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Sample records for personal injury claims

  1. 32 CFR 536.60 - Splitting property damage and personal injury claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Splitting property damage and personal injury... Splitting property damage and personal injury claims. Normally, a claim will include all damages that accrue by reason of the incident. Where a claimant has a claim for property damage and personal injury...

  2. Medical reports on persons claiming compensation for personal injury.

    PubMed

    Cornes, P; Aitken, R C

    1992-06-01

    An audit of one insurance company's files on all employer's liability and third party motor claims settled over two years for 5000 pounds or more presented an opportunity to review the medical reports on the patients involved. A stratified random sample of files on 203 patients contained 602 reports prepared by 400 consultants. Content analysis was undertaken to evaluate compliance with published guidance on reports prepared for medico-legal purposes and to ascertain how well reports met recipients' requirements. While clinical topics were well covered, generally to a high standard, other functional, psychosocial and occupational topics, reflecting the wider clinical and non-clinical frame of reference within which lawyers and insurers normally seek information and advice, were covered less frequently, extensively and comprehensively--leaving considerable scope to improve these aspects of assessment and reporting. Further review of this aspect of professional practice should include attention to the appropriateness of existing guidance, postgraduate training requirements and the involvement of other agencies or professions in some aspects of assessment for medico-legal purposes.

  3. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... personal injury or death. 25.117 Section 25.117 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL CLAIMS General § 25.117 Proof of amount claimed for personal injury or death. The... examination, makes mutually convenient arrangements for such an examination, and bears the costs thereof. (c...

  4. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... personal injury or death. 25.117 Section 25.117 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL CLAIMS General § 25.117 Proof of amount claimed for personal injury or death. The... examination, makes mutually convenient arrangements for such an examination, and bears the costs thereof. (c...

  5. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... personal injury or death. 25.117 Section 25.117 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL CLAIMS General § 25.117 Proof of amount claimed for personal injury or death. The... examination, makes mutually convenient arrangements for such an examination, and bears the costs thereof. (c...

  6. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... personal injury or death. 25.117 Section 25.117 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL CLAIMS General § 25.117 Proof of amount claimed for personal injury or death. The... examination, makes mutually convenient arrangements for such an examination, and bears the costs thereof. (c...

  7. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... personal injury or death. 25.117 Section 25.117 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL CLAIMS General § 25.117 Proof of amount claimed for personal injury or death. The... examination, makes mutually convenient arrangements for such an examination, and bears the costs thereof. (c...

  8. Interrelationship of MMPI-2 validity scales in personal injury claims.

    PubMed

    Fox, D D; Gerson, A; Lees-Haley, P R

    1995-01-01

    A sample of MMPI-2s of worker's compensation and personal injury cases (N = 289) was gathered to examine the relationship of various indicators of exaggeration. Intercorrelations of the F, F-K, the MMPI Dissimulation Scale-revised (Ds-r), total of obvious minus subtle scales (O-S), Fake Bad Scale (FBS), VRIN, and TRIN were computed and the relative sensitivity of each score calculated using various cut-offs. Factor analysis suggests that malingering may take the form of inconsistent responding as well as symptom exaggeration. Patients evaluated at the request of plaintiff attorneys showed a seemingly greater degree of symptom exaggeration and inconsistent responding than did those referred by defense counsel.

  9. Surgical exploration of hand wounds in the emergency room: Preliminary study of 80 personal injury claims.

    PubMed

    Mouton, J; Houdre, H; Beccari, R; Tarissi, N; Autran, M; Auquit-Auckbur, I

    2016-12-01

    The SHAM Insurance Company in Lyon, France, estimated that inadequate hand wound exploration in the emergency room (ER) accounted for 10% of all ER-related personal injury claims in 2013. The objective of this study was to conduct a critical analysis of 80 claims that were related to hand wound management in the ER and led to compensation by SHAM. Eighty claims filed between 2007 and 2010 were anonymised then included into the study. To be eligible, claims had to be filed with SHAM, related to the ER management of a hand wound in an adult, and closed at the time of the study. Claims related to surgery were excluded. For each claim, we recorded 104 items (e.g., epidemiology, treatments offered, and impact on social and occupational activities) and analysed. Of the 70 patients, 60% were manual workers. The advice of a surgeon was sought in 16% of cases. The most common wound sites were the thumb (33%) and index finger (17%). Among the missed lesions, most involved tendons (74%) or nerves (29%). Many patients had more than one reason for filing a claim. The main reasons were inadequate wound exploration (97%), stiffness (49%), and dysaesthesia (41%). One third of patients were unable to return to their previous job. Mean sick-leave duration was 148 days and mean time from discharge to best outcome was 4.19%. Most claims (79%) were settled directly with the insurance company, 16% after involvement of a public mediator, and 12% in court. The mean compensatory damages award was 4595Euros. Inadequate surgical exploration of hand wounds is common in the ER, carries a risk of lasting and sometimes severe residual impairment, and generates considerable societal costs. IV. Copyright © 2016. Published by Elsevier Masson SAS.

  10. A guide to medico-legal photography for personal injury claims.

    PubMed

    Bryson, D

    1994-01-01

    Clinical photographs are in essence medico-legal records but when instructions are given to take photographs for litigation the requirement is for a more specialized approach than when producing a clinical record for the notes. There are special considerations when providing a medico-legal photographic service, from clients' instructions, preparations before photography, and the photography itself to presenting the photographs and handling the administration. As photographs are taken in support of claims for compensation for personal injury many of them can have far greater impact, financially and psychologically, on the client than clinical photographs. Inadequate coverage could be construed as professional negligence.

  11. Return to work of road accident victims claiming compensation for personal injury.

    PubMed

    Cornes, P

    1992-01-01

    Road accidents resulting in personal injury are an increasing cost to society. This study is based on 609 accident victims (of whom 521 survived injury) who were in employment when injured and whose claims for personal injury were settled for 5000 pounds or more by one insurance company over 2 years. It examines survivors' residual disablement, return to work and involvement with rehabilitation services. Data on a representative sample of 101 cases are analysed in more detail to identify possible 'predictors' of return to work. Both univariate and stepwise logistic regression analysis suggest that return to work is less associated with clinical variables, on which much medical advice on return to work is based, than with such other variables as time off work, absence of psychological problems and younger age. Very low rates of referral to rehabilitation may indicate that a rehabilitative approach to cost containment is underutilized in comparison with the traditional emphasis on preventive measures and enhanced medical treatment. More effective rehabilitation, however, may require new approaches to clinical case management, especially in orthopaedic departments where most personal injury claimants are treated.

  12. 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

    ... POSTAL SERVICE 39 CFR Part 912 Procedures To Adjudicate Claims for Personal Injury or Property Damage Arising Out of the 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...

  13. 19 CFR 24.71 - Claims for personal injury or damages to or loss of privately owned property.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Claims for personal injury or damages to or loss of privately owned property. 24.71 Section 24.71 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24...

  14. 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

    ... Loss of or Damage to Property or for Personal Injury or Death AGENCY: Bureau of Consumer Financial... personal injury or death, caused by the negligent or wrongful act or omission of any employee of the Bureau... injury, death, or property loss or damage caused by the negligent or wrongful act or omission of any...

  15. The influence of motor vehicle legislation on injury claim incidence.

    PubMed

    Lemstra, Mark; Olszynski, W P

    2005-01-01

    Although there have been numerous strategies to prevent motor vehicle collisions and their subsequent injuries, few have been effective in preventing motor vehicle injury claims. In this paper, we examine the role of legislation and compensation system in altering injury claim incidence. The population base for our natural experiment was all Saskatchewan, Manitoba, British Columbia and Quebec residents who submitted personal injury claims to their respective motor vehicle insurance provider from 1990 to 1999. The provinces of Saskatchewan and Manitoba switched from Tort to pure No-Fault insurance on January 1, 1995 and on March 1, 1994 respectively. British Columbia maintained tort insurance and Quebec maintained pure no-fault insurance throughout the entire 10-year period. The conversion from tort insurance to pure no-fault motor vehicle insurance resulted in a five-year 31% (RR = 0.69; 95% CI 0.68-0.70) reduction in total injury claims per 100,000 residents in Saskatchewan and a five-year 43% (RR = 0.57; 95% CI 0.56-0.58) reduction in Manitoba. At the same time, the province of British Columbia retained tort insurance and had a five-year 5% reduction (RR = 0.95; 95% CI 0.94-0.99). Quebec, which retained pure no-fault throughout the entire 10-year period, had less than one third of the injury claims per 100,000 residents than the tort province of British Columbia. The conversion from tort to pure no-fault legislation has a large influence in reducing motor vehicle injury claim incidence in Canada. Legislative system and injury compensation scheme have an observable impact on injury claim incidence and can therefore have significant impact on the health care system.

  16. Injury and Compensation Claims Module Maintenance Manual

    DTIC Science & Technology

    1989-01-01

    FIRST REALIZED DISEASE /ILLNESS CAUSED 13. *Press <Return> for EXPLAIN RELATES TO ILLNES "OWCP US6-NOI CODE_ 14. *Priss <Return> for NATURE OF INJURY...INJURY 4. OCCUPATION 5. DESCRIBE INJURY OR DISEASE : *Press <Return> for NATURE OF INJURY/ILLNESS* 6. AUTHORIZATION OF MEDICAL CARE A. FEES FOR SERVICFS...Reporting Office for OWCP - Enter/Edit 115 4.5.3 Claim Type File - Enter/Edit 116 4.5.4 Nature of Injury File - Enter/Edit 116 4.5.5 Body Part File

  17. Airway injury during anesthesia: a closed claims analysis.

    PubMed

    Domino, K B; Posner, K L; Caplan, R A; Cheney, F W

    1999-12-01

    Airway injury during general anesthesia is a significant source of morbidity for patients and a source of liability for anesthesiologists. To identify recurrent patterns of injury, the authors analyzed claims for airway injury in the American Society of Anesthesiologists (ASA) Closed Claims Project database. The ASA Closed Claims database is a standardized collection of case summaries derived from professional liability insurance companies closed claims files. All claims for airway injury were reviewed in depth and were compared to other claims during general anesthesia. Approximately 6% (266) of 4,460 claims in the database were for airway injury. The most frequent sites of injury were the larynx (33%), pharynx (19%), and esophagus (18%). Injuries to the esophagus and trachea were more frequently associated with difficult intubation. Injuries to temporomandibular joint and the larynx were more frequently associated with nondifficult intubation. Injuries to the esophagus were more severe and resulted in a higher payment to the plaintiff than claims for other sites of airway injury. Difficult intubation (odds ratio = 4.53, 95% confidence interval [CI] = 2.36, 8.71), age older than 60 yr (odds ratio = 2.97, 95% CI = 1.51, 5.87), and female gender (odds ratio = 2.43, 95% CI = 1.09, 5.42) were associated with claims for pharyngoesophageal perforation. Early signs of perforation, e.g., pneumothorax and subcutaneous emphysema, were present in only 51% of perforation claims, whereas late sequelae, e.g., retropharyngeal abscess and mediastinitis, occurred in 65%. Patients in whom tracheal intubation has been difficult should be observed for and told to watch for the development of symptoms and signs of retropharyngeal abscess, mediastinitis, or both.

  18. 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

  19. Characteristics of and risk factors for compensated occupational injury and disease claims in dairy farmers: a case-control study.

    PubMed

    Karttunen, J P; Rautiainen, R H

    2013-07-01

    Research indicates that dairy farmers have an elevated risk of work-related adverse health outcomes. This case-control study evaluated the characteristics of and risk factors for compensated occupational injury and disease claims among Finnish dairy farmers. The cases consisted of 19 farm couples in which both spouses had a history of multiple claims. There were 283 claims in total, a rate of 26.6 claims per 100 person-years. The controls consisted of 12 couples in which neither spouse had compensated or rejected claims during their work history as insured farmers. A combined mail/telephone survey charted potential risk factors for compensated claims. These claims frequently involved work tasks and causes related to animal husbandry. Cattle were the most common cause for injuries in general and for serious injuries in particular. Gender differences in farm work and claims were observed. Using logistic regression analyses, we identified personal and work-related risk factors including long work history, small-scale dairy farm operation, and conventional stanchion barn for dairy cattle. Outdated working conditions, while not statistically significant, were positively associated with claims as well. Declined current work ability and musculoskeletal or respiratory conditions were significantly associated with claims where each of these outcomes may contribute to the other. Identified factors could be used to select subgroups of dairy farmers with either elevated or reduced risk of claims. Prevention of adverse health outcomes could be most effective when targeted to farmers at highest risk of occupational injury and disease.

  20. 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 the...

  1. 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 the...

  2. 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 the...

  3. 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 the...

  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 the...

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

    PubMed

    Collie, Alex; Gabbe, Belinda; Fitzharris, Michael

    2015-05-12

    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. 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. 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 public health effects of injury claims management policy and

  6. 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

  7. Lessons to be learned: a retrospective analysis of physiotherapy injury claims.

    PubMed

    Johnson, Gillian M; Skinner, Margot A; Stephen, Rachel E

    2012-08-01

    Retrospective, descriptive analysis. To describe the prevalence and nature of insurance claims for injuries attributed to physiotherapy care. In New Zealand, a national insurance scheme, the Accident Compensation Corporation, provides comprehensive, no-fault personal injury coverage. The patterns of injury sustained during physiotherapy care have not previously been described. De-identified data for all injuries registered with the Accident Compensation Corporation from 2005 to 2010 and attributed to physiotherapy were accessed. Prevalence patterns (percentages) of new-claim data were determined for physiotherapy intervention category, injury site, nature of injury, age, and sex. A subcategory, exercise-related injuries, was analyzed according to injury site and whether the injury was related (primary) or unrelated (secondary) to the intended therapeutic goal. There were 279 claims related to physiotherapy care filed with the Accident Compensation Corporation during the studied reporting period. Injury was attributed predominantly to exercise (n = 88, 31.5% of cases) and manual therapy (n = 74, 26.5% of cases). The prevalence of events categorized as exercise related was greatest in those who were 55 to 59 years of age (n = 14, 16.3%) and greater in females (n = 47, 54.7%). Of the exercise-related injuries, 39.8% were in the lower-limb region and 35.2% were categorized as sprains/strains. Injuries attributed to exercise exceeded those linked to other therapies provided by physiotherapists, yet exercise therapy rarely features as a cause of adverse events reported to the physiotherapy profession. The proportion of exercise-related injury events underlines the need for ensuring safe and careful consideration of exercise prescription. Harm, level 4.

  8. 46 CFR 310.9 - Medical attention and injury claims.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Medical attention and injury claims. 310.9 Section 310.9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRAINING MERCHANT MARINE TRAINING Regulations and Minimum Standards for State, Territorial or Regional Maritime Academies and Colleges § 310.9...

  9. 46 CFR 310.9 - Medical attention and injury claims.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Medical attention and injury claims. 310.9 Section 310.9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRAINING MERCHANT MARINE TRAINING Regulations and Minimum Standards for State, Territorial or Regional Maritime Academies and Colleges § 310.9...

  10. IIHS head restraint ratings and insurance injury claim rates.

    PubMed

    Trempel, Rebecca E; Zuby, David S; Edwards, Marcy A

    2016-08-17

    The Insurance Institute for Highway Safety (IIHS) rates front seat/head restraint designs using a combination of static and dynamic measurements following RCAR-IIWPG procedures. The purpose of this study was to determine whether vehicles with better IIHS-rated seats/head restraints had lower injury risk in rear-end collisions and how the effect of better rated seats interacted with driver gender and age. The presence of an associated insurance injury claim was determined for rear-impact crashes using 2001-2014 model year cars and SUVs. Logistic regression was used to compare injury risk for vehicles with good, acceptable, and marginal IIHS-rated seats/head restraints with poor-rated seats/head restraints. Analyses were run by gender and driver age and also by the rate of more severe injury claims. Injury rates were 11.2% lower for vehicles with seats/head restraints rated good compared to vehicles with seats/head restraints rated poor. The percentage reduction for good- versus poor-rated seats was greater for females (12.7%) than males (8.9%). Comparing good- with poor-rated seats, driver ages 15-24 had the largest reduction at 19.8%, followed by 10.7% for driver ages 45-64 and 10.4% for driver ages 25-44. Seats/head restraints with better IIHS ratings are associated with lower injury rates in rear-impact collisions than seats rated poor. The reductions in injury rates were strongest for females and for young-to-middle-age drivers. The strong reductions in injury rates for these groups are encouraging given their high initial injury rates.

  11. 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

  12. Body Mass Index is a Predictor of Fire Fighter Injury and Worker Compensation Claims

    PubMed Central

    Kuehl, Kerry S.; Kisbu-Sakarya, Yasemin; Elliot, Diane L.; Moe, Esther L.; DeFrancesco, Carol A.; MacKinnon, David P.; Lockhart, Ginger; Goldberg, Linn; Kuehl, Hannah E.

    2012-01-01

    Objective To determine the relationship between lifestyle variables including body mass index (BMI) and filing a worker’s compensation claim due to firefighter injury. Methods A cross-sectional evaluation of firefighter injury related worker compensation claims occurring 5 years after the original PHLAME study intervention. Results Logistic regression analysis for variables predicting filing a worker’s compensation claim due to an injury were performed. with a total of 433 participants. The odds of filing a compensation claim were almost three times higher for firefighters with a BMI >30 compared to firefighters with normal BMI (odds ratio=2.89, p<.05). Conclusions This study addresses a high priority area of reducing firefighter injuries and worker’s compensation claims. Maintaining a healthy body weight is important to reduce injury and worker’s compensation claims among firefighters. PMID:22569476

  13. 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.

  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

    ... AFFAIRS Agency Information Collection (Report of Accidental Injury in Support of Claim for Compensation or... Injury in Support of Claim for Compensation or Pension/Statement of Witness to Accident, VA Form 21- 4176... Respondents: 4,400. Dated: November 22, 2011. By direction of the Secretary. Denise McLamb, Program Analyst...

  15. The increasing threat of personal watercraft injuries.

    PubMed

    Latch, Rebecca; Fiser, Debra H

    2004-05-01

    A trend of increasing number and severity of injuries associated with use of personal watercraft (PWC) has been noted as the use and popularity of PWC also rises. The rate of injuries secondary to PWC use is greater than that from other water sports. Multiple etiologies of injury have been reported, including closed head trauma, spinal injuries, facial fractures, chest trauma, abdominal injuries, and drowning. These injuries may occur from collision with other objects, falls from the PWC, and encounters with the hydrostatic jet stream. The most significant contributing factors to injury seem to be carelessness and inattention. However, some studies show that substance abuse may also contribute. Recommendations to reduce morbidity and mortality include using U.S. Coast Guard-approved personal flotation devices (PFD), limiting use of PWC to trained adults, and improving recognition of significant PWC injury by medical personnel.

  16. 22 CFR 72.28 - Claims for lost, stolen, or destroyed personal estate.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Claims for lost, stolen, or destroyed personal..., THEIR PROPERTY AND ESTATES DEATHS AND ESTATES Personal Estates of Deceased United States Citizens and Nationals § 72.28 Claims for lost, stolen, or destroyed personal estate. (a) The legal representative of the...

  17. The AANA Foundation Closed Malpractice Claims Study on nerve injuries during anesthesia care.

    PubMed

    Fritzlen, Tracie; Kremer, Michael; Biddle, Chuck

    2003-10-01

    Anesthesia-associated nerve injury is a common cause of patient morbidity and litigation. To identify factors associated with perioperative nerve injuries and rationalize preventive strategies, 44 cases from the American Association of Nurse Anesthetists (AANA) Foundation Closed Malpractice Claims Database pertaining to nerve injuries in which nurse anesthetists provided care were analyzed. Emerging patterns and themes related to the development of injury were identified. The database is a collection of medical liability claims filed against CRNAs insured by the St Paul Fire and Marine Insurance Company; 44 claims of anesthesia-related nerve injury were analyzed. The most common injury was to the brachial plexus (15 [34%]), followed by ulnar nerve injury (7 [16%]), radial nerve injury (5 [11%]), peroneal nerve injury (4 [9%]), paraplegia (4 [9%]), lumbosacral injury (3[7%]), and a variety of "other" injuries (8[18%]). These numbers and percentages total more than 44 (100%) as some patients incurred multiple injuries. Documentation on the anesthesia record of the use of intraoperative protective padding and patient position was lacking or inadequate in a majority of the claims. Effective strategies for the prevention of nerve injury during anesthesia are reviewed. Abnormal body habitus, several disease states, anesthesia technique, improper positioning, lack of adequate padding, and tourniquet use have been implicated as risk factors.

  18. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of the property or their authorized agent may file a claim for property damage. (b) Personal injury or death. (1) The injured person or authorized agent may file a claim for personal injury. (2) The... decedent's estate or any other person legally entitled to do so under applicable local law may file a claim...

  19. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of the property or their authorized agent may file a claim for property damage. (b) Personal injury or death. (1) The injured person or authorized agent may file a claim for personal injury. (2) The... decedent's estate or any other person legally entitled to do so under applicable local law may file a claim...

  20. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of the property or their authorized agent may file a claim for property damage. (b) Personal injury or death. (1) The injured person or authorized agent may file a claim for personal injury. (2) The... decedent's estate or any other person legally entitled to do so under applicable local law may file a claim...

  1. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of the property or their authorized agent may file a claim for property damage. (b) Personal injury or death. (1) The injured person or authorized agent may file a claim for personal injury. (2) The... decedent's estate or any other person legally entitled to do so under applicable local law may file a claim...

  2. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of the property or their authorized agent may file a claim for property damage. (b) Personal injury or death. (1) The injured person or authorized agent may file a claim for personal injury. (2) The... decedent's estate or any other person legally entitled to do so under applicable local law may file a claim...

