard to convenience and feeling safe. Territorial behaviour supported the need for control and freedom. A more successful reappropriation process was associated with more effective family functioning. Territorial behaviours and effective family functioning should be considered by occupational therapists working with families.

  18. Core self-evaluations and Snyder's hope theory in persons with spinal cord injuries.

    PubMed

    Smedema, Susan Miller; Chan, Jacob Yuichung; Phillips, Brian N

    2014-11-01

    The objective of the study was to evaluate a motivational model of core self-evaluations (CSE), hope (agency and pathways thinking), participation, and life satisfaction in persons with spinal cord injuries. A cross-sectional, correlational design with path analysis was used to evaluate the model. 187 adults with spinal cord injuries participated in this study. The results indicated an excellent fit between the data and the proposed model. Specifically, CSE was found to directly predict agency and pathways thinking, participation, and life satisfaction. CSE was also found to indirectly predict participation and life satisfaction through agency thinking. Although CSE contributes directly to participation and life satisfaction, it also has a unique role in increasing individuals' motivation to pursue goals, which also predicts participation and life satisfaction. Counseling interventions should be multifaceted and address the components of CSE to increase hope, participation, and life satisfaction. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  19. 46 CFR 327.4 - Claim requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... statements made in the claim are subject to the provision of 18 U.S.C. 287 and 1001 and all other penalty... physicians and hospitals related to a seaman's claim for injury, illness, or death shall be attached. If the... years. (5) If the claim does not involve a seaman's death, the following information shall be submitted...

  20. 46 CFR 327.4 - Claim requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... and all other penalty provisions for making false, fictitious, or fraudulent claims, statements or... clinical records of physicians and hospitals related to a seaman's claim for injury, illness, or death... two preceding calendar years. (5) If the claim does not involve a seaman's death, the following...

  1. 46 CFR 327.4 - Claim requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... and all other penalty provisions for making false, fictitious, or fraudulent claims, statements or... clinical records of physicians and hospitals related to a seaman's claim for injury, illness, or death... two preceding calendar years. (5) If the claim does not involve a seaman's death, the following...

  2. Modulation of hand aperture during reaching in persons with incomplete cervical spinal cord injury

    PubMed Central

    Stahl, Victoria; Hayes, Heather B; Buetefisch, Cathrin; Wolf, Steven L; Trumbower, Randy D

    2014-01-01

    The intact neuromotor system prepares for object grasp by first opening the hand to an aperture that is scaled according to object size and then closing the hand around the object. After cervical spinal cord injury (SCI), hand function is significantly impaired, but the degree to which object-specific hand aperture scaling is affected remains unknown. Here we hypothesized that persons with incomplete cervical SCI have a reduced maximum hand opening capacity but exhibit novel neuromuscular coordination strategies that permit object-specific hand aperture scaling during reaching. To test this hypothesis, we measured hand kinematics and surface electromyography (EMG) from seven muscles of the hand and wrist during attempts at maximum hand opening as well as reaching for four balls of different diameters. Our results showed that persons with SCI exhibited significantly reduced maximum hand aperture compared to able-bodied (AB) controls. However, persons with SCI preserved the ability to scale peak hand aperture with ball size during reaching. Persons with SCI also used distinct muscle coordination patterns that included increased co-activity of flexors and extensors at the wrist and hand compared to AB controls. These results suggest that motor planning for aperture modulation is preserved even though execution is limited by constraints on hand opening capacity and altered muscle co-activity. Thus, persons with incomplete cervical SCI may benefit from rehabilitation aimed at increasing hand opening capacity and reducing flexor-extensor co-activity at the wrist and hand. PMID:25511164

  3. Modulation of hand aperture during reaching in persons with incomplete cervical spinal cord injury.

    PubMed

    Stahl, Victoria A; Hayes, Heather B; Buetefisch, Cathrin M; Wolf, Steven L; Trumbower, Randy D

    2015-03-01

    The intact neuromotor system prepares for object grasp by first opening the hand to an aperture that is scaled according to object size and then closing the hand around the object. After cervical spinal cord injury (SCI), hand function is significantly impaired, but the degree to which object-specific hand aperture scaling is affected remains unknown. Here, we hypothesized that persons with incomplete cervical SCI have a reduced maximum hand opening capacity but exhibit novel neuromuscular coordination strategies that permit object-specific hand aperture scaling during reaching. To test this hypothesis, we measured hand kinematics and surface electromyography from seven muscles of the hand and wrist during attempts at maximum hand opening as well as reaching for four balls of different diameters. Our results showed that persons with SCI exhibited significantly reduced maximum hand aperture compared to able-bodied (AB) controls. However, persons with SCI preserved the ability to scale peak hand aperture with ball size during reaching. Persons with SCI also used distinct muscle coordination patterns that included increased co-activity of flexors and extensors at the wrist and hand compared to AB controls. These results suggest that motor planning for aperture modulation is preserved even though execution is limited by constraints on hand opening capacity and altered muscle co-activity. Thus, persons with incomplete cervical SCI may benefit from rehabilitation aimed at increasing hand opening capacity and reducing flexor-extensor co-activity at the wrist and hand.

  4. Neuromuscular constraints on muscle coordination during overground walking in persons with chronic incomplete spinal cord injury

    PubMed Central

    Hayes, Heather B.; Chvatal, Stacie A.; French, Margaret A.; Ting, Lena H.; Trumbower, Randy D.

    2014-01-01

    Objective Incomplete spinal cord injury (iSCI) disrupts motor control and limits the ability to coordinate muscles for overground walking. Inappropriate muscle activity has been proposed as a source of clinically observed walking deficits after iSCI. We hypothesized that persons with iSCI exhibit lower locomotor complexity compared to able-body (AB) controls as reflected by fewer motor modules, as well as, altered module composition and activation. Methods Eight persons with iSCI and eight age-matched AB controls walked overground at prescribed cadences. Electromyograms of fourteen single leg muscles were recorded. Nonnegative matrix factorization was used to identify the composition and activation of motor modules, which represent groups of consistently co-activated muscles that accounted for 90% of variability in muscle activity. Results Motor module number, composition, and activation were significantly altered in persons with iSCI as compared to AB controls during overground walking at self-selected cadences. However, there was no significant difference in module number between persons with iSCI and AB controls when cadence and assistive device were matched. Conclusions Muscle coordination during overground walking is impaired after chronic iSCI. Significance Our results are indicative of neuromuscular constraints on muscle coordination after iSCI. Altered muscle coordination contributes to person-specific gait deficits during overground walking. PMID:24618214

  5. Visceral pain and life quality in persons with spinal cord Injury: a brief report.

    PubMed

    Kogos, Stephen C; Richards, J Scott; Baños, James H; Ness, Timothy J; Charlifue, Susan W; Whiteneck, Gale G; Lammertse, Daniel P

    2005-01-01

    Few studies have examined the prevalence of visceral pain in persons with spinal cord injury (SCI), and virtually no studies have looked at the relationship between visceral pain and self-reported quality of life. We examined the frequency of reported visceral pain at 5, 10, and 15 years after injury to determine whether the presence of visceral pain is related to quality of life, and to determine to what extent visceral pain should be of concern to clinicians treating patients with SCI. Visceral pain and quality of life in persons with SCI were compared from a combined Craig Hospital and National Model SCI Systems database at 5 (N = 33), 10 (N = 132), and 15 (N = 96) years after injury. The rates of visceral pain increased at each measurement (10% at year 5, 22% at year 10, and 32% at year 15); although these numbers reflect cross-sectional data, they do show a clear statistical change. Only a limited true longitudinal sample was available, but at 10 years after injury, individuals who had reported visceral pain at any time reported a significantly lower quality of life than those never experiencing visceral pain, F1,188 = 3.95, P < 0.05. Although visceral pain may not be as prevalent as the more researched neuropathic and musculoskeletal subtypes of pain, it may account for a higher percentage of people with SCI who report pain than previously recognized. More quantitative and longitudinal research is needed to examine the relationship of visceral pain with overall quality of life and to pursue interventions.

  6. Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury.

    PubMed

    van Leeuwen, Christel M; Post, Marcel W; Westers, Paul; van der Woude, Lucas H; de Groot, Sonja; Sluis, Tebbe; Slootman, Hans; Lindeman, Eline

    2012-01-01

    To clarify relationships between activities, participation, mental health, and life satisfaction in persons with spinal cord injury (SCI) and specify how personal factors (self-efficacy, neuroticism, appraisals) interact with these components. We hypothesized that (1) activities are related directly to participation, participation is related directly to mental health and life satisfaction, and mental health and life satisfaction are 2 interrelated outcome variables; and (2) appraisals are mediators between participation and mental health and life satisfaction, and self-efficacy and neuroticism are related directly to mental health and life satisfaction and indirectly through appraisals. Follow-up measurement of a multicenter prospective cohort study 5 years after discharge from inpatient rehabilitation. Eight Dutch rehabilitation centers with specialized SCI units. Persons (N=143) aged 18 to 65 years at the onset of SCI. Not applicable. Mental health was measured by using the Mental Health subscale of the 36-Item Short Form Health Survey and life satisfaction with the sum score of "current life satisfaction" and "current life satisfaction compared with life satisfaction before SCI." Structural equation modeling showed that activities and neuroticism were related to participation and explained 49% of the variance in participation. Self-efficacy, neuroticism, and 2 appraisals were related to mental health and explained 35% of the variance in mental health. Participation, 3 appraisals, and mental health were related to life satisfaction and together explained 50% of the total variance in life satisfaction. Mental health and life satisfaction can be seen as 2 separate but interrelated outcome variables. Self-efficacy and neuroticism are related directly to mental health and indirectly to life satisfaction through the mediating role of appraisals. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. The person with a spinal cord injury: an evolving prototype for life care planning.

    PubMed

    Stiens, Steven A; Fawber, Heidi L; Yuhas, Steven A

    2013-08-01

    The sequela of spinal cord injury (SCI) can provide a prototype for life care planning because the segmental design of the vertebrate body allows assessments to be quantitative, repeatable, and predictive of the injured person's impairments, self-care capabilities, and required assistance. Life care planning for patients with SCI uses a standard method that is comparable between planner, yet individualizes assessment and seeks resources that meet unique patient-centered needs in their communities of choice. Clinical care and rehabilitation needs organized with an SCI problem list promotes collaboration by the interdisciplinary team, caregivers, and family in efficient achievement of patient-centered goals and completion of daily care plans.

  8. The Impact Of Sports Activities On Quality Of Life Of Persons With A Spinal Cord Injury

    PubMed Central

    Eminović, Fadilj; Dopsaj, Milivoj; Pavlović, Dragan; Arsić, Sladjana; Otašević, Jadranka

    2016-01-01

    Abstract Objectives Studying the quality of life of people with a spinal cord injury is of great importance as it allows the monitoring of both functioning and adaptation to disability. The aim of this study was to determine the difference between persons with a spinal cord injury involved in sports activities and those not involved in sports activities in relation to their quality of life and the presence of secondary health conditions (pressure ulcers, urinary infections, muscle spasms, osteoporosis, pain, kidney problems-infections, calculosis and poor circulation). Methods The study included a total of 44 participants with spinal cord injury-paraplegia of both genders; 26 of them were athletes and 18 were not athletes. The athletes were training actively for the last two years, minimally 2-3 times per week. A specially designed questionnaire, medical documentation and the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23) were used for research purposes. Chi-square test was used to analyze the differences between the groups, while multiple analysis of variance (MANOVA) was used to determine the differences between the sets of variables. Results Among the participants, the athletes perceived higher quality of life than the non-athletes (male gender p<0.001 and female gender p<0.05). Regarding secondary health conditions, the athletes reported the presence of less pain (p=0.034) and a subjective feeling of better circulation (p=0.023). Conclusion The implementation of sports activities significantly improves quality of life in the population of people with spinal cord injury-paraplegia. However, sports activities only partially affect secondary health conditions. PMID:27284378

  9. Profile analyses of the Personality Assessment Inventory following military-related traumatic brain injury.

    PubMed

    Kennedy, Jan E; Cooper, Douglas B; Reid, Matthew W; Tate, David F; Lange, Rael T

    2015-05-01

    Personality Assessment Inventory (PAI) profiles were examined in 160 U.S. service members (SMs) following mild-severe traumatic brain injury (TBI). Participants who sustained a mild TBI had significantly higher PAI scores than those with moderate-severe TBI on eight of the nine clinical scales examined. A two-step cluster analysis identified four PAI profiles, heuristically labeled "High Distress", "Moderate Distress", "Somatic Distress," and "No Distress". Postconcussive and posttraumatic stress symptom severity was highest for the High Distress group, followed by the Somatic and Moderate Distress groups, and the No Distress group. Profile groups differed in age, ethnicity, rank, and TBI severity. Findings indicate that meaningful patterns of behavioral and personality characteristics can be detected in active duty military SMs following TBI, which may prove useful in selecting the most efficacious rehabilitation strategies. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Soleus H-reflex recruitment is not altered in persons with chronic spinal cord injury.

    PubMed

    Schindler-Ivens, Sheila M; Shields, Richard K

    2004-05-01

    To determine whether spasticity in persons with spinal cord injury (SCI) is associated with elevated monosynaptic reflex excitability. One-way experimental. Research laboratory. Convenience sample of 9 subjects (8 men, 1 woman) with chronic and complete SCI and 20 persons (14 men, 6 women) with no neurologic impairment. Subjects with SCI exhibited lower-extremity spasticity as indicated by velocity-dependent increased resistance to passive muscle stretch, abnormally brisk deep tendon reflexes, involuntary lower-extremity flexion and/or extension spasms, and clonus. Soleus H-reflex recruitment curves were elicited in all subjects. Soleus H-reflex threshold (HTH), gain (HGN), and amplitude (HPP). There was no difference between subjects with and without SCI in HTH, HGN, or HPP. Spasticity in people with chronic and complete SCI was not associated with increased excitability of the connections between Ia afferent projections and motoneurons. Factors extrinsic to these connections may have a role in spasticity caused by SCI.

  11. Profile Analyses of the Personality Assessment Inventory Following Military-Related Traumatic Brain Injury

    PubMed Central

    Kennedy, Jan E.; Cooper, Douglas B.; Reid, Matthew W.; Tate, David F.; Lange, Rael T.

    2015-01-01

    Personality Assessment Inventory (PAI) profiles were examined in 160 U.S. service members (SMs) following mild–severe traumatic brain injury (TBI). Participants who sustained a mild TBI had significantly higher PAI scores than those with moderate–severe TBI on eight of the nine clinical scales examined. A two-step cluster analysis identified four PAI profiles, heuristically labeled “High Distress”, “Moderate Distress”, “Somatic Distress,” and “No Distress”. Postconcussive and posttraumatic stress symptom severity was highest for the High Distress group, followed by the Somatic and Moderate Distress groups, and the No Distress group. Profile groups differed in age, ethnicity, rank, and TBI severity. Findings indicate that meaningful patterns of behavioral and personality characteristics can be detected in active duty military SMs following TBI, which may prove useful in selecting the most efficacious rehabilitation strategies. PMID:25857403

  12. Biomechanical evaluation of wrist-driven flexor hinge orthosis in persons with spinal cord injury.

    PubMed

    Kang, Yeoun-Seung; Park, Yoon-Ghil; Lee, Bum-Suk; Park, Hyung-Soon

    2013-01-01

    The wrist-driven flexor hinge orthosis (WDFHO) is a device used to restore hand function in persons with tetraplegic spinal cord injury by furnishing three-point prehension. We assessed the effectiveness and biomechanical properties of the WDFHO in 24 persons with cervical 6 or 7 tetraplegia who have severely impaired hand function. This study introduces a mechanical operating model to assess the efficiency of the WDFHO. Experimental results showed that pinch force increased significantly (p < 0.001) after using the WDFHO and was found to positively correlate with the strength of wrist extensor muscles (r = 0.41, p < 0.001). However, when the strength of the wrist extensors acting on the WDFHO was greater, the reciprocal wrist and finger motion that generates three-point prehension was less effective (r = 0.79, p < 0.001). Reliable and valid biomechanical evaluation of the WDFHO could improve our understanding of its biomechanics.

  13. Mobility for persons with spinal cord injury: an evaluation of two systems.

    PubMed

    Heinemann, A W; Magiera-Planey, R; Schiro-Geist, C; Gimines, G

    1987-02-01

    Wheelchairs and knee-ankle-foot orthoses (KAFOs) were evaluated by 92 persons with spinal cord injuries resulting in paraplegia to determine reasons for use and to determine their adequacy. While 67% of the sample was prescribed KAFOs, only 16 (26%) persons who were prescribed braces were still using them for any purpose, and only 4% as their sole means of mobility. Reasons for disuse and problems with braces were examined. Wheelchairs were rated significantly higher than long leg braces on value, potency and activity level permitted. A needs assessment revealed that transportation and mobility concerns were more prevalent than other areas of concern. Differences between KAFO users and former users were examined by discriminant analyses. Former users tended to have complete lesions and to be older; current users tended to have incomplete lesions and to be younger. Despite the problems associated with KAFOs, it is clear that this technology will continue to be useful to some degree for about 10% of individuals.

  14. Long-term functioning following whiplash injury: the role of social support and personality traits.

    PubMed

    Nijs, Jo; Inghelbrecht, Els; Daenen, Liesbeth; Hachimi-Idrissi, Said; Hens, Luc; Willems, Bert; Roussel, Nathalie; Cras, Patrick; Bernheim, Jan

    2011-07-01

    Transition from acute whiplash injury to either recovery or chronicity and the development of chronic whiplash-associated disorders (WAD) remains a challenging issue for researchers and clinicians. The roles of social support and personality traits in long-term functioning following whiplash have not been studied concomitantly. The present study aimed to examine whether social support and personality traits are related to long-term functioning following whiplash. One hundred forty-three subjects, who had experienced a whiplash injury in a traffic accident 10-26 months before the study took place, participated. The initial diagnoses were a 'sprain of the neck' (ICD-9 code 847.0); only the outcome of grades I-III acute WAD was studied. Long-term functioning was considered within the biopsychosocial model: it was expressed in terms of disability, functional status, quality of life and psychological well-being. Participants filled out a set of questionnaires to measure the long-term functioning parameters (i.e. the Neck Disability Index, Medical Outcome Study Short-Form General Health Survey, Anamnestic Comparative Self-Assessment measure of overall well-being and the Symptom Checklist-90) and potential determinants of long-term functioning (the Dutch Personality Questionnaire and the Social Support List). The results suggest that social support (especially the discrepancies dimension of social support) and personality traits (i.e. inadequacy, self-satisfaction and resentment) are related to long-term functioning following whiplash injury (Spearman rho varied between 0.32 and 0.57; p < 0.01). Within the discrepancy dimension, everyday emotional support, emotional support during problems, appreciative support and informative support were identified as important correlates of long-term functioning. Future prospective studies are required to confirm the role of social support and personality traits in relation to long-term functioning following whiplash. For such

  15. Adaptive logic networks in rehabilitation of persons with incomplete spinal cord injury

    SciTech Connect

    Armstrong, W.W. |

    1995-12-31

    Persons with incomplete spinal cord injury are generally at least partially paralyzed and are often unable to walk. Manually-controlled electrical stimulation has been used to act upon nerves or muscles to cause leg movement so such persons can achieve functional walking. They use crutches or a mobile walker for support, and initiate each stimulus by pressing a button. Artificial intelligence and machine learning techniques are now making it possible to automate the process of stimulus-initiation. Supervised training of an automatic system can be based on samples of correct stimulation given by the patient or by a therapist, accompanied by data from sensors indicating the state of the person`s body and its relation to the ground during walking. A major issue is generalization, i.e. whether the result of training can be used for control at a later time or in somewhat different circumstances. As the possibilities grow for increasing the number and variety of sensors on a patient, and for easily implanting more numerous stimulation channels, the need is increasing for powerful learning systems which can automatically develop effective and safe control algorithms. This paper explains the foundations of adaptive logic networks, and illustrates how they have been used to develop an experimental walking prosthesis used in a laboratory setting. Successful generalization has been observed using parameters from training which took place minutes to days earlier.

  16. Non-suicidal self-injury: the contribution of general personality functioning.

    PubMed

    Mullins-Sweatt, Stephanie N; Lengel, Gregory J; Grant, Demond M

    2013-01-01

    Non-suicidal self-injury (NSSI) is a public health problem of increasing significance. The purpose of the present study was to determine if individuals with and without a history of NSSI would differ significantly on the domains and facets of the Five Factor Model (FFM) as well as the facets from the UPPS-P Impulsive Behaviour Scale. Self-report measures of personality, borderline personality disorder and NSSI were administered to an undergraduate sample (n = 211). Individuals who had engaged in NSSI had significantly elevated levels of FFM facets of neuroticism (i.e. anxiousness, angry hostility, depressiveness, self-consciousness, impulsiveness and vulnerability) and openness (i.e. aesthetics, feelings and values) and significantly lower levels of conscientiousness (i.e. order, achievement, self-discipline and deliberation). Additionally, those with an NSSI history scored higher on UPPS-P negative urgency, lack of premeditation and lack of perseverance. The knowledge gained from this study provides further support for personality's role in NSSI. This information may aid in the identification of risk factors for NSSI and assist in efforts examining interventions for NSSI that are targeted toward personality-relevant strategies.

  17. Initial validation of personal self-advocacy measures for individuals with acquired brain injury.

    PubMed

    Hawley, Lenore; Gerber, Donald; Pretz, Christopher; Morey, Clare; Whiteneck, Gale

    2016-08-01

    The purpose of this study was to evaluate the psychometric properties of 2 novel measures assessing personal advocacy, self-efficacy and personal advocacy activities in individuals with acquired brain injury (ABI). This was an instrument development study using (a) expert panel review with a content validity index, (b) consumer survey, and (c) Rasch analysis. Participants were adults (N = 162) with ABI recruited through a community survey. Participants completed the Self-Advocacy Scale (SAS) and the Personal Advocacy Activity Scale (PAAS). Using Rasch analysis to inform instrument development, after modification on the basis of item response theory analysis, the SAS, a measure of advocacy self-efficacy, was found to be unidimensional with an eigenvalue of 1.6, exhibited monotonicity, and had an item reliability of 0.97. Similarly, the PAAS, a measure of advocacy activity, was found to exhibit monotonicity, is unidimensional (eigenvalue of 1.7) and had an item reliability of 0.97. Both measures demonstrated concurrent validity, because they were significantly correlated with other established measures of related constructs and with each other. A separation reliability of 0.97 (real not model) for both the SAS and PAAS suggests that items will likely hold their relative positions in a similar sample. This study supported the PAAS and the SAS as reliable and valid measures of personal advocacy activity and associated self-efficacy in individuals post-ABI. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Feasibility of Handcycle Training During Inpatient Rehabilitation in Persons With Spinal Cord Injury.

    PubMed

    Nooijen, Carla F; van den Brand, Ilse L; Ter Horst, Paul; Wynants, Mia; Valent, Linda J; Stam, Henk J; van den Berg-Emons, Rita J

    2015-09-01

    To assess the feasibility of a handcycle training program during inpatient rehabilitation and the changes in physical capacity in persons with subacute spinal cord injury (SCI). Before-after trial. Rehabilitation centers. Persons with subacute SCI in regular rehabilitation (N=45). A structured handcycle interval training program during the last 8 weeks of inpatient rehabilitation. Training was scheduled 3 times per week (24 sessions total), with an intended frequency of ≥2 times per week. Intended intensity was a Borg score of 4 to 7 on a 10-point scale. Feasibility was assessed, and participant satisfaction was evaluated (n=30). A maximal handcycling test was performed 8 weeks prior to discharge and at discharge to determine peak power output and peak oxygen uptake (VO2peak) (n=23). Of the participants, 91% completed the handcycle training, and no adverse events were reported. Mean training frequency was 1.8±0.5 times per week, and mean Borg score was 6.2±1.4. Persons with complete lesions demonstrated lower training feasibility. Most participants were satisfied with the handcycle training. Peak power output and VO2peak improved significantly after the training period (P<.01) by 36.4% and 9.6%, respectively. Overall, handcycle training during inpatient rehabilitation in persons with SCI was feasible except for the training frequency. Persons with complete lesions likely need extra attention to benefit optimally from handcycling training. Because the improvements in physical capacity were larger than those known to occur in persons with paraplegia receiving regular rehabilitation, the results suggest that the addition of handcycle training may result in larger increases in physical capacity compared with regular rehabilitation only. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Analysis of the effect of car size on accident injury probability using automobile insurance data.