  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. Personality Disturbances Associated with Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    Prigatano, George P.

    1992-01-01

    Reviews personality disturbances associated with traumatic brain injury. Attempts to clarify terms and review empirical findings. Notes that longitudinal prospective studies that use appropriate control groups are needed. Suggests future research may benefit by considering long-term effects of early agitation following traumatic brain injury and…

  5. Occupational eye injury and risk reduction: Kentucky workers' compensation claim analysis 1994-2003.

    PubMed

    McCall, B P; Horwitz, I B; Taylor, O A

    2009-06-01

    Occupational eye injuries are a significant source of injury in the workplace. Little population-based research in the area has been conducted, and is necessary for developing and prioritizing effective interventions. Workers' compensation data from the state of Kentucky for the years 1994-2003 were analysed by demographics, injury nature and cause, cost, and occupational and industrial characteristics. The US Bureau of Labor Statistics' Current Population Survey was utilised to compute injury rates for demographic and occupational groups. There were 10,545 claims of ocular injury, representing 6.29 claims per 10,000 workers on average annually. A substantial drop in the claim rate was found after the state passed monetary penalties for injuries caused by employer negligence or OSHA violations. Claims by men were over three times more likely than those by women to have associated claim costs (OR 0.52; 95% CI 0.32 to 0.85; p = 0.009). The highest eye injury rates per 10,000 of 13.46 (95% CI 12.86 to 14.07) were found for the helpers/labourers occupation, and of 19.95 (95% CI 18.73 to 21.17) for the construction industry. The total cost of claim payments over the period was over $3,480,000, and average cost per claim approximated $331. Eye injuries remain a significant risk to worker health, especially among men in jobs requiring intensive manual labour. Evidence showed that increased legislative regulation led to a decline in eye injuries, which was consistent with other recent findings in the area. Additionally, targeting groups most at risk, increasing worker training, providing effective eye protection equipment, and developing workplace safety cultures may together reduce occupational eye injuries.

  6. 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

    ... AFFAIRS Proposed Information Collection (Report of Accidental Injury in Support of Claim for Compensation... of Claim for Compensation or Pension/Statement of Witness to Accident, VA Form 21- 4176. OMB Control..., Program Analyst, Enterprise Records Service. BILLING CODE 8320-01-P ...

  7. Relationship between stressfulness of claiming for injury compensation and long-term recovery: a prospective cohort study.

    PubMed

    Grant, Genevieve M; O'Donnell, Meaghan L; Spittal, Matthew J; Creamer, Mark; Studdert, David M

    2014-04-01

    Each year, millions of persons worldwide seek compensation for transport accident and workplace injuries. Previous research suggests that these claimants have worse long-term health outcomes than persons whose injuries fall outside compensation schemes. However, existing studies have substantial methodological weaknesses and have not identified which aspects of the claiming experience may drive these effects. To determine aspects of claims processes that claimants to transport accident and workers' compensation schemes find stressful and whether such stressful experiences are associated with poorer long-term recovery. Prospective cohort study of a random sample of 1010 patients hospitalized in 3 Australian states for injuries from 2004 through 2006. At 6-year follow-up, we interviewed 332 participants who had claimed compensation from transport accident and workers' compensation schemes ("claimants") to determine which aspects of the claiming experience they found stressful. We used multivariable regression analysis to test for associations between compensation-related stress and health status at 6 years, adjusting for baseline determinants of long-term health status and predisposition to stressful experiences (via propensity scores). Disability, quality of life, anxiety, and depression. Among claimants, 33.9% reported high levels of stress associated with understanding what they needed to do for their claim; 30.4%, with claim delays; 26.9%, with the number of medical assessments; and 26.1%, with the amount of compensation they received. Six years after their injury, claimants who reported high levels of stress had significantly higher levels of disability (+6.94 points, World Health Organization Disability Assessment Schedule sum score), anxiety and depression (+1.89 points and +2.61 points, respectively, Hospital Anxiety and Depression Scale), and lower quality of life (-0.73 points, World Health Organization Quality of Life instrument, overall item), compared

  8. 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.

  9. 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 may...

  10. 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 may...

  11. 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 may...

  12. 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 may...

  13. 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 may...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Regulations and Minimum Standards for State, Territorial or Regional Maritime Academies and Colleges § 310.9... employees shall look to the State alone for pay, allowances, compensation and other benefits during injury...

  15. Injuries and illnesses among hospital workers in Ohio. A study of workers' compensation claims from 1993 to 1996.

    PubMed

    Khuder, S A; Schaub, E A; Bisesi, M S; Krabill, Z T

    1999-01-01

    Occupational illnesses and injuries are common problems facing workers and employers. The purpose of this study was to determine the nature and extent of illnesses and injuries among hospital workers in Ohio. All workers' compensation claims for 22 hospitals in Ohio during the period 1993-1996 were reviewed. The majority of the claims were for sprain and strain injuries. Most of the claims were approved. Back injury was the leading cause of injury in both genders, and females reported a significantly higher percentage of back injuries. The incidence rates for injuries and illnesses were lower than national rates for other industries. Generally, there was a downward trend in the number of claims during the study period. A negative linear trend in injury rates by hospital size was detected. Our findings suggest the need for safety programs, especially in smaller hospitals, with the goal of preventing sprain and strain injuries.

  16. Analysis of workers' compensation claims data for machine-related injuries in metal fabrication businesses.

    PubMed

    Yamin, Samuel C; Bejan, Anca; Parker, David L; Xi, Min; Brosseau, Lisa M

    2016-08-01

    Metal fabrication workers are at high risk for machine-related injury. Apart from amputations, data on factors contributing to this problem are generally absent. Narrative text analysis was performed on workers' compensation claims in order to identify machine-related injuries and determine work tasks involved. Data were further evaluated on the basis of cost per claim, nature of injury, and part of body. From an initial set of 4,268 claims, 1,053 were classified as machine-related. Frequently identified tasks included machine operation (31%), workpiece handling (20%), setup/adjustment (15%), and removing chips (12%). Lacerations to finger(s), hand, or thumb comprised 38% of machine-related injuries; foreign body in the eye accounted for 20%. Amputations were relatively rare but had highest costs per claim (mean $21,059; median $11,998). Despite limitations, workers' compensation data were useful in characterizing machine-related injuries. Improving the quality of data collected by insurers would enhance occupational injury surveillance and prevention efforts. Am. J. Ind. Med. 59:656-664, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  17. 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.

  18. 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

  19. What Adverse Events and Injuries Are Cited in Anesthesia Malpractice Claims for Nonspine Orthopaedic Surgery?

    PubMed

    Kent, Christopher D; Stephens, Linda S; Posner, Karen L; Domino, Karen B

    2017-12-01

    Malpractice claims that arise during the perioperative care of patients receiving orthopaedic procedures will frequently involve both orthopaedic surgeons and anesthesiologists. The Anesthesia Closed Claims database contains anesthesia malpractice claim data that can be used to investigate patient safety events arising during the care of orthopaedic patients and can provide insight into the medicolegal liability shared by the two specialties. (1) How do orthopaedic anesthetic malpractice claims differ from other anesthesia claims with regard to patient and case characteristics, common events and injuries, and liability profile? (2) What are the characteristics of patients who had neuraxial hematomas after spinal and epidural anesthesia for orthopaedic procedures? (3) What are the characteristics of patients who had orthopaedic anesthesia malpractice claims for central ischemic neurologic injury occurring during shoulder surgery in the beach chair position? (4) What are the characteristics of patients who had malpractice claims for respiratory depression and respiratory arrests in the postoperative period? The Anesthesia Closed Claims Project database was the source of data for this study. This national database derives data from a panel of liability companies (national and regional) and includes closed malpractice claims against anesthesiologists representing > 30% of practicing anesthesiologists in the United States from all types of practice settings (hospital, surgery centers, and offices). Claims for damage to teeth or dentures are not included in the database. Patient characteristics, type of anesthesia, damaging events, outcomes, and liability characteristics of anesthesia malpractice claims for events occurring in the years 2000 to 2013 related to nonspine orthopaedic surgery (n = 475) were compared with claims related to other procedures (n = 1592) with p < 0.05 as the criterion for statistical significance and two-tailed tests. Odds ratios and their 95

  20. 32 CFR 842.46 - Who may file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... authorized agents may file claims for personal injury. (c) Duly appointed guardians of minor children or any... injuries. (d) Executors or administrators of a decedent's estate or another person legally entitled to do...

  1. 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 backmore » ($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.« less

  2. 49 CFR 229.41 - 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. 229.41 Section... Requirements § 229.41 Protection against personal injury. Fan openings, exposed gears and pinions, exposed... with guards to prevent personal injury. ...

  3. 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... Requirements § 238.117 Protection against personal injury. On or after November 8, 1999, all moving parts, high... personal injury. This section does not apply to the interior of a private car. ...

  4. 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

  5. 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.

  6. Are the predictors of work absence following a work-related injury similar for musculoskeletal and mental health claims?

    PubMed

    Smith, Peter M; Black, Oliver; Keegel, Tessa; Collie, Alex

    2014-03-01

    To examine if the factors associated with days of absence following a work-related injury are similar for mental health versus musculoskeletal (MSK) conditions. A secondary analysis of wage replacement workers' compensation claims in the state of Victoria, Australia. We examined the relationship between individual, injury, occupational and workplace variables with days of wage replacement over the 2-year period following first day of absence from work separately for mental health claims and MSK claims using negative binomial regression models. Mental health conditions were associated with a greater number of days of absence over the 2 years following first incapacity compared to MSK conditions. Differences were observed in employment, injury and industry variables on absence from work for mental claims compared to MSK claims. Working in the agriculture, forestry, fishing and mining industries and employment with a small organisation were more strongly associated with the number of days of wage-replacement among MSK compared to mental health claims, and working in the public administration and safety, or education and training industries or being employed in a position with high time pressure were associated with greater days of wage-replacement among mental health compared to MSK claims. Predictors of days away from work in the 2 years following an injury differ for mental health versus MSK claims. Given the increasing number of mental health claims in Australia more research is required to understand differences in return-to-work for this group of claimants compared to those with physical injuries.

  7. 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.

  8. 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.

  9. 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.

  10. 13 CFR 114.103 - Who may file a claim?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... column, then it may be presented by persons listed in the second column. Claim factors Claim presenters Injury to or loss of property The owner of the property, his or her duly authorized agent, or legal...

  11. Learning from no-fault treatment injury claims to improve the safety of older patients.

    PubMed

    Wallis, Katharine Ann

    2015-09-01

    New Zealand's treatment injury compensation claims data set provides an uncommon no-fault perspective of patient safety incidents. Analysis of primary care claims data confirmed medication as the leading threat to the safety of older patients in primary care and drew particular attention to the threat posed by antibiotics. For most injuries there was no suggestion of error. The no-fault perspective reveals the greatest threat to the safety of older patients in primary care to be, not error, but the risk posed by treatment itself. To improve patients' safety, in addition to reducing error, clinicians need to reduce patients' exposure to treatment risk, where appropriate. © 2015 Annals of Family Medicine, Inc.

  12. 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.

  13. Reoccurring Injury, Chronic Health Conditions, and Behavioral Health: Gender Differences in the Causes of Workers' Compensation Claims.

    PubMed

    Schwatka, Natalie V; Shore, Erin; Atherly, Adam; Weitzenkamp, David; Dally, Miranda J; Brockbank, Claire V S; Tenney, Liliana; Goetzel, Ron Z; Jinnett, Kimberly; McMillen, James; Newman, Lee S

    2018-02-12

    To examine how work and non-work health-related factors contribute to workers' compensation (WC) claims by gender. Workers (N = 16,926) were enrolled in the Pinnacol Assurance Health Risk Management study, a multiyear, longitudinal research program assessing small and medium-sized enterprises in Colorado. Hypotheses were tested using gender stratified logistic regression models. For both women and men, having incurred a prior WC claim increased the odds of a future claim. The combination of incurring a prior claim and having metabolic health conditions resulted in lower odds of a future claim. Behavioral health risk factors increased the odds of having a claim more so among women than among men. This study provides data to support multifactorial injury theories, and the need for injury prevention efforts that consider workplace conditions as well as worker health.

  14. 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

  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

    ... (Statement of Person Claiming To Have Stood in Relation of a Parent) Activity: Comment Request AGENCY... information needed to determine a claimant's who stood in relation of parents to a deceased veteran... information technology. Title: Statement of Person Claiming to Have Stood in Relation of a Parent, VA Form 21...

  16. 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

    ... (Statement of Person Claiming To Have Stood in Relation of a Parent) Activity: Comment Request AGENCY... needed to determine a claimant's who stood in relation of parents to a deceased Veteran eligibility for.... Title: Statement of Person Claiming to Have Stood in Relation of a Parent, VA Form 21P-524. OMB Control...

  17. 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

    ... (Statement of Person Claiming To Have Stood in Relation of a Parent) Under OMB Review AGENCY: Veterans... OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235...: Statement of Person Claiming to Have Stood in Relation of a Parent, VA Form 21-524. OMB Control Number: 2900...

  18. 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

  19. A methodology for the extraction of quantitative risk indexes from medical injuries compensation claims.

    PubMed

    Dalle Carbonare, Simona; Folli, Fulvia; Patrini, Emanuele; Bellazzi, Riccardo

    2009-01-01

    The prevention of adverse events and medical injuries due to malpractice or suboptimal delivery of health care services is one of the major concerns of citizens and Health Care Organizations. One way to understand adverse events is to analyze the compensation requests for medical injuries that are claimed to hospital or health care services. In this paper we describe the results obtained by applying a probabilistic model, called the actuarial model, to analyze 317 cases of injuries with compensation requests collected from 1999 to the first semester of 2007 by the Azienda Ospedaliera (A.O.) of Lodi, in the Northern part of Italy. The approach, adapted from operational and financial risk management, proved to be useful to understand the risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.

  20. Delicate dances: immigrant workers' experiences of injury reporting and claim filing.

    PubMed

    Kosny, Agnieszka; MacEachen, Ellen; Lifshen, Marni; Smith, Peter; Jafri, Gul Joya; Neilson, Cynthia; Pugliese, Diana; Shields, John

    2012-01-01

    Immigrants often come to Canada for the purpose of employment and make up a large proportion of our labour force. Yet, these workers' labour market experience may not always be positive - new immigrant workers can have difficulties finding a job in their field and may end up working in 'survival jobs' that expose them to workplace hazards. Workers who are new to Canada may not be familiar with legislation designed to protect them at work or with social programs that can help after a work-related injury. Through a series of in-depth interviews this study examined the experiences of new immigrants after they were injured on the job. The analysis revealed that many workers were in manual, 'survival jobs' and had not received job or occupational health and safety training. Many did not speak the English language well and knew little about their rights. While workers often felt trepidation about reporting their injury, most told a health care provider or employer that they were injured or in pain. This, however, rarely led to timely or appropriate claim filing. Workers were often discouraged from filing a claim, misinformed about their rights or offered 'time off work' in lieu of reporting the injury to worker's compensation. In instances where a claim was filed, communication problems were common and led to mistakes being made on forms and misunderstandings with the adjudicator and employer. Interpretation services were not always offered consistently or at the correct time. Efforts must be made to systematically inform new immigrants of their health and safety rights, responsibilities and entitlements as they are entering the labour market. Systems must be put in place to ensure that immigrants can access the compensation system in the event of a work-related injury and that employers and healthcare providers fulfil their reporting responsibilities.

  1. Patient and hospital characteristics associated with claims and compensations for patient injuries in coronary artery bypass grafting in Finland.

    PubMed

    Järvelin, Jutta; Rosenqvist, Gunnar; Häkkinen, Unto; Sintonen, Harri

    2009-07-01

    To analyse the association between individual patients' risk factors and rates of claims and compensations for patient injuries in an insurance scheme in which proof of negligence is not required. And to explore whether either hospital productivity or volume of procedures is related to claims and compensation rates. A two-step sequential logistic regression was applied on data collected from administrative registers. It included 17,834 patients who had undergone coronary artery bypass grafting at public hospitals in Finland between 1998 and 2002. The main outcome measure was the odds of claiming and receiving compensation. Men were less likely to claim compensation (odds ratio [OR] 0.66; 95% confidence interval 0.54-0.81), but among those having claimed were more likely to receive compensation (OR 2.08; 1.15-3.75) than women. Patients with a co-morbidity were more likely to claim (OR 1.29; 1.06-1.57), but among those having claimed were less likely to receive compensation (OR 0.52; 0.31-0.86) than those without a co-morbidity. Advanced age reduced the probability of claiming (OR 0.71; 0.52-0.96). Although high-risk patients file a claim more frequently than low-risk patients, the latter have a higher probability of getting their claims accepted and receiving compensation. This risk pattern is probably a reflection of compensation practices related to patient injuries involving an infection.

  2. 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.

  3. 78 FR 18365 - Commencement of Iraq Claims Adjudication Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ..., are defined as: claims of U.S. nationals for compensation for serious personal injuries knowingly... Agreement for claims of hostage-taking \\2\\ provided that (1) the claimant has already received compensation... warranting additional compensation. For purposes of this referral, ``serious personal injury'' may include...

  4. 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

  5. Age-related patterns in work-related injury claims from older New Zealanders, 2009-2013: Implications of injury for an aging workforce.

    PubMed

    Lilley, Rebbecca; Jaye, Chrystal; Davie, Gabrielle; Keeling, Sally; Waters, Debra; Egan, Richard

    2018-01-01

    This study describes the incidence, nature and cause of work-related injuries in older New Zealand workers to understand the risks of work-related injury in this rapidly aging population. Data for the period 2009-2013 from 25,455 injured workers aged 55-79 years, extracted from national work-related injury entitlement claims, were stratified by age group and analysed by sex, industry, injury type and cause. Age-specific claims rates were calculated by year, sex and ethnicity. Patterns of injury differed by age: 70-79 year olds had the highest injury rates and proportion of claims due to falls (45%), for the self-employed (32%), for the agriculture sector (24%), and for fatal injuries (5%). The burden of work-related injuries in older workers, particularly in those aged over 70, will increase with their increasing participation in work. Workplace injury prevention strategies and interventions need to consider the specific characteristics and vulnerabilities of older workers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Applying crash data to injury claims - an investigation of determinant factors in severe motor vehicle accidents.

    PubMed

    Shannon, Darren; Murphy, Finbarr; Mullins, Martin; Eggert, Julian

    2018-04-01

    An extensive number of research studies have attempted to capture the factors that influence the severity of vehicle impacts. The high number of risks facing all traffic participants has led to a gradual increase in sophisticated data collection schemes linking crash characteristics to subsequent severity measures. This study serves as a departure from previous research by relating injuries suffered in road traffic accidents to expected trauma compensation payouts and deriving a quantitative cost function. Data from the National Highway Traffic Safety Administration's (NHTSA) Crash Injury Research (CIREN) database for the years 2005-2014 is combined with the Book of Quantum, an Irish governmental document that offers guidelines on the appropriate compensation to be awarded for injuries sustained in accidents. A multiple linear regression is carried out to identify the crash factors that significantly influence expected compensation costs and compared to ordered and multinomial logit models. The model offers encouraging results given the inherent variation expected in vehicular incidents and the subjectivity influencing compensation payout judgments, attaining an adjusted-R 2 fit of 20.6% when uninfluential factors are removed. It is found that relative speed at time of impact and dark conditions increase the expected costs, while rear-end incidents, incident sustained in van-based trucks and incidents sustained while turning result in lower expected compensations. The number of airbags available in the vehicle is also a significant factor. The scalar-outcome approach used in this research offers an alternative methodology to the discrete-outcome models that dominate traffic safety analyses. The results also raise queries on the future development of claims reserving (capital allocations earmarked for future expected claims payments) as advanced driver assistant systems (ADASs) seek to eradicate the most frequent types of crash factors upon which insurance

  7. 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.

  8. The art of directing a workers' compensation claim: personal observations on the role of the workers' compensation claim adjuster.

    PubMed

    Wendt, Chris; Emmett, Ted

    2004-05-01

    Workers' compensation claims are becoming more complex and expensive every day. One of the contributing factors for the increase is the aging workforce as well as federal legislation such as the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). The workforce is aging, mobile, and educated about their rights. The key to avoiding spiraling costs is a strong safety and claims program that is sponsored by senior management,valued by the employees, and implemented by the entire company.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. The relationship between insurance claim closure and recovery after traffic injuries for individuals with whiplash associated disorders.

    PubMed

    Boyle, Eleanor; Cassidy, J David; Côté, Pierre; Carroll, Linda J

    2017-05-01

    The purpose of this study was to determine if time to claim closure was similar to time to self-reported recovery in a no fault motor vehicle collision insurance system. A prospective cohort of traffic injured adults with a whiplash-associated disorder (WAD) was assembled. We excluded participants who applied for benefits after 42 days of the collision, who were in hospital for more than two days and participants who were not followed up at least once after their injury. Questionnaires were completed at baseline, six weeks, three-, six-, nine- and 12-months after the collision. The mean age of the cohort was 39 years and 66% were female. The mean number of days until claim closure and for self-reported recovery was 291days and 134 days, respectively. We found those who had their claim closed at each follow-up period had lower levels of disability and were more likely to report they were recovered than participants with open claims. We conclude that time to claim closure could be used as an outcome measure in traffic collision; however, this measure should be used with caution since it over-estimates the true time to recovery. Implications for Rehabilitation Time to claim closure as an outcome measure for whiplash-associated disorders has been criticized in the literature because it is thought that closure is not reflective of the health status of the individual. We found that claim closure was associated with lower levels of disability, but the time to claim closure was significantly longer than the time to self-reported recovery. Time to claim closure may be used with caution as a "proxy" measure of recovery from an injury; however, it must be noted that it over-estimates the true time of recovery.