    PubMed

    Krishnan, K S; Carnahan, J V

    1985-04-01

    The Highway Loss Data Institute (HLDI) compiles injury and collision claim information from major insurance companies. These data have indicated that a disproportionately large number of injury claims are made for small cars. As a result, it might be concluded that small cars increase injury risk to their occupants. Recent advertisements by a major automobile manufacturer suggest a similar conclusion should be drawn from these data. In this paper it is shown that the apparent higher injury risk attributed to small cars can reflect the behavior of persons driving small cars. The number of injury claim accidents per collision claim accident is examined as an alternative measure of injury risk. Possible problems in interpretation are discussed.

  20. Disaster anxiety and self-assistance behaviours among persons with cervical cord injury in Japan: a qualitative study

    PubMed Central

    Takahashi, Kyo; Kitamura, Yayoi

    2016-01-01

    Objectives Persons with disabilities, especially those with a severe disability, have a vague anxiety about future disasters; however, the measures of self-assistance for disaster preparedness have not been standardised. The present study aimed to describe disaster-related anxiety and behaviours related to disaster preparedness among persons who have cervical cord injury in Japan. Design Qualitative study. Setting Tokyo Metropolitan area, Japan. Participants 16 persons with cervical cord injury participated. Inclusion criteria were being 20 years old and older, being diagnosed with cervical cord injury, being able to communicate verbally, having an interest in disaster preparedness, and belonging to a self-help group of persons with cervical cord injury in the Tokyo Metropolitan area. Results Participants usually had ‘anxiety about health management’ and it became more serious once they thought about a disaster. We identified three themes in relation to their anxiety: ‘storing needed items,’ ‘staying in a safe place’ and ‘having reliable caregivers.’ We also identified three other themes that were the reasons behind these themes: ‘travel experiences,’ ‘experiences of failure’ and ‘information from peers.’ Conclusions To buffer the anxiety about health management in a disaster, it would be important for persons with cervical cord injury to store needed items, stay in a safe place and have reliable caregivers. Various daily experiences, including experiences of failure, would encourage such behaviours. PMID:27091817

  1. Disaster anxiety and self-assistance behaviours among persons with cervical cord injury in Japan: a qualitative study.

    PubMed

    Takahashi, Kyo; Kitamura, Yayoi

    2016-04-18

    Persons with disabilities, especially those with a severe disability, have a vague anxiety about future disasters; however, the measures of self-assistance for disaster preparedness have not been standardised. The present study aimed to describe disaster-related anxiety and behaviours related to disaster preparedness among persons who have cervical cord injury in Japan. Qualitative study. Tokyo Metropolitan area, Japan. 16 persons with cervical cord injury participated. Inclusion criteria were being 20 years old and older, being diagnosed with cervical cord injury, being able to communicate verbally, having an interest in disaster preparedness, and belonging to a self-help group of persons with cervical cord injury in the Tokyo Metropolitan area. Participants usually had 'anxiety about health management' and it became more serious once they thought about a disaster. We identified three themes in relation to their anxiety: 'storing needed items,' 'staying in a safe place' and 'having reliable caregivers.' We also identified three other themes that were the reasons behind these themes: 'travel experiences,' 'experiences of failure' and 'information from peers.' To buffer the anxiety about health management in a disaster, it would be important for persons with cervical cord injury to store needed items, stay in a safe place and have reliable caregivers. Various daily experiences, including experiences of failure, would encourage such behaviours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Participation and integration from the perspective of persons with spinal cord injury from five European countries.

    PubMed

    Ruoranen, Kaisa; Post, Marcel W M; Juvalta, Sibylle; Reinhardt, Jan D

    2015-03-01

    To examine the subjective understanding of participation and integration of persons with spinal cord injuries from 5 European countries and to compare these findings with the International Classification of Functioning, Disability and Health (ICF)'s conceptualization of participation. Semi-structured interviews with 54 persons with acquired spinal cord injuries and 3 with spina bifida from 5 countries were examined using qualitative content analysis. Integration was most often associated with social acceptance and, furthermore, with ordinary performance, equality and freedom of choice. Participation was most often described as ordinary performance, with less emphasis on social acceptance and equality. However, participation and integration overlapped in people's narratives and were difficult to separate. The perception of participation and integration was largely similar across countries. In contrast to others, however, Finnish interviewees were more likely to associate participation with contributing to society. A variety of life domains was identified, of which recreation and leisure, work life, sports and going out were the most prevalent. While participation domains are well covered by the ICF, as is the notion of ordinary performance, interviewees also referred to a rights (e.g. acceptance) and duties (e.g. contribution) perspective.

  3. A natural setting behavior management program for persons with acquired brain injury: a randomized controlled trial.

    PubMed

    Carnevale, George J; Anselmi, Vera; Johnston, Mark V; Busichio, Kim; Walsh, Vanessa

    2006-10-01

    To investigate the efficacy of a behavior management program delivered in the natural community setting for persons with brain injury and their caregivers. Three-group randomized controlled trial. Homes and other community settings. Thirty-seven persons with traumatic and other acquired brain injury and their caregivers. Natural Setting Behavior Management (NSBM) involving education and individualized behavior modification program versus education only versus control group. Changes in frequency of targeted problematic behaviors. Subscale in Questionnaire on Resources and Stress, Maslach Burnout Inventory, and the Neurobehavioral Functioning Inventory. While no significant effects were detected at termination of education only (P<.075) or of NSBM (P<.56), significant treatment effects were found at the main outcome point 3 months after termination of services (P<.002). Rates of disruptive or aggressive behaviors declined significantly in the NSBM group. Differences in caregiver-rated stress, burden, and aggression were not statistically significant. A program of caregiver education and individualized behavior management in natural settings can decrease the frequency of disruptive behavioral challenges. Larger studies are needed to clarify the duration and intensity of education and individualized treatment required to diminish behavioral challenges and to understand relationships with general stress and burden experienced by caregivers.

  4. Development of self-inflicted injury: Comorbidities and continuities with borderline and antisocial personality traits.

    PubMed

    Crowell, Sheila E; Kaufman, Erin A

    2016-11-01

    Self-inflicted injury (SII) is a continuum of intentionally self-destructive behaviors, including nonsuicidal self-injuries, suicide attempts, and death by suicide. These behaviors are among the most pressing yet perplexing clinical problems, affecting males and females of every race, ethnicity, culture, socioeconomic status, and nearly every age. The complexity of these behaviors has spurred an immense literature documenting risk and vulnerability factors ranging from individual to societal levels of analysis. However, there have been relatively few attempts to articulate a life span developmental model that integrates ontogenenic processes across these diverse systems. The objective of this review is to outline such a model with a focus on how observed patterns of comorbidity and continuity can inform developmental theories, early prevention efforts, and intervention across traditional diagnostic boundaries. Specifically, when SII is viewed through the developmental psychopathology lens, it becomes apparent that early temperamental risk factors are associated with risk for SII and a range of highly comorbid conditions, such as borderline and antisocial personality disorders. Prevention efforts focused on early-emerging biological and temperamental contributors to psychopathology have great potential to reduce risk for many presumably distinct clinical problems. Such work requires identification of early biological vulnerabilities, behaviorally conditioned social mechanisms, as well as societal inequities that contribute to self-injury and underlie intergenerational transmission of risk.

  5. Differentiating Adolescent Self-Injury from Adolescent Depression: Possible Implications for Borderline Personality Development

    PubMed Central

    Crowell, Sheila E.; Beauchaine, Theodore P.; Hsiao, Ray C.; Vasilev, Christina A.; Yaptangco, Mona; Linehan, Marsha M.; McCauley, Elizabeth

    2011-01-01

    Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report markers of vulnerability and risk. Such a comparison may have important implications for treatment, prevention, and developmental models of self injury and borderline personality disorder. We used a multi-method, multi-informant approach to examine how adolescent SII differs from adolescent depression. Self-injuring, depressed, and typical adolescent females (n = 25 per group) and their mothers completed measures of psychopathology and emotion regulation, among others. In addition, we assessed electrodermal responding (EDR), a peripheral biomarker of trait impulsivity. Participants in the SII group (a) scored higher than depressed adolescents on measures of both externalizing psychopathology and emotion dysregulation, and (b) exhibited attenuated EDR, similar to patterns observed among impulsive, externalizing males. Self-injuring adolescents also scored higher on measures of borderline pathology. These findings reveal a coherent pattern of differences between self-injuring and depressed adolescent girls, consistent with theories that SII differs from depression in etiology and developmental course. PMID:22016199

  6. Personal factors and working conditions as predictors of work injuries among industrial workers.

    PubMed

    Kamel, M I; Atta, H Y; Foda, N T; Mostafa, Y A; Youssef, R M

    1998-01-01

    The purpose of this study was to determine the personal factors and working conditions that predict work injuries among industrial workers. To fulfill this aim, a case control study was conducted including 2003 industrial workers who sustained a work injury and an equal number of controls. All were subjected to an interview questionnaire to collect relevant information. Moreover, records were reviewed to obtain the medical history of enrolled workers. Data revealed that workers in the index and control groups are comparable in respect to their sociodemographic characteristics. The multivariate logistic regression analysis pointed out that safety training significantly reduces the risk of work accidents among industrial workers. On the other hand, work accidents are more likely to occur in the main working shift. Moreover, workers who suffer from chronic health problems calling for surgical treatment, as well as those who reported family problems, are more likely to experience work accidents. These workers should receive considerable attention to reduce the extent of work injuries. More importantly, safety-training programs are mandatory for accident prevention in industrial settings.

  7. Differentiating adolescent self-injury from adolescent depression: possible implications for borderline personality development.

    PubMed

    Crowell, Sheila E; Beauchaine, Theodore P; Hsiao, Ray C; Vasilev, Christina A; Yaptangco, Mona; Linehan, Marsha M; McCauley, Elizabeth

    2012-01-01

    Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report markers of vulnerability and risk. Such a comparison may have important implications for treatment, prevention, and developmental models of self injury and borderline personality disorder. We used a multi-method, multi-informant approach to examine how adolescent SII differs from adolescent depression. Self-injuring, depressed, and typical adolescent females (n = 25 per group) and their mothers completed measures of psychopathology and emotion regulation, among others. In addition, we assessed electrodermal responding (EDR), a peripheral biomarker of trait impulsivity. Participants in the SII group (a) scored higher than depressed adolescents on measures of both externalizing psychopathology and emotion dysregulation, and (b) exhibited attenuated EDR, similar to patterns observed among impulsive, externalizing males. Self-injuring adolescents also scored higher on measures of borderline pathology. These findings reveal a coherent pattern of differences between self-injuring and depressed adolescent girls, consistent with theories that SII differs from depression in etiology and developmental course.

  8. Randomized Controlled Trial of Personalized Motivational Interventions in Substance Using Patients With Facial Injuries

    PubMed Central

    Shetty, Vivek; Murphy, Debra A.; Zigler, Corwin; Yamashita, Dennis-Duke R.; Belin, Thomas R.

    2011-01-01

    Purpose The proximate use of illicit drugs or alcohol (substance use) is the most common precipitator of facial injuries among socioeconomically disadvantaged populations. Reducing these risky behaviors could minimize adverse health sequelae and potential reinjury. The objective of our study was to test whether a culturally competent, personalized motivational intervention incorporated into surgical care could significantly reduce existing substance use behaviors in facial injury patients. Patients and Methods Substance-using subjects (n = 218) presenting with facial injuries to a level 1 trauma center were randomly assigned to either a personalized motivational intervention (PMI) condition or a health-information (HI) control condition. After a brief assessment of the individual’s substance use severity and willingness to change these behaviors, both groups attended 2 counseling sessions with a trained interventionist. The PMI subjects (n = 118) received individualized, motivational interventions, whereas the HI subjects (n = 100) received only general health information. Both groups were reassessed at 6 and 12 months postinjury, and changes in substance-use patterns were measured to assess the effects of intervention. Results The PMI and HI groups were closely matched on their sociodemographic and substance use characteristics. Subjects in the PMI group showed statistically significant declines in drug use at both the 6- and 12-month assessments. The intervention’s effect on lowering illicit drug use was greatest at the 6-month assessment but had weakened by the 1-year follow-up. The efficacy of the PMI was moderated by an individual’s initial drug use severity; individuals with greater drug use dependency at baseline were seen to have larger intervention effects, as did individuals who were most aware of their drug problem and willing to change their substance use behaviors. Unlike illicit drug use, changes in alcohol use did not differ significantly

  9. The influence of injury cause, contact-sport participation, and personal knowledge on expectation of outcome from mild traumatic brain injury.

    PubMed

    Edmed, Shannon L; Sullivan, Karen A

    2014-01-01

    This study investigated the influence of injury cause, contact-sport participation, and prior knowledge of mild traumatic brain injury (mTBI) on injury beliefs and chronic symptom expectations of mTBI. A total of 185 non-contact-sport players (non-CSPs) and 59 contact-sport players (CSPs) with no history of mTBI were randomly allocated to one of two conditions in which they read either a vignette depicting a sport-related mTBI (mTBIsport) or a motor-vehicle-accident-related mTBI (mTBIMVA). The vignettes were otherwise standardized to convey the same injury parameters (e.g., duration of loss of consciousness). After reading a vignette, participants reported their injury beliefs (i.e., perceptions of injury undesirability, chronicity, and consequences) and their expectations of chronic postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD) symptoms. Non-CSPs held significantly more negative beliefs and expected greater PTSD symptomatology and greater PCS affective symptomatology from an mTBIMVA vignette thann mTBIsport vignette, but this difference was not found for CSPs. Unlike CSPs, non-CSPs who personally knew someone who had sustained an mTBI expected significantly less PCS symptomatology than those who did not. Despite these different results for non-CSPs and CSPs, overall, contact-sport participation did not significantly affect injury beliefs and symptom expectations from an mTBIsport. Expectations of persistent problems after an mTBI are influenced by factors such as injury cause even when injury parameters are held constant. Personal knowledge of mTBI, but not contact sport participation, may account for some variability in mTBI beliefs and expectations. These factors require consideration when assessing mTBI outcome.

  10. A longitudinal study of pain, personality, and brain plasticity following peripheral nerve injury.

    PubMed

    Goswami, Ruma; Anastakis, Dimitri J; Katz, Joel; Davis, Karen D

    2016-03-01

    We do not know precisely why pain develops and becomes chronic after peripheral nerve injury (PNI), but it is likely due to biological and psychological factors. Here, we tested the hypotheses that (1) high Pain Catastrophizing Scale (PCS) scores at the time of injury and repair are associated with pain and cold sensitivity after 1-year recovery and (2) insula gray matter changes reflect the course of injury and improvements over time. Ten patients with complete median and/or ulnar nerve transections and surgical repair were tested ∼3 weeks after surgical nerve repair (time 1) and ∼1 year later for 6 of the 10 patients (time 2). Patients and 10 age-/sex-matched healthy controls completed questionnaires that assessed pain (patients) and personality and underwent quantitative sensory testing and 3T MRI to assess cortical thickness. In patients, pain intensity and neuropathic pain correlated with pain catastrophizing. Time 1 pain catastrophizing trended toward predicting cold pain thresholds at time 2, and at time 1 cortical thickness of the right insula was reduced. At time 2, chronic pain was related to the time 1 pain-PCS relationship and cold sensitivity, pain catastrophizing correlated with cold pain threshold, and insula thickness reversed to control levels. This study highlights the interplay between personality, sensory function, and pain in patients following PNI and repair. The PCS-pain association suggests that a focus on affective or negative components of pain could render patients vulnerable to chronic pain. Cold sensitivity and structural insula changes may reflect altered thermosensory or sensorimotor awareness representations.

  11. Health care costs of borderline personality disorder and matched controls with major depressive disorder: a comparative study based on anonymized claims data.

    PubMed

    Bode, Katharina; Vogel, Rolf; Walker, Jochen; Kröger, Christoph

    2016-12-18

    Borderline personality disorder (BPD) and major depressive disorder (MDD) pose a significant burden to the German health care system in terms of direct and indirect costs. The aim of this study was to determine the incremental costs that arise due to the treatment of patients with BPD, in relation to MDD patients adjusted for gender and age. Insured persons who suffered from BPD (F60.3; N = 6599) or MDD (F32, F33; N = 26,396) in the year 2010 were identified from the German Health Risk Institute research database. To estimate the costs resulting from disorder-specific health care service utilization and the mean total costs per patient for the health care system, we analyzed anonymized claims data of individuals with BPD and matched individuals with MDD. The costs resulting from disorder-specific health care service utilization 1 year after index diagnosis amounted to 8508 EUR for BPD and 8281 EUR for MDD per patient utilizing services. With mean total annual costs per patient of 4636 EUR versus 2020 EUR 1 year preceding index diagnosis, 7478 EUR versus 3638 EUR in the year after index diagnosis, and 11,817 EUR versus 6058 EUR 2 years after index diagnosis, BPD patients incurred markedly higher costs. Since the treatment of BPD causes incremental costs for the German health care system compared to the treatment of MDD, and since both conditions are associated with a high level of suffering, there is a need for establishing adequate and early treatment of these mental disorders.

  12. Self-Perceived Reasons for Unemployment Cited by Persons with Spinal Cord Injury: Relationship to Gender, Race, Age, and Level of Injury.

    ERIC Educational Resources Information Center

    Krause, J. Stuart; Anson, Carol A.

    1996-01-01

    Purpose of study was to identify reasons persons with spinal cord injury attribute to their unemployment status, and determine if different demographic categories hold different beliefs in this regard. Participants (n=231) completed the Multidimensional Adjustment Profile. Inability to physically perform same type of work was primary reason cited.…

  13. Characteristics of persons and jobs with needlestick injuries in a national data set.

    PubMed

    Leigh, J Paul; Wiatrowski, William J; Gillen, Marion; Steenland, N Kyle

    2008-08-01

    Physicians, nurses, and others are at risk of needlesticks, yet little national information is available regarding incidence across demographic and occupational categories. Analysis was conducted on national data on occupational injuries for 1992-2003 from the Bureau of Labor Statistics (BLS). Because BLS data were limited to cases with 1 or more days of work loss, and reasons related to reporting of incidents, the data only reflected a subset of all needlesticks. Nevertheless, the data were internally consistent across categories so that relative magnitudes were reliable. Statistical tests for differences in proportions were conducted that compared needlesticks with all other occupational injuries and employment. Cases with 1 or more days of work loss numbered 903 per year, on average, from 1992 through 2003. Women comprised 73.3% (95% CI: 72.5%-74.2%) of persons injured. For those reporting race, white, non-Hispanic comprised 69.3% of the total (95% CI: 68.1%-70.4%); black, non-Hispanic, 14.8% (95% CI: 13.9%-15.6%); and Hispanic, 13.8% (95% CI: 12.9%-14.6%). The age bracket 35 to 44 years had the highest percentage of injuries at 34.0% (95% CI: 33.1%-34.9%). Ages over 54 years reported smaller percentages of needlestick injuries than either all other injuries or employment. Occupations with greatest frequencies included registered nurses, nursing aides and orderlies, janitors and cleaners, licensed practical nurses, and maids and housemen. Occupations with greatest risks included biologic technicians, janitors and cleaners, and maids and housemen. Almost 20% (95% CI: 18.88%-20.49%) of needlesticks occurred outside the services industry. Seven percent (95% CI: 6.56%-7.53%) of needlesticks resulted in 31 or more days of work loss in contrast to 20.46% (95% CI: 20.44%-20.48%) of all other injuries. In this nationally representative sample, the most frequent demographic and occupational categories were women; white, non-Hispanic; ages 35 to 44 years; and registered

  14. Non-suicidal self-injury among Dutch and Belgian adolescents: Personality, stress and coping.

    PubMed

    Kiekens, G; Bruffaerts, R; Nock, M K; Van de Ven, M; Witteman, C; Mortier, P; Demyttenaere, K; Claes, L

    2015-09-01

    This study examines: (1) the prevalence of Non-Suicidal Self-Injury (NSSI) among Dutch and Belgian adolescents, (2) the associations between Big Five personality traits and NSSI engagement/versatility (i.e., number of NSSI methods), and (3) whether these associations are mediated by perceived stress and coping. A total of 946 Flemish (46%) and Dutch (54%) non-institutionalized adolescents (Mean age=15.52; SD=1.34, 44% females) were surveyed. Measures included the NSSI subscale of the Self-Harm-Inventory, the Dutch Quick Big Five Personality questionnaire, the Perceived Stress Scale and the Utrecht Coping List for Adolescents. Examination of zero-order correlations was used to reveal associations, and hierarchical regression analysis was used to reveal potential mediators which were further examined within parallel mediation models by using a bootstrapping-corrected procedure. Lifetime prevalence of NSSI was 24.31%. Neuroticism; perceived stress; and distractive, avoidant, depressive, and emotional coping were positively associated with NSSI engagement, whereas Agreeableness, Conscientiousness; and active, social, and optimistic coping were negatively associated with NSSI engagement. Observed relationships between personality traits and NSSI engagement were consistently explained by perceived stress and depressive coping. A higher versatility of NSSI was not associated with any Big Five personality trait, but was associated with higher scores on perceived stress and depressive coping and with lower scores on active and optimistic coping. Our study suggests that a specific personality constellation is associated with NSSI engagement via high stress levels and a typical depressive reaction pattern to handle stressful life events. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Cross-cultural validity of four quality of life scales in persons with spinal cord injury

    PubMed Central

    2010-01-01

    Background Quality of life (QoL) in persons with spinal cord injury (SCI) has been found to differ across countries. However, comparability of measurement results between countries depends on the cross-cultural validity of the applied instruments. The study examined the metric quality and cross-cultural validity of the Satisfaction with Life Scale (SWLS), the Life Satisfaction Questionnaire (LISAT-9), the Personal Well-Being Index (PWI) and the 5-item World Health Organization Quality of Life Assessment (WHOQoL-5) across six countries in a sample of persons with spinal cord injury (SCI). Methods A cross-sectional multi-centre study was conducted and the data of 243 out-patients with SCI from study centers in Australia, Brazil, Canada, Israel, South Africa, and the United States were analyzed using Rasch-based methods. Results The analyses showed high reliability for all 4 instruments (person reliability index .78-.92). Unidimensionality of measurement was supported for the WHOQoL-5 (Chi2 = 16.43, df = 10, p = .088), partially supported for the PWI (Chi2 = 15.62, df = 16, p = .480), but rejected for the LISAT-9 (Chi2 = 50.60, df = 18, p = .000) and the SWLS (Chi2 = 78.54, df = 10, p = .000) based on overall and item-wise Chi2 tests, principal components analyses and independent t-tests. The response scales showed the expected ordering for the WHOQoL-5 and the PWI, but not for the other two instruments. Using differential item functioning (DIF) analyses potential cross-country bias was found in two items of the SWLS and the WHOQoL-5, three items of the LISAT-9 and four items of the PWI. However, applying Rasch-based statistical methods, especially subtest analyses, it was possible to identify optimal strategies to enhance the metric properties and the cross-country equivalence of the instruments post-hoc. Following the post-hoc procedures the WHOQOL-5 and the PWI worked in a consistent and expected way in all countries. Conclusions QoL assessment using the summary

  16. Narrative discourse impairments in Persian-speaking persons with traumatic brain injury: a pilot study.

    PubMed

    Ghayoumi Anaraki, Zahra; Marini, Andrea; Yadegari, Fariba; Mahmoodi Bakhtiari, Behrooz; Fakharian, Esmaeil; Rahgozar, Mehdi; Rassouli, Maryam

    2014-01-01

    Studies have shown the presence of narrative discourse difficulties in persons with traumatic brain injury (TBI), even in those who do not suffer from aphasia. Yet, there still exist inconsistencies between the results of different studies, in particular at the microlinguistic level. Moreover, a limited number of languages have been studied in this regard. Therefore, this study aimed at examining these skills in Persian-speaking individuals with TBI. The purpose of this pilot study was to analyse the microlinguistic and macrolinguistic skills of these individuals to determine impaired linguistic measures at different levels of narrative discourse. Fourteen non-aphasic Persian-speaking persons with TBI (9 with severe TBI and 5 with moderate TBI), aged 19-40 years (mean = 25.84, SD = 5.69), and 61 age-matched healthy adults completed a narrative task. Measures of language productivity, clause density, verbal error ratio, and cohesion ratio were calculated. Also, test-retest and inter-rater reliability coefficients were analysed. The TBI group was impaired in some microlinguistic and all macrolinguistic measures compared to their control peers. The results of this study suggest that multi-level narrative discourse analyses of Persian-speaking individuals with TBI may be useful for speech/language pathologists wishing to evaluate communication disorders in persons with TBI. © 2015 S. Karger AG, Basel.