  16. 28 CFR 104.31 - Procedure for claims evaluation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... COMPENSATION FUND OF 2001 Claim Intake, Assistance, and Review Procedures § 104.31 Procedure for claims..., described herein as “Track A” and “Track B,” selected by the claimant on the Personal Injury Compensation Form or Death Compensation Form. (1) Procedure for Track A. The Claims Evaluator shall determine...

  17. 32 CFR 536.44 - FECA and LSHWCA claims exclusions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... exclusions. A federal or NAFI employee's personal injury or wrongful death claim payable under the Federal... 32 National Defense 3 2010-07-01 2010-07-01 true FECA and LSHWCA claims exclusions. 536.44 Section 536.44 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS...

  18. Personality disorder symptomatology and neuropsychological functioning in closed head injury.

    PubMed

    Ruocco, Anthony C; Swirsky-Sacchetti, Thomas

    2007-01-01

    Despite an emerging literature characterizing the neuropsychological profiles of borderline, antisocial, and schizotypal personality disorders, relations between personality disorder traits and neurocognitive domains remain unknown. The authors examined associations among Millon Clinical Multiaxial Inventory-III personality disorder scales and eight neuropsychological domains in 161 patients referred for neuropsychological evaluation following closed head injury. Most personality disorder scales were associated with some decrement in cognitive function, particularly speeded processing, executive function, and language, while histrionic and narcissistic scales had positive relations with neuropsychological functioning. Results suggest that many personality disorder traits are related to neurocognitive function, particularly those functions subserved by frontal and temporal regions.

  19. Second WCB claims: who is at risk?

    PubMed

    Cherry, Nicola M; Sithole, Fortune; Beach, Jeremy R; Burstyn, Igor

    2010-01-01

    Many workers with one Workers' Compensation Board (WCB) claim make further claims. If the characteristics of the job, initial injury or worker were predictive of an early second claim, interventions at the time of return to work after the first claim might be effective in reducing the burden of work-related injury. This report explores the characteristic of those who make a second claim. Records of all Alberta WCB claims from January 1, 1995, to December 31, 2004, for individuals 18 to < 66 years old were reviewed. For each individual's first claim, sex and age of claimant, type of injury, type of accident, occupation, industry, an indicator of company size, and industry claim rate were extracted, as well as the date of any second claim. The likelihood of second claim and mean time to second claim were estimated. Multivariate analyses were performed using Cox regression. 1,047,828 claims were identified from 490,230 individuals. Of these, 49.2% had at least two claims. In the multivariate model a reduced time to second claim was associated with male sex, younger age and some types of injury and accident. Machining trades were at highest risk of early second claim (hazard ratio [HR] 2.54 compared with administration), and of the industry sectors manufacturing was at highest risk (HR 1.37 compared with business, personal and professional services). Some caution is needed in interpreting these data as they may be affected by under-reporting and job changes between claims. Nonetheless, they suggest that there remains room for interventions to reduce the considerable differences in risk of a second claim among workers, jobs and industries.

  20. 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.…

  1. 32 CFR 536.35 - Unique issues related to environmental claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the United States based on contamination by toxic substances found in the air or the ground must be... geographical jurisdiction over the claim and USARCS. Claims for personal injury from contamination frequently arise at an area that is the subject of claims for cleanup of the contamination site. The cleanup claims...

  2. 32 CFR 536.35 - Unique issues related to environmental claims.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the United States based on contamination by toxic substances found in the air or the ground must be... geographical jurisdiction over the claim and USARCS. Claims for personal injury from contamination frequently arise at an area that is the subject of claims for cleanup of the contamination site. The cleanup claims...

  3. 32 CFR 536.35 - Unique issues related to environmental claims.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... issues related to environmental claims. Claims for property damage, personal injury, or death arising in... 32 National Defense 3 2012-07-01 2009-07-01 true Unique issues related to environmental claims. 536.35 Section 536.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS...

  4. 32 CFR 536.35 - Unique issues related to environmental claims.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... issues related to environmental claims. Claims for property damage, personal injury, or death arising in... 32 National Defense 3 2014-07-01 2014-07-01 false Unique issues related to environmental claims. 536.35 Section 536.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS...

  5. 32 CFR 536.35 - Unique issues related to environmental claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... issues related to environmental claims. Claims for property damage, personal injury, or death arising in... 32 National Defense 3 2013-07-01 2013-07-01 false Unique issues related to environmental claims. 536.35 Section 536.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS...

  6. 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…

  7. 29 CFR 15.304 - Are there limits to claims for loss of or damages to personal property under the WIA?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... personal property under the WIA? 15.304 Section 15.304 Labor Office of the Secretary of Labor... Operation of the Job Corps § 15.304 Are there limits to claims for loss of or damages to personal property under the WIA? (a) Only claims involving damage or loss to personal property that occurred while at the...

  8. 29 CFR 15.304 - Are there limits to claims for loss of or damages to personal property under the WIA?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... personal property under the WIA? 15.304 Section 15.304 Labor Office of the Secretary of Labor... Operation of the Job Corps § 15.304 Are there limits to claims for loss of or damages to personal property under the WIA? (a) Only claims involving damage or loss to personal property that occurred while at the...

  9. 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.

  10. 29 CFR 15.4 - Administrative claim; where to file.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... accompanied by a claim for money damages in a sum certain for injury to or loss of property or personal injury... hereunder to the Council for Claims and Compensation, Office of the Solicitor of Labor, U.S. Department of... 29 Labor 1 2010-07-01 2010-07-01 true Administrative claim; where to file. 15.4 Section 15.4 Labor...

  11. 32 CFR 536.76 - Claims not payable under the Military Claims Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... which was in violation of DA directives, such as illegal war trophies. (e) Claims for rent, damage, or other payments involving the acquisition, use, possession or disposition of real property or interests... example, claims for property damage or loss or personal injury or death of inhabitants of unfriendly...

  12. 32 CFR 536.76 - Claims not payable under the Military Claims Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... which was in violation of DA directives, such as illegal war trophies. (e) Claims for rent, damage, or other payments involving the acquisition, use, possession or disposition of real property or interests... example, claims for property damage or loss or personal injury or death of inhabitants of unfriendly...

  13. 32 CFR 536.76 - Claims not payable under the Military Claims Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... which was in violation of DA directives, such as illegal war trophies. (e) Claims for rent, damage, or other payments involving the acquisition, use, possession or disposition of real property or interests... example, claims for property damage or loss or personal injury or death of inhabitants of unfriendly...

  14. 32 CFR 536.76 - Claims not payable under the Military Claims Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... which was in violation of DA directives, such as illegal war trophies. (e) Claims for rent, damage, or other payments involving the acquisition, use, possession or disposition of real property or interests... example, claims for property damage or loss or personal injury or death of inhabitants of unfriendly...

  15. 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

  16. 9 CFR 201.33 - Persons damaged may maintain suit; filing and notification of claims; time limitations; legal...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Persons damaged may maintain suit; filing and notification of claims; time limitations; legal expenses. 201.33 Section 201.33 Animals and Animal Products GRAIN INSPECTION, PACKERS AND STOCKYARDS ADMINISTRATION (PACKERS AND STOCKYARDS PROGRAMS...

  17. Vocational Interests of Persons with Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Rohe, Daniel E.; Athelstan, Gary T.

    1982-01-01

    Studied vocational interests of persons with spinal cord injury. Using the Strong Campbell Interest Inventory, participants' scores were compared to norms for men and women in general on the inventory. Showed their interests were often incongruent with their physical limitations and suggested that counselors must assist in identifying vocational…

  18. Treating persons with traumatic brain injury: history and updates.

    PubMed

    Niemeier, Janet P; Grafton, Lori M; Chilakamarri, Tara

    2015-04-01

    The scientific traumatic brain injury (TBI) literature chronicles 50 years of epidemiologic data, neurobehavioral and cognitive symptoms, diagnostic tools for measuring outcomes, and treatments for persons with TBI. In this article, we review the state of our knowledge about TBI causes and symptom complexities, evidence-based treatments, and ongoing treatment needs.

  19. 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

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

    PubMed

    Elbers, Nieke A; Akkermans, Arno J; Cuijpers, Pim; Bruinvels, David J

    2011-02-02

    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. 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. This study evaluates the effectiveness of an

  1. Seasonality in acute liver injury? Findings in two health care claims databases.

    PubMed

    Weinstein, Rachel B; Schuemie, Martijn J; Ryan, Patrick B; Stang, Paul E

    2016-01-01

    Presumed seasonal use of acetaminophen-containing products for relief of cold/influenza ("flu") symptoms suggests that there might also be a corresponding seasonal pattern for acute liver injury (ALI), a known clinical consequence of acetaminophen overdose. The objective of this study was to determine whether there were any temporal patterns in hospitalizations for ALI that would correspond to assumed acetaminophen use in cold/flu season. In the period 2002-2010, monthly hospitalization rates for ALI using a variety of case definitions were calculated. Data sources included Truven MarketScan(®) Commercial Claims and Encounters (CCAE) and Medicare Supplemental and Coordination of Benefits (MDCR) databases. We performed a statistical test for seasonality of diagnoses using the periodic generalized linear model. To validate that the test can distinguish seasonal from nonseasonal patterns, we included two positive controls (ie, diagnoses of the common cold [acute nasopharyngitis] and influenza), believed to change with seasons, and two negative controls (female breast cancer and diabetes), believed to be insensitive to season. A seasonal pattern was observed in monthly rates for common cold and influenza diagnoses, but this pattern was not observed for monthly rates of ALI, with or without comorbidities (cirrhosis or hepatitis), breast cancer, or diabetes. The statistical test for seasonality was significant for positive controls (P<0.001 for each diagnosis in both databases) and nonsignificant for ALI and negative controls. No seasonal pattern was observed in the diagnosis of ALI. The positive and negative controls showed the expected patterns, strengthening the validity of the statistical and visual tests used for detecting seasonality.

  2. 32 CFR 750.45 - Filing claim.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... inhabitants. (4) States and their political subdivisions (including agencies). (5) Prisoners of war for personal property, but not personal injury. (6) Subrogees, to the extent they paid the claim. (b) Who may... occurs in time of war or armed conflict, however, or if war or armed conflict intervenes within 2 years...

  3. 32 CFR 750.45 - Filing claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... inhabitants. (4) States and their political subdivisions (including agencies). (5) Prisoners of war for personal property, but not personal injury. (6) Subrogees, to the extent they paid the claim. (b) Who may... occurs in time of war or armed conflict, however, or if war or armed conflict intervenes within 2 years...

  4. 32 CFR 750.45 - Filing claim.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... inhabitants. (4) States and their political subdivisions (including agencies). (5) Prisoners of war for personal property, but not personal injury. (6) Subrogees, to the extent they paid the claim. (b) Who may... occurs in time of war or armed conflict, however, or if war or armed conflict intervenes within 2 years...

  5. 32 CFR 750.45 - Filing claim.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... inhabitants. (4) States and their political subdivisions (including agencies). (5) Prisoners of war for personal property, but not personal injury. (6) Subrogees, to the extent they paid the claim. (b) Who may... occurs in time of war or armed conflict, however, or if war or armed conflict intervenes within 2 years...

  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... Text of Provisions and Clauses 52.247-21 Contractor Liability for Personal Injury and/or Property... transportation or for transportation-related services: Contractor Liability for Personal Injury and/or Property...

  7. Tradeoffs of using administrative claims and medical records to identify the use of personalized medicine for patients with breast cancer.

    PubMed

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

    2011-06-01

    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. To describe agreement, sensitivity, and specificity of administrative claims compared with medical records for 2 pairs of targeted tests and treatments for breast cancer. 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). Women (35 to 65 y of age) with incident breast cancer diagnosed in 2006 to 2007 (n=775). Use of human epidermal growth factor receptor 2 (HER2) and gene expression profiling (GEP) testing, trastuzumab, and adjuvant chemotherapy in claims and medical records. 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. 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.

  8. 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

  9. 32 CFR 750.48 - Measure of damages in injury or death cases.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... following is provided as guidance. (1) Measure of damages for overseas personal injury claims. Allowable....48 Section 750.48 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS GENERAL CLAIMS REGULATIONS Military Claims Act § 750.48 Measure of damages in injury or death cases. (a...

  10. Medical care surrounding work-related back injury claims among Washington State Union Carpenters, 1989-2003.

    PubMed

    Kucera, Kristen L; Lipscomb, Hester J; Silverstein, Barbara

    2011-01-01

    We describe medical care received through workers' compensation (WC) and union-provided insurance surrounding work-related back injuries and examine relationships between care provided and time off work among a large cohort of carpenters. Union records identified a cohort of 20,642 carpenters working in Washington State from 1989-2003 and their private health insurance claims. These data were linked to workers' compensation files from this state-run program including records of medical care. Over 74,000 WC medical encounters resulted from 2959 work-related back injuries. Eleven percent received private care for musculoskeletal back pain within 90 days of work-related injury; this proportion increased with increasing lost days. Delay to physical therapy was more prevalent among those out of work longest. The proportion of claimants with care from both systems and from private utilization only increased after the first 90 days and, for the subset with at least one paid lost work day, after return to work. Examination of medical care through both systems versus solely in workers' compensation provides a more complete understanding of back injury care while also demonstrating complexity. Differences in outcomes based upon treatment shortly after injury are worthy of further exploration.

  11. 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

  12. 24 CFR 17.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... bearing on either the responsibility of the United States for the death or the damages claimed. (c... information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required...

  13. 24 CFR 17.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... bearing on either the responsibility of the United States for the death or the damages claimed. (c... information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required...

  14. 24 CFR 17.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... bearing on either the responsibility of the United States for the death or the damages claimed. (c... information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required...

  15. 24 CFR 17.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... bearing on either the responsibility of the United States for the death or the damages claimed. (c... information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required...

  16. 24 CFR 17.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... bearing on either the responsibility of the United States for the death or the damages claimed. (c... information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required...

  17. 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

    ... 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 the Department..., examine, adjudicate and render final decisions with respect to claims for [[Page 73052

  18. 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...

  19. In-person retail marketing claims in tobacco and E-cigarette shops in Southern California.

    PubMed

    Yang, Joshua S; Wood, Michele M; Peirce, Katelynn

    2017-01-01

    E-cigarette use has been increasing in the United States, though knowledge of potential risks and harms associated with e-cigarette use is low. Marketing of e-cigarettes may serve as a source of information to shape beliefs and attitudes toward e-cigarettes. The purpose of this study was to identify the most common marketing claims made within "vape" and tobacco shops in sales interactions with customers in demographically diverse cities. Vape and tobacco shops from three diverse cities in Southern California were selected for inclusion in the study. From May 2015 to July 2015, simulated customers asked salespeople in vape and tobacco shops how e-cigarettes compare to conventional cigarettes, and then recorded the resulting claims that were made using a standardized form designed for this purpose. Data were analyzed from January to March 2016. The most frequent claims made by sales staff were that: smoking e-cigarettes helps one quit smoking (57% of the simulated shopping interactions), e-cigarettes come in multiple flavors (54%), and e-cigarettes are healthier than conventional cigarettes (50%). Simulated customer interactions that took place in vape shops included more positive marketing claims than those that occurred in tobacco shops; this relationship approached statistical significance ( p  = .087). There was a significant relationship between city and the average number of positive e-cigarette claims made ( p  < .001). A wide range of marketing claims are made about e-cigarettes in retail settings. These may vary by geographic location, community demographics, and type of retail outlet.

  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, 2010 CFR

    2010-01-01

    ... pollutant or contaminant attributable to DOE? 770.9 Section 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF... a hazardous substance or pollutant or contaminant attributable to DOE? (a) If an agreement for the... contaminant that is the basis of the claim. (d) DOE may not indemnify a person or entity for a claim made...

  1. Early healthcare provider communication with patients and their workplace following a lost-time claim for an occupational musculoskeletal injury.

    PubMed

    Kosny, Agnieszka; Franche, Renée-Louise; Pole, Jason; Krause, Niklas; Côté, Pierre; Mustard, Cameron

    2006-03-01

    One of the key players in the return-to-work (RTW) and work accommodation process is the healthcare provider (HCP). This study examines the association between RTW approximately one month post injury and early, proactive HCP communication with the patient and workplace. In this cross-sectional study 187 Ontario workers completed a telephone survey 17-43 days post injury. All had accepted or pending lost-time claims for back, neck or upper extremity occupational musculoskeletal injuries. Logistic regression was used to analyze the effects of three self-reported items "your HCP told you the date you could RTW," "your HCP advised you on how to prevent re-injury or recurrence," "your HCP made contact with your workplace" on self-reported RTW. Fourteen potential confounders were also tested in the model including sex, age, income, education, occupational classification, worksite size, co-morbidity, psycho-physical work demands, pain, job satisfaction, depression, and time from injury to interview. The HCP giving a patient a RTW date (adjusted OR=3.33, 95% CI=1.62-6.87) and giving a patient guidance on how to prevent recurrence and re-injury (adjusted OR=2.71, 95% CI=1.24-5.95) were positively associated with an early RTW. Contact by the HCP with the workplace was associated with RTW, however, this association became weaker upon adjusting for confounding variables (crude OR=2.11, 95% C1=1.09-4.09; adjusted OR=1.72, 95% CI=0.83-3.58). Our study lends support to the HCP playing an active role early in the RTW process, one that includes direct contact with the workplace and proactive communication with the patient.

  2. Capturing the psychologic-personal perspective in spinal cord injury.

    PubMed

    Geyh, Szilvia; Müller, Rachel; Peter, Claudio; Bickenbach, Jerome E; Post, Marcel W M; Stucki, Gerold; Cieza, Alarcos

    2011-11-01

    The overall objective of this study was to illustrate a systematic approach for capturing the psychologic-personal perspective in International Classification of Functioning, Disability and Health-based comprehensive research on spinal cord injury (SCI) in terms of what and how to measure. The specific aims were to identify (1) relevant areas of research for capturing the psychologic-personal factors in a study that is planned and conceptualized according to the comprehensive context of the International Classification of Functioning, Disability and Health, using SCI as a case in point; (2) a set of domains relevant for SCI research from a psychologic-personal perspective; and (3) suitable measurement instruments that can be considered for the assessment of those identified domains based on a set of predefined guiding principles. The psychologic-personal factor structure was developed based on an item pool of 1246 entries from secondary analyses of available data from SCI studies. The domain set for psychologic-personal factors was identified through reviewing the scientific literature in PubMed and PsycInfo. The set of measurement instruments was collected using available measurement reviews, searches in the literature, instrument databases, and further sources and was selected using guiding principles. Forty specific psychologic-personal factors, subdivided into seven areas of research, were identified: (1) sociodemographic personal characteristics, (2) the position in the immediate social and physical context, (3) personal history and biography, (4) feelings, (5) thoughts and beliefs, (6) motives, and (7) patterns of experience and behavior. The psychologic-personal factors domain set contains both cross-cutting outcome domains, namely quality-of-life, life satisfaction, subjective well-being, and sociodemographic personal characteristics, life events, positive and negative affect, perceived stress, locus of control, self-efficacy, purpose in life, coping

  3. Personality predictors of injury-related posttraumatic stress disorder.

    PubMed

    Fauerbach, J A; Lawrence, J W; Schmidt, C W; Munster, A M; Costa, P T

    2000-08-01

    This longitudinal, cohort study examined the effect of personality traits on the emergence of posttraumatic stress disorder (PTSD) in a recently traumatized, civilian, mixed-gender sample with significant injuries. Burn survivors (N = 70) were administered the NEO-Personality Inventory (NEO-PI) and the Structured Clinical Interview for DSM III-R (SCID) at hospital discharge and readministered the SCID 4 and 12 months later. Overall, the sample of burn survivors scored significantly higher on neuroticism and extraversion and lower on openness, agreeableness, and conscientiousness relative to a normative national sample. Furthermore, multivariate analysis of variance revealed that PTSD symptom severity groups (i.e., single symptom, multiple symptoms, subthreshold PTSD, PTSD) were differentially related to neuroticism and extraversion. Planned comparisons indicated that neuroticism was higher and extraversion was lower in those who developed PTSD compared with those who did not develop PTSD.

  4. Claim rates of compensable back injuries by age, gender, occupation, and industry. Do they relate to return-to-work experience?

    PubMed

    Gluck, J V; Oleinick, A

    1998-07-15

    A retrospective cohort study of Michigan workers' compensation cases involving back injuries in 1986 and 1987 with incidence and outcome data. To determine claim rates by age, gender, and industry or occupation for compensable back injuries and to investigate the relation between occupation and return to work. The cohort of 24,094 Michigan workers' compensation cases from 1986 and 1987 in which claimants were compensated for back injuries was reviewed. Compensation eligibility requires more than 7 days' disability after injury. Claim rates for back injuries by age, gender, and industry or occupation using employment data interpolated from 1980 and 1990 Census 1% Public Use Microdata Samples. Cox proportional hazards analysis was performed for return to work in the first 8 weeks after injury, with occupation coded at the three-digit level. All-age claim rates for Michigan compensable back injuries by occupation ranged between 0.03% and 1.7% annually (0.39% for all cases) and were generally higher in women in white collar occupations and in men in blue collar occupations. The claim rate peaked in men in the 25-34 year range, with the highest rates in manual labor occupations. The peak claim rates by age were less marked in women, tending to occur broadly throughout the 25-44-year range. Similar all-age values were recorded by industry. The male-to-female risk ratio over all occupations does not vary by age and is approximately 1.4:1. As the classification of occupation became more detailed, large differences in risk were documented within major occupation groups. The highest risk in this study was approximately 6% annually for 25-44 year old men in driver-sales (beverage truck drivers and delivery workers). Only 7 of 40 occupation categories showed a significant relative hazard for return to work in the first 8 weeks after injury, and these were blue collar occupations with earlier return than the reference sales category. For Michigan compensable back injuries, a

  5. Gender differences in work-related injury/illness: analysis of workers compensation claims.

    PubMed

    Islam, S S; Velilla, A M; Doyle, E J; Ducatman, A M

    2001-01-01

    Risk of work-related injuries/illnesses among females has not been well documented. This study compares compensable work-related injuries/illnesses between females and males across all major industrial sectors and occupations using a state-managed Workers Compensation database. Incidence rates were calculated by dividing the number of compensable injuries/illnesses among West Virginia Workers Compensation claimants by the total number of female and male workers in each specific industry class (based on SIC codes). Gender-specific denominators for occupations were estimated using 1990 U.S. Census data. The overall injury/illness rate was significantly lower in females than males (5. 5 vs. 11.5 per 100 employees), a trend that extended to all major industrial classes with the exception of service and agricultural sectors. The distribution of types of injury/illness varied by gender, occupation, and industry with significantly higher risk of carpal tunnel syndrome, burn, sprain, and fracture in females compared to males. Female workers have a greater risk of specific injury/illness compared to males in various industries. Further research will be needed to understand the role of differential job-tasks within each occupation in explaining the risk difference. Copyright 2001 Wiley-Liss, Inc.

  6. Measuring Fatigue in Persons with Spinal Cord Injury

    PubMed Central

    Anton, Hubert A.; Miller, William C.; Townson, Andrea F.

    2013-01-01

    Objective To evaluate the psychometric properties of the Fatigue Severity Scale (FSS) in persons with spinal cord injury (SCI). Design A two week methodological study was conducted to assess the internal consistency, reliability and the construct validity of the FSS. Setting A tertiary spinal cord rehabilitation facility. Participants 48 community living individuals at least one year post SCI with ASIA A or B SCI and no medical conditions causing fatigue. Main Outcome Measures The ASIA Impairment Scale; the FSS; a Visual Analogue Scale for Fatigue (VAS-F), the SF-36 vitality scale, and the Centre for Epidemiological Studies Depression – Scale (CES-D) Results Our sample was predominantly male (n=31, 65%) with tetraplegia (n=26, 54%) and ASIA A injuries (n=30, 63%). The mean FSS score at baseline was 4.4 (SD=1.4) with 54% (N=26) scoring greater than 4. The internal consistency of the FSS was Cronbach’s alpha = 0.89. Two-week test-retest reliability was ICC=0.84 (95% CI 0.74 – 0.90). The magnitude of the relationship was as hypothesized for the VAS-F(r=.67) and CES-D (r=.58) and lower than hypothesized for the vitality subscore (r=−.48) of the SF-36. Conclusions The FSS has acceptable reliability with regard to internal consistency, test-retest reliability, and validity in persons with motor complete SCI. PMID:18295634

  7. 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

  8. 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…

  9. 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

  10. Work-Related Illness and Injury Claims Among Nationally Certified Athletic Trainers Reported to Washington and California From 2001 to 2011

    PubMed Central

    Kucera, Kristen L.; Roos, Karen G.; Hootman, Jennifer M.; Lipscomb, Hester J.; Dement, John M.; Silverstein, Barbara A.

    2017-01-01

    Background Little is known about the work-related injury and illnesses experienced by certified athletic trainers (AT). Methods The incidence and characteristics of injury/illness claims filed in two workers’ compensation systems were described from 2001 to 2011. Yearly populations at risk were estimated from National Athletic Trainers’ Association membership statistics. Incidence rate ratios (IRR) were reported by job setting. Results Claims were predominantly for traumatic injuries and disorders (82.7%: 45.7% sprains/strains, 12.0% open wounds, 6.5% bruises) and at these body sites (back 17.2%, fingers 12.3%, and knee 9.6%) and over half were caused by body motion and overexertion (51.5%). Compared with school settings, clinic/hospital settings had modestly higher claim rates (IRR = 1.29, 95% CI: 1.06–1.52) while other settings (e.g., professional or youth sport, nursing home) had lower claim rates (IRR = 0.63, 95% CI: 0.44–0.70). Conclusions These first known estimates of work-related injuries/illnesses among a growing healthcare profession help identify occupational tasks and settings imposing injury risk for ATs. PMID:27779316

  11. Claims-Based Identification Methods and the Cost of Fall-related Injuries among U.S. Older Adults

    PubMed Central

    Hoffman, Geoffrey J.; Hays, Ron D.; Shapiro, Martin; Wallace, Steven P.; Ettner, Susan L.

    2016-01-01

    Objectives Compare expenditures of fall-related injuries (FRIs) using several methods to identify FRIs in administrative claims data. Research Design Using 2007-2009 Medicare claims and 2008 Health and Retirement Survey data, FRIs were identified using external-cause-of-injury (e-codes 880/881/882/884/885/888) only, e-codes plus a broad set of primary diagnosis codes, and a newer approach using e-codes and diagnostic and procedural codes. Linear regression models adjusted for sociodemographic, health, and geographic characteristics were used to estimate per-FRI, service component, patient cost share, expenditures by type of initial FRI treatment (inpatient, ED only, outpatient) and total annual FRI-related Medicare expenditures. Subjects The analysis included 5,497 community-dwelling adults ≥65 (228 FRI, 5,269 non-FRI individuals) with continuous Medicare coverage and alive during the 24-month study. Results The 3 FRI identification methods produced differing distributions of index FRI type and varying estimated expenditures: $12,171 (95% CI: $4,662-$19,680), $5,648 (95% CI: $3,819-$7,476), and $9,388 (95% CI: $5,969-$12,808). In all models, most spending occurred in hospital, outpatient, and SNF settings, but greater proportions of SNF and outpatient spending were observed with commonly used FRI identification methods. Patient cost-sharing was estimated at $691 to $1,900 across the three methods. Inpatient-treated index FRIs were more expensive than ED and outpatient-treated FRIs across all methods, but were substantially higher when identifying FRI using only e-codes. Estimated total FRI-related Medicare expenditures were highly variable across methods. Conclusion FRIs are costly, with implications for Medicare and its beneficiaries. However, expenditure estimates vary considerably based on the method used to identify FRIs. PMID:27057747

  12. The Risk of Hospital Admission Due to Traumatic Brain Injury Is Increased in Older Persons With Severe Functional Limitations.

    PubMed

    Büchele, Gisela; Rapp, Kilian; König, Hans-Helmut; Jaensch, Andrea; Rothenbacher, Dietrich; Becker, Clemens; Benzinger, Petra

    2016-07-01

    Hospital admissions due to traumatic brain injuries (TBIs) in older persons are increasing. Falls are the leading mechanism of injury in this age group. TBIs are associated with unfavorable outcomes such as mortality and institutionalization. To estimate rates of TBIs in older persons with severe functional limitations, expressed as "care need," living in the community, and in older persons with care need living in nursing homes compared with older persons without care need. More than 1.2 million persons aged 65 years and older living in Bavaria, Germany, and insured with one of the largest German health insurances (health care and long-term care insurance). Age-standardized rates were calculated based on hospital claims data and claims data of the long-term care insurance and were compared between groups. The 3 groups were defined by claims data of the long-term care insurance. TBI in older persons account for 4.8 hospital admissions per 1000 person-years. Overall TBI rates do not differ significantly between men and women. TBI rates are lowest in persons without care need and are highest for older persons living in nursing homes. Their contribution to the overall burden of TBI is lower than their contribution to the burden of fragility fractures. TBIs in older persons are common. Those with severe functional limitations are at increased risk for TBI. Nursing home residents have the highest rates of TBI. Fall prevention programs should seek to prevent not only fragility fractures but also head impact. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  13. 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…

  14. 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

  15. Self-care competence among persons with spinal cord injury.

    PubMed

    Boss, B J; Pecanty, L; McFarland, S M; Sasser, L

    1995-06-01

    The authors of this article report the results of a secondary data analysis which examined the self-care competence of persons with spinal cord injury (SCI) and the retention of cognitive and functional skills following discharge from acute rehabilitation as well as additional learning of self-care following discharge. The sample consisted of 48 persons with SCI from two Veterans Affairs Medical Centers and a state university affiliated rehabilitation program. The data collection tool was the Self-Care Assessment Tool (SCAT) which measures cognitive and functional skills in eight self-care areas: bathing/grooming, nutritional management, taking medications, mobility/transfer/safety, skin management, bladder management, bowel management, and dressing. The overall self-care competence of the participants was high (mean = 78.25) as was their competence in the eight self-care areas. In general, participants retained both the cognitive information and functional skills learned in the acute rehabilitation setting and also continued to learn after discharge in both cognitive information and functional skills.

  16. 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…

  17. Death at no cost? Persons with no health insurance claims in the last year of life in Switzerland.

    PubMed

    Panczak, Radoslaw; von Wyl, Viktor; Reich, Oliver; Luta, Xhyljeta; Maessen, Maud; Stuck, Andreas E; Berlin, Claudia; Schmidlin, Kurt; Goodman, David C; Egger, Matthias; Clough-Gorr, Kerri; Zwahlen, Marcel

    2018-03-14

    Lack of health insurance claims (HIC) in the last year of life might indicate suboptimal end-of-life care, but reasons for no HIC are not fully understood because information on causes of death is often missing. We investigated association of no HIC with characteristics of individuals and their place of residence. We analysed HIC of persons who died between 2008 and 2010, which were obtained from six providers of mandatory Swiss health insurance. We probabilistically linked these persons to death certificates to get cause of death information and analysed data using sex-stratified, multivariable logistic regression. Supplementary analyses looked at selected subgroups of persons according to the primary cause of death. The study population included 113,277 persons (46% males). Among these persons, 1199 (proportion 0.022, 95% CI: 0.021-0.024) males and 803 (0.013, 95% CI: 0.012-0.014) females had no HIC during the last year of life. We found sociodemographic and health differentials in the lack of HIC at the last year of life among these 2002 persons. The likelihood of having no HIC decreased steeply with older age. Those who died of cancer were more likely to have HIC (adjusted odds ratio for males 0.17, 95% CI: 0.13-0.22; females 0.19, 95% CI: 0.12-0.28) whereas those dying of mental and behavioural disorders (AOR males 1.83, 95% CI:1.42-2.37; females 1.65, 95% CI: 1.27-2.14), and males dying of suicide (AOR 2.15, 95% CI: 1.72-2.69) and accidents (AOR 2.41, 95% CI: 1.96-2.97) were more likely to have none. Single, widowed, and divorced persons also were more likely to have no HIC (AORs in range of 1.29-1.80). There was little or no association between the lack of HIC and characteristics of region of residence. Patterns of no HIC differed across main causes of death. Associations with age and civil status differed in particular for persons who died of cancer, suicide, accidents and assaults, and mental and behavioural disorders. Particular groups might be more

  18. Geographic variation in expenditures for workers' compensation physician claims.

    PubMed

    Miller, T R; Levy, D T

    1997-07-01

    We examine interstate variations in the cost of claims for physician care using injury claims from Worker's Compensation, and consider some of the factors that may explain cost differences. Multivariate regression analysis is used to isolate state variations, while controlling for personal and injury characteristics, and state characteristics. Statistical analyses reveal considerable variation in expenditures for physician care of injuries across states, even after controlling for case mix and state characteristics. We also find that the presence of HMOs and of general practitioners as a percent of physicians are associated with lower claims, and that the percent of the state that is urban is associated with higher claims. The large variation in costs suggests a potential to affect the costs of physician care for work-related injuries.

  19. Rasch analysis of measurement instruments capturing psychological personal factors in persons with spinal cord injury.

    PubMed

    Peter, Claudio; Schulenberg, Stefan E; Buchanan, Erin M; Prodinger, Birgit; Geyh, Szilvia

    2016-02-01

    To evaluate the metric properties of distinct measures of psychological personal factors comprising feelings, beliefs, motives, and patterns of experience and behaviour assessed in the Swiss Spinal Cord Injury Cohort Study (SwiSCI), using Rasch methodology. SwiSCI Pathway 2 is a community-based, nationwide, cross-sectional survey for persons with spinal cord injury (SCI) (n = 511). The Rasch partial credit model was used for each subscale of the Positive Affect Negative Affect Scale (PANAS), Appraisal of Life Events Scale (ALE), Purpose in Life test - Short Form (PIL-SF), and the Big Five Inventory-K (BFI-K). The measures were unidimensional, with the exception of the positive affect items of the PANAS, where pairwise t-tests resulted in 10% significant cases, indicating multidimensionality. The BFI-K subscale agreeableness revealed low reliability (0.53). Other reliability estimates ranged between 0.61 and 0.89. Ceiling and floor effects were found for most measures. SCI-related differential item functioning (DIF) was rarely found. Language DIF was identified for several items of the BFI-K, PANAS and the ALE, but not for the PIL-SF. A majority of the measures satisfy the assumptions of the Rasch model, including unidimensionality. Invariance across language versions still represents a major challenge.

  20. 32 CFR 564.55 - Claims not payable.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... (a) Contributory negligence. Negligence or wrongful act of the claimant or of his agent or employee... or incident occurred will be followed in determining whether contributory negligence is present but the doctrine of comparative negligence will not be applied. (b) Personal injury. Claims for personal...

  1. 32 CFR 536.121 - Claims not payable as maritime claims.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... governing statute, for example, claims for property loss or damage or personal injury or death by.... (d) Are presented by a national, or a corporation controlled by a national, of a country at war or... friendly to the United States. A prisoner of war or an interned enemy alien is not excluded or barred from...

  2. 32 CFR 536.121 - Claims not payable as maritime claims.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... governing statute, for example, claims for property loss or damage or personal injury or death by.... (d) Are presented by a national, or a corporation controlled by a national, of a country at war or... friendly to the United States. A prisoner of war or an interned enemy alien is not excluded or barred from...

  3. 32 CFR 536.121 - Claims not payable as maritime claims.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... governing statute, for example, claims for property loss or damage or personal injury or death by.... (d) Are presented by a national, or a corporation controlled by a national, of a country at war or... friendly to the United States. A prisoner of war or an interned enemy alien is not excluded or barred from...

  4. 32 CFR 536.121 - Claims not payable as maritime claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... governing statute, for example, claims for property loss or damage or personal injury or death by.... (d) Are presented by a national, or a corporation controlled by a national, of a country at war or... friendly to the United States. A prisoner of war or an interned enemy alien is not excluded or barred from...

  5. 32 CFR 536.136 - Scope for claims arising under the Foreign Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... foreign country or a political subdivision thereof, against the United States for personal injury, death... wrongful death case, if the decedent is an inhabitant of a foreign country, even though his survivors are U... foreign-born spouces, see DA Pam 27-20, paragraph 2-20a. (c) Effect of Army Maritime Claims Settlement Act...

  6. 32 CFR 536.136 - Scope for claims arising under the Foreign Claims Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... foreign country or a political subdivision thereof, against the United States for personal injury, death... wrongful death case, if the decedent is an inhabitant of a foreign country, even though his survivors are U... foreign-born spouces, see DA Pam 27-20, paragraph 2-20a. (c) Effect of Army Maritime Claims Settlement Act...

  7. 32 CFR 536.136 - Scope for claims arising under the Foreign Claims Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... foreign country or a political subdivision thereof, against the United States for personal injury, death... wrongful death case, if the decedent is an inhabitant of a foreign country, even though his survivors are U... foreign-born spouces, see DA Pam 27-20, paragraph 2-20a. (c) Effect of Army Maritime Claims Settlement Act...

  8. 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)

  9. Symptomatic cervical disc herniation following a motor vehicle collision: return to work comparative study of workers' compensation versus personal injury insurance status.

    PubMed

    Scuderi, Gaetano J; Sherman, Andrew L; Brusovanik, Georgiy V; Pahl, Michael A; Vaccaro, Alexander R

    2005-01-01

    Patients with approved workers' compensation injuries receive guaranteed compensation for the duration of their injury, whereas patients with personal injury claims are only compensated, if at all, at the time of a successful settlement or trial verdict at a time point distant from their injury. This study compares the financial impact and loss of work patterns due to a workers' compensation (WC) claim or personal injury in patients with a symptomatic cervical disc herniation resulting from a motor vehicle collision. A prospective study of patients who were seen by a single spine specialist between 1/2/96 and 9/1/01. A consecutive evaluation of 531 patients who were treated for a cervical pain syndrome caused by a motor vehicle collision. Mechanism of injury and insurance type, ie, workers' compensation or personal injury, was recorded for each patient as well as treatment response and return to work patterns. The data were analyzed using the two-way Z test. All patients were managed in a similar manner with noninvasive treatment initially, followed by injections, and finally surgical intervention in those who failed conservative measures. Return to work rates and work disability were determined at either final follow-up or at the last doctor's visit before loss to follow-up. 270 of 531 patients were diagnosed with a symptomatic one or two level disc herniation by a cervical magnetic resonance imaging scan. Fifty-four patients were insured through the workers' compensation board, and 216 reported their crash as a personal injury claim. In the WC group the work disability at 3 months follow-up revealed a cumulative 2,262 total lost days of work (average 37.1 days per person). At the point of maximal medical improvement (MMI) or 2-year follow-up, total days lost from work were 7,107 (average 131.6 days per person.) In the personal injury non-WC group, the 3-month follow-up of lost days of work was 1,093 days (average 5.1 days per person.) At 2 years follow-up, the

  10. 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

  11. Trunk muscle activation in a person with clinically complete thoracic spinal cord injury.

    PubMed

    Bjerkefors, Anna; Carpenter, Mark G; Cresswell, Andrew G; Thorstensson, Alf

    2009-04-01

    The aim of this study was to assess if, and how, upper body muscles are activated in a person with high thoracic spinal cord injury, clinically classified as complete, during maximal voluntary contractions and in response to balance perturbations. Data from one person with spinal cord injury (T3 level) and one able-bodied person were recorded with electromyography from 4 abdominal muscles using indwelling fine-wire electrodes and from erector spinae and 3 upper trunk muscles with surface electrodes. Balance perturbations were carried out as forward or backward support surface translations. The person with spinal cord injury was able to activate all trunk muscles, even those below the injury level, both in voluntary efforts and in reaction to balance perturbations. Trunk movements were qualitatively similar in both participants, but the pattern and timing of muscle responses differed: upper trunk muscle involvement and occurrence of co-activation of ventral and dorsal muscles were more frequent in the person with spinal cord injury. These findings prompt further investigation into trunk muscle function in paraplegics, and highlight the importance of including motor tests for trunk muscles in persons with thoracic spinal cord injury, in relation to injury classification, prognosis and rehabilitation.

  12. 29 CFR 15.5 - Administrative claim; evidence or information to substantiate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required to submit the following evidence or information: (1) An authenticated death certificate or other competent...

  13. 22 CFR 304.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... information which may have a bearing on either the responsibility of the United States for the death or the.... (6) Any other evidence or information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on...

  14. 22 CFR 304.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... information which may have a bearing on either the responsibility of the United States for the death or the.... (6) Any other evidence or information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on...

  15. 22 CFR 304.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... information which may have a bearing on either the responsibility of the United States for the death or the.... (6) Any other evidence or information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on...

  16. 29 CFR 15.5 - Administrative claim; evidence or information to substantiate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required to submit the following evidence or information: (1) An authenticated death certificate or other competent...

  17. 22 CFR 304.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... information which may have a bearing on either the responsibility of the United States for the death or the.... (6) Any other evidence or information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on...

  18. 22 CFR 304.4 - Administrative claim; evidence and information to be submitted.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... information which may have a bearing on either the responsibility of the United States for the death or the.... (6) Any other evidence or information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on...

  19. 29 CFR 15.5 - Administrative claim; evidence or information to substantiate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required to submit the following evidence or information: (1) An authenticated death certificate or other...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. Inpatient migration patterns in persons with spinal cord injury: A registry study with hospital discharge data.

    PubMed

    Ronca, Elias; Scheel-Sailer, Anke; Koch, Hans Georg; Metzger, Stefan; Gemperli, Armin

    2016-12-01

    This study investigated and compared patient migration patterns of persons with spinal cord injury, the general population and persons with morbid obesity, rheumatic conditions and bowel disease, for secondary health conditions, across administrative boundaries in Switzerland. The effects of patient characteristics and health conditions on visiting hospitals outside the residential canton were examined using complete, nationwide, inpatient health records for the years 2010 and 2011. Patients with spinal cord injury were more likely to obtain treatment outside their residential canton as compared to all other conditions. Facilitators of patient migration in persons with spinal cord injury and the general hospital population were private or accidental health insurances covering costs. Barriers of patient migration in persons with spinal cord injury were old age, severe multimorbidity, financial coverage by basic health insurance, and minority language region.

  5. Personality and behavioural change after severe blunt head injury--a relative's view.

    PubMed Central

    Brooks, D N; McKinlay, W

    1983-01-01

    A close relative of 55 severely head injured adults rated the personality of the patient at 3, 6 and 12 months after injury, using a Yes/No judgement, and analogue scales comprising bipolar adjectives. The relative assessed the "current" as well as the "premorbid" personality at each time. Personality change was associated with many negative scores on the analogue scale, and increasing negative scores were associated with high "subjective burden" on the relative. Severity of injury (post-traumatic amnesia) was of no significance in predicting the extent or pattern of personality change. PMID:6842246

  6. 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.