  17. Web-Based Specialist Support for Spinal Cord Injury Person's Care: Lessons Learned.

    PubMed

    Della Mea, Vincenzo; Marin, Dario; Rosin, Claudio; Zampa, Agostino

    2012-01-01

    Persons with disability from spinal cord injury (SCI) are subject to high risk of pathological events and need a regular followup even after discharge from the rehabilitation hospital. To help in followup, we developed a web portal for providing online specialist as well as GP support to SCI persons. After a feasibility study with 13 subjects, the portal has been introduced in the regional healthcare network in order to make it compliant with current legal regulations on data protection, including smartcard authentication. Although a number of training courses have been made to introduce SCI persons to portal use (up to 50 users), the number of accesses remained very low. Reasons for that have been investigated by means of a questionnaire submitted to the initial feasibility study subjects and included the still easier use of telephone versus our web-based smartcard-authenticated portal, in particular, because online communications are still perceived as an unusual way of interacting with the doctor. To summarize, the overall project has been appreciated by the users, but when it is time to ask for help to, the specialist, it is still much easier to make a phone call.

  18. Cardiovascular disease risk factors in persons with paraplegia: the Stockholm spinal cord injury study.

    PubMed

    Wahman, Kerstin; Nash, Mark S; Westgren, Ninni; Lewis, John E; Seiger, Ake; Levi, Richard

    2010-03-01

    To examine cardiovascular disease risk factors and risk clusters in Swedish persons with traumatic wheelchair-dependent paraplegia. Prospective examination. A total of 135 individuals aged 18-79 years with chronic (>or= 1 year) post-traumatic paraplegia. Cardiovascular disease risk factors; dyslipidemia, impaired fasting glucose, hypertension, overweight, smoking, and medication usage for dyslipidemia, hypertension, and diabetes mellitus, were analyzed according to authoritative guidelines. Stepwise regression tested the effects of age, gender, and injury characteristics on cardiovascular disease risks. High-prevalence risk factors were dyslipidemia (83.1%), hypertension (39.3%), and overweight (42.2%) with pervasive clustering of these risks. Being older was related to increased cardiovascular disease risk, except for dyslipidemia. Hypertension was more common in low-level paraplegia. Prevalence of impaired fasting glucose was lower than previously reported after paraplegia. A high percentage of persons being prescribed drug treatment for dyslipidemia and hypertension failed to reach authoritative targets for cardiovascular disease risk reduction. Swedish persons with paraplegia are at high risk for dyslipidemia, hypertension, and overweight. Impaired fasting glucose was not as common as reported in some previous studies. Pharmacotherapy for dyslipidemia and hypertension often failed to achieve recommended targets. Population-based screening and therapeutic countermeasures to these cardiovascular disease risks are indicated.

  19. The relationship between the postprandial lipemic response and lipid composition in persons with spinal cord injury

    PubMed Central

    Emmons, Racine R.; Cirnigliaro, Christopher M.; Kirshblum, Steven C.; Bauman, William A.

    2014-01-01

    Objective To determine the influence of lipid concentration, lipid particle size, and total abdominal fat (TAF) on postprandial lipemic response (PPLr) in persons with spinal cord injury (SCI). Methods Thirty-five persons with SCI (17 paraplegia, 18 tetraplegia) and 18 able-bodied (AB) individuals participated. Following a 10-hour fast, blood was drawn for lipids, apolipoprotein (apo) A1 and B concentrations, and low-density (LSP) and high-density (HSP) lipoprotein particle sizes. A high-fat milkshake was consumed (∼1.3 g fat/kg). Blood was drawn at 2, 4, and 6 hours to determine PPLr, (triglyceride (TG) area under the curve). TAF and visceral (VF) fat were measured by ultrasonography; total body fat (TBF) by dual-energy X-ray absorptiometry. Differences between the groups were determined by independent sample t-tests. Pearson correlation coefficients determined the relationship among PPLr and lipids, and TAF. Results There were no significant differences in fasting TG, low-density lipoprotein (LDL), apoB, TAF, or PPLr values between the groups. In SCI, PPLr significantly correlated with: apoB (r = 0.63, P < 0.01, LSP (r = 0.57, P < 0.01), and TAF (r = 0.36, P < 0.01). After controlling for age and duration of injury, PPLr significantly correlated with apoB (r = 0.66, P = 0.001), TBF (r = 0.45, P = 0.03), VF (r = 0.66, P = 0.02), and TAF (r = 0.56, P = 0.007). Conclusions Although concentrations of LDL cholesterol and apoB were not different between SCI and AB groups, LSP, apoB, and TAF correlated with PPLr in persons with SCI. ApoB was associated with a greater PPLr in those with motor complete SCI, after controlling for age and duration of injury. PMID:24961488

  20. 24 CFR 17.67 - Claims files.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Claims files. 17.67 Section 17.67... files. Each claims collection officer is responsible for obtaining current credit data about each person against whom a claim is pending in his office. The file shall be kept reasonably up to date by...

  1. 32 CFR 536.15 - Claims policies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... payable claims nor did it intend that small non-meritous claims be paid. Practically any claim, regardless... fair analysis should be paramount. Personal contact with claimants or their representatives is... will publish written interpretations of this part. Interpretations will have the same force and effect...

  2. 32 CFR 536.15 - Claims policies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... payable claims nor did it intend that small non-meritous claims be paid. Practically any claim, regardless... fair analysis should be paramount. Personal contact with claimants or their representatives is... will publish written interpretations of this part. Interpretations will have the same force and effect...

  3. 10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false What conditions apply to DOE indemnification of claims... pollutant or contaminant attributable to DOE? 770.9 Section 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF... entity requesting indemnification for a particular claim must: (1) Notify the Field Office Manager in...

  4. Health care utilization in persons with spinal cord injury: part 1-outpatient services.

    PubMed

    Gemperli, A; Ronca, E; Scheel-Sailer, A; Koch, H G; Brach, M; Trezzini, B

    2017-09-01

    This was a cross-sectional questionnaire survey. The objective of this study was to identify the care-seeking behavior of persons with spinal cord injury (SCI) with respect to the various health care providers and ascertain circumstances that lead to situations where required care was not received. This study was conducted in the entire country of Switzerland. Statistical analysis of frequency of annual visits to health care providers by 17 specialties, and description of situations where health care was required but not received, in persons with chronic SCI living in the community. Main medical contact person was the general practitioner (GP; visited by 88% during last 12 months). The physiotherapist (visited by 72%) was the health care provider with the most visits (average of 30 visits in 12 months). GPs, physiotherapists, urologists and spinal medicine specialists were often contacted in combination, by many participants, often for check-up visits. A situation where care was required but not received was reported by 53 (11%) of participants, with a substantially higher rate in migrants (29%). Main problems why care was not received were bladder and bowel problems and main reasons of care not received were regional or temporal unavailability. Individuals with SCI are frequent users of medical services. There is no group of medical specialists that covers all needs of persons with SCI, what emphasizes health care provision from a comprehensive perspective including a wide array of services. Instances with care required but not received appeared to be rare and more likely in participants with migration background.

  5. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton

    PubMed Central

    Asselin, Pierre K.; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M.

    2016-01-01

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment. PMID:27340808

  6. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton.

    PubMed

    Asselin, Pierre K; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M

    2016-06-16

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment.

  7. Improving home accessibility for a person with a disability after spinal cord injury.

    PubMed

    Bozzolini, G; Cassibba, S

    2008-12-01

    Houses may become hostile and dangerous. To provide autonomy and safety of action and to optimize residual sensory and motor faculties, living units can be redesigned according to the new needs of the disabled person, without ignoring the harmony of the house. Formerly, designers used to focus on architectural barriers and on the creation of ''special'' products for ''particular'' cases. Currently, they prefer to look for components and objects which answer the needs of a wider range of users. The Authors were involved in the case of a 41-year old patient, who has been paraplegic from 8 years due to a D10 injury. Such a patient expressed a strong need to be autonomous at home. After having considered the patient's requests and expectations of autonomy, the Authors analyzed the patient's house to evaluate carefully her determination and the actual possibility of collaboration. Then, they analyzed the existing technical literature and drawn up a program based on four main types of environmental interventions, also using the legislative support provided by the current laws on this subject: 1) breaking down of architectural barriers; 2) design and plant engineering; 3) accessible furniture; 4) aids for personal autonomy. The result was positive both in terms of structural targets achieved and subject's personal satisfaction and autonomy. The variety of functional limits of the person as well as the complexity of the living units to be renovated, make problem solving not univocal. Although in such an experience the control of expenditure was evaluated and reached, such an aspect cannot be compared to similar studies.

  8. Simulation of traumatic brain injury symptoms on the Personality Assessment Inventory: an analogue study.

    PubMed

    Keiski, Michelle A; Shore, Douglas L; Hamilton, Joanna M; Malec, James F

    2015-04-01

    The purpose of this study was to characterize the operating characteristics of the Personality Assessment Inventory (PAI) validity scales in distinguishing simulators feigning symptoms of traumatic brain injury (TBI) while completing the PAI (n = 84) from a clinical sample of patients with TBI who achieved adequate scores on performance validity tests (n = 112). The simulators were divided into two groups: (a) Specific Simulators feigning cognitive and somatic symptoms only or (b) Global Simulators feigning cognitive, somatic, and psychiatric symptoms. The PAI overreporting scales were indeed sensitive to the simulation of TBI symptoms in this analogue design. However, these scales were less sensitive to the feigning of somatic and cognitive TBI symptoms than the feigning of a broad range of cognitive, somatic, and emotional symptoms often associated with TBI. The relationships of TBI simulation to consistency and underreporting scales are also explored.

  9. Motives for nonsuicidal self-injury among women with borderline personality disorder.

    PubMed

    Kleindienst, Nikolaus; Bohus, Martin; Ludäscher, Petra; Limberger, Matthias F; Kuenkele, Katrin; Ebner-Priemer, Ulrich W; Chapman, Alexander L; Reicherzer, Markus; Stieglitz, Rolf-Dieter; Schmahl, Christian

    2008-03-01

    Patients with borderline personality disorder (BPD) are known to use nonsuicidal self-injury (NSSI) as a dysfunctional strategy to regulate intense emotions. The primary purpose of this study was to clarify the motives for NSSI along with their interrelations. We further investigated the variety of emotions preceding NSSI and possible effects of NSSI on these emotions. To this end, a structured self-rating questionnaire on NSSI was administered to 101 female BPD-patients exhibiting NSSI. Most patients reported multiple motives for NSSI. The motives were more likely to compound than to exclude one another. Negative reinforcement was almost always involved in NSSI, whereas positive reinforcement (e.g., "getting a kick") played an additional role among about half of the patients. NSSI was usually preceded by a large variety of negative feelings that were reported to clearly improve with NSSI. In conclusion, therapists should anticipate a multidimensional functional spectrum when exploring motives of NSSI.

  10. 32 CFR 750.44 - Claims not payable.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Military Claims Act § 750.44 Claims not payable. (a) Any claim for damage, loss, destruction, injury, or... complained of occurred would permit recovery from a private individual under like circumstances, and then... cognizable under: (1) Military Personnel and Civilian Employees' Claims Act, as amended. 31 U.S.C. 3721....

  11. 45 CFR 35.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Administrative claim; who may file. 35.3 Section 35.3 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION TORT CLAIMS AGAINST THE GOVERNMENT Procedures § 35.3 Administrative claim; who may file. (a) A claim for injury to or...

  12. 34 CFR 35.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Administrative claim; who may file. 35.3 Section 35.3 Education Office of the Secretary, Department of Education TORT CLAIMS AGAINST THE GOVERNMENT Procedures § 35.3 Administrative claim; who may file. (a) A claim for injury to or loss of property may be...

  13. Using personality traits to construct linear growth models of mental health in family members of individuals with severe brain injury.

    PubMed

    Trujillo, Michael; Perrin, Paul B; Doser, Karoline; Norup, Anne

    2016-11-01

    No studies have examined the impact of personality traits on mental health among caregivers of individuals with severe brain injury. Therefore, the purpose of the current study was to construct linear growth models to examine whether the personality traits of family members of individuals with severe brain injury could predict the trajectories of their own mental health-related quality of life (HRQoL), anxiety, and depression beginning in a neurointensive care unit through 1 year after injury. Danish family members of individuals with severe brain injury (n = 52) completed the Short Form-36 assessing mental HRQoL (vitality, social functioning, role limitations-emotional, mental health), anxiety, and depression across 5 time points during the 1st year after injury. The measure of personality was administered 3 months after the patients' discharge. All mental HRQoL, anxiety, and depression variables improved significantly over time. Caregivers who were less neurotic and less conscientious had higher vitality, social functioning, and mental health over time, whereas caregivers who were more agreeable had higher social functioning over time. Caregivers with lower neuroticism had lower anxiety and depression over time, as well as a more accelerated decrease in anxiety and depression. Caregivers' personality traits were strongly associated over time with mental HRQoL, anxiety, and depression, with neuroticism being especially important for trajectories of anxiety and depression. These results suggest that personality assessments for caregivers of individuals with severe brain injury could help identify those most at risk for poor mental health over the course of rehabilitation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Wheelchair-specific fitness of persons with a long-term spinal cord injury: cross-sectional study on effects of time since injury and physical activity level.

    PubMed

    de Groot, Sonja; van der Scheer, Jan W; Bakkum, Arjan J T; Adriaansen, Jacinthe J E; Smit, Christof A; Dijkstra, Catja; Post, Marcel W M; van der Woude, Lucas H V

    2016-01-01

    To study the impact of time since injury (TSI) and physical activity (PA) on fitness of persons with spinal cord injury (SCI). Cross-sectional study. Persons with SCI (N = 158) in three TSI strata: 10-19, 20-29 and ≥30 years after SCI and divided in an active and inactive group. Fitness [peak power output (POpeak) and peak oxygen uptake (VO2peak)] was assessed. In persons with tetraplegia, no significant relationship was found between TSI and fitness after controlling for confounders, while a higher activity level was related to a higher POpeak in this group. Active people with tetraplegia also showed less decline in POpeak with an increase in TSI compared to inactive people. In persons with paraplegia, after controlling for confounders, it was shown that TSI had a negative effect on POpeak, while PA was not significantly associated with fitness in people with paraplegia. In people with paraplegia, fitness was significantly lower in those with a longer TSI. Persons with a long TSI might need more attention to remain fit and PA might be an important element in that respect as shown by the results of the group with a tetraplegia. Wheelchair-specific fitness seems to diminish over time after paraplegia. An active lifestyle is related to wheelchair-specific fitness in persons with tetraplegia. Prevention of long-term deconditioning is very important.

  15. Powered Exoskeletons for Walking Assistance in Persons with Central Nervous System Injuries: A Narrative Review.

    PubMed

    Esquenazi, Alberto; Talaty, Mukul; Jayaraman, Arun

    2017-01-01

    Individuals with central nervous system injuries are a large and apparently rapidly expanding population-as suggested by 2013 statistics from the American Heart Association. Increasing survival rates and lifespans emphasize the need to improve the quality of life for this population. In persons with central nervous system injuries, mobility limitations are among the most important factors contributing to reduced life satisfaction. Decreased mobility and subsequently reduced overall activity levels also contribute to lower levels of physical health. Braces to assist walking are options for greater-functioning individuals but still limit overall mobility as the result of increased energy expenditure and difficulty of use. For individuals with greater levels of mobility impairment, wheelchairs remain the preferred mobility aid yet still fall considerably short compared with upright bipedal walking. Furthermore, the promise of functional electrical stimulation as a means to achieve walking has yet to materialize. None of these options allow individuals to achieve walking at speeds or levels comparable with those seen in individuals with unimpaired gait. Medical exoskeletons hold much promise to fulfill this unmet need and have advanced as a viable option in both therapeutic and personal mobility state, particularly during the past decade. The present review highlights the major developments in this technology, with a focus on exoskeletons for lower limb that may encompass the spine and that aim to allow independent upright walking for those who otherwise do not have this option. Specifically reviewed are powered exoskeletons that are either commercially available or have the potential to restore upright walking function. This paper includes a basic description of how each exoskeleton device works, a summation of key features, their known limitations, and a discussion of current and future clinical applicability. Copyright © 2017 American Academy of Physical Medicine

  16. Rasch analysis of alcohol abuse and dependence diagnostic criteria in persons with spinal cord injury.

    PubMed

    Reslan, S; Kalpakjian, C Z; Hanks, R A; Millis, S R; Bombardier, C H

    2017-05-01

    Cross-sectional. The objective of the study is to examine whether alcohol use disorders should be conceptualized categorically as abuse and dependence as in the 'Diagnostic and Statistical Manual of Mental Disorders' 4th edition or on a single continuum with mild to severe category ratings as in the 'Diagnostic and Statistical Manual of Mental Disorders' 5th edition in people with spinal cord injury (SCI). United States of America. Data from 379 individuals who sustained SCI either traumatically or non-traumatically after the age of 18 and were at least 1 year post injury. Rasch analyses used the alcohol abuse and dependence modules of the Structured Clinical Interview for DSM-IV-TR Axis I Disorders Non-patient Edition (SCID-I/NP). Fifty-seven percent (n=166) of the entire sample endorsed criteria for alcohol abuse, and 25% (n=65) endorsed criteria for alcohol dependence. Fit values were generally acceptable except for one item (for example, alcohol abuse criterion 2), suggesting that the items fit the expectation of unidimensionality. Examination of the principal components analysis did not provide support for unidimensionality. The item-person map illustrates poor targeting of items. Alcohol abuse and dependence criterion appear to reflect a unidimensional construct, a finding that supports a single latent construct or factor consistent with the DSM-5 diagnostic model.

  17. Claiming Copernicus.

    PubMed

    Fara, Patricia

    2005-12-01

    The reputations of scientific heroes shift constantly, modified by politicians as well as by historians. Now that the Scientific Revolution has been reappraised, Nicolas Copernicus is portrayed as a friend of the Catholic Church rather than a scientific martyr. As a German-speaking Pole he has been claimed as a figure of national historical importance by both Germany and Poland, and since the early 20th century has been an important symbol of Polish independence.

  18. Finding a Way to Cope: A Qualitative Study of the Experiences of Persons With Spinal Cord Injury.

    PubMed

    Chuang, Ching-Hui; Yang, Yu-O; Kuo, Liang Tseng

    2015-12-01

    Spinal cord injury (SCI) is a catastrophe that causes disabilities and permanently changes people's lives. The people have to adapt to the loss of self-care ability and may need long-term rehabilitation. The recovery can be problematic, affecting physiological, psychological, and financial aspects of life. The purpose of this study was to explore the lived experiences of persons with SCI living in Taiwan. In 2009, we conducted a qualitative study on 10 participants with SCI recruited from the Association of Spinal Cord Injury Persons in Taiwan. Open-ended interviews were conducted using a guide and tape recorder for subsequent transcription. A phenomenological method was used to collect data by interviews. The core experience of persons with SCI was "finding a way to cope," which was a process from despair to self-acceptance and composed of four categories: (a) shock and unpreparedness for the injury: the catastrophe of the injury itself and the underrecognition of physiological disabilities; (b) panic and fear: denying the injury and yearning for a miracle; (c) abyss of despair: imprinting of life, bearing the agony alone, and chaos of life; and (d) reflection on the meaning of life: adaptation to physical disabilities, self-acceptance, and growth. Our research was descriptive and focused on the structure of the lived experiences of persons with SCI. Many issues of inequality also revealed physical disabilities, such as difficulty looking professional, resulting in burden of stress and frustration. These results highlight persons with SCI should be classified as case management and integration of social welfare resources to facilitate care for persons with SCI after discharge.

  19. Borderline Personality Symptoms Differentiate Non-Suicidal and Suicidal Self-Injury in Ethnically Diverse Adolescent Outpatients

    ERIC Educational Resources Information Center

    Muehlenkamp, Jennifer J.; Ertelt, Troy W.; Miller, Alec L.; Claes, Laurence

    2011-01-01

    Background: There is little research on how specific borderline personality disorder (BPD) symptoms relate to suicide attempts or suicide and non-suicidal self-injury (NSSI) within adolescent populations, which is important to know given the recent proposal of an NSSI disorder. Even less well known is whether specific BPD symptoms distinguish NSSI…

  20. Promoting Adaptive Behavior in Persons with Acquired Brain Injury, Extensive Motor and Communication Disabilities, and Consciousness Disorders

    ERIC Educational Resources Information Center

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Belardinelli, Marta Olivetti; Buonocunto, Francesca; Sacco, Valentina; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa; Badagliacca, Francesco

    2012-01-01

    These two studies extended the evidence on the use of technology-based intervention packages to promote adaptive behavior in persons with acquired brain injury and multiple disabilities. Study I involved five participants in a minimally conscious state who were provided with intervention packages based on specific arrangements of optic, tilt, or…

  1. Borderline Personality Symptoms Differentiate Non-Suicidal and Suicidal Self-Injury in Ethnically Diverse Adolescent Outpatients

    ERIC Educational Resources Information Center

    Muehlenkamp, Jennifer J.; Ertelt, Troy W.; Miller, Alec L.; Claes, Laurence

    2011-01-01

    Background: There is little research on how specific borderline personality disorder (BPD) symptoms relate to suicide attempts or suicide and non-suicidal self-injury (NSSI) within adolescent populations, which is important to know given the recent proposal of an NSSI disorder. Even less well known is whether specific BPD symptoms distinguish NSSI…

  2. Promoting Adaptive Behavior in Persons with Acquired Brain Injury, Extensive Motor and Communication Disabilities, and Consciousness Disorders

    ERIC Educational Resources Information Center

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Belardinelli, Marta Olivetti; Buonocunto, Francesca; Sacco, Valentina; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa; Badagliacca, Francesco

    2012-01-01

    These two studies extended the evidence on the use of technology-based intervention packages to promote adaptive behavior in persons with acquired brain injury and multiple disabilities. Study I involved five participants in a minimally conscious state who were provided with intervention packages based on specific arrangements of optic, tilt, or…

  3. Exploring the relationship between non suicidal self-injury and borderline personality traits in young adults.

    PubMed

    Vega, Daniel; Torrubia, Rafael; Soto, Àngel; Ribas, Joan; Soler, Joaquim; Pascual, Juan Carlos; Rodríguez-Fornells, Antoni; Marco-Pallarés, Josep

    2017-10-01

    Non-suicidal self-injury (NSSI) is highly prevalent during late adolescence and young adulthood. There is some evidence of a link between NSSI and Borderline Personality Disorder (BPD), but little is known about the association between BPD traits and the various functions that maintain NSSI. The main purpose of this study was to explore the association between borderline personality traits and NSSI functions in a sample of college students. We also compared NSSI functions in college students who engaged in NSSI to those in an age-matched sample of BPD patients. This study included a total of 238 college students and 36 BPD patients. Participants were asked to complete a number of clinical measures. In the non-clinical sample, BPD features were more pronounced in the presence of NSSI, and we observed a differential relationship between NSSI functions and psychopathological BPD-traits. The NSSI clinical variables most strongly associated with BPD were frequency, variety of methods and severity, but not age of onset. Our results provide new information on the relationship between BPD and NSSI in young adults, and could be used to improve the early detection of vulnerable BPD-individuals and in planning NSSI treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Social injury: An interpretative phenomenological analysis of the attitudes towards suicide of lay persons in Ghana

    PubMed Central

    Osafo, Joseph; Hjelmeland, Heidi; Akotia, Charity Sylvia; Knizek, Birthe Loa

    2011-01-01

    One way of furthering our understanding of suicidal behaviour is to examine people's attitudes towards it and how they conceive the act. The aim of this study was to understand how lay persons conceive the impact of suicide on others and how that influences their attitudes towards suicide; and discuss the implications for suicide prevention in Ghana. This is a qualitative study, using a semi-structured interview guide to investigate the attitudes and views of 27 lay persons from urban and rural settings in Ghana. Interpretative Phenomenological Analysis was used to analyse the data. Findings showed that the perceived breach of interrelatedness between people due to suicidal behaviour influenced the informants’ view of suicide as representing a social injury. Such view of suicide influenced the negative attitudes the informants expressed towards the act. The negative attitudes towards suicide in Ghana are cast in consequential terms. Thus, suicide is an immoral act because it socially affects others negatively. The sense of community within the African ethos and The Moral Causal Ontology for Suffering are theoretical postulations that are used to offer some explanations of the findings in this study. PMID:22065981

  5. Perceptions of an Adapted Mindfulness Program for Persons Experiencing Substance Use Disorders and Traumatic Brain Injury.