  7. 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

  8. Protect Against Personal Injury to Limit Your Liability.

    ERIC Educational Resources Information Center

    Greene, Brenda Z.

    1985-01-01

    Accidents and injuries involving students, employees, or others using school facilities or equipment can result in lengthy and costly litigation. A proven way to reduce potential accidents and injuries is to work to eliminate the circumstances in which accidents occur. It is important to identify risks; the areas with the highest accident…

  9. 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…

  10. 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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. 32 CFR 536.129 - Claims cognizable as UCMJ claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Personnel Claims Act and chapter 11 of AR 27-20, which provides compensation only for tangible personal... 32 National Defense 3 2010-07-01 2010-07-01 true Claims cognizable as UCMJ claims. 536.129 Section 536.129 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS...

  12. 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…

  13. 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.

  14. 20 CFR 362.9 - Fraudulent claims.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... has intentionally misrepresented an item claimed, as to cost, condition, cost of repair or other significant information, the claim as to that item will be disallowed in its entirety even though some actual...' PERSONAL PROPERTY CLAIMS § 362.9 Fraudulent claims. Claims are not payable for items fraudulently claimed...

  15. 20 CFR 362.9 - Fraudulent claims.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... has intentionally misrepresented an item claimed, as to cost, condition, cost of repair or other significant information, the claim as to that item will be disallowed in its entirety even though some actual...' PERSONAL PROPERTY CLAIMS § 362.9 Fraudulent claims. Claims are not payable for items fraudulently claimed...

  16. 24 CFR 17.67 - Claims files.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... ADMINISTRATIVE CLAIMS Procedures for the Collection of Claims by the Government General Provisions § 17.67 Claims files. Each claims collection officer is responsible for obtaining current credit data about each person... Department Claims Officer for claims referred to the Assistant Secretary for Administration for collection...

  17. 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…

  18. Personalized Medicine in Veterans with Traumatic Brain Injuries

    DTIC Science & Technology

    2011-05-01

    autism and Prader - Willi -like characteristics are found to have reduced levels of HBII52 in the brain (Hogart et al., J Med Genet 46(2):86-93, 2009...indices of Persistent Postconcussive Syndrome as well as well as other significant injury-related factors associated with mild TBI in OEF/OIF veterans

  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, 2010 CFR

    2018-01-01

    ... 10 Energy 4 2018-01-01 2018-01-01 false What conditions apply to DOE indemnification of claims against a person or entity based on the release or threatened release of a hazardous substance or pollutant or contaminant attributable to DOE? § 770.9 Section § 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIE...

  20. Workers' compensation claims for musculoskeletal disorders and injuries of the upper extremity and knee among union carpenters in Washington State, 1989-2008.

    PubMed

    Lipscomb, Hester J; Schoenfisch, Ashley L; Cameron, Wilfrid; Kucera, Kristen L; Adams, Darrin; Silverstein, Barbara A

    2015-04-01

    Numerous aspects of construction place workers at risk of musculoskeletal disorders and injuries (MSDIs). Work organization and the nature of MSDIs create surveillance challenges. By linking union records with workers' compensation claims, we examined 20-year patterns of MSDIs involving the upper extremity (UE) and the knee among a large carpenter cohort. MSDIs were common and accounted for a disproportionate share of paid lost work time (PLT) claims; UE MSDIs were three times more common than those of the knee. Rates declined markedly over time and were most pronounced for MSDIs of the knee with PLT. Patterns of risk varied by extremity, as well as by age, gender, union tenure, and predominant work. Carpenters in drywall installation accounted for the greatest public health burden. A combination of factors likely account for the patterns observed over time and across worker characteristics. Drywall installers are an intervention priority. © 2015 Wiley Periodicals, Inc.

  1. Complications and patient-injury after ankle fracture surgery. -A closed claim analysis with data from the Patient Compensation Association in Denmark.

    PubMed

    Bjørslev, Naja; Ebskov, Lars Bo; Mersø, Camilla; Wong, Christian

    2018-02-01

    The Patient Compensation Association (PCA) receives claims for financial compensation from patients who believe they have sustained damage from their treatment in the Danish health care system. In this study, we have analysed closed claims in which patients suffered injuries due to the surgical treatment of their ankle fracture. We identified causalities contributing to these injuries and malpractices, as well as the economic consequences of these damages. Fifty-one approved closed claims from the PCA database from the years 2004-2009 were analysed in a retrospective systematic review. All patients were adults with an iatrogenic injury, and received compensation. A root cause analysis was performed to identify whether the patient suffered the damage preoperatively, during surgery or postoperatively, and to determine the level of education of the injurious doctor. Economic compensation, co-morbidities and end-result complications were registered. In 9 of the cases the injuries happened preoperatively, but the majority of the injuries, namely 34 occurred during surgery. In 21 of the cases the damage happened postoperatively. Thirty percentages of the patients were mistreated in more than one phase. Level of competence was medical specialists in 2/3 and junior doctors in 1/3 of the cases. In the preoperative phase both groups were equally responsible for the inflicted damage. In the perioperative- and postoperative group, medical specialists inflicted the majority of damages. General recommendations regarding ORIF were not followed in 21/49 of the perioperative damages. The pronation fracture was the most common. The patients received a total average compensation of 17.561 USD each. Managing the complex ankle fracture, requires considerable experience. This study indicates that extra attention should be paid to the most technically demanding fractures as the pronation-external-rotation-, diabetic- and fragility fractures. Surgeons should follow the recommendations for

  2. 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)

  3. Return to Work for Persons with Traumatic Brain Injury and Spinal Cord Injury: Three Case Studies.

    ERIC Educational Resources Information Center

    Wehman, Paul; And Others

    1994-01-01

    Supported employment was utilized in the vocational rehabilitation of two people with traumatic brain injury and one with a traumatic spinal cord injury. Supported employment was found to yield real work outcomes, though it required substantial amounts of money to return the three patients to relatively low-paying jobs. Funding issues are…

  4. Exercise and sport for persons with spinal cord injury.

    PubMed

    Martin Ginis, Kathleen A; Jörgensen, Sophie; Stapleton, Jessica

    2012-11-01

    This review article provides an overview of the evidence that links exercise and sports participation to physical and psychological well-being among people with spinal cord injury. Two aspects of physical well-being are examined, including the prevention of chronic disease and the promotion of physical fitness. Multiple aspects of psychosocial well-being are discussed, including mental health, social participation, and life satisfaction. The review concludes with future research recommendations and a discussion of challenges and opportunities for using exercise and sports to promote health and well-being among people living with spinal cord injury. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  5. Personalized Medicine in Veterans with Traumatic Brain Injuries

    DTIC Science & Technology

    2013-05-01

    to identify unique molecular indices of Persistent Postconcussive Syndrome as well as well as other significant injury-related factors associated with...HBII52 small nucleolar RNA in the regulation of alternative splicing of the serotonin 2c receptor [38], and that patients with autism and Prader ... Willi -like characteristics are found to have reduced levels of HBII52 in the brain [39]. The miRNA miR132 is induced by neuronal activity and

  6. 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

  7. Multicenter Study of Sexual Functioning in Spouses/Partners of Persons With Traumatic Brain Injury.

    PubMed

    Sander, Angelle M; Maestas, Kacey Little; Pappadis, Monique R; Hammond, Flora M; Hanks, Robin A

    2016-05-01

    To investigate sexual functioning and its predictors in spouses/partners of persons with traumatic brain injury (TBI). Inception cohort survey. Community. Persons (N=70) with complicated mild to severe TBI admitted to 1 of 6 participating TBI Model Systems inpatient rehabilitation units and their spouses/partners who were both living in the community and assessed 1 year after injury. Not applicable. Derogatis Interview for Sexual Functioning Self-Report; Global Sexual Satisfaction Index. Twenty percent of spouses/partners of persons with TBI reported sexual dysfunction, and 44% reported dissatisfaction with sexual functioning. Sixty-two percent of spouses/partners reported a decrease in sexual activity during the year postinjury, 34% reported a decrease in sexual drive or desire, and 34% indicated that sexuality was less important in comparison to preinjury. The sexual functioning of spouses/partners of persons with TBI was highly associated with the sexual functioning of the person with TBI. Age of spouses/partners and sexual functioning in persons with the TBI were significant predictors of spouses'/partners' sexual functioning, even after controlling for sex of partners and the physical, cognitive, participation, and sexual functioning of the persons with injury. Greater sexual dysfunction in spouses/partners was associated with older age and with poorer sexual functioning in the person with injury. Rehabilitation professionals should provide education on the potential impact of TBI on sexual functioning for both persons with TBI and their spouses/partners, and integrate the assessment of sexual functioning into their clinical assessment, making appropriate referrals for therapy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. 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.

  9. Substance use and receipt of treatment by persons with long-term spinal cord injuries.

    PubMed

    Heinemann, A W; Doll, M D; Armstrong, K J; Schnoll, S; Yarkony, G M

    1991-06-01

    The purpose of this study was to assess the rate of self-reported substance use, consequent problems, perceived need for treatment, and receipt of treatment by persons with long-term spinal cord injury (SCI). Information was obtained from 86 persons with traumatic SCI who were between 13 and 58 years of age at injury, cognitively intact, injured more than two years earlier, English speaking, and recruited from two SCI organizations. The mean age of the sample was 39.5 years at recruitment: 69% were men. Participants reported substance use information across four periods covering six months before injury to an average of 13 years after injury. All participants reported use of substances with abuse potential at some time in their lives; the time of greatest use was injury to six months before first interview. The duration of this period ranged from 18 months to 43 years. Problems resulting from substance use were reported by 70%; more than half (52%) the sample reported problems during this postinjury period. Sixteen percent of the sample believed they needed treatment at some time; the time of greatest perceived need was in the period after injury. Treatment for substance abuse was received by 7%. Problems attributable to abuse of both prescription and nonprescription medication were reported, suggesting the importance of close monitoring of substance-use patterns in persons with SCI who are prescribed sedating or narcotic medications. Timely assessment of problems related to substance use and provision of treatment services to persons with traumatic injury are indicated to prevent a potential dual disability.

  10. 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.

  11. 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

  12. 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

  13. Health and wellness characteristics of persons with traumatic brain injury.

    PubMed

    Braden, Cynthia A; Cuthbert, Jeffrey P; Brenner, Lisa; Hawley, Lenore; Morey, Clare; Newman, Jody; Staniszewski, Kristi; Harrison-Felix, Cynthia

    2012-01-01

    To describe health and wellness characteristics of persons with TBI living in the community, compare to other disability populations and evaluate the associations between health-related constructs. Observational. Outpatient rehabilitation hospital and a Veterans Affairs Medical Centre. Seventy-four community-dwelling adults with moderate-to-severe TBI. None. Health Promoting Lifestyle Profile II (HPLP-II), Self Rated Abilities Health Practices Scale (SRAHP), Barriers to Health Promoting Activities for Disabled Scale (BHPAD), Medical Outcomes Study 12-Item Health Status Survey Short Form (SF-12), Personal Resource Questionnaire-adapted (PRQ-a), Perceived Wellness Survey (PWS), Diener Satisfaction with Life Scale (SWLS) and Participation Assessment with Recombined Tools-Objective (PART-O). Health-promoting behaviours, self-efficacy and barriers to health were comparable to other disability populations. Perceived health status, participation and life satisfaction were decreased. Measures of health promotion and self-efficacy were positively associated with perceived mental health status, life satisfaction and participation. Barriers to healthy activities were negatively associated with health promotion, self-efficacy and perceived mental health status. Health and wellness status was below desired levels for the study cohort, and comparable to other disability populations. Better understanding of associations among health-related constructs is needed. Continued research on conceptually-based health and wellness interventions for persons with TBI is recommended.

  14. 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

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [REG-127270-06] RIN 1545-BF81 Damages Received on Account of Personal Physical Injuries or Physical Sickness; Hearing AGENCY: Internal... hearing is being held in room 2615, Internal Revenue Building, 1111 Constitution Avenue, NW., Washington...

  15. 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…

  16. Type-D Personality and Elevated Psychological Symptoms In Early Adjustment of Severe Burn Injury Patients.

    PubMed

    Mujezinovic, Ajdin; Kwiet, Julia; Kornhaber, Rachel; Holt, Rachael; Streimer, Jeffrey; Vandervord, John; Rogers, Vanessa; Shaw, Joanne; Law, Jeremy; Cleary, Michelle; McLean, Loyola

    2018-04-01

    Severe burn injuries are highly traumatic requiring lengthy recovery. High levels of distress in the early stages of treatment have been associated with poor physical and psychosocial recovery outcomes. Identifying traits relating to distress and personal coping styles may aid screening. Type-D, or 'distressed', personality may be such a trait. Type-D personality refers to an ongoing personality organization defined by a tendency to experience greater negative emotions and thoughts while simultaneously socially inhibiting their expression (Denollet et al., 1996 . Type-D has been linked to poor health outcomes in those with cardiovascular disease as well as other populations and has been found to be associated with elevated psychological symptoms. Currently, there are no investigations in the literature looking at Type-D in the severe burns injury population. This study aimed to investigate Type-D in severe burn injury patients, specifically regarding the presence of psychological symptoms in early treatment, using data gathered during a pilot study conducted at a severe burn injury unit. The DS-16, Davidson Trauma scale and Depression Anxiety and Stress Scale scores were analysed along with demographic and clinical data in 54 participants (40 males, 14 females). Participants who were found to have Type-D displayed significantly higher levels of psychopathology. Additionally, Type-D was found to be a significant predictor of psychological symptoms.

  17. 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…

  18. 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…

  19. The effect of falls and fall injuries on functioning in community-dwelling older persons.

    PubMed

    Tinetti, M E; Williams, C S

    1998-03-01

    Several preventive strategies have proven effective at reducing the occurrence and rate of falling. It remains to be determined, however, whether, and to what extent, falls and/or fall injuries are independent determinants of adverse functional outcomes in older persons. A probability sample of 1,103 community-dwelling persons over age 71 years was followed for 3 years. The 957 cohort members (87%) who participated in at least one follow-up interview while residing in the community were included in this study. Outcome measures included one and three year change in basic and instrumental activities of daily living (BADLs-IADLs), social activities, and physical activities. Based on daily calendars and hospital surveillance, participants were placed into one of four levels of fall status: no falls, one fall without serious injury, at least two falls without serious injury, and one or more falls with serious injury. Hierarchical linear regression models, sequentially adding six domains of covariates, were constructed to examine fall status as a risk factor for change in function. One noninjurious fall (beta = -.437; p < .01), at least two noninjurious falls (beta = -.877; p < .001); and at least one injurious fall (beta = -1.254; p < .001) were each associated with decline in BADL-IADL function over 3 years after adjusting for covariates (model R2 = .2617). Experiencing two or more noninjurious falls (beta = -.538; p < .05) was associated with decline in social activities (model R2 = .2779) while experiencing at least one injurious fall (beta = -.580; p < .01) was associated with decline in physical activity (model R2 = .4231). Falls and fall injuries appear to be independent determinants of functional decline in community-dwelling older persons. Falling is a health condition meeting all criteria for prevention: high frequency, evidence of preventability, and high burden of morbidity.

  20. 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. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  1. Non-Cognitive Personality Assessment and Risk of Injuries Among Army Trainees.

    PubMed

    Oetting, Alexis A; Garvin, Nadia U; Boivin, Michael R; Cowan, David N

    2017-03-01

    Low levels of pre-accession physical fitness and activity are risk factors for stress fractures and other overuse musculoskeletal injuries among military trainees. One dimension in the Tailored Adaptive Personality Assessment System (TAPAS), a non-cognitive personality test given to Army applicants, specifically assesses propensity to engage in physical activity. This dimension may serve as a surrogate measure for activity or fitness. The study examines the associations between TAPAS dimension scores and risk of musculoskeletal injuries. Fifteen TAPAS dimension scores for 15,082 U.S. Army trainees entering military service in 2010 were provided by the U.S. Army Research Institute for Social and Behavioral Sciences. During 2013-2015, the associations between TAPAS dimension scores (as a continuous variable) and injuries in the first 6 months of service were evaluated using logistic regression, with the measure of association being the OR. The TAPAS physical conditioning dimension was associated with musculoskeletal injuries and stress fractures among both men (musculoskeletal injury, OR=0.83, 95% CI=0.79, 0.86; stress fracture, OR=0.68, 95% CI=0.57, 0.80) and women (musculoskeletal injury, OR=0.77, 95% CI=0.70, 0.85; stress fracture, OR=0.60, 95% CI=0.43, 082). No other dimensions were both significantly and consistently associated with either injury. The TAPAS physical conditioning dimension is a strong predictor of musculoskeletal injury and stress fracture among male and female U.S. Army trainees, and may serve as a pre-accession screen for self-reported physical activity. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

  2. 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.

  3. 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

  4. Use of psychoactive substances in persons with spinal cord injury: a literature review.

    PubMed

    Tétrault, M; Courtois, F

    2014-12-01

    To undertake a critical review of literature on use of legal and illegal psychoactive substances (PAS) in persons with spinal cord injury (SCI) before and after trauma. Hundred and five articles published between 1980 and 2014 on alcohol and drug use in persons with SCI before and after trauma were retrieved from the PubMed and PsycInfo search engines. Before injury, 25% to 96% of people with SCI reported using alcohol, while 32% to 35% had used illegal drugs. At the time of injury, 31% to 50% of individuals with SCI were intoxicated with alcohol, 16% to 33% with drugs and 26% with a combination of drugs and alcohol. Among those reporting PAS use before injury, up to 50% stated that they had reduced their use during active rehabilitation, during which time only 6% consumed psychoactive substances for the first time. A variety of risk factors are associated with consumption subsequent to spinal cord injury: personality alteration (impulsiveness, aggressiveness), posttraumatic depression, poor coping skills, lack of social support and pain. PAS use can affect the process of rehabilitation, diminish the effectiveness of medication and result in various medical complications. Few studies have explored the use of alcohol, drugs and psychoactive medications before SCI and during active rehabilitation. To our knowledge, no study has analyzed the evolution of PAS use after hospital discharge, even though return home is associated with new stressors that may trigger risky behaviors. It should be a priority, as early as possible during rehabilitation, to detect persons at risk of developing PAS abuse. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. 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.

  6. 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.

  7. 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. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  8. 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. Copyright © 2012 S. Karger AG, Basel.

  9. Perceived difficulty in use of everyday technology in persons with acquired brain injury of different severity: a comparison with controls.

    PubMed

    Fallahpour, Mandana; Kottorp, Anders; Nygård, Louise; Lund, Maria Larsson

    2014-07-01

    To compare the perceived difficulty in use of everyday technology in persons with acquired brain injury with different levels of severity of disability with that of controls. This comparison study recruited 2 samples of persons with acquired brain injury and controls, comprising a total of 161 participants, age range 18-64 years. The long and short versions of the Everyday Technology Use Questionnaire and the Extended Glasgow Outcome Scale were used to evaluate participants. Persons with acquired brain injury demonstrated lower mean levels of perceived ability in use of everyday technology than controls (F = 21.84, degrees of freedom = 1, p < 0.001). Further analysis showed a statistically significant mean difference in perceived difficulty in use of everyday technology between persons with severe disability and good recovery, between persons with severe disability and controls, and between persons with moderate disability and controls. No significant mean difference was found between persons with severe disability and moderate disability, between persons with moderate disability and good recovery, and between persons with good recovery and controls. Perceived difficulty in using everyday technology is significantly increased among persons with acquired brain injury with severe to moderate disability compared with controls. Rehabilitation services should consider the use of everyday technology in order to increase participation in everyday activities after acquired brain injury.

  10. 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.

  11. A pilot study of perceived needs of persons with new spinal cord injury.

    PubMed

    Cushman, Laura A; Scherer, Marcia J

    2002-06-01

    Persons with new spinal cord injury have varying perceptions of their own needs in multiple life domains such as readiness and need to use assistive technologies, but these are often not directly addressed. These areas were the focus of the present study. This descriptive study looked at subjective need in a variety of areas with a new measure and also assessed perceptions related to assistive technology and quality of life. Perceptions of various needs were compared at baseline and at 1- and 6-mo. follow-up. The Perceived Needs Inventory, the Assistive Technology Device Predisposition Assessment, and the Diener Satisfaction with Life Scale were the main outcome measures given 22 patients with new injuries in an inpatient service for acute spinal cord injury with community follow-up. As the Perceived Needs Inventory provided distinct information and showed good test-reliability and some evidence of construct validity, it may be a useful adjunctive tool with such patients.

  12. Use of medicines, adherence and attitudes to medicines among persons with chronic spinal cord injury.

    PubMed

    Høgholen, H; Storhaug, A; Kvernrød, K; Kostovski, E; Viktil, K K; Mathiesen, L

    2018-01-01

    A cross-sectional study. To describe the use of medicines and adherence among persons with spinal cord injury (SCI). Further, to examine the influence of pain, spasms and beliefs about medicines on adherence. Sunnaas Rehabilitation Hospital, Norway. Persons (⩾18 years) with chronic SCI (more than 1-year post injury), using at least one drug regularly, and admitted for a follow-up stay at Sunnaas Rehabilitation Hospital were included. Participants were interviewed about their drug regimen and filled out validated self-report questionnaires: Morisky Medication Adherence Scale (MMAS-8), beliefs about medicines questionnaire (BMQ), visual analogue scale (VAS) for pain and modified Penn spasm frequency scale (mPSFS). The 105 participants used in average 4.2 drugs regularly (range, 1-15), and 70% reported high or moderate adherence to their treatment. Of the 39 participants using oral spasmolytics, 74% reported high or moderate adherence to these drugs. A total of 97% of the participants reported high perceptions of necessity to their treatment and 54% reported a high level of concern. The persons with SCI included in this study used in average the same number of regular drugs compared to persons with other chronic conditions. Regardless of high overall adherence, the participants were more concerned about their medicines compared to other patient groups. Further studies are required for understanding adherence and attitudes toward medicines in this population, especially to help the persons with chronic SCI feel safe about their drug regimen.