    PubMed

    Kristofersson, Gisli K; Beckers, Tom; Krueger, Rick

    Of the 1.4 million Americans who sustain traumatic brain injuries (TBIs) each year up to half experience substance use disorders (SUDs). This often leads to various issues such as increased rates of mental health problems and delay or lack of return to full employment. The purpose of this program evaluation was to describe Vinland National Center's (Vinland's) client and staff perceptions of a 4-week mindfulness-based intervention adapted from the original mindfulness-based stress reduction program for persons experiencing SUDs and TBIs. It focused on the possible relevance and applicability of mindfulness practice for this population. Four focus groups were conducted based on Krueger's methods in conducting focus groups: two with Vinland staff members and two focus groups with residents. The analysis of staff focus groups revealed general staff satisfactions with the intervention. A general consensus was that the mindfulness intervention fitted well with the needs of Vinland's clients and their current program. Client feedback further revealed general satisfaction with the mindfulness curriculum. No adverse effects were noted related to the mindfulness intervention. The results of this program evaluation suggest that implementing a mindfulness-based intervention for persons experiencing SUDs/TBIs warrants further investigation.

  6. Multiple Reflex Pathways Contribute to Bladder Activation by Intraurethral Stimulation in Persons With Spinal Cord Injury.

    PubMed

    McGee, Meredith J; Swan, Brandon D; Danziger, Zachary C; Amundsen, Cindy L; Grill, Warren M

    2017-08-08

    To measure the urodynamic effects of electrical co-stimulation of 2 individual sites in the proximal and distal urethra in persons with spinal cord injury (SCI). This work was motivated by preclinical findings that selective co-stimulation of the cranial urethral sensory nerve and the dorsal genital nerve, which innervate the proximal and distal portions of the urethra, respectively, increased reflex bladder activation and voiding efficiency. Electrical co-stimulation of urethral afferents was conducted in persons with chronic SCI during urodynamics. The effects of different frequencies of intraurethral stimulation at multiple urethral locations on bladder pressure and pelvic floor electromyographic activity were measured. Electromyographic activity indicated that multiple reflex pathways were recruited through stimulation that contributed to bladder activation. The size of reflex bladder contractions evoked by stimulation was dependent on stimulation location or reflex activated and stimulation frequency. Pudendal nerve afferents are a promising target to restore lost bladder control, as stimulation with different frequencies may be used to treat urinary incontinence and increase continent volumes or to generate stimulation-evoked bladder contractions for on-demand voiding. This work identified that co-stimulation of multiple afferent reflex pathways can enhance activation of spinal circuits and may enable improved bladder emptying in SCI when stimulation of a single pathway is not sufficient. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Cortical activation during visual illusory walking in persons with spinal cord injury: A pilot study

    PubMed Central

    Eick, John; Richardson, Elizabeth J.

    2014-01-01

    Objective To determine the location of cortical activation during a visual illusion walking paradigm, a recently proposed treatment for spinal cord injury (SCI)-related neuropathic pain, in persons with SCI compared to able-bodied controls. Design Pilot experimental fMRI trial. Setting Outpatient rehabilitation clinic. Participants Three persons with paraplegia and five able bodied participants were included in this study. Interventions Not applicable. Main Outcome Measures Cortical activation as measured by blood oxygenation-level dependent (BOLD) method of fMRI. Results During visually illusory walking, there was significant activation in the somatosensory cortex among those with SCI. In contrast, able-bodied participants showed little to no significant activation in this area, but rather, in the frontal and pre-motor areas. Conclusions Treatment modalities for SCI-related neuropathic pain that are based on sensory input paradigms such as virtual or visual illusory walking may work by targeting somatosensory cortex, an area that has been previously found to functionally reorganize following SCI. PMID:25461820

  8. 32 CFR 536.22 - Claims investigative responsibility-General.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... involving serious injury or death or those in which property damage exceeds $50,000. A command claims... forwarded to the Commander USARCS. (d) Geographic concept of responsibility. A command claims service or...

  9. Energy expenditure and metabolism during exercise in persons with a spinal cord injury.

    PubMed

    Price, Michael

    2010-08-01

    Resting energy expenditure of persons with a spinal cord injury (SCI) is generally lower than that seen in able-bodied (AB) individuals due to the reduced amounts of muscle mass and sympathetic nervous system available. However, outside of clinical studies, much less data is available regarding athletes with an SCI. In order to predict the energy expenditure of persons with SCI, the generation and validation of prediction equations in relation to specific levels of SCI and training status are required. Specific prediction equations for the SCI would enable a quick and accurate estimate of energy requirements. When compared with the equivalent AB individuals, sports energy expenditure is generally reduced in SCI with values representing 30-75% of AB values. The lowest energy expenditure values are observed for sports involving athletes with tetraplegia and where the sport is a static version of that undertaken by the AB, such as fencing. As with AB sports there is a lack of SCI data for true competition situations due to methodological constraints. However, where energy expenditure during field tests are predicted from laboratory-based protocols, wheelchair ergometry is likely to be the most appropriate exercise mode. The physiological and metabolic responses of persons with SCI are similar to those for AB athletes, but at lower absolute levels. However, the underlying mechanisms pertaining to substrate utilization appear to differ between the AB and SCI. Carbohydrate feeding has been shown to improve endurance performance in athletes with generally low levels of SCI, but no data have been reported for mid to high levels of SCI or for sport-specific tests of an intermittent nature. Further research within the areas reviewed may help to bridge the gap between what is known regarding AB athletes and athletes with SCI (and other disabilities) during exercise and also the gap between clinical practice and performance.

  10. 20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION... be directed to the district office having custody of the official file. (c) Any administrative...

  11. 20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION... be directed to the district office having custody of the official file. (c) Any administrative...

  12. 20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION... be directed to the district office having custody of the official file. (c) Any administrative...

  13. 29 CFR 15.303 - How does a Job Corps student file a claim for loss of or damages to personal property under the WIA?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true How does a Job Corps student file a claim for loss of or... Operation of the Job Corps § 15.303 How does a Job Corps student file a claim for loss of or damages to... subpart must be filed with the appropriate Job Corps Regional Office within 2 years of the date upon which...

  14. Weight matters: physical and psychosocial well being of persons with spinal cord injury in relation to body mass index.

    PubMed

    Chen, Yuying; Cao, Yue; Allen, Victoria; Richards, J Scott

    2011-03-01

    To examine the relationship of body mass index (BMI) with multiple health indices among persons with spinal cord injury (SCI). Multicenter cross-sectional study. A total of 16 SCI Model Systems throughout the United States. A total of 1107 men and 274 women (N=1381), mean age ± SD, 43.1±14.6 years (tetraplegia, 56.9%; complete injuries, 50.2%; mean years since injury ± SD, 7.8±8.6), who received follow-up in 2006 to 2009, were classified into 1 of the 4 BMI categories-underweight, normal, overweight, and obese-based on self-reported height and measured weight. Not applicable. Rehospitalization, pain, self-perceived health, FIM, Craig Handicap Assessment and Reporting Technique, Patient Health Questionnaire-9 (PHQ-9), and the Diener's Satisfaction With Life Scale (SWLS). The prevalence of underweight, overweight, and obesity was 7.5%, 31.4%, and 22.1%, respectively, which varied by age, sex, marital status, education, and neurologic impairment. For those with tetraplegia and functional motor-complete injuries, rehospitalization occurred more frequently among obese persons, while days rehospitalized were the longest among underweight persons. Pain was more severe in those classified as obese. Community mobility was lower in the underweight, overweight, and obese groups than in those with normal weight. There was no significant association between BMI and self-perceived health, FIM, PHQ-9, and SWLS beyond the effect of neurologic impairment. Prevention and intervention directed at those significantly overweight or underweight deserve consideration as priorities in the continuity of care for persons with SCI. Efforts should be targeted particularly to those at higher risk, including persons with more severe injuries, who are less educated, and who are living alone. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Need and use of assistive devices for personal mobility by individuals with spinal cord injury

    PubMed Central

    Florio, Jordanne; Arnet, Ursina; Gemperli, Armin; Hinrichs, Timo

    2016-01-01

    Objective To investigate the provision, use, and unmet need of assistive devices for personal mobility in the Swiss population with spinal cord injury (SCI). Design Community survey 2012 of the Swiss Spinal Cord Injury Cohort Study. Participants Individuals aged 16 or older with traumatic or non-traumatic SCI residing in Switzerland. Interventions Not applicable. Outcome Measures Provision, frequency of use, and unmet need (i.e. perceiving the need of a device but it not being provided) of 11 mobility devices were assessed by self-report and analyzed descriptively. Provision of devices was further analyzed by sex, age, SCI etiology, SCI severity, and time since SCI. Results Devices reported highest for provision (N = 492; mean age 55.3 ± 15.1 years; 28.9% female) were adapted cars (78.2%) and manual wheelchairs (69.9%). Provision of various devices markedly varied with age and SCI severity (e.g. 34.6% of those aged 76+ had a walking frame compared to 3.1% of those aged 31–45; 50.0% of participants with complete tetraplegia had a power wheelchair compared to 7.6% of those with complete paraplegia). Many devices were mostly used daily (e.g. manual wheelchair) while others were mostly used less frequently (e.g. handbikes). Unmet need was highest for arm braces (53.2% of those in need) and power assisted wheelchairs (47.3%), and lowest for crutches (11.4%) and manual wheelchairs (4.8%). Conclusion The devices individuals have or use is largely dependent on their age and SCI severity. While most participants have access to basic mobility devices, there is still a considerable degree of unmet need for certain devices. PMID:26666510

  16. Falls in persons with spinal cord injury: validity and reliability of the Berg Balance Scale.

    PubMed

    Wirz, Markus; Müller, Roland; Bastiaenen, Caroline

    2010-01-01

    Persons with spinal cord injury who are able to walk are at risk for falls. The objectives were to investigate if the Berg Balance Scale (BBS) can discriminate those with a propensity to fall; to determine whether the BBS is associated with mobility measures, fear of falling, and muscle strength; and to assess interobserver reliability. The measurement tools used were the BBS, the Spinal Cord Independence Measure, the Falls Efficacy Scale (FES-I), the Walking Index for Spinal Cord Injury, the 10-m walk test, and the standard neurological classification including motor scores (MS). Falls were recorded retrospectively for the previous month and prospectively for the subsequent 4 months. To determine interobserver reliability, BBS performance was videotaped and analyzed by additional physical therapists. Associations between BBS and the number of falls, measures of mobility, FES-I, and MS were calculated using Spearman correlations. The interobserver reliability was quantified using Kendall's coefficient of concordance and intraclass correlation coefficients (ICCs). Forty-two participants were included of whom 26 sustained 1 or more falls. BBS performance correlated with measures of mobility, FES-I, and MS (r(s) = -.83 to .93; P < .001) but not with the number of falls (r(s) = -.17; P = .28). The interobserver reliability was excellent, both for single items (.84-.98, P < .001) and for the total score (ICC = .95; 95% confidence interval = 0.910-0.975). The BBS proved to be reliable and to relate well with other mobility measures, fear of falling, and muscle strength. However, it was unable discriminate between people who did fall and people who did not fall.

  17. Extending technology-aided leisure and communication programs to persons with spinal cord injury and post-coma multiple disabilities.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Ricciuti, Riccardo A; Trignani, Roberto; Oliva, Doretta; Signorino, Mario; D'Amico, Fiora; Sasanelli, Giovanni

    2015-01-01

    These two studies extended technology-aided programs to promote leisure and communication opportunities to a man with cervical spinal cord injury and a post-coma man with multiple disabilities. The studies involved the use of ABAB designs, in which A and B represented baseline and intervention phases, respectively. The programs focused on enabling the participants to activate songs, videos, requests, text messages, and telephone calls. These options were presented on a computer screen and activated through a small pressure microswitch by the man with spinal cord injury and a special touch screen by the post-coma man. To help the latter participant, who had no verbal skills, with requests and telephone calls, series of words and phrases were made available that he could activate in those situations. Data showed that both participants were successful in managing the programs arranged for them. The man with spinal cord injury activated mean frequencies of above five options per 10-min session. The post-coma man activated mean frequencies of about 12 options per 20-min session. Technology-aided programs for promoting leisure and communication opportunities might be successfully tailored to persons with spinal cord injury and persons with post-coma multiple disabilities. Implications for Rehabilitation Technology-aided programs may be critical to enable persons with pervasive motor impairment to engage in leisure activities and communication events independently. Persons with spinal cord injury, post-coma extended brain damage, and forms of neurodegenerative disease, such as amyotrophic lateral sclerosis, may benefit from those programs. The programs could be adapted to the participants' characteristics, both in terms of technology and contents, so as to improve their overall impact on the participants' functioning and general mood.

  18. 32 CFR 1659.1 - Claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM EXTRAORDINARY EXPENSES OF REGISTRANTS § 1659.1 Claims. (a) Claims for payment of actual and reasonable expenses of: (1) Emergency medical care, including hospitalization of registrants who suffer illness or injury; and (2) The...

  19. Nature of Medical Malpractice Claims Against Radiation Oncologists.

    PubMed

    Marshall, Deborah; Tringale, Kathryn; Connor, Michael; Punglia, Rinaa; Recht, Abram; Hattangadi-Gluth, Jona

    2017-05-01

    To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38 million in indemnity payments. The most common alleged errors included "improper performance" (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity), "errors in diagnosis" (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity), and "no medical misadventure" (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. "Improper performance" was the primary alleged error associated with injury resulting in death. Compared with claims involving death, major temporary injury (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.29-5.85, P=.009), significant permanent injury (OR 3.1, 95% CI 1.48-6.46, P=.003), and major permanent injury (OR 5.5, 95% CI 1.89-16.15, P=.002) had a higher likelihood of a claim resulting in indemnity payment. Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims against radiation oncologists may help direct efforts to improve quality of care

  20. 32 CFR 536.85 - Claims payable under the Federal Tort Claims Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the Federal Tort Claims Act... the scope of their employment under circumstances in which the United States, if a private person... occurred. The FTCA is a limited waiver of sovereign immunity without which the United States may not...

  1. 32 CFR 536.85 - Claims payable under the Federal Tort Claims Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the Federal Tort Claims Act... the scope of their employment under circumstances in which the United States, if a private person... occurred. The FTCA is a limited waiver of sovereign immunity without which the United States may not...

  2. Preinjury alcohol and drug use among persons with spinal cord injury: Implications for rehabilitation

    PubMed Central

    Stroud, Michael W.; Bombardier, Charles H.; Dyer, Joshua R.; Rimmele, Carl T.; Esselman, Peter C.

    2011-01-01

    Context/objective To describe preinjury alcohol and drug use and opportunities for secondary prevention among persons with recent spinal cord injury (SCI). Design Survey. Setting Acute inpatient rehabilitation program. Participants Participants were 118 (84.8%) of 139 consecutive admissions who met inclusion criteria and were screened for preinjury alcohol and drug use. Interventions None. Outcome measures Alcohol and drug use, toxicology results, alcohol problems, readiness to change, and treatment preferences. Results Participants were on average 37 years old, 84% were men, and 85% were white. Fifty-one percent of the sample was considered ‘at-risk’ drinkers. Significant lifetime alcohol-related problems were reported by 38% of the total sample. Thirty-three percent reported recent illicit drug use and 44% of the 82 cases with toxicology results were positive for illicit drugs. Seventy-one percent of at-risk drinkers reported either considering changes in alcohol use or already taking action. Forty-one percent reported interest in trying substance abuse treatment or Alcoholics Anonymous (AA). Motivation to change alcohol use was significantly and positively associated with self-reported indicators of alcohol problem severity. Conclusion Preinjury alcohol and drug abuse are common among persons with recent SCI. Substance abuse screening is feasible and detects not only salient clinical problems but also significant motivation to change and interest in AA or treatment, all of which represent an important window of opportunity for appropriate brief interventions and referrals. In contrast with the idea that alcoholism is a ‘disease of denial’, the majority of at-risk drinkers with new onset SCI indicate they are considering making changes. PMID:22118253

  3. Personality Assessment Inventory profiles of veterans: Differential effects of mild traumatic brain injury and psychopathology.

    PubMed

    Miskey, Holly M; Shura, Robert D; Yoash-Gantz, Ruth E; Rowland, Jared A

    2015-09-01

    Neuropsychiatric complaints often accompany mild traumatic brain injury (mTBI), a common condition in post-deployed Veterans. Self-report, multi-scale personality inventories may elucidate the pattern of psychiatric distress in this cohort. This study investigated valid Personality Assessment Inventory (PAI) profiles in post-deployed Veterans. Measures of psychopathology and mTBI were examined in a sample of 144 post-deployed Veterans divided into groups: healthy controls (n = 40), mTBI only (n = 31), any mental health diagnosis only (MH; n = 25), comorbid mTBI and Posttraumatic Stress Disorder (mTBI/PTSD; n = 23), and comorbid mTBI, PTSD, and other psychological diagnoses (mTBI/PTSD/MDD+; n = 25). There were no significant differences between the mTBI and the control group on mean PAI subscale elevation, or number of subscale elevations above 60T or 70T. The other three groups had significantly higher overall mean scores, and more elevations above 60 and 70T compared to both controls and mTBI only. The mTBI/PTSD/MDD+ group showed the highest and most elevations. After entering demographics, PTSD, and number of other psychological diagnoses into hierarchical regressions using the entire sample, mTBI history did not predict mean PAI subscale score or number of elevations above 60T or 70T. PTSD was the only significant predictor. There were no interaction effects between mTBI and presence of PTSD, or between mTBI and total number of diagnoses. This study suggests that mTBI alone is not uniquely related to psychiatric distress in Veterans, but that PTSD accounts for self-reported symptom distress.

  4. Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: analyses using four severity metrics

    PubMed Central

    Cripton, Peter A; Shen, Hui; Brubacher, Jeff R; Chipman, Mary; Friedman, Steven M; Harris, M Anne; Winters, Meghan; Reynolds, Conor C O; Cusimano, Michael D; Babul, Shelina; Teschke, Kay

    2015-01-01

    Objective To examine the relationship between cycling injury severity and personal, trip, route and crash characteristics. Methods Data from a previous study of injury risk, conducted in Toronto and Vancouver, Canada, were used to classify injury severity using four metrics: (1) did not continue trip by bike; (2) transported to hospital by ambulance; (3) admitted to hospital; and (4) Canadian Triage and Acuity Scale (CTAS). Multiple logistic regression was used to examine associations with personal, trip, route and crash characteristics. Results Of 683 adults injured while cycling, 528 did not continue their trip by bike, 251 were transported by ambulance and 60 were admitted to hospital for further treatment. Treatment urgencies included 75 as CTAS=1 or 2 (most medically urgent), 284 as CTAS=3, and 320 as CTAS=4 or 5 (least medically urgent). Older age and collision with a motor vehicle were consistently associated with increased severity in all four metrics and statistically significant in three each (both variables with ambulance transport and CTAS; age with hospital admission; and motor vehicle collision with did not continue by bike). Other factors were consistently associated with more severe injuries, but statistically significant in one metric each: downhill grades; higher motor vehicle speeds; sidewalks (these significant for ambulance transport); multiuse paths and local streets (both significant for hospital admission). Conclusions In two of Canada's largest cities, about one-third of the bicycle crashes were collisions with motor vehicles and the resulting injuries were more severe than in other crash circumstances, underscoring the importance of separating cyclists from motor vehicle traffic. Our results also suggest that bicycling injury severity and injury risk would be reduced on facilities that minimise slopes, have lower vehicle speeds, and that are designed for bicycling rather than shared with pedestrians. PMID:25564148

  5. Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: analyses using four severity metrics.

    PubMed

    Cripton, Peter A; Shen, Hui; Brubacher, Jeff R; Chipman, Mary; Friedman, Steven M; Harris, M Anne; Winters, Meghan; Reynolds, Conor C O; Cusimano, Michael D; Babul, Shelina; Teschke, Kay

    2015-01-05

    To examine the relationship between cycling injury severity and personal, trip, route and crash characteristics. Data from a previous study of injury risk, conducted in Toronto and Vancouver, Canada, were used to classify injury severity using four metrics: (1) did not continue trip by bike; (2) transported to hospital by ambulance; (3) admitted to hospital; and (4) Canadian Triage and Acuity Scale (CTAS). Multiple logistic regression was used to examine associations with personal, trip, route and crash characteristics. Of 683 adults injured while cycling, 528 did not continue their trip by bike, 251 were transported by ambulance and 60 were admitted to hospital for further treatment. Treatment urgencies included 75 as CTAS=1 or 2 (most medically urgent), 284 as CTAS=3, and 320 as CTAS=4 or 5 (least medically urgent). Older age and collision with a motor vehicle were consistently associated with increased severity in all four metrics and statistically significant in three each (both variables with ambulance transport and CTAS; age with hospital admission; and motor vehicle collision with did not continue by bike). Other factors were consistently associated with more severe injuries, but statistically significant in one metric each: downhill grades; higher motor vehicle speeds; sidewalks (these significant for ambulance transport); multiuse paths and local streets (both significant for hospital admission). In two of Canada's largest cities, about one-third of the bicycle crashes were collisions with motor vehicles and the resulting injuries were more severe than in other crash circumstances, underscoring the importance of separating cyclists from motor vehicle traffic. Our results also suggest that bicycling injury severity and injury risk would be reduced on facilities that minimise slopes, have lower vehicle speeds, and that are designed for bicycling rather than shared with pedestrians. Published by the BMJ Publishing Group Limited. For permission to use (where

  6. Determinants of handbike use in persons with spinal cord injury: results of a community survey in Switzerland.

    PubMed

    Arnet, Ursina; Hinrichs, Timo; Lay, Veronika; Bertschy, Sue; Frei, Heinz; Brinkhof, Martin W G

    2016-01-01

    To examine the prevalence and determinants of handbike use in persons living with spinal cord injury in Switzerland. A population-based cross-sectional survey in Switzerland. The crude prevalence of handbike use among the 1549 participants was 22.6%, varying between 25.3% in men and 17.7% in women. Prevalence was higher in complete than in incomplete spinal cord injury (SCI) (41.5% versus 11.9% in paraplegia, 25.6% versus 11.1% in tetraplegia). Multivariable analysis of handbike use confirmed differences with lesion characteristics and gender and showed a decline with age, lowest rates in the low-income group, variation with language, but no association with level of education or cause of spinal cord injury. In total, 45.8% of users reported to engage in handcycling at least once a week. Frequent contextual reasons for refraining from handcycling were: no interest (26%); inability due to disability (20%); unfamiliarity with the handbike (19%) and financial constraints (14%). Conditional on the major determinants that include demographic factors and lesion characteristics, main barriers involve contextual factors that can principally be overcome. Our findings thus suggest scope for promoting handcycling as a means towards a healthy and more physically active lifestyle in persons living with SCI. Handcycling is an effective means of improving health and quality of life of persons with a spinal cord injury. Persons with the following traits are most likely to use the handbike: persons younger than 62 years, with a complete paraplegia, who are German-speaking (vs. French/Italian) and having a middle or high net income. Indicated reasons for not using a handbike varied by SCI characteristics and included disinterest, inability related to the level of impairment, unfamiliarity and financial costs. Barriers that involve the above mentioned contextual factors can principally be overcome by targeted policy or information campaigns.

  7. 32 CFR 536.155 - Claims payable involving tortfeasors other than nonappropriated fund employees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... claims can arise from the activities of: (1) Members of NAFIs or authorized users of NAFI sports... manner prescribed in AR 608-10, except as excluded below. Such claims are generally limited to injuries... all claims (including derivative claims), arising as a result of injury to, or death of, any...