  13. 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.

  14. 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.

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

    PubMed Central

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

    2017-01-01

    Background Individuals with high levels of hostility may be more susceptible to the influence of television on violence and risk taking behaviors. Aim This study aimed to examine whether hostile personality trait modifies the association between TV viewing and injuries. Methods 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. Results 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. Conclusions These findings suggest that individuals who watch more TV and have a hostile personality trait may be at a greater risk for injury. PMID:26274936

  16. 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

  17. PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury

    DTIC Science & Technology

    2013-04-01

    a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury Paul N. Kizakevich, M.S., P.E. Research Triangle Institute...opportunities applied for and/or received based on experience/ training supported by this award...were conducted in a private conference room housed at the WTB headquarters. A trained focus group moderator led each discussion using the RTI and

  18. 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.

  19. 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

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

    PubMed Central

    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. PMID:27833273

  1. Changes in personality after mild traumatic brain injury from primary blast vs. blunt forces.

    PubMed

    Mendez, Mario F; Owens, Emily M; Jimenez, Elvira E; Peppers, Dominique; Licht, Eliot A

    2013-01-01

    Injuries from explosive devices can cause blast-force injuries, including mild traumatic brain injury (mTBI). This study investigated changes in personality from blast-force mTBI in comparison to blunt-force mTBI. Clinicians and significant others assessed US veterans who sustained pure blast-force mTBI (n = 12), as compared to those who sustained pure blunt-force mTBI (n = 12). Inclusion criteria included absence of any mixed blast-blunt trauma and absence of post-traumatic stress disorder. Measures included the Interpersonal Measure of Psychopathy (IM-P), the Big Five Inventory (BFI), the Interpersonal Adjectives Scale (IAS) and the Frontal Systems Behaviour Scale (FrSBe). There were no group differences on demographic or TBI-related variables. Compared to the Blunt Group, the Blast Group had more psychopathy on the IM-P, with anger, frustration, toughness and boundary violations and tended to more neuroticism on the BFI. When pre-TBI and post-TBI assessments were compared on the IAS and FrSBe, only the patients with blast force mTBI had become more cold-hearted, aloof-introverted and apathetic. These results suggest that blast forces alone can cause negativistic behavioural changes when evaluated with selected measures of personality. Further research on isolated blast-force mTBI should focus on these personality changes and their relationship to blast over-pressure.

  2. 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…

  3. 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.

  4. 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

    2015-05-04

    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.

  5. Geographic variation in expenditures for Workers' Compensation hospitalized claims.

    PubMed

    Miller, T R; Levy, D T

    1999-02-01

    Past literature finds considerable variation in the cost of physician care and in the utilization of medical procedures. Variation in the cost of hospitalized care has received little attention. We examine injury costs of hospitalized claims across states. Multivariate regression analysis is used to isolate state variations, while controlling for personal and injury characteristics, and state characteristics. Injuries to workers filing Workers' Compensation lost workday claims. About 35,000 randomly sampled Workers' Compensation claims from 17 states filed between 1979 and 1988. Medical payments per episode of three injury groups: upper and lower extremity fractures and dislocations, other upper extremity injuries, and back strains and sprains. Statistical analyses reveal considerable variation in expenditures for hospitalized injuries across states, even after controlling for case mix and state characteristics. A substantial portion of the variation is explained by state rate regulations; regulated states have lower costs. The large variation in costs suggests a potential to affect the costs of hospitalized care. Efforts should be directed at those areas that have higher costs without sufficient input price, quality, or case mix justification.

  6. Rasch measurement properties of the Pain Medication Questionnaire in persons with spinal cord injury.

    PubMed

    Hand, B N; Velozo, C A; Krause, J S

    2017-08-01

    Secondary analysis of cross-sectional population-based self-report data. To determine how well the Pain Medication Questionnaire (PMQ) measures risk of pain medication misuse and its precision in separating individuals with spinal cord injury (SCI) into meaningful classification categories. Academic medical center in Southeastern United States. Data were collected from a population-based registry of SCI (n=971). Eligible participants included adults with traumatic SCI with residual effects who were at least 1 year post injury and 18 years of age and who had PMQ data in which they reported active use of pain medication at the time of the study (n=745). Most items (23/26) of the PMQ contributed to a single unidimensional construct. Rasch analysis results revealed that the rating scale, majority of persons (>93%), and majority of items (20/23) fit the Rasch measurement model. The PMQ demonstrated adequate reliability (person reliability =0.67) and separated persons into two strata-those likely to misuse pain medication and those with low liklihood of misusing pain medication. Findings offer a deeper understanding of the measurement properties of the PMQ as a precursor for widespread population-based studies to elucidate the incidence of pain medication misuse in persons with SCI. Results also have important research and clinical implications for commonly used PMQ total score cut-offs, which may misclassify an individual's risk of pain medication misuse.Spinal Cord advance online publication, 1 August 2017; doi:10.1038/sc.2017.89.

  7. The Role of Core Self-Evaluations in the Relationship between Stress and Depression in Persons with Spinal Cord Injury

    ERIC Educational Resources Information Center

    DeAngelis, Jesse B.; Yaghmaian, Rana; Smedema, Susan Miller

    2016-01-01

    Purpose: To investigate the role of core self-evaluations (CSE) in the relationship between perceived stress and depression in persons with spinal cord injury. Method: Two hundred forty-seven adults with spinal cord injury completed an online survey measuring perceived stress, CSE, and depressive symptoms. Results: A multiple regression analysis…

  8. Enhancing primary care for persons with spinal cord injury: More than improving physical accessibility.

    PubMed

    Milligan, James; Lee, Joseph

    2016-09-01

    In Ontario, Canada, legislation exists that mandates that all medical practices be fully accessible by 2025, in an effort to improve access to primary care for persons with physical disabilities. The simple removal of physical barriers may not guarantee improved access to appropriate care. In this clinical note, members of an interprofessional primary care-based Mobility Clinic reflect on opportunities to improve primary care beyond just better physical accessibility for persons with spinal cord injury (SCI). The importance of collaborations between funders, researchers, and clinicians are examined. Using a participatory action research model, the unique perspective of consumers and consumer networks are incorporated into the Mobility Clinic's clinical and research efforts to improve primary care for persons with SCI.

  9. 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.

  10. Housing priorities of persons with a spinal cord injury and their household members.

    PubMed

    Labbé, Delphine; Jutras, Sylvie; Jutras, Dominique

    2016-08-01

    This study aimed to identify the housing priorities of families living with persons with a spinal cord injury (SCI). A new tool, the psycho-environmental housing priorities (PEHP), was developed following the principles of Q-methodology and based on the psycho-environmental model. The PEHP includes 48 items concerning housing needs that were presented to 29 persons with SCI and to 30 of their household members to determine the more important needs in their home. Four different profiles of housing priorities emerged from the analysis, with persons with SCI and household members being dispersed across these profiles. Some needs, such as social contact and security, were identified as priorities in all the profiles while others, such as pleasure, were unique to some profiles. Our study highlights the heterogeneity of housing needs and the importance of addressing each family as unique when considering housing. The results also show that some housing needs ought to be considered because they were identified as important by everyone. Rehabilitation professionals could use the PEHP as a tool to help households living with a person with SCI plan their housing modifications to better meet the needs of all inhabitants. Implications for Rehabilitation Spinal cord injury causes impairment that significantly alters the relationship with the housing environment and modifies the relative importance of housing needs. Persons with SCI and household members have varying housing needs, as suggested by the identification of four distinct profiles of housing priorities using the psycho-environmental housing priorities (PEHP). The security and social contact needs emerge as important in all profiles and may be considered "universal needs". Rehabilitation professionals may use the PEHP as a tool to help households living with a person with SCI plan their housing modifications, for instance to identify compatible and conflicting priorities, and develop solutions agreeable to everyone

  11. [Administrative Prevalence and Health Care Situation of Dementia Patients in Acute Care Hospitals: An Epidemiological Health Care Study Based on Claims Data of Insured Persons in Saxony].

    PubMed

    Motzek, Tom; Werblow, Andreas; Schmitt, Jochen; Marquardt, Gesine

    2018-02-05

    The increasing number of people with dementia will challenge the health care system, especially acute care. Using health insurance claims data, the study objective was to examine the regional patterns of the administrative prevalence of dementia, the prevalence of dementia in hospitals and the care situation in hospitals. We used 2014 claims data from AOK PLUS, the largest statutory health insurance service in Saxony. If dementia was diagnosed either in an outpatient or inpatient setting in 3 of 4 quarters in a year, a person was categorised as a dementia case (n=61,700). The analysis of health care status included 61,239 patients with dementia and 183,477 control subjects. The control group was matched using the criteria of gender, age and region of residence. For those older than 65 years, the overall administrative prevalence rate of dementia was 9.3%. The estimated prevalence for those in hospitals was 16.7%. In 2014, there were 33% more admissions, 36% more hospital days and 18% higher costs per person-year among people diagnosed with dementia than the control subjects. The longer annual hospital stays and the higher costs were primarily caused by the greater number of admissions of people with dementia. Inpatient service use was, compared to people without dementia, characterized by a need for care and assistance, rather than by a need for medical therapeutic and diagnostic procedures. To improve the health care situation of people with dementia, to adapt to the challenges facing hospitals and to reduce the financial burden caused by dementia, more efforts are needed to improve the health care situation. Measures include, among others, improvements in recognition of dementia and reduction of unnecessary hospital stays. © Georg Thieme Verlag KG Stuttgart · New York.

  12. 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.

  13. Personal Bankruptcy After Traumatic Brain or Spinal Cord Injury: The Role of Medical Debt

    PubMed Central

    Relyea-Chew, Annemarie; Hollingworth, William; Chan, Leighton; Comstock, Bryan A.; Overstreet, Karen A.; Jarvik, Jeffrey G.

    2012-01-01

    Objective To estimate the prevalence of medical debt among traumatic brain injury (TBI) and spinal cord injury (SCI) patients who discharged their debts through bankruptcy. Design A cross-sectional comparison of bankruptcy filings of injured versus randomly selected bankruptcy petitioners. Setting Patients hospitalized with SCI or TBI (1996–2002) and personal bankruptcy petitioners (2001–2004) in western Washington State. Participants Subjects (N=186) who filed for bankruptcy, comprised of 93 patients with previous SCI or TBI and 93 randomly selected bankruptcy petitioners. Interventions Not applicable. Main Outcome Measures Medical and nonmedical debt, assets, income, expenses, and employment recorded in the bankruptcy petition. Results Five percent of randomly selected petitioners and 26% of petitioners with TBI or SCI had substantial medical debt (debt that accounted for more than 20% of all unsecured debts). SCI and TBI petitioners had fewer assets and were more likely to be receiving government income assistance at the time of bankruptcy than controls. SCI and TBI patients with a higher blood alcohol content at injury were more likely to have substantial medical debts (odds ratio=2.70; 95% confidence interval, 1.04–7.00). Conclusions Medical debt plays an important role in some bankruptcies after TBI or SCI. We discuss policy options for reducing financial distress after serious injury. PMID:19254605

  14. Years of potential life lost from unintentional injuries among persons aged 0-19 years - United States, 2000-2009.

    PubMed

    2012-10-19

    Unintentional injuries are the leading cause of deaths among persons aged 0-19 years in the United States. Quantifying years of potential life lost (YPLL) highlights childhood causes of mortality and provides a simple method to identify important causes of premature death and specific groups in need of intervention. Deaths attributed to unintentional injuries among persons aged 0-19 years number approximately 12,000 each year in the United States; another 9 million young persons are treated for nonfatal injuries in emergency departments. To estimate the burden of premature deaths attributed to unintentional injuries among persons aged 0-19 years, CDC calculated state-specific YPLL by sex, age, race, and injury mechanism based on data from the National Vital Statistics System multiple cause of death files for the period 2000-2009. This report summarizes the results of that analysis, which found that an average of 890 years of potential life were lost each year because of unintentional injuries for every 100,000 persons aged 0-19 years. The burden of unintentional injuries was higher among males compared with females, among persons aged <1 year and those aged 15-19 years compared with the other 5-year age groups, among American Indian/Alaska Native (AI/AN) compared with those of any other race/ethnicity, and among those residing in two clusters of adjacent states (the South Central states of Arkansas, Louisiana, Mississippi, and Alabama, and the Mountain states of Montana, Wyoming, and South Dakota) compared with any other region. These estimates can be used to target injury prevention strategies to young persons most at risk.

  15. A comparison of nonfatal unintentional injuries in the United States among U.S.-born and foreign-born persons.

    PubMed

    Sinclair, Sara A; Smith, Gary A; Xiang, Huiyun

    2006-08-01

    The objective of this research was to compare the risk of nonfatal unintentional injuries between foreign-born and U.S.-born persons. Cross-sectional, nationally representative data were used from the 2000-2003 National Health Interview Survey to compare the risk of injury between 62,267 foreign-born and 322,200 U.S.-born persons. Nonfatal unintentional injuries occurring during the three months prior to the interview were compared by age, gender, education, poverty status, region of residence, family size, and health insurance coverage status. There were a total of 7,654 injured persons with U.S.-born persons having a weighted injury prevalence of 2.3% (95% confidence interval [CI]: 2.2, 2.4) and foreign-born persons having a weighted injury prevalence of 1.2% (95% CI: 1.0, 1.3). With the U.S.-born population as the reference and while controlling for sociodemographic characteristics, the odds ratio of injury risk was 0.54 (95% CI: 0.48, 0.62) for the foreign-born population. Transportation-related injuries occurred more frequently among foreign-born persons than among U.S.-born persons (23.7%, 95% CI: 19.7, 28.3 vs. 15.0%, 95% CI: 14.0, 16.2, respectively). This research is the first step in determining the morbidity from unintentional injuries among the foreign-born population in the U.S.

  16. Differences in the Community Built Environment Influence Poor Perceived Health among Persons with Spinal Cord Injury

    PubMed Central

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

    2015-01-01

    Objectives 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 (GIS) data. Design Secondary analysis of cross-sectional survey data. Setting Community. Participants 503 persons with chronic SCI enrolled in the Spinal Cord Injury Model Systems (SCIMS) database. All cases were residents of New Jersey, completed an interview during the years 2000–2012, had a complete residential address, and were community living at the time of follow-up. Intervention Not applicable. Main Outcome Measure Perceived health. Results Bivariate tests indicated that persons with SCI residing in communities with more (versus less) mixed land use and small (versus 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 (OR 0.54; 95% 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 to persons living in less mixed areas (OR 2.14; 95% CI 1.12–4.08). Conclusions 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 due to 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

  17. 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

  18. 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...

  19. 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...

  20. 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.

  1. Persons with acquired brain injury and multiple disabilities access stimulation independently through microswitch-based technology.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; D'Agostino, Ida; Navarro, Jorge; Addante, Luigi M

    2010-10-01

    The possibility of enabling two adults with acquired brain injury and profound multiple disabilities to use microswitch-based technology to attain preferred environmental stimuli on their own was assessed. Each of the participants was provided with two microswitches that could be activated by right and left head-turning or head-bending responses. The microswitches were introduced sequentially according to a multiple probe design across microswitches (responses) and allowed access to different sets of auditory or visual stimuli. Eventually, the two microswitches were made available simultaneously. Sessions lasted 5 min. Each participant learned to use the two microswitches successfully and maintained consistent levels of responding when they were simultaneously available. During this phase, both participants showed large within-session variations in their right and left response frequencies, with one of them showing an overall prevalence of the left-side response. The importance of assistive technology within programs for persons with acquired brain injury and multiple disabilities is discussed.

  2. Pain perception in self-injurious patients with borderline personality disorder.

    PubMed

    Russ, M J; Roth, S D; Lerman, A; Kakuma, T; Harrison, K; Shindledecker, R D; Hull, J; Mattis, S

    1992-09-15

    Pain ratings during the cold pressor test were significantly lower in female inpatients with borderline personality disorder who report that they do not experience pain during self-injury (BPD-NP group, n = 11), compared with similar patients who report that they do experience pain during self-injury (BPD-P group, n = 11), and normal female subjects (n = 6). Pain ratings were not significantly different in the BPD-P and normal control groups. Self-report ratings of depression, anger, anxiety, and confusion were significantly lower, and ratings of vigor significantly higher following the cold pressor test in the BPD-NP group, but not in the BPD-P group. Only anxiety was significantly lower in the normal control group following the cold pressor test. The implications and limitations of these preliminary findings are discussed.

  3. 20 CFR 429.104 - What evidence do I need to submit with my claim?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... information that may have a bearing on either the responsibility of the United States for the death or the...) Any other evidence or information that may have a bearing either on the responsibility of the United... bearing on either the responsibility of the United States for the personal injury or the damages claimed...

  4. 20 CFR 429.104 - What evidence do I need to submit with my claim?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... information that may have a bearing on either the responsibility of the United States for the death or the...) Any other evidence or information that may have a bearing either on the responsibility of the United... bearing on either the responsibility of the United States for the personal injury or the damages claimed...

  5. 20 CFR 429.104 - What evidence do I need to submit with my claim?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... information that may have a bearing on either the responsibility of the United States for the death or the...) Any other evidence or information that may have a bearing either on the responsibility of the United... bearing on either the responsibility of the United States for the personal injury or the damages claimed...

  6. 20 CFR 429.104 - What evidence do I need to submit with my claim?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... information that may have a bearing on either the responsibility of the United States for the death or the...) Any other evidence or information that may have a bearing either on the responsibility of the United... bearing on either the responsibility of the United States for the personal injury or the damages claimed...

  7. 20 CFR 429.104 - What evidence do I need to submit with my claim?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... information that may have a bearing on either the responsibility of the United States for the death or the...) Any other evidence or information that may have a bearing either on the responsibility of the United... bearing on either the responsibility of the United States for the personal injury or the damages claimed...

  8. Secondary health conditions and quality of life in persons living with spinal cord injury for at least ten years.

    PubMed

    Adriaansen, Jacinthe J E; Ruijs, Laura E M; van Koppenhagen, Casper F; van Asbeck, Floris W A; Snoek, Govert J; van Kuppevelt, Dirk; Visser-Meily, Johanna M A; Post, Marcel W M

    2016-11-11

    To describe the prevalence of secondary health conditions among persons with long-term spinal cord injury, and the relationship between these secondary health conditions and quality of life. Multicentre, cross-sectional study. Individuals (n = 282) with traumatic or non-traumatic spinal cord injury for ≥ 10 years, age at injury 18-35 years, current age 28-65 years, and using a wheelchair. Occurrence of 13 secondary health conditions was assessed during a consultation with a rehabilitation physician. Quality of life was measured with the International Spinal Cord Injury Quality of Life Basic Data Set. Median time since injury was 22.0 years. Median number of secondary health conditions was 4. The most prevalent secondary health conditions were: musculoskeletal pain (63.5%), oedema (38.7%), neuropathic pain (34.1%) and urinary tract infections (33.3%). Only oedema showed a significant association with increasing time since injury. Median Total Quality of Life Basic Data Set score was 7. Musculoskeletal pain, pressure ulcers, problematic spasticity and constipation showed an independent association with quality of life in multiple regression analysis, but in general, these associations were weak. Secondary health conditions are common among persons with long-term spinal cord injury and the following secondary health conditions were independently associated with lower quality of life: musculoskeletal pain, pressure ulcers, problematic spasticity, and constipation. Minimizing the impact of secondary health conditions should be a priority in the long-term care of persons with spinal cord injury.

  9. 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

  10. 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.

  11. The effect of publication on Internet-based solicitation of personal-injury litigants.

    PubMed

    Juurlink, David N; Park-Wyllie, Laura Y; Kapral, Moira K

    2007-11-20

    Serious adverse drug events can prompt personal-injury lawsuits. However, the extent to which biomedical publication regarding drug-induced harm can influence the legal process has not been well characterized. Using an advanced Google search strategy, we determined the number of Internet "hits" for websites soliciting plaintiffs for medicolegal action before and after publication of a study that highlighted the risk of dysglycemia among patients taking the antibiotic gatifloxacin. We found that early online release and print publication were associated with an immediate and sustained increase in the number of websites soliciting plaintiffs for legal action.

  12. The effect of publication on Internet-based solicitation of personal-injury litigants

    PubMed Central

    Juurlink, David N.; Park-Wyllie, Laura Y.; Kapral, Moira K.

    2007-01-01

    Serious adverse drug events can prompt personal-injury lawsuits. However, the extent to which biomedical publication regarding drug-induced harm can influence the legal process has not been well characterized. Using an advanced Google search strategy, we determined the number of Internet “hits” for websites soliciting plaintiffs for medicolegal action before and after publication of a study that highlighted the risk of dysglycemia among patients taking the antibiotic gatifloxacin. We found that early online release and print publication were associated with an immediate and sustained increase in the number of websites soliciting plaintiffs for legal action. PMID:18025428

  13. Unintentional injuries treated in hospital emergency departments among persons aged 65 years and older, United States, 2006-2011.

    PubMed

    DeGrauw, Xinyao; Annest, Joseph L; Stevens, Judy A; Xu, Likang; Coronado, Victor

    2016-02-01

    With the aging of the United States population, unintentional injuries among older adults, and especially falls-related injuries, are an increasing public health concern. We analyzed emergency department (ED) data from the Nationwide Emergency Department Sample, 2006-2011. We examined unintentional injury trends by 5-year age groups, sex, mechanism, body region, discharge disposition, and primary payer. For 2011, we estimated the medical costs of unintentional injury and the distribution of primary payers, plus rates by injury mechanisms and body regions injured by 5-year age groups. From 2006 to 2011, the age-adjusted annual rate of unintentional injury-related ED visits among persons aged ≥ 65 years increased significantly from 7987 to 8163, per 100,000 population. In 2011, 65% of injuries were due to falls. Rates for fall-related injury ED visits increased with age and the highest rate was among those aged ≥ 100. Each year, about 85% of unintentional injury-related ED visits in this population were expected to be paid by Medicare. In 2011, the estimated lifetime medical cost of unintentional injury-related ED visits among those aged ≥ 65 years was $40 billion. Increasing rates of ED-treated unintentional injuries, driven mainly by falls among older adults, will challenge our health care system and increase the economic burden on our society. Prevention efforts to reduce falls and resulting injuries among adults aged ≥ 65 years have the potential to increase well-being and reduce health care spending, especially the costs covered by Medicare. With the aging of the U.S. population, unintentional injuries, and especially fall-related injuries, will present a growing challenge to our health care system as well as an increasing economic burden. To counteract this trend, we must implement effective public health strategies, such as increasing knowledge about fall risk factors and broadly disseminating evidence-based injury and fall prevention programs in both

  14. 46 CFR 327.4 - Claim requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 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...

  15. 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.

  16. 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

  17. 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

  18. Risk factors for osteoporotic fractures in persons with spinal cord injuries and disorders.

    PubMed

    Bethel, M; Weaver, F M; Bailey, L; Miskevics, S; Svircev, J N; Burns, S P; Hoenig, H; Lyles, K; Carbone, L D

    2016-10-01

    Clinical risk factors for fracture were explored among Veterans with a spinal cord injury. At the end of 11 years of follow-up, the absolute risk of fracture was approximately 20 %. Among the clinical and SCI-related factors explored, a prior history of fracture was strongly associated with incident fracture. Few studies to date have comprehensively addressed clinical risk factors for fracture in persons with spinal cord injury (SCI). The purpose of this study was to identify risk factors for incident osteoporotic fractures in persons with a SCI that can be easily determined at the point of care. The Veteran's Affairs Spinal Cord Dysfunction Registry, a national database of persons with a SCI, was used to examine clinical and SCI-related risk factors for fracture. Incident fractures were identified in a cohort of persons with chronic SCI, defined as SCI present for at least 2 years. Cox regression models were used to estimate the risk of incident fractures. There were 22,516 persons with chronic SCI included in the cohort with 3365 incident fractures. The mean observational follow-up time for the overall sample was 6.2 years (median 6.0, IQR 2.9-11.0). The mean observational follow-up time for the fracture group was 3.9 years (median 3.3, IQR 1.4-6.1) and 6.7 years (median 6.7, IQR 3.1-11.0) for the nonfracture group. By the end of the study, which included predominantly older Veterans with a SCI observed for a relatively short period of time, the absolute (i.e., cumulative hazard) for incident fractures was 0.17 (95%CI 0.14-0.21). In multivariable analysis, factors associated with an increased risk of fracture included White race, traumatic etiology of SCI, paraplegia, complete extent of SCI, longer duration of SCI, use of anticonvulsants and opioids, prevalent fractures, and higher Charlson Comorbidity Indices. Women aged 50 and older were also at higher risk of sustaining an incident fracture at any time during the 11-year follow-up period. There are

  19. Factors influencing mode of claims settlement in workers' compensation cases.

    PubMed

    Morrison, D L; Wood, G A; MacDonald, S

    1995-01-01

    This paper examines the variables that influence the means by which 10,192 injured workers settled their compensation claims during 1990. The data on which this study is based come from a state in Australia where there are three means by which workers' compensation claims can be settled by lump sum payment: settlement following a specific injury payment, early settlement payment and settlement following a common law payment. This paper is specifically concerned with identifying the variables that determine whether the claim will be settled by a lump sum payment and whether different modes of claims settlement by lump sum are unique and predictable from a range of variables that include injury characteristics and demographics. The results of logistic regression modelling revealed that those who received a lump sum settlement could be reliably distinguished from those who did not receive such a payment. Each mode of settlement varied in the extent to which it could be predicted. Contrary to expectations, the most difficult form of settlement mode to predict was that of specific injury payments (4% accurate) with the most predictive being early settlement payments (81% accurate). Common law payments were also highly predictable (48% accurate). The form of lump sum payment received by injured workers was found to depend on a range of injury characteristics, indices of severity and for common law payments, gender and potential income loss. It is argued that although injury characteristics play a part in the process of claims settlement, personal circumstances and insurance company policies are influential in dictating the form by which workers compensation cases are finalized.

  20. The challenges of everyday technology in the workplace for persons with acquired brain injury.

    PubMed

    Kassberg, Ann-Charlotte; Prellwitz, Maria; Larsson Lund, Maria

    2013-07-01

    To explore and describe how persons with an acquired brain injury (ABI) managed the everyday technology (ET) that they needed to use in their workplace and how this use influences their opportunities to work. Nine persons with an ABI were interviewed and observed when managing ET in their workplace. The data were analysed qualitatively with a constant comparative method. The main category, "The challenge of managing ET in the workplace", consisted of three categories, all of which reflected different kinds of discrepancies between the participants' ability to manage ET and the demands that ET imposes on them in work: "Struggling with ET to be able to continue to work; "Depending on strategies to cope with ET to continue in a particular profession", and "Managing ET at work but concerned about keeping up with the changes". The result revealed discrepancies between the abilities of the persons with ABI to manage ET in relation to the demands that technology imposed on them in their work setting. This indicated that professionals need to consider the role of ET when designing interventions supporting a person's return to work after an ABI.

  1. 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. Copyright © 2012 John Wiley & Sons, Ltd.

  2. American Community Survey: earnings and employment for persons with traumatic brain injury.

    PubMed

    Gamboa, A M; Holland, Gwendolyn H; Tierney, John P; Gibson, David S

    2006-01-01

    In 2000, the United States Census Bureau began the annual American Community Survey (ACS), which collects data on earnings and employment for persons with various types of impairment. One of the impairments is cognitive disability, defined as existing when a person has a condition lasting six months or more that results in difficulty learning, remembering, or concentrating. Individuals with such limitations are often defined as having mild traumatic brain injury (TBI). Persons with mild TBI often retain the ability to work competitively. Such individuals, however, typically earn less when employed year-round, full-time than do persons without disability and have lower levels of employment, resulting in reduced worklife expectancy. This article focuses on the effects of cognitive disability on earnings and employment. The ACS data are reported by gender and education level for those without disability or with cognitive disability. Employment levels are translated into worklife expectancies and the method of conversion through use of a joint probability of life, participation, and employment is examined.

  3. Methylphenidate reduces mental fatigue and improves processing speed in persons suffered a traumatic brain injury.

    PubMed

    Johansson, B; Wentzel, A-P; Andréll, P; Mannheimer, C; Rönnbäck, L

    2015-01-01

    Post-traumatic brain injury symptoms, such as mental fatigue, have considerable negative impacts on quality-of-life. In the present study the effects of methylphenidate in two different dosages were assessed with regard to mental fatigue, pain and cognitive functions in persons who had suffered a traumatic brain injury. Fifty-one subjects were included and 44 completed the study. The treatment continued for 12 weeks, including three treatment periods with no medication for 4 weeks, administration of low dose methylphenidate (up to 5 mg × 3) for 4 weeks and normal dose methylphenidate (up to 20 mg × 3) for a further 4 weeks. The patients were randomized into three groups where all groups were given all treatments. Significantly reduced mental fatigue, assessed with the Mental Fatigue Scale (MFS) and increased information processing speed (coding, WAIS-III), were detected. The SF-36 vitality and social functioning scales were also improved significantly. Pain was not reduced by methylphenidate. The positive effects of treatment were dose-dependent, with the most prominent effects being at 60 mg methylphenidate/day spread over three doses. Observed side-effects were increased blood pressure and increased heart rate. Methylphenidate was generally well-tolerated and it improved long-lasting mental fatigue and processing speed after traumatic brain injury.

  4. 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

  5. A review of instruments assessing participation in persons with spinal cord injury.

    PubMed

    Noonan, V K; Miller, W C; Noreau, L

    2009-06-01

    A systematic search of the literature. To critically review instruments that assess participation in persons with spinal cord injury (SCI). Vancouver, British Columbia. Four electronic databases (MEDLINE/PubMed, CINAHL, EMBASE and PsychInfo) were searched for studies published between 1980 and March 2008. Instruments were included if information was published in English in at least one peer-reviewed journal on its measurement properties (reliability, validity and responsiveness) in a sample that included adults with SCI. Instruments were evaluated using criteria proposed for disability outcome measures. Six instruments were included: Craig Handicap Assessment and Reporting Technique (CHART); Impact on Participation and Autonomy Questionnaire (IPA); Assessment of Life Habits Scale (Life-H); Occupational Performance History Interview; Physical Activity Recall Assessment for People with Spinal Cord Injury; and Reintegration to Normal Living Index. Evidence supporting the reliability of the instruments was reported for four of the six instruments and was adequate. Validity was assessed in all the instruments. Only the Life-H and CHART have been compared with each other. No evidence on responsiveness was available. The instruments differ in how participation is operationalized. Currently, the CHART that measures objective aspects of participation has the most evidence supporting its measurement properties. More evidence is becoming available for instruments such as the IPA, which consider the person's perspective. It is important to determine what information about participation is required before selecting an instrument.

  6. 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

  7. Functional Priorities in Persons with Spinal Cord Injury: Using Discrete Choice Experiments To Determine Preferences.

    PubMed

    Lo, Charles; Tran, Yvonne; Anderson, Kim; Craig, Ashley; Middleton, James

    2016-11-01

    Major goals of rehabilitation and health interventions in people with spinal cord injury (SCI) are to improve functional independence, increase social participation, and enhance quality of life (QOL). Determining functional areas perceived by consumers as most important can assist in research prioritization, planning for delivery of health services, and policy development. Five high priority areas of functioning for the SCI population (arm/hand use, walking, bladder/bowel control, sexual function, and relief of pain) were chosen to determine the preferences for these five attributes. A discrete choice experiment was conducted involving 151 persons with SCI sampled from Australia and the United States of America. Consistent with prior research, arm/hand function had the highest preference, with odds ratios of subjects being 44-76% more likely to choose arm/hand function over the other four functions. Preference for normal arm/hand function was found to be significantly more preferred by the group with paraplegia compared with those with tetraplegia; that is, retaining and not trading off existing arm/hand function for other improved functions. There were no significant differences found in preferences between bladder/bowel function and walking or elimination of pain, although walking was preferred in earlier (≤ 10) post-injury years and pain amelioration became more important with a longer duration (>10 years) post-injury. Sexual function had the lowest preference when traded against the other four functions. Understanding the functional preferences of persons with SCI will help to inform future research design, as well as enabling successful translation of research into practice and health policy, meeting the needs of people with SCI.

  8. Risk Factors for Traumatic Brain Injuries During Falls in Older Persons.

    PubMed

    Hwang, Hei-Fen; Cheng, Chui-Hsuan; Chien, Ding-Kuo; Yu, Wen-Yu; Lin, Mau-Roung

    2015-01-01

    To identify risk factors for traumatic brain injuries (TBIs) during falls in older Taiwanese people. Case patients consisted of 113 patients aged 60 years or older with a moderate/severe TBI due to a fall. Two control groups: (1) 339 older patients with a soft-tissue injury; and (2) 113 with a mild-TBI due to a fall. Proxies were required to provide information for a considerable number of patients. Matched case-control study. The emergency departments of 3 general hospitals. Sociodemographic, lifestyle behavior, chronic condition, medication use, functional abilities, and fall-related characteristics. When patients with a soft-tissue injury were assigned to the control group, men were 2.06-fold more likely to have a moderate/severe TBI than women. Subjects who took antiarrhythmics within 4 hours of a fall were 2.59-fold more likely to have a moderate/severe TBI than those who took none. Subjects who were negotiating stairs and getting in/out of the bed/chair were 3.12-fold and 2.97-fold, respectively, more likely to have a moderate/severe TBI than those who fell while walking. Falling backward and sideways was 4.07-fold and 2.30-fold, respectively, more likely to cause a moderate/severe TBI than falling forward. When patients with a mild-TBI were assigned to the control group, results were similar, with the exception that the effect of antiarrhythmic use became nonsignificant and subjects who took 2 or more medications were 3.07-fold more likely to have a moderate/severe TBI than those who took none. Avoiding a head impact during a backward or sideways fall, reducing unnecessary use of polypharmacy and antiarrhythmics, and maintaining safety during stair negotiation and bed/chair transfer may protect an elderly person from a severe brain injury.

  9. The role of nociceptive input and tissue injury on stress regulation in borderline personality disorder.

    PubMed

    Willis, Franziska; Kuniss, Sarah; Kleindienst, Nikolaus; Naoum, Janina; Reitz, Sarah; Boll, Sabrina; Bohus, Martin; Treede, Rolf-Detlef; Baumgärtner, Ulf; Schmahl, Christian

    2017-03-01

    Approximately 60% to 90% of patients with borderline personality disorder (BPD) show nonsuicidal self-injurious behavior (NSSI) with cutting being the most frequently applied method. One of NSSI's functions is to reduce aversive tension. Previous studies have found a tension-reducing effect of painful tissue injury by an incision. It is still unclear whether this effect is based on the effect of tissue injury or the effect of pain experience, or both. The aim of this study was to determine whether tissue injury leads to a stronger stress reduction than a sole pain stimulus in patients with BPD. After stress induction, 57 BPD patients and 60 healthy controls (HCs) received either an incision or a non-tissue-injuring mechanical nociceptive stimulus ("blade") typically perceived as painful or a non-nociceptive tactile sham stimulus (blunt end of scalpel). Participants were unaware of which procedure was applied. For stress assessment, subjective and objective parameters were measured. As immediate response to the stimulus application, we found greater stress reduction after both painful stimuli (incision and blade) in BPD patients but no difference in stress decrease between the tissue-injuring incision and the non-tissue-injuring pain stimulus (blade). Compared with HCs, incision and blade were followed by greater immediate decrease of arousal in BPD patients. Our findings confirm that among BPD patients, the nociceptive input leads to stress reduction. In contrast, the impact of tissue damage on stress reduction was relatively small. In addition, the results suggest that painful stimuli lead to a greater stress reduction in BPD patients compared with HCs.

  10. Home aids and personal assistance 10-45 years after spinal cord injury.

    PubMed

    Biering-Sørensen, T; Hansen, R B; Biering-Sørensen, F

    2009-05-01

    Assessment of home aids, adaptations and personal assistance received after traumatic spinal cord injury (SCI). Clinic for Spinal Cord Injuries, Denmark. Uptake area, 2.5 million inhabitants. Cross-sectional follow-up with retrospective data from medical files. Individuals with traumatic SCI before 1 January 1991, still in regular follow-up and with sufficient medical record. In all, 279 were included, and 236 answered the questionnaire (193 men and 43 women), with a response rate of 84.6%. Mean age at follow-up was 50.5 years, and mean follow-up time, 24.1 years. One hundred and twenty-six were paraplegic and 110, tetraplegic. Responders and non-responders were comparable. Most common aids or adaptations reported were commode/shower chair on wheels or a seat (69%), grab bar by the toilet (41%), electrical bed (44%), special mattress (28%), lift/hoist (20%), computers (39%) and kitchen tools or cutlery with special handles (14%). In all, 7.6% of the participants reported no aids. Eighty-two percent answered 'Yes' to the question 'Have the aids, you currently or previously needed, been available to you?' The majority reported that their source of information about aid had been various journals and magazines. Twenty-one percent had personal helpers, with 60 h per week in median (range 2-168). Thirty-three percent received domestic help with 2.5 h per week in median (range 0.5-37). Eight percent had a home nurse. A total of 98.7% were living in their own homes. This is the first study of a representative SCI population giving information on home aids. Individuals with SCI in Denmark seem to be sufficiently supplied with aids and personal assistance.

  11. 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.

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

    DTIC Science & Technology

    2016-10-01

    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 5b...DISTRIBUTION / AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Development of a pressure

  13. 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.

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

    PubMed Central

    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. PMID:22934107

  15. Greatly increased prevalence of esophageal dysmotility observed in persons with spinal cord injury.

    PubMed

    Radulovic, M; Schilero, G J; Yen, C; Bauman, W A; Wecht, J M; Ivan, A; La Fountaine, M F; Korsten, M A

    2015-10-01

    The effects of spinal cord injury (SCI) on esophageal motility are largely unknown. Furthermore, due to the complete or partial loss of sensory innervation to the upper gastrointestinal tract, a symptom-based diagnosis of esophageal dysmotility is problematic in the SCI population. To determine the prevalence and characterize the type of motility disorders observed in persons with chronic SCI compared with that of able-bodied (AB) controls based on esophageal pressure topography isometrics acquired by high-resolution manometry and categorized by application of the Chicago Classification. High-resolution manometry of the esophagus was performed in 39 individuals: 14 AB, 12 with paraplegia (level of injury between T4-T12) and 13 with tetraplegia (level of injury between C5-C7). A catheter containing multiple pressure sensors arranged at 360° was introduced into the esophagi of subjects at a distance that allowed visualization of both the upper esophageal sphincters (UES) and lower esophageal sphincters (LES). After a period to acquire pressures at baseline, subjects were asked to perform 10 wet swallows with 5-mL boluses of isotonic saline while esophageal pressure and impedance were being recorded. No significant differences were noted for gender, age, or body mass index between AB and SCI groups. Twenty-one of 25 (84%) subjects with SCI had at least one motility abnormality: 12% with Type II achalasia, 4% with Type III achalasia, 20% with esophagogastric junction outflow obstruction, 4% with the hypercontractile esophagus, and 48% with peristaltic abnormalities (weak peristalsis with small or large defects or frequent failed peristalsis). In contrast, only 7% (1 out of 14) of the AB subjects had any type of esophageal motility disorder. Despite the lack of subjective complaints and clinical awareness, esophageal dysmotility appears to be a highly prevalent condition in persons with SCI. The use of new and improved techniques, as well as a more stringent

  16. Helping persons with traumatic brain injury of minority origin: improve career and employment outcomes.

    PubMed

    Wehman, Paul; Targett, Pam; Yasuda, Satoko; McManus, Shannon; Briel, Lori

    2007-01-01

    Racial and ethnic minorities have a disproportionately high rate of disability compared to white Americans, with African and Hispanic Americans overrepresented in all disability categories. Subsequently, the demand for quality employment and rehabilitation services for individuals with disabilities from minority racial or ethnic groups is increasing. In order to meet the increasing demands of minorities who are severely impaired, vocational rehabilitation professionals and other team members assisting those with traumatic brain injury (TBI) with employment need to become familiar with effective models of service delivery. This article reviews the literature related to return to work following TBI for minorities. A brief review of the supported employment for TBI and supported education literature is also provided. Afterwards, 2 case studies, illustrating the effectiveness of supported employment and educational services, are offered to show how minority individuals with severe TBI can return to work or college postinjury, when services are individualized to meet personal needs.

  17. 49 CFR 1005.2 - Filing of claims.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... VOLUNTARY DISPOSITION OF LOSS AND DAMAGE CLAIMS AND PROCESSING SALVAGE § 1005.2 Filing of claims. (a) Compliance with regulations. A claim for loss or damage to baggage or for loss, damage, injury, or delay to..., or baggage check, or carrier on whose line the alleged loss, damage, injury, or delay occurred...

  18. 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

  19. Objective motor assessment for personalized rehabilitation of upper extremity in brain injury patients.

    PubMed

    Villán-Villán, Mailin Adriana; Pérez-Rodríguez, Rodrigo; Martín, Cristina; Sánchez-González, Patricia; Soriano, Ignasi; Opisso, Eloy; Elena Hernando, Dra M; Tormos, José María; Medina, Josep; Gómez, Enrique J

    2018-04-07

    The increasing number of patients with acquired brain injury and the current subjectivity of the conventional upper extremity (UE) assessment tests require new objective assessment techniques. This research proposes a novel objective motor assessment (OMA) methodology based on the Fugl-Meyer assessment (FMA). The goals are to automatically calculate the objective scores (OSs) of FMA-UE movements (as well as a global OS) and to interpret the estimated OSs. Fifteen patients participated in the study. The OMA algorithm was designed to detect small-scale variations in UE movements. The OSs for 14 FMA-UE movements and the global OSs were automatically calculated using the algorithm and evaluated by 2 therapists. The interpretation of the global OSs was performed at 3 levels: by item, movement and globally. The global OSs calculated by our algorithm had a significant correlation with the therapists' scores (0.783 and 0.938, p <  0.01). All OSs for each movement were correlated with the scores given by the therapists. The correlation coefficient can reach values as high as 0.981 (p <  0.01). We provide a new objective assessment tool for therapists to help them improve the diagnostic accuracy and to achieve a more personalized and potentially effective physical rehabilitation of brain injury patients.

  20. 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.

  1. 32 CFR 842.132 - Claims by NAFI employees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... performance of duty and workers' compensation claims. Claims for injuries arising out of performance of duty and workers' compensation claims are not within the scope of this subpart because the exclusive remedy... 32 National Defense 6 2010-07-01 2010-07-01 false Claims by NAFI employees. 842.132 Section 842...