  8. Clinical assessment of decision-making capacity in acquired brain injury with personality change.

    PubMed

    Owen, Gareth S; Freyenhagen, Fabian; Martin, Wayne; David, Anthony S

    2017-01-01

    Assessment of decision-making capacity (DMC) can be difficult in acquired brain injury (ABI) particularly with the syndrome of organic personality disorder (OPD) (the "frontal lobe syndrome"). Clinical neuroscience may help but there are challenges translating its constructs to the decision-making abilities considered relevant by law and ethics. An in-depth interview study of DMC in OPD was undertaken. Six patients were purposefully sampled and rich interview data were acquired for scrutiny using interpretative phenomenological analysis. Interview data revealed that awareness of deficit and thinking about psychological states can be present. However, the awareness of deficit may not be "online" and effectively integrated into decision-making. Without this online awareness of deficit the ability to appreciate or use and weigh information in the process of deciding some matters appeared absent. We argue that the decision-making abilities discussed are: (1) necessary for DMC, (2) threatened by ABI , and (3) assessable at interview. Some advice for practically incorporating these abilities within assessments of DMC in patients with OPD is outlined.

  9. Clinical assessment of decision-making capacity in acquired brain injury with personality change

    PubMed Central

    Owen, Gareth S.; Freyenhagen, Fabian; Martin, Wayne; David, Anthony S.

    2017-01-01

    Assessment of decision-making capacity (DMC) can be difficult in acquired brain injury (ABI) particularly with the syndrome of organic personality disorder (OPD) (the “frontal lobe syndrome”). Clinical neuroscience may help but there are challenges translating its constructs to the decision-making abilities considered relevant by law and ethics. An in-depth interview study of DMC in OPD was undertaken. Six patients were purposefully sampled and rich interview data were acquired for scrutiny using interpretative phenomenological analysis. Interview data revealed that awareness of deficit and thinking about psychological states can be present. However, the awareness of deficit may not be “online” and effectively integrated into decision-making. Without this online awareness of deficit the ability to appreciate or use and weigh information in the process of deciding some matters appeared absent. We argue that the decision-making abilities discussed are: (1) necessary for DMC, (2) threatened by ABI , and (3) assessable at interview. Some advice for practically incorporating these abilities within assessments of DMC in patients with OPD is outlined. PMID:26088818

  10. Emotion differentiation as a protective factor against nonsuicidal self-injury in borderline personality disorder.

    PubMed

    Zaki, Landon F; Coifman, Karin G; Rafaeli, Eshkol; Berenson, Kathy R; Downey, Geraldine

    2013-09-01

    Evidence that nonsuicidal self-injury (NSSI) serves a maladaptive emotion regulation function in borderline personality disorder (BPD) has drawn attention to processes that may increase risk for NSSI by exacerbating negative emotion, such as rumination. However, more adaptive forms of emotion processing, including differentiating broad emotional experiences into nuanced emotion categories, might serve as a protective factor against NSSI. Using an experience-sampling diary, the present study tested whether differentiation of negative emotion was associated with lower frequency of NSSI acts and urges in 38 individuals with BPD who reported histories of NSSI. Participants completed a dispositional measure of rumination and a 21-day experience-sampling diary, which yielded an index of negative emotion differentiation and frequency of NSSI acts and urges. A significant rumination by negative emotion differentiation interaction revealed that rumination predicted higher rates of NSSI acts and urges in participants with difficulty differentiating their negative emotions. The results extend research on emotion differentiation into the clinical literature and provide empirical support for clinical theories that suggest emotion identification and labeling underlie strategies for adaptive self-regulation and decreased NSSI risk in BPD.

  11. [Civil competence assessment of the mental disorders involved in compensation of personal injury].

    PubMed

    Pang, Yan-xia; Zhang, Qin-ting; Cai, Wei-xiong; Huang, Fu-yin; Tang, Tao; Wu, Jia-sheng; Wang, Jian-jun; Dong, Ri-xia

    2009-02-01

    To seek and ascertain indicators that can be used in the civil competence assessment of the mental disorders involved in compensation of personal injury. A retrospective study was made on the data related to the interviewee's mental status assessed by forensic experts during the period from 2003 to 2005 in Institute of Forensic Science, Ministry of Justice, P.R.China. The 6 indicators, including awareness of situation, factual understanding of issues, appreciation of likely consequences, rational manipulation of information, functioning in one's own environment, and communication of choice, were graded and statistically analyzed using SPSS 11.5 software. The 6 indicators correlated well with the assessment of forensic experts ,with the related coefficient between 0.632 and 0.876, and the inter-related coefficient among the 6 indicators between 0.575 and 0.911. The 6 indicators could be used for the civil competence assessment and may also be taken as the basis for further standardization and quantification of civil competence.

  12. Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer.

    PubMed

    Solana, Javier; Cáceres, César; García-Molina, Alberto; Opisso, Eloy; Roig, Teresa; Tormos, José M; Gómez, Enrique J

    2015-01-01

    Cognitive rehabilitation aims to remediate or alleviate the cognitive deficits appearing after an episode of acquired brain injury (ABI). The purpose of this work is to describe the telerehabilitation platform called Guttmann Neuropersonal Trainer (GNPT) which provides new strategies for cognitive rehabilitation, improving efficiency and access to treatments, and to increase knowledge generation from the process. A cognitive rehabilitation process has been modeled to design and develop the system, which allows neuropsychologists to configure and schedule rehabilitation sessions, consisting of set of personalized computerized cognitive exercises grounded on neuroscience and plasticity principles. It provides remote continuous monitoring of patient's performance, by an asynchronous communication strategy. An automatic knowledge extraction method has been used to implement a decision support system, improving treatment customization. GNPT has been implemented in 27 rehabilitation centers and in 83 patients' homes, facilitating the access to the treatment. In total, 1660 patients have been treated. Usability and cost analysis methodologies have been applied to measure the efficiency in real clinical environments. The usability evaluation reveals a system usability score higher than 70 for all target users. The cost efficiency study results show a relation of 1-20 compared to face-to-face rehabilitation. GNPT enables brain-damaged patients to continue and further extend rehabilitation beyond the hospital, improving the efficiency of the rehabilitation process. It allows customized therapeutic plans, providing information to further development of clinical practice guidelines.

  13. Reproducibility and effect of posture on impulse oscillation parameters in persons with spinal cord injury

    PubMed Central

    Cirnigliaro, Christopher M.; Lesser, Marvin; Moyer, Jeremy; Kirshblum, Steven C.; Bauman, William A.; Spungen, Ann M.

    2012-01-01

    Background The impulse oscillation system (IOS) offers significant value in the assessment of airway dynamics in persons with spinal cord injury (SCI) because of minimal patient effort but measurement reproducibility in SCI is unknown. Objective To evaluate between-day reproducibility and the effect of posture on airway resistance [respiratory resistances at 5 Hz (R5) and 20 Hz (R20)] in subjects with tetraplegia, paraplegia and able-bodied controls. Methods Ten subjects with tetraplegia, 10 subjects with paraplegia and 11 able-bodied individuals were evaluated using IOS. Three 30 second trials were obtained in each while in the seated and supine position on Day 1, and repeated on Day 2. Results The within-day coefficient of variation (CV%) for R5 and R20 were comparable in the 3 study groups in the seated and supine positions. Compared to controls, the between-day CV% for the combined data was higher in subjects with tetraplegia and paraplegia for R5 seated, and was higher in subjects with tetraplegia for R5 supine. Conclusions IOS has applicability to the study of within-day respiratory resistance in SCI. However, performing longer-term studies in subjects with tetraplegia and paraplegia may be problematic because of the greater variability for R5 when compared to able-bodied individuals. PMID:22330188

  14. 40 CFR 14.12 - Principal types of unallowable claims.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Principal types of unallowable claims. 14.12 Section 14.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL EMPLOYEE PERSONAL PROPERTY CLAIMS § 14.12 Principal types of unallowable claims. Claims that ordinarily will not be...

  15. 40 CFR 14.12 - Principal types of unallowable claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Principal types of unallowable claims. 14.12 Section 14.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL EMPLOYEE PERSONAL PROPERTY CLAIMS § 14.12 Principal types of unallowable claims. Claims that ordinarily will not be...

  16. 5 CFR 180.105 - Claims not allowed.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Claims not allowed. 180.105 Section 180.105 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYEES' PERSONAL PROPERTY CLAIMS § 180.105 Claims not allowed. (a) A claim is not allowable if: (1) The damage or...

  17. Work-related injuries in drywall installation.

    PubMed

    Lipscomb, H J; Dement, J M; Gaal, J S; Cameron, W; McDougall, V

    2000-10-01

    Administrative data sources were used to describe the work-related injuries of drywall carpenters, to calculate rates of occurrence, and to explore high risk sub-groups. Health insurance eligibility files were used to identify a cohort of active union carpenters affiliated with a union local whose predominant work involved drywall installation in the state of Washington. These files contained the hours worked by each individual for each month between January 1989 and December 1995, providing person-hours at risk as a union carpenter. The Washington Department of Labor and Industries (L&I) provided records of workers' compensation claims filed by these individuals. Over seven years 1773 drywall carpenters filed 2567 workers' compensation claims representing an overall rate of 53.3 per 200,000 hours worked. These claims were filed by 1046 different individuals, or 59.0 percent of the cohort. Claims resulting in paid lost time from work were filed at a rate of 12.5 per 200,000 hours worked (n = 609) by 445 (25.1%) different individuals. The most common mechanisms of injury involved being struck (38.3%), overexertion (28.1%), and falls (13.2%). Struck by injuries most commonly involved cuts to the upper extremity. Overexertion injuries were most commonly described as sprains or strains involving the back. Sheetrock was associated with over 40 percent of these injuries. Falls most commonly involved injuries to the knee followed by the back and multiple injuries. Struck by injuries decreased steadily with increasing age and increasing time in the union. There was a steady increase in the rate of falls with increasing age. Overexertion injuries were responsible for the greatest proportion of costs for medical care, permanent impairment, and paid lost days. The high rates of overexertion injuries among these workers is consistent with known ergonomic stresses on drywall jobs. However, these workers are also at high risk of acute traumatic injuries.

  18. 10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false What conditions apply to DOE indemnification of claims... pollutant or contaminant attributable to DOE? 770.9 Section 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.9 What conditions apply...

  19. 10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false What conditions apply to DOE indemnification of claims... pollutant or contaminant attributable to DOE? 770.9 Section 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.9 What conditions apply...

  20. 10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false What conditions apply to DOE indemnification of claims... pollutant or contaminant attributable to DOE? 770.9 Section 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.9 What conditions apply...

  1. Use of healthcare a long time after severe burn injury; relation to perceived health and personality characteristics.

    PubMed

    Wikehult, B; Willebrand, M; Kildal, M; Lannerstam, K; Fugl-Meyer, A R; Ekselius, L; Gerdin, B

    2005-08-05

    The aim of the study was to evaluate which factors are associated with the use of healthcare a long time after severe burn injury. After a review process based on clinical reasoning, 69 former burn patients out of a consecutive group treated at the Uppsala Burn Unit from 1980--1995 were visited in their homes and their use of care and support was assessed in a semi-structured interview. Post-burn health was assessed with the Burn-Specific Health Scale-Brief (BSHS-B) and personality was assessed with the Swedish universities Scales of Personality (SSP). The participants were injured on average eight years previously. Thirty-four had current contact with healthcare due to their burn injury and had significantly lower scores on three BSHS-B-domains: Simple Abilities, Work and Hand function, and significantly higher scores for the SSP-domain Neuroticism and the SSP-scales Stress Susceptibility, Lack of Assertiveness, and lower scores for Social Desirability. There was no relation to age, gender, time since injury, length of stay, or to the surface area burned. A routine screening of personality traits as a supplement to long-term follow-ups may help in identifying the patient's need for care.

  2. Insurance claims after vascular surgery in Sweden.

    PubMed

    Rudström, H; Bergqvist, D; Ahlberg, J; Björck, M

    2011-10-01

    The study aimed to estimate the incidence and causes of insurance claims (IC) after vascular surgery (VS) reported to the Swedish Medical Injury Insurance (SMII); and to validate the registration of complications in the National Vascular Registry (Swedvasc). The medical records of all IC in VS in Sweden reported to the SMII 2002-2007 were scrutinised and cross-referenced against Swedvasc. There were 193 claims after VS: varicose-veins (66), lower extremity (45), aortic (31) or carotid artery (21), access (19) or other VS (11). Frequent causes of claims were peripheral nerve injury (76), wound infection (22) and cranial nerve injury (15). More than half of the patients suffered permanent injuries, three died. As many as 55 (28%) received economic compensation (an average of 45% of all ICs in SMII). The highest frequency of compensated claims (1:650 yearly procedures) was for carotid artery surgery. Of the procedures, 187 were elective. Compared with the Swedvasc, claudication was a more common indication (28% vs. 12%). Nearly one-fifth (18%) were incorrectly registered in Swedvasc. The most common causes of insurance claims were peripheral nerve injuries and infections. Patients raising insurance claims after vascular surgery undergo acute procedures less frequently, and are correctly registered in the Swedvasc in 82% of cases. Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  3. Preserved Error-Monitoring in Borderline Personality Disorder Patients with and without Non-Suicidal Self-Injury Behaviors

    PubMed Central

    Vega, Daniel; Vilà-Balló, Adrià; Soto, Àngel; Amengual, Julià; Ribas, Joan; Torrubia, Rafael; Rodríguez-Fornells, Antoni; Marco-Pallarés, Josep

    2015-01-01

    Background The presence of non-suicidal self-injury acts in Borderline Personality Disorder (BPD) is very prevalent. These behaviors are a public health concern and have become a poorly understood phenomenon in the community. It has been proposed that the commission of non-suicidal self-injury might be related to a failure in the brain network regulating executive functions. Previous studies have shown that BPD patients present an impairment in their capacity to monitor actions and conflicts associated with the performance of certain actions, which suppose an important aspect of cognitive control. Method We used Event Related Potentials to examine the behavioral and electrophysiological indexes associated with the error monitoring in two BPD outpatients groups (17 patients each) differentiated according to the presence or absence of non-suicidal self-injury behaviors. We also examined 17 age- and intelligence- matched healthy control participants. Results The three groups did not show significant differences in event-related potentials associated with errors (Error-Related Negativity and Pe) nor in theta power increase following errors. Conclusions This is the first study investigating the behavioral and electrophysiological error monitoring indexes in BPD patients characterized by their history of non-suicidal self-injury behaviors. Our results show that error monitoring is preserved in BPD patients and suggest that non-suicidal self-injury acts are not related to a dysfunction in the cognitive control mechanisms. PMID:26636971

  4. Preserved Error-Monitoring in Borderline Personality Disorder Patients with and without Non-Suicidal Self-Injury Behaviors.

    PubMed

    Vega, Daniel; Vilà-Balló, Adrià; Soto, Àngel; Amengual, Julià; Ribas, Joan; Torrubia, Rafael; Rodríguez-Fornells, Antoni; Marco-Pallarés, Josep

    2015-01-01

    The presence of non-suicidal self-injury acts in Borderline Personality Disorder (BPD) is very prevalent. These behaviors are a public health concern and have become a poorly understood phenomenon in the community. It has been proposed that the commission of non-suicidal self-injury might be related to a failure in the brain network regulating executive functions. Previous studies have shown that BPD patients present an impairment in their capacity to monitor actions and conflicts associated with the performance of certain actions, which suppose an important aspect of cognitive control. We used Event Related Potentials to examine the behavioral and electrophysiological indexes associated with the error monitoring in two BPD outpatients groups (17 patients each) differentiated according to the presence or absence of non-suicidal self-injury behaviors. We also examined 17 age- and intelligence- matched healthy control participants. The three groups did not show significant differences in event-related potentials associated with errors (Error-Related Negativity and Pe) nor in theta power increase following errors. This is the first study investigating the behavioral and electrophysiological error monitoring indexes in BPD patients characterized by their history of non-suicidal self-injury behaviors. Our results show that error monitoring is preserved in BPD patients and suggest that non-suicidal self-injury acts are not related to a dysfunction in the cognitive control mechanisms.

  5. Conditional and continuous electrical stimulation increase cystometric capacity in persons with spinal cord injury.

    PubMed

    Horvath, Eric E; Yoo, Paul B; Amundsen, Cindy L; Webster, George D; Grill, Warren M

    2010-03-01

    Individuals with spinal cord injury (SCI) exhibit neurogenic detrusor overactivity (NDO) causing high intravesicle pressures and incontinence. The first aim was to measure changes in maximum cystometric capacity (MCC) evoked by electrical stimulation of the dorsal genital nerve (DGN) delivered either continuously or conditionally (only during bladder contractions) in persons with SCI. The second aim was to use the external anal sphincter electromyogram (EMG(EAS)) for real-time control of conditional stimulation. Serial filling cystometries were performed in nine volunteers with complete or incomplete supra-sacral SCI. Conditional stimulation was delivered automatically when detrusor pressure increased to 8-12 cmH(2)O above baseline. MCCs were measured for each treatment (continuous, conditional, and no stimulation) and compared using post-ANOVA Tukey HSD paired comparisons. Additional treatments in two subjects used the EMG(EAS) for automatic control of conditional stimulation. Continuous and conditional stimulation increased MCC by 63 +/- 73 ml (36 +/- 24%) and 74 +/- 71 ml (51 +/- 37%), respectively (P < 0.05), compared to no stimulation. There was no significant difference between MCCs for conditional and continuous stimulation, but conditional stimulation significantly reduced stimulation time (174 +/- 154 sec, or 27 +/- 17% of total time) as compared to continuous stimulation (469 +/- 269 sec, 100% of total time, P < 0.001). The EMG(EAS) algorithm provided reliable detection of bladder contractions (six of six contractions over four trials) and reduced stimulation time (21 +/- 8% of total time). Conditional stimulation generates increases in bladder capacity while substantially reducing stimulation time. Furthermore, EMG(EAS) was successfully used as a real-time feedback signal to control conditional electrical stimulation in a laboratory setting. (c) 2009 Wiley-Liss, Inc.

  6. Enabling Work: Occupational Therapy Interventions for Persons with Occupational Injuries and Diseases: A Scoping Review.

    PubMed

    Blas, Alexa Jane T; Beltran, Kenneth Matthew B; Martinez, Pauline Gail V; Yao, Daryl Patrick G

    2017-09-08

    Purpose This review aims to map the scope of published research on occupational therapy (OT) interventions and pertinent work and work-related outcomes for persons with occupational injuries and diseases. Methods The scoping review adapted Arksey and O'Malley's framework. Six electronic databases were searched. Ancestral search was also done on five systematic reviews. The search was conducted from September 2015 to October 2015. Interventions and outcomes were coded using the International Classification of Functioning, Disability and Health Core Set for Vocational Rehabilitation to plot trends. Results Forty-six articles were included in the review. The top five intervention approaches included: acquiring skills (12.27%), health services, systems, and policies (10.43%), products and technology for employment (9.20%), handling stress and other psychological demands (7.98%), and apprenticeship (6.74%). The top five outcomes targeted included: remunerative employment (15.71%); sensation of pain (10.99%); emotional functions (5.76%); handling stress and other psychological demands (5.76%); economic self-sufficiency (4.71%); muscle endurance functions (4.71%); exercise tolerance functions (4.71%); undertaking multiple tasks (4.19%); acquiring, keeping, and terminating a job (4.19%); and looking after one's health (4.19%). Conclusion The trend in interventions show the use of activities and environment facilitators which are attuned to the conceptual nature of OT. Furthermore, the trend in outcomes show that there is substantial evidence that supports the use of OT to target work. This review may provide a platform for collaboration with other professionals and also help identify research directions to strengthen the evidence base for OT in work-related practice.

  7. 39 CFR 912.5 - Administrative claim; when presented.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... incident, accompanied by a claim for money damages in a sum certain for injury to or loss of property... obtained from the local District Tort Claims Coordinator, the National Tort Center, or online at usa.gov... Postal Service shall have six months in which to make final disposition of the claim as amended, and the...

  8. 39 CFR 912.5 - Administrative claim; when presented.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... incident, accompanied by a claim for money damages in a sum certain for injury to or loss of property... obtained from the local District Tort Claims Coordinator, the National Tort Center, or online at usa.gov... Postal Service shall have six months in which to make final disposition of the claim as amended, and the...

  9. 39 CFR 912.5 - Administrative claim; when presented.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... incident, accompanied by a claim for money damages in a sum certain for injury to or loss of property... obtained from the local District Tort Claims Coordinator, the National Tort Center, or online at usa.gov... Postal Service shall have six months in which to make final disposition of the claim as amended, and the...

  10. 39 CFR 912.5 - Administrative claim; when presented.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... incident, accompanied by a claim for money damages in a sum certain for injury to or loss of property... obtained from the local District Tort Claims Coordinator, the National Tort Center, or online at usa.gov... Postal Service shall have six months in which to make final disposition of the claim as amended, and the...

  11. 39 CFR 912.5 - Administrative claim; when presented.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... incident, accompanied by a claim for money damages in a sum certain for injury to or loss of property... obtained from the local District Tort Claims Coordinator, the National Tort Center, or online at usa.gov... Postal Service shall have six months in which to make final disposition of the claim as amended, and the...

  12. 32 CFR 757.15 - Claims not asserted.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS AFFIRMATIVE CLAIMS... policies that cover the injury. (c) Employers of merchant seamen. Claims are not asserted against the employer of a merchant seaman who receives Federal medical care under 42 U.S.C. 249. (d) Department...

  13. 32 CFR 757.15 - Claims not asserted.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS AFFIRMATIVE CLAIMS... policies that cover the injury. (c) Employers of merchant seamen. Claims are not asserted against the employer of a merchant seaman who receives Federal medical care under 42 U.S.C. 249. (d) Department...

  14. 32 CFR 757.15 - Claims not asserted.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Claims not asserted. In some cases, public policy considerations limit the DoN's assertion of claims... policies that cover the injury. (c) Employers of merchant seamen. Claims are not asserted against the... transferred to a Department of Veterans' Affairs hospital. This policy does not apply in cases where the MTF...

  15. 32 CFR 536.26 - Identification of a proper claim.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Standard Form (SF) 95 (Claim for Damage, Injury, or Death). When the claim is not presented on an SF 95, the claimant will be requested to complete an SF 95 to ease investigation and processing. (d) If a... substantiate the claim are not present, such as those listed on the back of an SF 95 or in the Attorney...

  16. 32 CFR 536.26 - Identification of a proper claim.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Standard Form (SF) 95 (Claim for Damage, Injury, or Death). When the claim is not presented on an SF 95, the claimant will be requested to complete an SF 95 to ease investigation and processing. (d) If a... substantiate the claim are not present, such as those listed on the back of an SF 95 or in the Attorney...

  17. 32 CFR 536.26 - Identification of a proper claim.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Standard Form (SF) 95 (Claim for Damage, Injury, or Death). When the claim is not presented on an SF 95, the claimant will be requested to complete an SF 95 to ease investigation and processing. (d) If a... substantiate the claim are not present, such as those listed on the back of an SF 95 or in the Attorney...

  18. 32 CFR 536.26 - Identification of a proper claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Standard Form (SF) 95 (Claim for Damage, Injury, or Death). When the claim is not presented on an SF 95, the claimant will be requested to complete an SF 95 to ease investigation and processing. (d) If a... substantiate the claim are not present, such as those listed on the back of an SF 95 or in the Attorney...

  19. 40 CFR 1620.10 - Action on approved claim.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... claim approved under this part is contingent on claimant's execution of a Standard Form 95 (Claim for Damage, Injury or Death); a claims settlement agreement; and a Standard Form 1145 (Voucher for Payment), as well as any other forms as may be required. When a claimant is represented by an attorney,...

  20. 40 CFR 1620.10 - Action on approved claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... claim approved under this part is contingent on claimant's execution of a Standard Form 95 (Claim for Damage, Injury or Death); a claims settlement agreement; and a Standard Form 1145 (Voucher for Payment), as well as any other forms as may be required. When a claimant is represented by an attorney,...

  1. Psychometric Validation of the World Health Organization Disability Assessment Schedule 2.0-Twelve-Item Version in Persons with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Smedema, Susan Miller; Ruiz, Derek; Mohr, Michael J.

    2017-01-01

    Purpose: To evaluate the factorial and concurrent validity and internal consistency reliability of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12-item version in persons with spinal cord injuries. Method: Two hundred forty-seven adults with spinal cord injuries completed an online survey consisting of the WHODAS…

  2. Development, Implementation, and Validation of Supported Employment Model(s) for Traumatically Brain Injured Persons. Head Injury Re-entry Project (Project HIRe). Final Report.

    ERIC Educational Resources Information Center

    Thomas, Dale F.; Menz, Fredrick E.

    The final report of the Head Injury Re-entry Project (Project HIRe) describes activities of this 3-year (1987 to 1990) project, which used a "best practices" model approach and a community-based employment strategy with persons having traumatic brain injury (TBI) in nonurban areas. Among 15 project accomplishments are the following: (1)…

  3. Participation in physical activity in persons with spinal cord injury: a comprehensive perspective and insights into gender differences.

    PubMed

    Rauch, Alexandra; Fekete, Christine; Cieza, Alarcos; Geyh, Szilvia; Meyer, Thorsten

    2013-07-01

    To prevent secondary conditions and to improve and maintain health, regular physical activity is recommended as an important component of a health-promoting lifestyle for persons with spinal cord injury (SCI). However, participation in physical activity is low in persons with SCI, especially in women. The objective of this study is to identify (1) categories of functioning, the environment and personal factors that influence participation in physical activity in persons with SCI and (2) gender differences within identified factors. An explorative qualitative study design using both focus groups and individual interviews based on a semi-structured interview guide was used. Statements were linked to categories or chapters of the four components of functioning (body structures, body functions, activities and participation) and of the environment included in the International Classification of Functioning, Disability and Health (ICF) and a recently developed list of personal factors. An in-depth analysis of the statements was performed to identify relevant associations and gender differences. Twenty-six persons (13 female, 13 male) participated in the study. Sixty-seven categories and four chapters from all components of functioning and environmental factors included in the ICF and 33 subdivisions of personal factors were found to be associated with physical activity in persons with SCI. Gender differences could be assigned to areas of gender roles, social support, athletic identity, interests, and general behavioral patterns. This study contributes to a comprehensive understanding of participation in physical activity in persons with SCI and presents a first step toward the identification of gender differences. The results should be validated by further quantitative research. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. 28 CFR 543.31 - Filing a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... correspond with you. (b) Where do I obtain a form for filing a claim? You may obtain a form from staff in the... occurred. If the loss or injury occurred in a specific regional office or within the geographical... injury occurred in the Central Office, you may either mail or deliver the claim to the Office of General...

  5. Perceived personal importance of exercise and fears of re-injury: a longitudinal study of psychological factors related to activity after anterior cruciate ligament reconstruction.

    PubMed

    Gignac, Monique Am; Cao, Xingshan; Ramanathan, Subha; White, Lawrence M; Hurtig, Mark; Kunz, Monica; Marks, Paul H

    2015-01-01

    Psychological perceptions are increasingly being recognized as important to recovery and rehabilitation post-surgery. This research longitudinally examined perceptions of the personal importance of exercise and fears of re-injury over a three-year period post anterior cruciate ligament (ACL) reconstruction. Stability and change in psychological perceptions was examined, as well as the association of perceptions with time spent in different types of physical activity, including walking, household activities, and lower and higher risk for knee injury activities. Participants were athletes, 18-40 years old, who underwent ACL reconstruction for first-time ACL injuries. They were recruited from a tertiary care centre in Toronto, Canada. Participants completed interviewer-administered questionnaires pre-surgery and at years one, two and three, postoperatively. Questions assessed demographics, pain, functional limitations, perceived personal importance of exercise, fear of re-injury and physical activities (i.e., walking; household activities; lower risk for knee injury activities; higher risk for knee injury activities). Analyses included fixed-effect longitudinal modeling to examine the association of a fear of re-injury and perceived personal importance of exercise and changes in these perceptions with the total hours spent in the different categories of physical activities, controlling for other factors. Baseline participants were 77 men and 44 women (mean age = 27.6 years; SD = 6.2). At year three, 78.5% of participants remained in the study with complete data. Fears of re-injury decreased over time while personal importance of exercise remained relatively stable. Time spent in walking and household activities did not significantly change with ACL injury or surgery. Time spent in lower and higher risk of knee injury physical activity did not return to pre-injury levels at three years, post-surgery. Greater time spent in higher risk of knee injury activities

  6. Accuracy of self-reported length of coma and posttraumatic amnesia in persons with medically verified traumatic brain injury.

    PubMed

    Sherer, Mark; Sander, Angelle M; Maestas, Kacey Little; Pastorek, Nicholas J; Nick, Todd G; Li, Jingyun

    2015-04-01

    To determine the accuracy of self-reported length of coma and posttraumatic amnesia (PTA) in persons with medically verified traumatic brain injury (TBI) and to investigate factors that affect self-report of length of coma and PTA duration. Prospective cohort study. Specialized rehabilitation center with inpatient and outpatient programs. Persons (N=242) with medically verified TBI who were identified from a registry of persons who had previously participated in TBI-related research. Not applicable. Self-reported length of coma and self-reported PTA duration. Review of medical records revealed that the mean medically documented length of coma and PTA duration was 6.9±12 and 19.2±22 days, respectively, and the mean self-reported length of coma and PTA duration was 16.7±22 and 106±194 days, respectively. The average discrepancy between self-report and medical record for length of coma and PTA duration was 8.2±21 and 64±176 days, respectively. Multivariable regression models revealed that time since injury, performance on cognitive tests, and medical record values were associated with self-reported values for both length of coma and PTA duration. In this investigation, persons with medically verified TBI showed poor accuracy in their self-report of length of coma and PTA duration. Discrepancies were large enough to affect injury severity classification. Caution should be exercised when considering self-report of length of coma and PTA duration. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Time and Effort Required by Persons with Spinal Cord Injury to Learn to Use a Powered Exoskeleton for Assisted Walking.

    PubMed

    Kozlowski, Allan J; Bryce, Thomas N; Dijkers, Marcel P

    2015-01-01

    Powered exoskeletons have been demonstrated as being safe for persons with spinal cord injury (SCI), but little is known about how users learn to manage these devices. To quantify the time and effort required by persons with SCI to learn to use an exoskeleton for assisted walking. A convenience sample was enrolled to learn to use the first-generation Ekso powered exoskeleton to walk. Participants were given up to 24 weekly sessions of instruction. Data were collected on assistance level, walking distance and speed, heart rate, perceived exertion, and adverse events. Time and effort was quantified by the number of sessions required for participants to stand up, walk for 30 minutes, and sit down, initially with minimal and subsequently with contact guard assistance. Of 22 enrolled participants, 9 screen-failed, and 7 had complete data. All of these 7 were men; 2 had tetraplegia and 5 had motor-complete injuries. Of these, 5 participants could stand, walk, and sit with contact guard or close supervision assistance, and 2 required minimal to moderate assistance. Walk times ranged from 28 to 94 minutes with average speeds ranging from 0.11 to 0.21 m/s. For all participants, heart rate changes and reported perceived exertion were consistent with light to moderate exercise. This study provides preliminary evidence that persons with neurological weakness due to SCI can learn to walk with little or no assistance and light to somewhat hard perceived exertion using a powered exoskeleton. Persons with different severities of injury, including those with motor complete C7 tetraplegia and motor incomplete C4 tetraplegia, may be able to learn to use this device.

  8. Time and Effort Required by Persons with Spinal Cord Injury to Learn to Use a Powered Exoskeleton for Assisted Walking

    PubMed Central

    Bryce, Thomas N.; Dijkers, Marcel P.

    2015-01-01

    Background: Powered exoskeletons have been demonstrated as being safe for persons with spinal cord injury (SCI), but little is known about how users learn to manage these devices. Objective: To quantify the time and effort required by persons with SCI to learn to use an exoskeleton for assisted walking. Methods: A convenience sample was enrolled to learn to use the first-generation Ekso powered exoskeleton to walk. Participants were given up to 24 weekly sessions of instruction. Data were collected on assistance level, walking distance and speed, heart rate, perceived exertion, and adverse events. Time and effort was quantified by the number of sessions required for participants to stand up, walk for 30 minutes, and sit down, initially with minimal and subsequently with contact guard assistance. Results: Of 22 enrolled participants, 9 screen-failed, and 7 had complete data. All of these 7 were men; 2 had tetraplegia and 5 had motor-complete injuries. Of these, 5 participants could stand, walk, and sit with contact guard or close supervision assistance, and 2 required minimal to moderate assistance. Walk times ranged from 28 to 94 minutes with average speeds ranging from 0.11 to 0.21 m/s. For all participants, heart rate changes and reported perceived exertion were consistent with light to moderate exercise. Conclusion: This study provides preliminary evidence that persons with neurological weakness due to SCI can learn to walk with little or no assistance and light to somewhat hard perceived exertion using a powered exoskeleton. Persons with different severities of injury, including those with motor complete C7 tetraplegia and motor incomplete C4 tetraplegia, may be able to learn to use this device. PMID:26364280

  9. Vocationally Orientated Rehabilitation Service Requests: The Case of Employed Persons Experiencing a Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Young, Amanda E.; Murphy, Gregory C.

    2003-01-01

    A survey of 168 employed people who suffered spinal cord injuries found that 50% were employed after injury; 61% thought they could have benefitted from additional services such as discussion of options and follow-up on vocational issues. Dissatisfaction with employment status was related to perceived need for more services. (Contains 20…

  10. A 20-year Longitudinal Perspective on the Vocational Experiences of Persons with Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Crewe, Nancy M.

    2000-01-01

    Uses interviews conducted in 1974 and 1994 to investigate the vocational experiences of individuals with spinal cord injuries. Participants had received a spinal cord injury 22-45 years previously. Results revealed that all but seven of the participants had been in remunerative employment. Work experiences, comprehensive rehabilitation service,…

  11. Body composition of active persons with spinal cord injury and with poliomyelitis

    USDA-ARS?s Scientific Manuscript database

    This study sought to evaluate the body composition of subjects with active spinal cord injuries and polio. Two groups of males and females, active, free-living, of similar ages and body mass index (BMI), were distributed according to the source of deficiency: SCI – low spinal cord injury (T5-T12) an...

  12. Differentiating Adolescent Self-Injury from Adolescent Depression: Possible Implications for Borderline Personality Development

    ERIC Educational Resources Information Center

    Crowell, Sheila E.; Beauchaine, Theodore P.; Hsiao, Ray C.; Vasilev, Christina A.; Yaptangco, Mona; Linehan, Marsha M.; McCauley, Elizabeth

    2012-01-01

    Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report…

  13. Relationships between Personality Disorders, Social Disturbances, and Physical Disability Following Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    Lezak, Muriel D.

    1987-01-01

    The post-injury psychosocial problems of 42 adult male head injury patients over a 3-year period were evaluated using the Portland Adaptability Inventory. In all time periods, the areas most impaired were social contact, work/school, and leisure as well as elevated frequencies of problems with anxiety, depression, and significant relationships.…

  14. Vocationally Orientated Rehabilitation Service Requests: The Case of Employed Persons Experiencing a Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Young, Amanda E.; Murphy, Gregory C.

    2003-01-01

    A survey of 168 employed people who suffered spinal cord injuries found that 50% were employed after injury; 61% thought they could have benefitted from additional services such as discussion of options and follow-up on vocational issues. Dissatisfaction with employment status was related to perceived need for more services. (Contains 20…

  15. A 20-year Longitudinal Perspective on the Vocational Experiences of Persons with Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Crewe, Nancy M.

    2000-01-01

    Uses interviews conducted in 1974 and 1994 to investigate the vocational experiences of individuals with spinal cord injuries. Participants had received a spinal cord injury 22-45 years previously. Results revealed that all but seven of the participants had been in remunerative employment. Work experiences, comprehensive rehabilitation service,…

  16. Differentiating Adolescent Self-Injury from Adolescent Depression: Possible Implications for Borderline Personality Development

    ERIC Educational Resources Information Center

    Crowell, Sheila E.; Beauchaine, Theodore P.; Hsiao, Ray C.; Vasilev, Christina A.; Yaptangco, Mona; Linehan, Marsha M.; McCauley, Elizabeth

    2012-01-01

    Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report…

  17. 36 CFR 222.62 - Ownership claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.62 Ownership claims. (a) Any person claiming ownership under State branding and estray laws of branded or unbranded horses or burros within a wild horse or burro territory or range on the National Forest System where such animals are not...

  18. 36 CFR 222.22 - Ownership claims.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.22 Ownership claims. (a) Any person claiming ownership under State branding and estray laws of branded or unbranded horses or burros within a wild horse or burro territory or range on the National Forest System where such animals are not...

  19. 36 CFR 222.22 - Ownership claims.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.22 Ownership claims. (a) Any person claiming ownership under State branding and estray laws of branded or unbranded horses or burros within a wild horse or burro territory or range on the National Forest System where such animals are not...

  20. 36 CFR 222.22 - Ownership claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.22 Ownership claims. (a) Any person claiming ownership under State branding and estray laws of branded or unbranded horses or burros within a wild horse or burro territory or range on the National Forest System where such animals are not...

  1. 36 CFR 222.62 - Ownership claims.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.62 Ownership claims. (a) Any person claiming ownership under State branding and estray laws of branded or unbranded horses or burros within a wild horse or burro territory or range on the National Forest System where such animals are not...

  2. 14 CFR 1261.104 - Allowable claims.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Allowable claims. 1261.104 Section 1261.104 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION PROCESSING OF MONETARY CLAIMS (GENERAL... for damage to, or loss of, personal property incident to service with NASA may be considered and...

  3. 14 CFR 1261.104 - Allowable claims.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Allowable claims. 1261.104 Section 1261.104 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION PROCESSING OF MONETARY CLAIMS (GENERAL... for damage to, or loss of, personal property incident to service with NASA may be considered and...

  4. 29 CFR 15.41 - Allowable claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Arising Out of the Operation of the Job Corps § 15.41 Allowable claims. (a)(1) A claim for damage to persons or property arising out of an act or omission of a student enrolled in the Job Corps may...

  5. 44 CFR 11.73 - Allowable claims.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) of this section. Claims for structural damage to mobile homes resulting from such structural damage... use the test of whether the claimant did their best under the circumstances to protect the property; or (v) When taken by force from the claimant's person. (6) Clothing. Claims may be allowed for...

  6. 44 CFR 11.73 - Allowable claims.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) of this section. Claims for structural damage to mobile homes resulting from such structural damage... use the test of whether the claimant did their best under the circumstances to protect the property; or (v) When taken by force from the claimant's person. (6) Clothing. Claims may be allowed for...

  7. 5 CFR 180.107 - Claims procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Claims procedure. 180.107 Section 180.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYEES' PERSONAL PROPERTY... General Counsel, Office of Personnel Management, 1900 E Street NW., Washington, DC 20415. Claims shall...

  8. 22 CFR 72.24 - Conflicting claims.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Conflicting claims. 72.24 Section 72.24 Foreign... ESTATES Personal Estates of Deceased United States Citizens and Nationals § 72.24 Conflicting claims... citizen or non-citizen national. If rival claimants, executors or administrators demand the...

  9. 22 CFR 72.24 - Conflicting claims.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Conflicting claims. 72.24 Section 72.24 Foreign... ESTATES Personal Estates of Deceased United States Citizens and Nationals § 72.24 Conflicting claims... citizen or non-citizen national. If rival claimants, executors or administrators demand the...

  10. Risk of Pain Medication Misuse After Spinal Cord Injury: The Role of Substance Use, Personality, and Depression.

    PubMed

    Clark, Jillian M R; Cao, Yue; Krause, James S

    2017-02-01

    Our purpose was to identify risk of pain medication misuse (PMM) among participants with spinal cord injury (SCI) by examining associations with multiple sets of risk factors including demographic and injury characteristics, pain experiences, frequency of pain medication use, substance use, personality, and depressive symptoms. Risk of PMM was defined by a cutoff score ≥30 measured using the Pain Medication Questionnaire (PMQ) and examined in 1,619 adults with traumatic SCI of at least 1 year duration who reported at least 1 painful condition and use of prescription pain medication using a cross-sectional design. Results indicated 17.6% of participants had scores of ≥30 on the PMQ. After controlling for demographic, injury, and pain characteristics, logistic regression analysis showed that being a current smoker, recently using cannabis (behavioral factors), and multiple psychological factors were associated with risk of PMM, as indicated by scores on the PMQ. These included elevated depressive symptomatology and exhibiting impulsive or anxious personality traits. Because risk of PMM is indicated in individuals with SCI, prescribers should assess and monitor multiple risk factors for PMM including substance use behaviors and psychological indicators. This article identifies behavioral substance use and psychological factors associated with risk of PMM, measured using the PMQ, among those with SCI. Identification of these related variables will help health care professionals better prescribe and monitor pain medication use and/or misuse among individuals with SCI. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  11. Operating room fires: a closed claims analysis.

    PubMed

    Mehta, Sonya P; Bhananker, Sanjay M; Posner, Karen L; Domino, Karen B

    2013-05-01

    To assess patterns of injury and liability associated with operating room (OR) fires, closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1985 were reviewed. All claims related to fires in the OR were compared with nonfire-related surgical anesthesia claims. An analysis of fire-related claims was performed to identify causative factors. There were 103 OR fire claims (1.9% of 5,297 surgical claims). Electrocautery was the ignition source in 90% of fire claims. OR fire claims more frequently involved older outpatients compared with other surgical anesthesia claims (P < 0.01). Payments to patients were more often made in fire claims (P < 0.01), but payment amounts were lower (median $120,166) compared to nonfire surgical claims (median $250,000, P < 0.01). Electrocautery-induced fires (n = 93) increased over time (P < 0.01) to 4.4% claims between 2000 and 2009. Most (85%) electrocautery fires occurred during head, neck, or upper chest procedures (high-fire-risk procedures). Oxygen served as the oxidizer in 95% of electrocautery-induced OR fires (84% with open delivery system). Most electrocautery-induced fires (n = 75, 81%) occurred during monitored anesthesia care. Oxygen was administered via an open delivery system in all high-risk procedures during monitored anesthesia care. In contrast, alcohol-containing prep solutions and volatile compounds were present in only 15% of OR fires during monitored anesthesia care. Electrocautery-induced fires during monitored anesthesia care were the most common cause of OR fires claims. Recognition of the fire triad (oxidizer, fuel, and ignition source), particularly the critical role of supplemental oxygen by an open delivery system during use of the electrocautery, is crucial to prevent OR fires. Continuing education and communication among OR personnel along with fire prevention protocols in high-fire-risk procedures may reduce the occurrence of OR fires.

  12. Impact of personality disorders on health-related quality of life one year after burn injury.

    PubMed

    Ekeblad, Frida; Gerdin, Bengt; Öster, Caisa

    2015-01-01

    Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. One burn-specific instrument (Burn Specific Health Scale-Brief (BSHS-B)) and two generic instruments (EuroQol Five Dimensions and Short Form 36 Health Survey) were used, and Psychiatric Axis I and II disorders were assessed one year post burn. This study identified an above normal prevalence of PDs among individuals afflicted by burn, and participants with PD had a significantly larger lifetime burden of Axis I disorders compared to participants without PD. Participants with PDs scored significantly lower than those without PD in the BSHS-B domain Skin involvement, and the effect of having a PD was related to the subscale Treatment regimens. There was no relationship between the presence of PD and generic HRQoL. An implication of these observations is that special rehabilitation efforts including more tailored interventions must be offered to these patients to ensure that the obstacles they perceive to caring for themselves in this respect are eliminated. This study identified an above normal prevalence of PDs among individuals afflicted by burn and these individuals reported poor burn-specific health-related quality of life. The identification of difficulties with compliance and endurance regarding daily skin care may cause negative consequences for optimal rehabilitation and underscore the importance of offering more tailored interventions in rehabilitation. Inflexible behavioral patterns related to the PD diagnosis imply the need for communication strategies by the rehabilitation team, which

  13. A qualitative needs assessment of persons who have experienced traumatic brain injury and their primary family caregivers.

    PubMed

    Rotondi, Armando J; Sinkule, Jennifer; Balzer, Kathleen; Harris, Jeffrey; Moldovan, Rene

    2007-01-01

    To determine the expressed needs of persons with traumatic brain injury (TBI) and their primary family caregivers. Semistructured interviews with content-analytic techniques to identify respondents' needs. Eighty persons with TBI, with an average time since their most severe TBI of 5.8 years, and 85 primary support persons. Respondents described their needs via phases that paralleled transitions in settings, treatments, and responsibilities (ie, acute care, in-patient rehabilitation, return home, and living in the community). Prominent themes during in-patient phases included provider quality, emotional support, and understanding the injuries. Prominent themes during the latter 2 phases included guidance, life planning, community integration, and behavioral and emotional issues. Participants reported insufficient education and preparation for the future. Current methods of identifying needs may not be based on these populations' perceptions, and often miss the natural divisions of needs that occur over the course of treatment and rehabilitation. To meet their needs, services must be responsive to changes in needs over time, accessible to consumers of services for as long as they are required, and designed to be directed and customized by users.

  14. Employment at Closure Is Associated with Enhanced Quality of Life and Subjective Well-Being for Persons with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Chapin, Martha H.; Holbert, Donald

    2010-01-01

    This study assessed whether persons with spinal cord injuries who had been successfully rehabilitated into employment following receipt of rehabilitation services had better quality of life and subjective well-being than the unsuccessfully rehabilitated who did not obtain employment following receipt of rehabilitation services. Persons who were…

  15. Employment at Closure Is Associated with Enhanced Quality of Life and Subjective Well-Being for Persons with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Chapin, Martha H.; Holbert, Donald

    2010-01-01

    This study assessed whether persons with spinal cord injuries who had been successfully rehabilitated into employment following receipt of rehabilitation services had better quality of life and subjective well-being than the unsuccessfully rehabilitated who did not obtain employment following receipt of rehabilitation services. Persons who were…

  16. Neonatal hypoglycaemia: learning from claims

    PubMed Central

    Hawdon, Jane M; Beer, Jeanette; Sharp, Deborah; Upton, Michele

    2017-01-01

    Objectives Neonatal hypoglycaemia is a potential cause of neonatal morbidity, and on rare but tragic occasions causes long-term neurodevelopmental harm with consequent emotional and practical costs for the family. The organisational cost to the NHS includes the cost of successful litigation claims. The purpose of the review was to identify themes that could alert clinicians to common pitfalls and thus improve patient safety. Design The NHS Litigation Authority (NHS LA) Claims Management System was reviewed to identify and review 30 claims for injury secondary to neonatal hypoglycaemia, which were notified to the NHS LA between 2002 and 2011. Setting NHS LA. Patients Anonymised documentation relating to 30 neonates for whom claims were made relating to neonatal hypoglycaemia. Dates of birth were between 1995 and 2010. Interventions Review of documentation held on the NHS LA database. Main outcome measures Identifiable risk factors for hypoglycaemia, presenting clinical signs, possible deficits in care, financial costs of litigation. Results All claims related to babies of at least 36 weeks’ gestation. The most common risk factor for hypoglycaemia was low birth weight or borderline low birth weight, and the most common reported presenting sign was abnormal feeding behaviour. A number of likely deficits in care were reported, all of which were avoidable. In this 10-year reporting period, there were 25 claims for which damages were paid, with a total financial cost of claims to the NHS of £162 166 677. Conclusions Acknowledging that these are likely to be the most rare but most seriously affected cases, the clinical themes arising from these cases should be used for further development of training and guidance to reduce harm and redivert NHS funds from litigation to direct care. PMID:27553590

  17. 39 CFR 777.28 - Claims and appeals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... relocation representative should assist eligible displaced persons in the preparation of claims for moving... relocation representative with the displaced person, to preclude technical difficulties in processing the... of the displaced person's claim, the Postal Service will promptly authorize payment of the...

  18. CIRRPC Science Panel report No. 6: Use of probability of causation by the veterans administration in the adjudication of claims of injury due to exposure to ionizing radiation

    SciTech Connect

    1988-08-01

    The report was prepared in response to a request from the Administrator of Veterans Affairs, Veterans Administration (VA) Coordination (CIRRPC) to provide guidelines to the VA with respect to the questions ``...for what levels of radiation exposure, if any, the radioepidemiological tables can be used credibly in the rule-making we are conducting pursuant to Public Law 98-542`` and ``...whether CIRRPC`s views in this regard vary with the type of cancer involved and whether use of the NIH tables for certain cancers may be more justifiable than for other cancers.`` The report prepared by the Science Subpanel on Radioepidemiological Tables and approved by the CIRRPC Science Panel answers these questions by listing those cancers both considered to be radiogenic in the NIH Report and to be applicable to veterans and by providing, for these cancers, radiation doses that allow the VA to exclude from further consideration those claims having ``no reasonable possibility`` (a VA stated criteria) of merit. The report provides important scientific information which can be used as part of the evidence for evaluating, along with other evidence, claims not eliminated by the screening procedure.

  19. Cardiovascular and thoracic battle injuries in the Lebanon War. Analysis of 3,000 personal cases.

    PubMed

    Zakharia, A T

    1985-05-01

    This report comprises 3,000 casualties of the Lebanon War whom I operated upon for cardiovascular-thoracic injuries in twelve Lebanese hospitals between January, 1969, and July, 1982. These patients were studied retrospectively through 1978 and prospectively thereafter. The logistics, weapons, wounds, and operative results in this study were unique. The patients' injuries can be categorized as follows: primarily thoracic, 1,251 (42%); peripheral vascular, 1,008 (34%); cardiac, 285 (9%); and thoracic mixed, 456 (15%). The male to female ratio was 3.6:1, the mean age 20 years, and the military to civilian ratio 1.7:1. The mean transport distance was 2 miles in 1,740 patients (58%). In patients with thoracic wounds, the incidence of cardiac involvement (14%) was higher than in World War II and Vietnam. The overall survival rate in casualties with cardiac injuries was 73%--best in pericardial, coronary, and right atrial wounds and dropping to 46% in left ventricular wounds, wherein pump failure was also a factor. A 13% (seven deaths) mortality for patients with injuries to the thoracic great vessels contrasted with the 1.2% (14 deaths) mortality for the rest of the patients with noncardiac thoracic wounds. Open thoracotomy in 818 operations (55%) reflected massive wounds and logistics. Pulmonary resection (310 operations) carried a 1.9% (five deaths) mortality and tube thoracostomy (683 operations) for lesser injuries, 0.7% (four deaths.) Thoracoabdominal injuries were 1.5 times more lethal. Fifty percent (504) of nonthoracic vascular wounds occurred in the femoral-popliteal area as a result of sniper attacks. Subintimal damage averaged 8 cm and mandated saphenous vein grafts in 72%. The mortality for injury to the aorta was 60% (12 deaths), contrasted with 1% (three deaths) for injury to extremity vessels. Hemorrhage and cardiac rupture were the most frequent causes of death. Early, proficient, open surgical control after or concomitant with intensive resuscitation

  20. [Evaluation of the community integration of persons with lateralised post-acute acquired brain injury].

    PubMed

    Huertas-Hoyas, E; Pedrero-Perez, E J; Aguila-Maturana, A M; Gonzalez-Alted, C

    2013-08-16

    INTRODUCTION. Hemispheric specialization is a topic of interest that has motivated an enormous amount of research in recent decades. After a unilateral brain injury, the consequences can affect various areas of specialization, leading, depending on the location of the injury, impairment in quality of life and community integration. PATIENTS AND METHODS. Cross-sectional study with a sample of 58 patients, 28 traumatic brain injury (TBI) and 30 cerebrovascular accidents, both lateralized. The level of integration in the community is measured by the Community Integration Questionnaire. RESULTS. There were three groups analyzed by considering unilateral injury (full sample, stroke sample, and TBI sample). Results showed a significantly high community integration of people with right hemisphere injury. However, to measure the level of community integration between TBI and stroke, the results showed no significant differences. CONCLUSION. According to the results of the study people with brain injury in the right hemisphere have a better community integration than people with lesions in the left hemisphere regardless of the origin of the lesions (vascular or traumatic). We discussed the reasons that may motivate the differences and clinical implications.

  1. Cannabis use in persons with traumatic spinal cord injury in Denmark.

    PubMed

    Andresen, Sven R; Biering-Sørensen, Fin; Hagen, Ellen Merete; Nielsen, Jørgen F; Bach, Flemming W; Finnerup, Nanna B

    2017-01-31

    To evaluate recreational and medical cannabis use in individuals with traumatic spinal cord injury, including reasons and predictors for use, perceived benefits and negative consequences. Cross-sectional survey in Denmark. A 35-item questionnaire was sent to 1,101 patients with spinal cord injury who had been in contact with a rehabilitation centre between 1990 and 2012. A total of 537 participants completed the questionnaire. Of these, 36% had tried cannabis at least once and 9% were current users. Of current users, 79% had started to use cannabis before their spinal cord injury. The main reason for use was pleasure, but 65% used cannabis partly for spinal cord injury-related consequences and 59% reported at least good effect on pain and spasticity. Negative consequences of use were primarily inertia and feeling quiet/subdued. Lower age, living in rural areas/larger cities, tobacco-smoking, high alcohol intake and higher muscle stiffness were significantly associated with cannabis use. Those who had never tried cannabis reported that they would mainly use cannabis to alleviate pain and spasticity if it were legalized. Cannabis use is more frequent among individuals with spinal cord injury in Denmark than among the general population. High muscle stiffness and various demographic characteristics (lower age, living in rural areas/larger cities, tobacco-smoking and high alcohol intake) were associated with cannabis use. Most participants had started using cannabis before their spinal cord injury. There was considerable overlap between recreational and disability-related use.

  2. Personality.

    PubMed

    Funder, D C

    2001-01-01

    Personality psychology is as active today as at any point in its history. The classic psychoanalytic and trait paradigms are active areas of research, the behaviorist paradigm has evolved into a new social-cognitive paradigm, and the humanistic paradigm is a basis of current work on cross-cultural psychology. Biology and evolutionary theory have also attained the status of new paradigms for personality. Three challenges for the next generation of research are to integrate these disparate approaches to personality (particularly the trait and social-cognitive paradigms), to remedy the imbalance in the person-situation-behavior triad by conceptualizing the basic properties of situations and behaviors, and to add to personality psychology's thin inventory of basic facts concerning the relations between personality and behavior.

  3. 32 CFR 842.14 - Claims and assistant claims officers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Claims and assistant claims officers. 842.14... LITIGATION ADMINISTRATIVE CLAIMS Functions and Responsibilities § 842.14 Claims and assistant claims officers.... (2) The assistant claims officer performs claims duties under the supervision of the claims officer...

  4. Access to environmental stimulation via eyelid responses for persons with acquired brain injury and multiple disabilities: a new microswitch arrangement.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Ricci, Irene; Buonocunto, Francesca; Sacco, Valentina

    2012-04-01

    This study assessed a new microswitch arrangement for eyelid responses using an optic sensor placed above the cheekbone and a small sticker on the person's eyelid. This new arrangement, which was designed to avoid interference of the microswitch with the person's visual functioning, was tested on three adults with acquired brain injury and multiple (consciousness, communication, and motor) disabilities. The study was carried out according to a non-concurrent multiple baseline design across participants. Data showed the new microswitch arrangement was suitable for all three participants, who increased their responding during the intervention phase of the study when their responses allowed them to access preferred stimulation. Practical implications of the findings are discussed.

  5. Estimating dollar-value outcomes of workman`s compensation claims using radial basis function networks

    SciTech Connect

    Hancock, M.F. Jr.

    1995-12-31

    The National Council on Compensation Insurance (NCCI) maintains a national data base of outcomes of workers` compensation claims. We consider whether a radial basis function network can predict the total dollar value of a claim based upon medical and demographic indicators (MDI`s). This work used data from 12,130 workers` compensation claims collected over a period of four years from the state of New Mexico. Two problems were addressed: (1) How well can the total incurred medical expense for all claims be predicted from available MDI`s? For individual claims? (2) How well can the duration of disability be predicted from available MDI`s? The available features intuitively correlated with total medical cost were selected, including type of injury, part of body injured, person`s age at time of injury, gender, marital status, etc. These features were statistically standardized and sorted by correlation with outcome valuation. Principal component analysis was applied. A radial basis function neural network was applied to the feature sets in both supervised and unsupervised training modes. For sets used in training, individual case valuations could consistently be predicted to within $1000 over 98% of the time. For these sets, it was possible to predict total medical expense for the training sets themselves to within 10%. When applied as blind tests against sets which were NOT part of the training data, the prediction was within 15% on the whole sets. Results on individual cases were very poor in only 30% of the cases were the predictions for the training sets within $1000 of their actual valuations. Single-factor analysis suggested that the presence of an attorney strongly decorrelated the data. A simple stratification was performed to remove cases involving attorneys and contested claims, and the procedures above repeated. Preliminary results based upon the very limited effort applied indicate that NCCI data support population estimates, but not single-point estimates.

  6. Health Care Utilization in Persons with Traumatic Spinal Cord Injury: The Importance of Multimorbidity and the Impact on Patient Outcomes

    PubMed Central

    Fallah, Nader; Park, So Eyun; Dumont, Frédéric S.; Leblond, Jean; Cobb, John; Noreau, Luc

    2014-01-01

    Background: Persons with spinal cord injury (SCI) living in the community have high health care utilization (HCU). To date, the interrelationships among multiple secondary health conditions (multimorbidity due to comorbidities and complications) that drive HCU and their impact on patient outcomes are unknown. Objective: To determine the association among multimorbidity, HCU, health status, and quality of life. Methods: Community-dwelling persons with traumatic SCI participated in an online/phone SCI Community Survey. Participants were grouped using the 7-item HCU questionnaire (group 1 did not receive needed care and/or rehospitalized; group 2 received needed care but rehospitalized; group 3 received needed care and not rehospitalized). Personal, injury, and environmental factors; multimorbidity (presence/absence of 30 comorbidities/ complications); health status (Short Form-12); and quality of life measures (Life Satisfaction-11 first question and single-item quality of life measure) were collected. Associations among these variables were assessed using multivariate analysis. Results: The 1,137 survey participants were divided into 3 groups: group 1 (n = 292), group 2 (n = 194), and group 3 (n = 650). Group 1 had the greatest number of secondary health conditions (15.14 ± 3.86) followed by group 2 (13.60 ± 4.00) and group 3 (12.00 ± 4.16) (P < .05). Multimorbidity and HCU were significant risk factors for having a lower SF-12 Mental (P < .001) and Physical Component Score (P < .001). They in turn were associated with participants reporting a lower quality of life (P < .001, for both questions). Conclusions: Multimorbidity and HCU are interrelated and associated with lower health status, which in turn is associated with lower quality of life. Future work will include the development of a screening tool to identify persons with SCI at risk of inappropriate HCU (eg, rehospitalization, not able to access care), which should lead to better patient outcomes and cost

  7. Investigating the over-representation of older persons in do-it-yourself home maintenance injury and barriers to prevention.

    PubMed

    Ashby, K; Ozanne-Smith, J; Fox, B

    2007-10-01

    To examine why older persons undertake high-risk do-it-yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low-risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Exploratory qualitative study using focus-group methodology. Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost-effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. This research is an important first step in understanding issues facing community-dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs.

  8. Investigating the over‐representation of older persons in do‐it‐yourself home maintenance injury and barriers to prevention

    PubMed Central

    Ashby, K; Ozanne‐Smith, J; Fox, B

    2007-01-01

    Objective To examine why older persons undertake high‐risk do‐it‐yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low‐risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Design Exploratory qualitative study using focus‐group methodology. Setting and subjects Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Results Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost‐effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. Conclusions This research is an important first step in understanding issues facing community‐dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs. PMID:17916890

  9. Personalization.

    ERIC Educational Resources Information Center

    Shore, Rebecca Martin

    1996-01-01

    Describes how a typical high school in Huntington Beach, California, curbed disruptive student behavior by personalizing the school experience for "problem" students. Through mostly volunteer efforts, an adopt-a-kid program was initiated that matched kids' learning styles to adults' personality styles and resulted in fewer suspensions…

  10. Personalization.

    ERIC Educational Resources Information Center

    Shore, Rebecca Martin

    1996-01-01

    Describes how a typical high school in Huntington Beach, California, curbed disruptive student behavior by personalizing the school experience for "problem" students. Through mostly volunteer efforts, an adopt-a-kid program was initiated that matched kids' learning styles to adults' personality styles and resulted in fewer suspensions…

  11. Carbohydrate and lipid disorders and relevant considerations in persons with spinal cord injury.

    PubMed Central

    Wilt, Timothy J; Carlson, Kathleen F; Goldish, Gary D; MacDonald, Roderick; Niewoehner, Catherine; Rutks, Indulis; Shamliyan, Tatyana; Tacklind, James; Taylor, Brent C; Kane, Robert L

    2008-01-01

    OBJECTIVES To assess the prevalence of carbohydrate and lipid disorders in adults with chronic spinal cord injury and evaluate their risk contribution to cardiovascular diseases and the potential impact of exercise and pharmacologic and dietary therapies to alter these disorders and reduce cardiovascular disease risk. DATA SOURCES MEDLINE (PubMed), Cochrane Database and Web sites of the American Spinal Injury Association, American Paraplegia Society, Paralyzed Veterans of America, Consortium of Spinal Cord Medicine, and WorldCat through August 2007. REVIEW METHODS English language observational studies addressing prevalence of carbohydrate and lipid disorders were included if they evaluated at least 100 adults with chronic spinal cord injury or a total of 100 subjects if using a control group. Epidemiologic investigations of more than 50 adults with spinal cord injury that were published in English after 1990 and reported cardiovascular morbidity and mortality were abstracted. Intervention studies from 1996-2007 were included regardless of design or size if they assessed exercise, diet, or pharmacologic therapies and reported carbohydrate, lipid, or cardiovascular outcomes. RESULTS The quality of evidence regarding the prevalence, impact, and outcomes of carbohydrate and lipid disorders in adults with chronic spinal cord injuries is weak. Evidence is limited by relatively few studies, small sample size, lack of appropriate control groups, failure to adjust for known confounding variables, and variation in reported outcomes. However, the existing evidence does not indicate that adults with spinal cord injuries are at markedly greater risk for carbohydrate and lipid disorders or subsequent cardiovascular morbidity and mortality than able-bodied adults. Body mass index is not reliable for assessing body composition, especially percent body fat, in adults with spinal cord injury. There are no high quality studies evaluating the impact of exercise, diet, or

  12. Cognitive recovery and development after traumatic brain injury in childhood: a person-oriented, longitudinal study.

    PubMed

    Jonsson, Catherine Aaro; Catroppa, Cathy; Godfrey, Celia; Smedler, Ann-Charlotte; Anderson, Vicki

    2013-01-15

    Influence of childhood traumatic brain injury (TBI) on cognitive recovery and subsequent development is poorly understood. In this longitudinal study we used cluster analysis to explore acute stage individual profiles of injury age and cognition in 118 children with traumatic brain injury. Repeated measures of cognitive function were conducted at 30 months, indicating recovery, and 10 years post-injury, indicating development. Nine clusters were identified. Recovery was evident in three clusters, two of them with low functioning profiles. Developmental gains occurred for three clusters and an acute profile of higher freedom from distractibility (FFD) and lower processing speed (PS) was related to positive differences. One cluster, average low functioning and especially low verbal comprehension, demonstrated a slower development than peers. This suggests that developmental change after TBI in childhood takes place on a continuum, with both chance of long-term catching up, and risk of poor development. An acute profile of higher FFD and lower PS seemed to reflect injury consequences and were followed by developmental gains. These results challenge previous findings, and warrant further investigation.

  13. Prediction of limb lean tissue mass from bioimpedance spectroscopy in persons with chronic spinal cord injury

    PubMed Central

    Cirnigliaro, Christopher M.; La Fountaine, Michael F.; Emmons, Racine; Kirshblum, Steven C.; Asselin, Pierre; Spungen, Ann M.; Bauman, William A.

    2013-01-01

    Background Bioimpedance spectroscopy (BIS) is a non-invasive, simple, and inexpensive modality that uses 256 frequencies to determine the extracellular volume impedance (ECVRe) and intracellular volume impedance (ICVRi) in the total body and regional compartments. As such, it may have utility as a surrogate measure to assess lean tissue mass (LTM). Objective To compare the relationship between LTM from dual-energy X-ray absorptiometry (DXA) and BIS impedance values in spinal cord injury (SCI) and able-bodied (AB) control subjects using a cross-sectional research design. Methods In 60 subjects (30 AB and 30 SCI), a total body DXA scan was used to obtain total body and leg LTM. BIS was performed to measure the impedance quotient of the ECVRe and ICVRi in the total body and limbs. Results BIS-derived ECVRe yielded a model for LTM in paraplegia, tetraplegia, and control for the right leg (RL) (R2 = 0.75, standard errors of estimation (SEE) = 1.02 kg, P < 0.0001; R2 = 0.65, SEE = 0.91 kg, P = 0.0006; and R2 = 0.54, SEE = 1.31 kg, P < 0.0001, respectively) and left leg (LL) (R2 = 0.76, SEE = 1.06 kg, P < 0.0001; R2 = 0.64, SEE = 0.83 kg, P = 0.0006; and R2 = 0.54, SEE = 1.34 kg, P < 0.0001, respectively). The ICVRi was similarly predictive of LTM in paraplegia, tetraplegia, and AB controls for the RL (R2 = 0.85, SEE = 1.31 kg, P < 0.0001; R2 = 0.52, SEE = 0.95 kg, P = 0.003; and R2 = 0.398, SEE = 1.46 kg, P = 0.0003, respectively) and LL (R2 = 0.62, SEE = 1.32 kg, P = 0.0003; R2 = 0.57, SEE = 0.91 kg, P = 0.002; and R2 = 0.42, SEE = 1.31 kg, P = 0.0001, respectively). Conclusion Findings demonstrate that the BIS-derived impedance quotients for ECVRe and ICVRi may be used as surrogate markers to track changes in leg LTM in persons with SCI. PMID:23941792

  14. The influence of personality traits and emotional and behavioral problems on repetitive nonsuicidal self-injury in a school sample.

    PubMed

    Lüdtke, Janine; Weizenegger, Benedict; Rauber, Rachel; Contin, Brigitte; In-Albon, Tina; Schmid, Marc

    2017-04-01

    Nonsuicidal self-injury (NSSI) is highly prevalent among adolescents and associated with various mental health problems and suicidality. Previous studies have found that certain personality traits are related to NSSI behavior, however only few studies examined personality traits in adolescents with NSSI. Our study aimed to assess the relationship between personality traits and emotional and behavioral problems in predicting repetitive NSSI among adolescents from a school sample. Four hundred and forty-seven students (M=14.95years, SD=0.74, 52% male) completed self-report measures on NSSI, personality traits, and emotional and behavioral problems. The past year prevalence of occasional and repetitive NSSI was 4.9% and 6.3% respectively. Repetitive NSSI was significantly associated with female gender, higher levels of age, novelty seeking, harm avoidance, self-transcendence, antisocial behavior, and positive self and lower levels of persistence and self-directedness in univariate analyses. However, multivariate logistic regression analyses indicated that only high levels of antisocial behavior and low levels of self-directedness significantly predicted repetitive NSSI. The association between a lack of self-directedness and NSSI emphasizes the significance of targeting self-directedness in psychotherapy by strengthening self-awareness, affect tolerance and emotion regulation, as well as establishing and pursuing long-term goals. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Vitality and mental health in disability: Associations with social relationships in persons with spinal cord injury and their partners.

    PubMed

    Tough, Hannah; Fekete, Christine; Brinkhof, Martin W G; Siegrist, Johannes

    2017-04-01

    Various social relationship constructs have been proposed to affect mental health. However, these constructs have rarely been studied in a comprehensive way in persons with chronic disabilities and their partners, inhibiting researchers from evaluating their relative importance. To investigate 1) the variation in the quantity and quality of social relationships in persons with spinal cord injury (SCI) and their partners; 2) dyadic coherence within social relationship constructs; 3) the interrelationships between social relationship constructs; and 4) the associations of social relationship constructs with vitality and mental health. Cross-sectional survey data from 133 couples of persons with SCI and their partners was used. Quantitative (social networks) and qualitative aspects (social support, relationship quality, loneliness, and reciprocity in partnerships) of social relationships were assessed. Correlations were performed to analyse dyadic coherence and interrelationships of social relationship constructs and multivariable regressions were applied to examine associations with vitality and mental health. Loneliness, larger social networks and higher relationship quality were more prevalent in SCI. All social relationship constructs, apart from loneliness, were more similar within couples than between couples and the interrelationships between different constructs were small. Qualitative aspects of relationships were more important than the quantitative aspects in their associations to vitality and mental health. These associations were most consistent for loneliness, reciprocity and relationship quality in both groups. In the long-term management of community functioning in persons with SCI and their partners, the fostering of high quality intimate relationships should take priority. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. [Welding spark injuries of the ear. Observations of personal case material].

    PubMed

    Mertens, J; Bubmann, M; Reker, U

    1991-08-01

    25 cases of tympanic welding spark injuries of the years 1959-1989 are reported. Early results and late sequelae after conservative therapy, immediate and interval operation are described and discussed. Regarding the tendency of tympanic defects to enlarge after thermal injuries despite conservative and early operative therapy, secondary seal by tympanoplasty is recommended. Even then, however, the rate of residual and recurring perforations must be reckoned as being higher than after tympanoplasty in comparable defects of other origin, due to the inferior nutritive supply owing to the extended scar caused by burning. On the other hand, the rate of inner ear traumatisation with 12% directly after welding injury and with 4% remaining impairment of hearing, is low.

  17. A single-person reduction and splinting technique for ankle injuries.

    PubMed

    Skelley, Nathan W; Ricci, William M

    2015-04-01

    Ankle injuries are one of the most common orthopaedic conditions treated in the emergency department. Initial reduction and splinting techniques of these injuries are variable and can place undue stress on the physician and cause patient discomfort. Novice and experienced practitioners have had to repeat splint application because of poor preparation, variable assistant experience, loss of fracture reduction, and improper application. We present a modified Quigley technique for ankle reduction and splinting that simplifies these issues and reduces stress on the patient and physician. The technique was used on 51 patients without any major complications. This technique can be performed entirely by 1 practitioner, by keeping the patient and physician in a comfortable position and is applicable to a wide range of lower extremity trauma injuries.

  18. Social communication skills group treatment: a feasibility study for persons with traumatic brain injury and comorbid conditions.

    PubMed

    Braden, Cynthia; Hawley, Lenore; Newman, Jody; Morey, Clare; Gerber, Don; Harrison-Felix, Cynthia

    2010-01-01

    To evaluate the feasibility of improving impaired social communication skills in persons with traumatic brain injury (TBI) and concomitant neurological or psychiatric conditions, using an intervention with evidence of efficacy in a TBI cohort without such complications. Cohort study with pre-post intervention and follow-up assessments. Thirty individuals with TBI ≥ 1 year post-injury and identified social communication problems participated in a group intervention to improve social communication skills. Group Interactive Structured Treatment (GIST) for Social Competence; 13 week, 1.5 hour manualized intervention. Profile of Pragmatic Impairment in Communication (PPIC); Social Communication Skills Questionnaire-Adapted (SCSQ-A); LaTrobe Communication Questionnaire (LCQ); Goal Attainment Scale (GAS), Awareness Questionnaire (AQ), Satisfaction with Life Scale (SWLS); Participation Assessment with Recombined Tools (PART). Participants made statistically significant gains on the SCSQ-A, GAS and SWLS post-treatment and at 6 months follow-up, using self and other ratings. Gains on the PPIC did not reach statistical significance but trended toward improvement. Treatment effects were not noted in analyses of the AQ or the PART. The LCQ showed statistically significant gains post-treatment and at follow-up. Participants showed improvement on subjective social communication skills measures post-treatment and at follow-up, demonstrating potential efficacy of the intervention in a broader population of persons with TBI, worthy of further investigation.

  19. Community integration and health-related quality-of-life following acquired brain injury for persons living at home.

    PubMed

    Gerber, Gary J; Gargaro, Judith; McMackin, Sally

    2016-01-01

    To study predictors of community integration (CI) and health-related quality-of-life (HRQoL) in a sample of Canadian adult, urban, multi-ethnic persons with acquired brain injury (ABI) receiving publicly-funded community services. Hypothesis 1 examined the predictive utility of age, ratings of disability, functioning and cognition for CI and HRQoL. Hypothesis 2 examined the correlation between CI and HRQoL. Cohort study. A convenience sample of community-residing clients completed measures with their care co-ordinators: Resident Assessment Instrument-Home Care (RAI-HC), Disability Rating Scale (DRS), Community Integration Questionnaire (CIQ) and the Quality-of-Life after Brain Injury Instrument (QOLIBRI). Regression analysis showed DRS scores explained significant variance in CIQ and QOLIBRI. Correlations also showed that cognitive skill and ADL/IADL functioning are strongly related to CI and the Daily life and autonomy QOLIBRI sub-scale. The CIQ Total was not correlated with QOLIBRI Total, although there were some significant correlations between the CIQ social sub-scale and QOLIBRI. Lesser degree of disability is a key predictor of greater CI and QoL. The present findings suggest that rehabilitation efforts should focus on minimizing disability and promoting social integration and involvement to avoid adverse long-term effects of ABI for community-resident persons.

  20. The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study

    PubMed Central

    2013-01-01

    Background Professionals in Japan tend to regard the individual contexts of persons with spinal cord injury (SCI) as the cause of their passive participation in self-care activities or self-management. However, the meaning of self-care involves variables that interrelate with sociocultural factors. Thus, it is necessary to uncover its meaning in the perceptions of persons with cervical spinal cord injury (CSCI) in order not only to implement better rehabilitation but also to understand the sociocultural constraints that determine the injured person’s attitudes to self-care and long-term health outcomes. Methods Semi-structured interviews with 29 CSCI participants from fourteen municipalities of Osaka, Hyogo, and Ehime prefectures were conducted. Participants contributed diverse perspectives on rehabilitation, lay-professional and family relationships, health promotion, and body conceptions. Interviews were recorded, transcribed and analyzed using the grounded theory approach to inter-relate categories and to develop theoretical constructions. Results Four main themes emerged from the data: rehabilitation for independence in ADLs; detachment from the body and self; embodiment; and self-management. From the participants’ point of view, rehabilitation programs in Japan aim at improving body functions for ADL performance, but provide little health education. These rehabilitation values might hinder some participants from developing self-esteem for their bodies. Moreover, socially-shaped family caregivers’ active engagement in the participants’ self-care allowed many participants to entirely rely on them for care. Through embodiment, participants found that self-care was not merely a means of independence in ADLs but also of self-management to enhance health and well-being, requiring collaborative relationships with caregivers. Conclusion Personal factors such as low motivation for self-care might be in part a reflection of social expectations of dependence for

  1. 27 CFR 26.309 - Claims for drawback.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., DEPARTMENT OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Claims for Drawback on Eligible Articles From the Virgin Islands § 26.309 Claims for drawback. (a) General. Persons bringing eligible articles into the United States from the Virgin Islands must file claim for drawback on...

  2. 20 CFR 362.10 - Principal types of claims allowable.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Principal types of claims allowable. 362.10 Section 362.10 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES EMPLOYEES' PERSONAL PROPERTY CLAIMS § 362.10 Principal types of claims allowable. (a) In general...

  3. 20 CFR 362.10 - Principal types of claims allowable.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Principal types of claims allowable. 362.10 Section 362.10 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES EMPLOYEES' PERSONAL PROPERTY CLAIMS § 362.10 Principal types of claims allowable. (a) In general...

  4. 44 CFR 11.74 - Claims not allowed.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... payment or other consideration to a proper claimant are not payable. (3) Assigned claims. Claims based... by persons not designated in § 11.71 are not payable. (6) Articles of extraordinary value. Claims are... articles of extraordinary value, when shipped with household goods or as unaccompanied baggage...

  5. 43 CFR 3830.3 - Who may locate mining claims?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Who may locate mining claims? 3830.3... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) LOCATING, RECORDING, AND MAINTAINING MINING CLAIMS OR SITES; GENERAL PROVISIONS Introduction § 3830.3 Who may locate mining claims? Persons...

  6. 43 CFR 3830.3 - Who may locate mining claims?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Who may locate mining claims? 3830.3... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) LOCATING, RECORDING, AND MAINTAINING MINING CLAIMS OR SITES; GENERAL PROVISIONS Introduction § 3830.3 Who may locate mining claims? Persons...

  7. 43 CFR 3830.3 - Who may locate mining claims?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Who may locate mining claims? 3830.3... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) LOCATING, RECORDING, AND MAINTAINING MINING CLAIMS OR SITES; GENERAL PROVISIONS Introduction § 3830.3 Who may locate mining claims? Persons...

  8. 43 CFR 3830.3 - Who may locate mining claims?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Who may locate mining claims? 3830.3... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) LOCATING, RECORDING, AND MAINTAINING MINING CLAIMS OR SITES; GENERAL PROVISIONS Introduction § 3830.3 Who may locate mining claims? Persons...

  9. 44 CFR 295.5 - Overview of the claims process.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the claim to the Authorized Official. (d) The Authorized Official will review the report and determine... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Overview of the claims... Overview of the claims process. (a) The CGFAA is intended to provide persons who suffered losses from...

  10. 27 CFR 70.100 - Penalty for fraudulently claiming drawback.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... claiming drawback. 70.100 Section 70.100 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Assessable Penalties § 70.100 Penalty for fraudulently claiming drawback. Whenever any person fraudulently claims or seeks to obtain an allowance of drawback on goods, wares, or merchandise on which no internal...

  11. 27 CFR 26.173 - Claims for drawback.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Claims for drawback. 26... Drawback on Eligible Articles From Puerto Rico § 26.173 Claims for drawback. (a) General. Persons bringing eligible articles into the United States from Puerto Rico must file claim for drawback on TTB Form 2635...

  12. 27 CFR 26.309 - Claims for drawback.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Claims for drawback. 26... Drawback on Eligible Articles From the Virgin Islands § 26.309 Claims for drawback. (a) General. Persons bringing eligible articles into the United States from the Virgin Islands must file claim for drawback on...

  13. 20 CFR 725.308 - Time limits for filing claims.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED Filing of Claims § 725.308 Time limits for filing claims... communicated to the miner or a person responsible for the care of the miner, or within three years after...

  14. 20 CFR 725.308 - Time limits for filing claims.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED Filing of Claims § 725.308 Time limits for filing claims... communicated to the miner or a person responsible for the care of the miner, or within three years after...

  15. 20 CFR 725.308 - Time limits for filing claims.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED Filing of Claims § 725.308 Time limits for filing claims... communicated to the miner or a person responsible for the care of the miner, or within three years after...

  16. 20 CFR 725.308 - Time limits for filing claims.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED Filing of Claims § 725.308 Time limits for filing claims... communicated to the miner or a person responsible for the care of the miner, or within three years after...

  17. 20 CFR 725.308 - Time limits for filing claims.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED Filing of Claims § 725.308 Time limits for filing claims... communicated to the miner or a person responsible for the care of the miner, or within three years after...

  18. 45 CFR 504.3 - Official claim forms.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Forces of the United States Held as Prisoner of War in Vietnam; for Persons Assigned to Duty on board the... WAR CLAIMS ACT OF 1948, AS AMENDED FILING OF CLAIMS AND PROCEDURES THEREFOR § 504.3 Official claim... or Who Went into Hiding to Avoid Capture or Internment in Southeast Asia During the Vietnam...

  19. 45 CFR 504.3 - Official claim forms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Forces of the United States Held as Prisoner of War in Vietnam; for Persons Assigned to Duty on board the... WAR CLAIMS ACT OF 1948, AS AMENDED FILING OF CLAIMS AND PROCEDURES THEREFOR § 504.3 Official claim... or Who Went into Hiding to Avoid Capture or Internment in Southeast Asia During the Vietnam...

  20. 45 CFR 504.3 - Official claim forms.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Forces of the United States Held as Prisoner of War in Vietnam; for Persons Assigned to Duty on board the... WAR CLAIMS ACT OF 1948, AS AMENDED FILING OF CLAIMS AND PROCEDURES THEREFOR § 504.3 Official claim... or Who Went into Hiding to Avoid Capture or Internment in Southeast Asia During the Vietnam...

  1. 45 CFR 504.3 - Official claim forms.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Forces of the United States Held as Prisoner of War in Vietnam; for Persons Assigned to Duty on board the... WAR CLAIMS ACT OF 1948, AS AMENDED FILING OF CLAIMS AND PROCEDURES THEREFOR § 504.3 Official claim... or Who Went into Hiding to Avoid Capture or Internment in Southeast Asia During the Vietnam...

  2. 45 CFR 504.3 - Official claim forms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Forces of the United States Held as Prisoner of War in Vietnam; for Persons Assigned to Duty on board the... WAR CLAIMS ACT OF 1948, AS AMENDED FILING OF CLAIMS AND PROCEDURES THEREFOR § 504.3 Official claim... or Who Went into Hiding to Avoid Capture or Internment in Southeast Asia During the Vietnam...

  3. 5 CFR 180.106 - Claims involving carriers and insurers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Claims involving carriers and insurers. 180.106 Section 180.106 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYEES' PERSONAL PROPERTY CLAIMS § 180.106 Claims involving carriers and insurers. (a...

  4. 20 CFR 702.222 - Claims; exceptions to time limitations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Claims; exceptions to time limitations. 702.222 Section 702.222 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR... Procedures Claims § 702.222 Claims; exceptions to time limitations. (a) Where a person entitled...

  5. 20 CFR 702.222 - Claims; exceptions to time limitations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Claims; exceptions to time limitations. 702.222 Section 702.222 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR... Procedures Claims § 702.222 Claims; exceptions to time limitations. (a) Where a person entitled...

  6. Medical liability insurance claims after treatment of varicose veins.

    PubMed

    Dickhoff, C; Cremers, J E L; Legemate, D A; Koelemay, M J W

    2014-06-01

    Since insight into the reason for filing claims after treatment of varicose veins of the lower extremity might help prevent future claims, we determined the incidence of and reasons for medical liability insurance claims after such treatments in the Netherlands. We performed a retrospective review of all medical liability insurance claims after varicose vein treatment handled by MediRisk between January 1993 and December 2007. A total of 144 claims were filed of which 104 were closed by the end of the study period. Nerve injury (n = 28), skin necrosis following sclerotherapy (n = 17), deep vein injury (n = 11) and insufficient communication (n = 9) accounted for more than 60% of all claims. Claims were equally distributed among registrars and consultants. Some 41 of the 104 closed claims were accepted. In 27 of the accepted cases, the physician had obviously failed in providing the care as expected from a medical practitioner allowed to perform these treatments. The majority of these 27 claims were due to injury of nerves (n = 11) or deep veins (n = 9). The incidence of claims after treatment of varicose veins in the Netherlands is low. Proper knowledge of anatomy and adequate communication, along with the introduction of less invasive treatments might prevent future claims. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. Behavioral Treatment for Pathological Gambling in Persons with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Guercio, John M.; Johnson, Taylor; Dixon, Mark R.

    2012-01-01

    The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week…

  8. Behavioral Treatment for Pathological Gambling in Persons with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Guercio, John M.; Johnson, Taylor; Dixon, Mark R.

    2012-01-01

    The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week…

  9. A Review of Behavioral Treatments for Self-Injurious Behaviors of Persons with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Lo Vullo, Santino V.

    2008-01-01

    Autism spectrum disorders (ASD) are considered to be among the most serious of the mental health conditions. Concomitant with many cases of ASD is intellectual disability. Further compounding the disability is the fact that both conditions are known risk factors for self-injurious behavior (SIB). To date, the most effective intervention methods,…

  10. Prevention Practice Differences Among Persons With Spinal Cord Injuries Who Rarely Versus Frequently Sustain Pressure Ulcers

    ERIC Educational Resources Information Center

    Jones, Michael L.; Marini, Irmo; Slate, John R.

    2005-01-01

    Pressure ulcers are common among people with spinal cord injury (SCI) and not only are costly to treat but also affect the quality of life of those affected by them. Despite a plethora of literature on prevention, there are few wellness studies focusing on the practices of people who do not develop pressure ulcers. This preliminary study sought to…

  11. Prevention Practice Differences Among Persons With Spinal Cord Injuries Who Rarely Versus Frequently Sustain Pressure Ulcers

    ERIC Educational Resources Information Center

    Jones, Michael L.; Marini, Irmo; Slate, John R.

    2005-01-01

    Pressure ulcers are common among people with spinal cord injury (SCI) and not only are costly to treat but also affect the quality of life of those affected by them. Despite a plethora of literature on prevention, there are few wellness studies focusing on the practices of people who do not develop pressure ulcers. This preliminary study sought to…

  12. Narrative Therapy and Non-Suicidal-Self-Injurious Behavior: Externalizing the Problem and Internalizing Personal Agency

    ERIC Educational Resources Information Center

    Hoffman, Rachel M.; Kress, Victoria E.

    2008-01-01

    The purpose of this article is to present an intervention, the externalization of client problems, which can be used to address non-suicidal-self-injurious behavior. Specific externalization techniques are discussed, including naming the problem, letter writing, and drawing. A case application and implications for practice are presented.

  13. A review of workers' compensation claims: the frequency of claim denial and medical treatment delay.

    PubMed

    Kelley, C R; Amparo, J M

    2000-01-01

    A retrospective chart review of 257 patients who presented between January to March 1998, was conducted to identify the frequency of workers' compensation claim denial among patients who reported to Straub Clinic and Hospital. Results showed that 12.8% of claims were either "denied" or temporarily "denied pending investigation". Analysis of all the claims found that only 2% resulted in delayed medical care. Further analysis of the denied claims revealed the vast majority of claims (78.8%) were denied because the medical provider and the patient had incorrect workers' compensation carrier information. Other independent variables studied (size of the employer, category of employer, injury type, status of case, length of case and number of visits) did not predict either denial of the claim or treatment delay. This study suggests that the efficiency of our State's Workers' Compensation system would be greatly improved by developing a system to provide medical care providers with accurate insurance information.

  14. Preventing construction worker injury incidents through the management of personal stress and organizational stressors.

    PubMed

    Leung, Mei-yung; Chan, Isabelle Yee Shan; Yu, Jingyu

    2012-09-01

    Construction workers (CWs) are positioned at the lowest level of an organization and thus have limited control over their work. For this reason, they are often deprived of their due rewards and training or sometimes are even compelled to focus on production at the expense of their own safety. These organizational stressors not only cause the CWs stress but also impair their safety behaviors. The impairment of safety behaviors is the major cause of CW injury incidents. Hence, to prevent injury incidents and enhance safety behaviors of CWs, the current study aimed to identify the impact of various organizational stressors and stress on CW safety behaviors and injury incidents. To achieve this aim, we surveyed 395 CWs. Using factor analysis, we identified five organizational stressors (unfair reward and treatment, inappropriate safety equipment, provision of training, lack of goal setting, and poor physical environment), two types of stress (emotional and physical), and safety behaviors. The results of correlation and regression analyses revealed the following: (1) injury incidents were minimized by safety behaviors but escalated by a lack of goal setting, (2) safety behaviors were maximized by moderate levels of emotional stress (i.e., an inverted U-shape relationship between these two variables) and increased in line with physical stress and inappropriate safety equipment, (3) emotional stress was positively predicted by the provision of training and inappropriate safety equipment, and (4) physical stress was predicted only by inappropriate safety equipment. Based on these results, we suggest various recommendations to construction stakeholders on how to prevent CW injury incidents.

  15. A randomized controlled trial of sertraline for the treatment of depression in persons with traumatic brain injury.

    PubMed

    Ashman, Teresa A; Cantor, Joshua B; Gordon, Wayne A; Spielman, Lisa; Flanagan, Steve; Ginsberg, Annika; Engmann, Clara; Egan, Matthew; Ambrose, Felicia; Greenwald, Brian

    2009-05-01

    To examine the efficacy of sertraline in the treatment of depression after traumatic brain injury (TBI). Double-blind, randomized controlled trial. Research center at a major urban medical center. Subjects were a referred and volunteer sample of 52 participants with TBI, a diagnosis of major depression disorder (MDD), and a score on the Hamilton Rating Scale for Depression (HAM-D) of 18 or greater. The majority of the sample was male (58%), had less than 14 years of education (73%), had incomes below $20,000 (82%), and were from minority backgrounds (75%). Approximately one third of the sample had mild brain injuries, and two thirds had moderate to severe brain injuries. The mean age was 47+/-11, and the mean time since injury was 17+/-14 years. One participant withdrew from the study because of side effects. Daily oral sertraline in doses starting at 25mg and increasing to therapeutic levels (up to 200mg) or placebo for 10 weeks. The HAM-D, the Beck Anxiety Inventory, and the Life-3 quality of life (QOL). No statistically significant differences were found at baseline between drug and placebo groups on baseline measures of depression (24.8+/-7.3 vs 27.7+/-7.0), anxiety (16.4+/-12.3 vs 24.0+/-14.9), or QOL (2.96+/-1.0 vs 2.9+/-0.9). The income level of those receiving placebo was significantly lower than those participants receiving medication. Analyses of covariance revealed significant changes from preintervention to posttreatment for all 3 outcome measures (P<.001) but no group effects. Random-effects modeling did not find any significant difference in patterns of scores of the outcome measures between the placebo and medication groups. Both groups showed improvements in mood, anxiety, and QOL, with 59% of the experimental group and 32% of the placebo group responding to the treatment, defined as a reduction of a person's HAM-D score by 50%.

  16. Trends in Fall-Related Traumatic Brain Injury among Older Persons in Connecticut from 2000-2007.

    PubMed

    Murphy, Terrence E; Baker, Dorothy I; Leo-Summers, Linda S; Tinetti, Mary E

    2014-01-01

    Anecdotal evidence suggests a rising trend in the occurrence of fall-related traumatic brain injuries (FR-TBI) among persons ≥ 70 years. To document this apparent trend on a more substantive basis, this report longitudinally describes overall and age-stratified rates of three outcomes attributed to FR-TBI among persons ≥ 70 years: emergency department visits (ED), hospitalizations, and terminal hospitalizations. Eight years (2000-2007) of observational data from emergency departments and acute care hospitals serving a non-randomly selected, densely populated region in southern Connecticut, U.S. From 2000-2007 among persons 70 years and older, overall rates of FR-TBI visits to emergency departments more than doubled while corresponding rates of hospitalization and terminal hospitalization rose 58% each. The point estimate of growth in the rate of ED in the oldest stratum was nearly triple that of the younger stratum whereas point estimates of growth in rates of hospitalization and terminal hospitalization were nearly four times higher. Total Medicare costs for ED visits increased nearly four-fold while corresponding costs for hospitalizations and terminal hospitalizations rose by 64% and 76%. The most common discharge diagnoses for ED and hospitalization were unspecified head injury and intracranial hemorrhage. The rapid rise in rates of FR-TBI and associated Medicare costs underscore the urgent need to prevent this burgeoning source of human suffering and health care utilization. We believe the rise in rates is at least partially due to a greater public awareness of the outcome that has been facilitated by increasing use of diagnostic imaging in the ED and hospital.

  17. Trends in Fall-Related Traumatic Brain Injury among Older Persons in Connecticut from 2000–2007

    PubMed Central

    Murphy, Terrence E; Baker, Dorothy I; Leo-Summers, Linda S; Tinetti, Mary E

    2014-01-01

    Background Anecdotal evidence suggests a rising trend in the occurrence of fall-related traumatic brain injuries (FR-TBI) among persons ≥ 70 years. To document this apparent trend on a more substantive basis, this report longitudinally describes overall and age-stratified rates of three outcomes attributed to FR-TBI among persons ≥ 70 years: emergency department visits (ED), hospitalizations, and terminal hospitalizations. Methods Eight years (2000–2007) of observational data from emergency departments and acute care hospitals serving a non-randomly selected, densely populated region in southern Connecticut, U.S. Results From 2000–2007 among persons 70 years and older, overall rates of FR-TBI visits to emergency departments more than doubled while corresponding rates of hospitalization and terminal hospitalization rose 58% each. The point estimate of growth in the rate of ED in the oldest stratum was nearly triple that of the younger stratum whereas point estimates of growth in rates of hospitalization and terminal hospitalization were nearly four times higher. Total Medicare costs for ED visits increased nearly four-fold while corresponding costs for hospitalizations and terminal hospitalizations rose by 64% and 76%. The most common discharge diagnoses for ED and hospitalization were unspecified head injury and intracranial hemorrhage. Conclusions The rapid rise in rates of FR-TBI and associated Medicare costs underscore the urgent need to prevent this burgeoning source of human suffering and health care utilization. We believe the rise in rates is at least partially due to a greater public awareness of the outcome that has been facilitated by increasing use of diagnostic imaging in the ED and hospital. PMID:25558438

  18. Change in Neuroplasticity-Related Proteins in Response to Acute Activity-Based Therapy in Persons With Spinal Cord Injury

    PubMed Central

    Astorino, Todd A.; Knoblach, Susan M.; Feather, Jillenne

    2014-01-01

    Background: Activity-based therapy (ABT) focuses on regaining motor and sensory function below the level of the lesion in persons with a spinal cord injury (SCI). This is accomplished through repetitive training of specific motor tasks. Research has shown that ABT may increase neuroplasticity in the rat and human spinal cord. Objective: The primary aim of this study was to examine acute alterations in neuroplasticity-related proteins during ABT in persons with SCI. Methods: Volunteers were current participants in an ABT program and consisted of 12 men and 3 women (age, 31.8 ± 10.9 years) with chronic SCI (injury duration, 63.9 ± 54.4 months). A single 2-hour bout of ABT consisted of standing load bearing, body weight-supported treadmill training, whole body vibration, and functional electrical stimulation. Blood samples were obtained at baseline and immediately after completion of each modality to determine serum levels of brain-derived neurotrophic factor (BDNF), prolactin, and cortisol. Results: One-way analysis of variance (ANOVA) with repeated measures was used to examine differences in proteins over time. Results revealed baseline levels of BDNF (2.37 ± 1.41 ng/mL) that were lower than previous research has demonstrated in persons with SCI. No change in BDNF or cortisol was found, although prolactin was significantly reduced in response to ABT. Conclusion: Despite the length of the bout, acute changes in BDNF were not observed. Whether different intensities or modalities of ABT may promote acute increases in serum BDNF in individuals with SCI remains to be determined and further study is merited. PMID:25477737

  19. The Dangers of Failing One or More Performance Validity Tests in Individuals Claiming Mild Traumatic Brain Injury-Related Postconcussive Symptoms

    PubMed Central

    Proto, Daniel A.; Pastorek, Nicholas J.; Miller, Brian I.; Romesser, Jennifer M.; Sim, Anita H.; Linck, John F.

    2014-01-01

    Evaluating performance validity is important in any neuropsychological assessment, and prior research recommends a threshold for invalid performance of two or more performance validity test (PVT) failures. However, extant findings also indicate that failing a single PVT is associated with significant changes in neuropsychological performance. The current study sought to determine if there is an appreciable difference in neuropsychological testing results between individuals failing different numbers of PVTs. In a sample of veterans with reported histories of mild traumatic brain injury (mTBI; N =178), analyses revealed that individuals failing only one PVT performed significantly worse than individuals failing no PVTs on measures of verbal learning and memory, processing speed, and cognitive flexibility. Additionally, individuals failing one versus two PVTs significantly differed only on delayed free recall scores. The current findings suggest that failure of even one PVT should elicit consideration of performance invalidity, particularly in individuals with histories of mTBI. PMID:25252598

  20. Non-suicidal self-injury (Nssi) in adolescent inpatients: assessing personality features and attitude toward death

    PubMed Central

    2012-01-01

    Background Non-suicidal self-injury (NSSI) is a common concern among hospitalized adolescents, and can have significant implications for short and long-term prognosis. Little research has been devoted on how personality features in severely ill adolescents interact with NSSI and "attitude toward life and death" as a dimension of suicidality. Developing more specific assessment methodologies for adolescents who engage in self-harm without suicidal intent is relevant given the recent proposal of a non-suicidal self-injury (NSSI) disorder and may be useful in predicting risk in psychiatrically impaired subjects. Methods Consecutively hospitalized adolescents in a psychiatric unit (N = 52; 71% females; age 12-19 years), reporting at least one recent episode of self-harm according to the Deliberate Self-harm Inventory, were administered the Structured Clinical Interview for DSM Mental Disorders and Personality Disorders (SCID I and II), the Children's Depression Inventory and the Multi-Attitude Suicide Tendency Scale (MAST). Results Mean age onset of NSSI in the sample was 12.3 years. All patients showed "repetitive" NSSI (high frequency of self-harm), covering different modalities. Results revealed that 63.5% of adolescents met criteria for Borderline Personality Disorder (BPD) and that the rest of the sample also met criteria for personality disorders with dysregulated traits. History of suicide attempts was present in 46.1% of cases. Elevated depressive traits were found in 53.8%. Results show a statistically significant negative correlation between the score on the "Attraction to Life" subscale of the MAST and the frequency and diversification of self-harming behaviors. Conclusions Most adolescent inpatients with NSSI met criteria for emotionally dysregulated personality disorders, and showed a reduced "attraction to life" disposition and significant depressive symptoms. This peculiar psychopathological configuration must be addressed in the treatment of adolescent