  2. Computer and internet use by persons after traumatic spinal cord injury.

    PubMed

    Goodman, Naomi; Jette, Alan M; Houlihan, Bethlyn; Williams, Steve

    2008-08-01

    To determine whether computer and internet use by persons post spinal cord injury (SCI) is sufficiently prevalent and broad-based to consider using this technology as a long-term treatment modality for patients who have sustained SCI. A multicenter cohort study. Twenty-six past and current U.S. regional Model Spinal Cord Injury Systems. Patients with traumatic SCI (N=2926) with follow-up interviews between 2004 and 2006, conducted at 1 or 5 years postinjury. Not applicable. Results revealed that 69.2% of participants with SCI used a computer; 94.2% of computer users accessed the internet. Among computer users, 19.1% used assistive devices for computer access. Of the internet users, 68.6% went online 5 to 7 days a week. The most frequent use for internet was e-mail (90.5%) and shopping sites (65.8%), followed by health sites (61.1%). We found no statistically significant difference in computer use by sex or level of neurologic injury, and no difference in internet use by level of neurologic injury. Computer and internet access differed significantly by age, with use decreasing as age group increased. The highest computer and internet access rates were seen among participants injured before the age of 18. Computer and internet use varied by race: 76% of white compared with 46% of black subjects were computer users (P<.001), and 95.3% of white respondents who used computers used the internet, compared with 87.6% of black respondents (P<.001). Internet use increased with education level (P<.001): eighty-six percent of participants who did not graduate from high school or receive a degree used the internet, while over 97% of those with a college or associate's degree did. While the internet holds considerable potential as a long-term treatment modality after SCI, limited access to the internet by those who are black, those injured after age 18, and those with less education does reduce its usefulness in the short term for these subgroups.

  3. Satisfaction with Cognitive Rehabilitation Delivered via the Internet in Persons with Acquired Brain Injury.

    PubMed

    Bergquist, Thomas F; Yutsis, Maya; Sullan, Molly J

    2014-01-01

    We examined the level of satisfaction with cognitive rehabilitation delivered via the Internet in persons with moderate to severe acquired brain injury (ABI). Fifteen adults with moderate to severe ABI were randomized to 30 days of Internet-based active treatment (AT) or to a wait list (WL) group, and crossed over to the opposite condition after 30 sessions. Both caregivers and participants were assessed at three time points during the study. This study focused on participant satisfaction with receiving treatment in this manner. Though the results of this study showed no significant treatment effect, the vast majority of participants (>87%) were satisfied with treatment. Treatment satisfaction accounted for 25% of additional variance in predicting lower family ratings of mood difficulties after final assessment (p<.03). Greater satisfaction with treatment was positively correlated with greater employment rate after treatment (r=.63, p=.02), as well as lower family ratings of memory and mood difficulties after final assessment (r=-.59, p=.03; r=-.58, p=.03,). Results suggest that treatment satisfaction in persons with ABI is related to less activity limitations, and maintaining employment after cognitive rehabilitation delivered via the Internet.

  4. Effect of carbohydrate ingestion on exercise performance and carbohydrate metabolism in persons with spinal cord injury.

    PubMed

    Temesi, John; Rooney, Kieron; Raymond, Jacqui; O'Connor, Helen

    2010-01-01

    Carbohydrate ingestion during exercise and as a pre-exercise bolus improves exercise performance in able-bodied athletes. Little is known about the potential for carbohydrate ingestion to improve exercise performance in athletes with spinal cord injury (SCI), nor the potential physiological limitations of such a practice resulting from an SCI. Therefore, this study investigated the effects of carbohydrate ingestion on exercise performance in physically active and athletic persons with SCI. Six participants with complete SCI (neurological level of lesion ranging from C(6) to T(7)) and normal glucose tolerance were studied twice during 60 min of arm cranking at 65% of peak oxygen consumption followed by a 20-min time trial with the ingestion of either a carbohydrate drink (CHO trial: 0.5 g CHO kg(-1) body weight in 500 ml) or placebo (PLA trial) applied in a double-blind counter-balanced manner. The participants with tetraplegia had sufficient neurological function to permit voluntary arm-cranking exercise. There was no difference in time-trial performance between CHO and PLA trials (P > 0.05). The results suggest that carbohydrate ingestion in persons with SCI does not improve exercise performance.

  5. Pressure ulcer risk factors in persons with spinal cord injury part 2: the chronic stage.

    PubMed

    Gélis, A; Dupeyron, A; Legros, P; Benaïm, C; Pelissier, J; Fattal, C

    2009-09-01

    Pressure ulcers (PUs) are a common complication following spinal cord injury (SCI). Prevalence for persons in the chronic SCI stage varies between 15 and 30%. The risk assessment scales used nowadays were designed on pathophysiological concepts and are not SCI-specific. Recently, an epidemiological approach to PU risk factors has been proposed for designing an SCI-specific assessment tool. The first results seem quite disappointing, probably because of the level of evidence of the risk factors used. To determine PU risk factors correlated to the chronic stage of SCI. Systematic review of the literature. There are several PU risk factors for chronic SCI stage: socio-demographics, neurological, medical or behavioral. The level of evidence varies: it is quite high for the socio-demographics and neurological factors and low for behavioral factors. Behavioral risk factors (relieving the pressure, careful skin monitoring, smoking) are probably the ones for which a preventive strategy can be established. It is important to develop specific assessment tools for these behavioral risk factors to determine their relevance and evaluate the effect of therapeutic educational programs on persons with SCI.

  6. Client-centred practice: Perspectives of persons with a traumatic brain injury.

    PubMed

    D'Cruz, Kate; Howie, Linsey; Lentin, Primrose

    2016-01-01

    Client-centred practice is well established as a core foundation of occupational therapy; however, there is little research evidence concerning the client experience. To understand client-centred practice from the perspective of adults with a traumatic brain injury (TBI) participating in community-based occupational therapy. Six adults with a moderate-severe TBI participated in two semi-structured, qualitative interviews each. In total 12 interview transcripts and additional data were coded using constructivist grounded theory methods. Data analysis produced three main themes and sub-themes: (i) Experiencing the client-therapist relationship: Seeing me as the person I was; Getting to know me in the now; Making a positive connection; (ii) Actively participating in therapy: Valuing the therapist; Being partners in therapy; and (iii) Finding my place in life: Adjusting to who I am now and Sharing my journey. The results present a framework for understanding client-centred practice as a person-centred process of engagement between the client and the therapist, as informed from the client perspective. Occupational therapists are encouraged to value and invest in the development of relationships with clients whilst the importance of seeking and integrating the client perspective into practice and research is affirmed for the profession.

  7. 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.

  8. 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…

  9. 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…

  10. Variability of leg kinematics during overground walking in persons with chronic incomplete spinal cord injury.

    PubMed

    Sohn, Won Joon; Tan, Andrew Q; Hayes, Heather B; Pochiraju, Saahith; Deffeyes, Joan; Trumbower, Randy D

    2018-03-20

    Incomplete spinal cord injury (iSCI) often leads to partial disruption of spinal pathways that are important for motor control of walking. Persons with iSCI present with deficits in walking ability due, in part, to inconsistent leg kinematics during stepping. While kinematic variability is important for normal walking, growing evidence indicates that excessive variability may limit walking ability and increase reliance on assistive devices (AD) after iSCI. The purpose of this study was to assess the effects of iSCI-induced impairments on kinematic variability during overground walking. We hypothesized that iSCI results in greater variability of foot and joint displacement during overground walking compared to controls. We further hypothesized that variability is larger in persons with limited walking speed and greater reliance on ADs. To test these hypotheses, iSCI and control subjects walked overground. Kinematic variability was quantified as step-to-step foot placement variability (endpoint), and variability in hip-knee, hip-ankle, and knee-ankle joint space (angular coefficient of correspondence; ACC). We characterized sensitivity of kinematic variability to cadence, auditory cue, and AD. Supporting our hypothesis, persons with iSCI exhibited greater kinematic variability than controls, which scaled with deficits in overground walking speed (p<0.01). Significant correlation between ACC and endpoint variability, and with walking speed, indicates both are markers of walking performance. Moreover, hip-knee and hip-ankle ACC discriminated between AD use, indicating that ACC may capture AD-specific control strategies. We conclude that increased variability of foot and joint displacement are indicative of motor impairment severity and may serve as therapeutic targets to restore walking after iSCI.

  11. A Clarion Call for Social Work Attention: Brothers and Sisters of Persons With Acquired Brain Injury in the United States.

    PubMed

    Degeneffe, Charles Edmund

    2016-08-11

    This article presents a clarion call for increased social work attention to the needs of siblings of persons with acquired brain injury (ABI) in the United States. The article overviews how siblings are psychosocially affected, how they provide care to the injured brothers and sisters, and how they personally develop as a result of their experiences. The article highlights the fact that social workers and other professionals often overlook the needs of siblings of persons with ABI and makes an appeal for social workers to advance clinical practice and research to benefit this often neglected population.

  12. Relational empathy and holistic care in persons with spinal cord injuries

    PubMed Central

    LaVela, Sherri L.; Heinemann, Allen W.; Etingen, Bella; Miskovic, Ana; Locatelli, Sara M.; Chen, David

    2017-01-01

    Objective: Describe perceptions of persons with SCI on their receipt of holistic care and relational empathy during health care encounters. Design: Mailed survey. Participants/Setting: Individuals with SCI who received care from the largest suppliers of SCI care and rehabilitation (Veterans Health Administration and SCI Model Systems). Outcome Measures: Using a survey and administrative databases, we collected demographic and injury characteristics, health status, health conditions, and the main outcome: Consultation and Relational Empathy (CARE) measure. Results: The sample included 450 individuals with SCI (124 Veterans and 326 civilians). Response rate was 39% (450/1160). Analyses were conducted on patients with complete data (n = 389). Veterans and civilians with SCI differed across many demographic characteristics, age at injury, and etiology, but mean CARE scores were equivalent. Fewer than half of the full SCI cohort had CARE scores above the normative value of 43. Having a recent pressure ulcer showed a trend for lower odds of having a normative or higher CARE score. Odds of having an above-normative CARE score were nearly 2 times greater for individuals with tetraplegia, and odds were higher for those with higher physical and mental health status. Conclusions: Higher physical and mental health status and tetraplegia were each independently associated with greater perceptions of holistic care and empathy in the therapeutic patient-provider relationship. Limited empathy, communication, and holistic care may arise when providers focus on disease/disease management, rather than on patients as individuals. Frequent health care use and secondary conditions may affect empathy and holistic care in encounters, making it essential to understand and employ efforts to improve the therapeutic relationship between patients with SCI and their providers. PMID:26833180

  13. Relational empathy and holistic care in persons with spinal cord injuries.

    PubMed

    LaVela, Sherri L; Heinemann, Allen W; Etingen, Bella; Miskovic, Ana; Locatelli, Sara M; Chen, David

    2017-01-01

    Describe perceptions of persons with SCI on their receipt of holistic care and relational empathy during health care encounters. Mailed survey. Individuals with SCI who received care from the largest suppliers of SCI care and rehabilitation (Veterans Health Administration and SCI Model Systems). Using a survey and administrative databases, we collected demographic and injury characteristics, health status, health conditions, and the main outcome: Consultation and Relational Empathy (CARE) measure. The sample included 450 individuals with SCI (124 Veterans and 326 civilians). Response rate was 39% (450/1160). Analyses were conducted on patients with complete data (n = 389). Veterans and civilians with SCI differed across many demographic characteristics, age at injury, and etiology, but mean CARE scores were equivalent. Fewer than half of the full SCI cohort had CARE scores above the normative value of 43. Having a recent pressure ulcer showed a trend for lower odds of having a normative or higher CARE score. Odds of having an above-normative CARE score were nearly 2 times greater for individuals with tetraplegia, and odds were higher for those with higher physical and mental health status. Higher physical and mental health status and tetraplegia were each independently associated with greater perceptions of holistic care and empathy in the therapeutic patient-provider relationship. Limited empathy, communication, and holistic care may arise when providers focus on disease/disease management, rather than on patients as individuals. Frequent health care use and secondary conditions may affect empathy and holistic care in encounters, making it essential to understand and employ efforts to improve the therapeutic relationship between patients with SCI and their providers.

  14. Impact of personal and environmental factors on employment outcome two years after moderate-to-severe traumatic brain injury.

    PubMed

    Forslund, Marit V; Roe, Cecilie; Arango-Lasprilla, Juan Carlos; Sigurdardottir, Solrun; Andelic, Nada

    2013-09-01

    To describe employment outcomes and assess the impact of personal and environmental factors on employment outcomes 2 years after moderate-to-severe traumatic brain injury. A prospective cohort of 100 patients with moderate-to-severe traumatic brain injury, aged 16-55 years, hospitalized in a Trauma Referral Centre during the period 2005-2007 and followed up at 1 and 2 years post-injury. Variables of interest were divided into personal and environmental factors. Personal factors include socio-demographics (age, gender, education, work demands, marital status and child-care). Environmental factors included social (support by friends), institutional (number of rehabilitation services, need for well-coordinated healthcare services), and physical (access to own transportation) factors. A multivariate logistic regression analysis was conducted with employment (working part-/full-time or studying) at 2-year follow-up as the dependent variable, and including independent variables based on significance from a univariate analysis, adjusting for injury severity. At the 2-year follow-up, 44% of patients were employed. Patients with less severe injuries (odds ratio (OR) = 1.2, p = 0.03), those supported by friends (OR = 3.5, p = 0.07), those not in need of well-coordinated health services (OR = 4.1, p = 0.04), and patients driving a vehicle at the 1-year follow-up (OR = 8.4, p < 0.001) were more likely to be employed at the 2-year follow-up. Rehabilitation professionals should be aware of the role of environmental factors when planning vocational rehabilitation services after traumatic brain injury.

  15. 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.

  16. Interval training elicits higher enjoyment versus moderate exercise in persons with spinal cord injury.

    PubMed

    Astorino, Todd A; Thum, Jacob S

    2018-01-01

    High intensity interval training (HIIT) is a robust and time-efficient approach to improve multiple health indices including maximal oxygen uptake (VO 2 max). Despite the intense nature of HIIT, data in untrained adults report greater enjoyment of HIIT versus continuous exercise (CEX). However, this has yet to be investigated in persons with spinal cord injury (SCI). To examine differences in enjoyment in response to CEX and HIIT in persons with SCI. Repeated measures, within-subjects design. University laboratory in San Diego, CA. Nine habitually active men and women (age = 33.3 ± 10.5 years) with chronic SCI. Participants performed progressive arm ergometry to volitional exhaustion to determine VO 2 peak. During subsequent sessions, they completed CEX, sprint interval training (SIT), or HIIT in randomized order. Physical activity enjoyment (PACES), affect, rating of perceived exertion (RPE), VO 2 , and blood lactate concentration (BLa) were measured. Despite a higher VO 2 , RPE, and BLa consequent with HIIT and SIT (P < 0.05), PACES was significantly higher (P = 0.03) in response to HIIT (107.4 ± 13.4) and SIT (103.7 ± 12.5) compared to CEX (81.6 ± 25.4). Fifty-five percent of participants preferred HIIT and 45% preferred SIT, with none identifying CEX as their preferred exercise mode. Compared to CEX, brief sessions of submaximal or supramaximal interval training elicit higher enjoyment despite higher metabolic strain. The long-term efficacy and feasibility of HIIT in this population should be explored considering that it is not viewed as more aversive than CEX.

  17. 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.

  18. 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

  19. Concordance with a STOPP (Screening Tool of Older Persons' Potentially Inappropriate Prescriptions) Criterion in Nova Scotia, Canada: Benzodiazepine and Zoplicone Prescription Claims by Older Adults with Fall-related Hospitalizaions.

    PubMed

    Hill-Taylor, B; Sketris, I S; Gardner, D M; Thompson, K

    2016-01-01

    Optimization of prescribing in older adults is needed. The STOPP criteria provide a systematic way of identifying potentially inappropriate prescribing in this population. Previous research indicates poor concordance between benzodiazepine prescribing and STOPP. To determine the extent and predictors of benzodiazepine and zopiclone (BZD-Z) pharmacy dispensations in older adults with a history of a recent fall, in concordance with STOPP. Prescription claims data from the Nova Scotia Seniors' Phamacare Program were linked with fall-related injury data from the CIHI Discharge Abstract Database. Adults aged ≥ 66 years making a claim for a BZD-Z in the 100 days prior to fall-related hospitalization were identified. Their BZD-Z claims in the 100 days following discharge were also identified. Descriptive statistics, trend tests and logistical regression modelling were performed to examine predictors for continued use of BZD-Z post-fall. Over 5 years, from a pool of 8,271 older adults discharged following a fall-related hospitalization, 1,789 (21.6%) had made a claim for a BZD-Z in the 100 days prior to admission. Of these, 82% were women. Younger age and female sex were predictors of continuing BZD-Z dispensations post-fall. In the 100 days following discharge, 74.2% (n=1327) made a claim for at least one BZD-Z. BZD-Z use continued in 74% of patients following discharge from a fall-related hospitalization, representing limited concordance with the STOPP criterion. Such hospitalizations and follow-up care present an opportunity to address an ongoing modifiable risk factor.

  20. 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

  1. Stress related workers' compensation claims: recommendations involving records release.

    PubMed

    Martin, K J

    1992-08-01

    1. The cost of stress claims is predicted to cripple the workers' compensation system, where stress claims are burgeoning and the average payout is twice that of a typical injury. The major reason to release medical records in a stress claim is to determine the validity of the claim arising from the job. 2. Occupational health nurses are frequently asked by the courts to reveal personal client information and may not be protected by the "nurse-client relationship" or "privileged communication." Politically, very little interest has been shown in restricting disclosure of private information. 3. Both ANA and AAOHN have adopted strong positions about safeguarding privacy. Legally, the ultimate responsibility for wrongful acts committed by the nurse falls on the individual nurse. 4. The most important reason to guard confidential health information is the basic tenet of the nurse-client relationship in which personal matters are held in confidence. To break this trust is to jeopardize the ability to provide optimal client care, which is the essence of nursing.

  2. 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. Copyright © 2013. Published by Elsevier Ltd.

  3. Validation and clinical utility of the executive function performance test in persons with traumatic brain injury.

    PubMed

    Baum, C M; Wolf, T J; Wong, A W K; Chen, C H; Walker, K; Young, A C; Carlozzi, N E; Tulsky, D S; Heaton, R K; Heinemann, A W

    2017-07-01

    This study examined the relationships between the Executive Function Performance Test (EFPT), the NIH Toolbox Cognitive Function tests, and neuropsychological executive function measures in 182 persons with traumatic brain injury (TBI) and 46 controls to evaluate construct, discriminant, and predictive validity. Construct validity: There were moderate correlations between the EFPT and the NIH Toolbox Crystallized (r = -.479), Fluid Tests (r = -.420), and Total Composite Scores (r = -.496). Discriminant validity: Significant differences were found in the EFPT total and sequence scores across control, complicated mild/moderate, and severe TBI groups. We found differences in the organisation score between control and severe, and between mild and severe TBI groups. Both TBI groups had significantly lower scores in safety and judgement than controls. Compared to the controls, the severe TBI group demonstrated significantly lower performance on all instrumental activities of daily living (IADL) tasks. Compared to the mild TBI group, the controls performed better on the medication task, the severe TBI group performed worse in the cooking and telephone tasks. Predictive validity: The EFPT predicted the self-perception of independence measured by the TBI-QOL (beta = -0.49, p < .001) for the severe TBI group. Overall, these data support the validity of the EFPT for use in individuals with TBI.

  4. 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.

  5. 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.

  6. 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

  7. [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.

  8. Improving personal self-advocacy skills for individuals with brain injury: A randomized pilot feasibility study.

    PubMed

    Hawley, Lenore; Gerber, Don; Morey, Clare

    2017-01-01

    To investigate the feasibility of a self-advocacy intervention for individuals with acquired brain injury (ABI). Two-arm, parallel-design, randomized feasibility study. Twelve participants, 1-year or more post-ABI (TBI and cerebral vascular accident (CVA)), were randomized into treatment/control groups. The treatment group received a group intervention and workbook; the control group received the workbook only. Outcome measures, taken at baseline, post-treatment and 6-weeks follow-up, included the General Self-Efficacy Scale (GSES), Satisfaction with Life Scale (SWLS) and Goal Attainment Scale (GAS) and two exploratory measures developed for the study: the Self Advocacy Scale (SAS) and the Personal Advocacy Activity Scale (PAAS). Participants were successfully recruited and treated per protocol. The treatment group exhibited improvements from baseline to post-treatment on all measures; the control group improved on the GSES and declined on all others. Both groups exhibited improvement on all measures at follow-up, except the PAAS, which declined. There were no significant group differences on non-parametric analysis at any assessment points; however, the magnitude of change at post-treatment approached significance for the SAS and PAAS. Initial feasibility for the methodology was demonstrated. Positive trends were noted. Further research could result in an evidence-based intervention to enhance self-advocacy post-ABI.

  9. 32 CFR 750.64 - Claim procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... section is not accepted by the claimant in full satisfaction of the claim, no award will be made, and the... damages caused by local national DON employees overseas are also payable under this section if the injury... the claimant accepts the amount offered in full satisfaction of the claim and signs a settlement...

  10. 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

  11. Use of an Errorless Learning Approach in a Person With Concomitant Traumatic Spinal Cord Injury and Brain Injury: A Case Report.

    PubMed

    Hartmann, Annie; Kegelmeyer, Deb; Kloos, Anne

    2018-04-01

    : Individuals with concomitant spinal cord injury and traumatic brain injury have cognitive deficits that may limit the ability to learn novel motor tasks necessary for functional independence. Errorless learning has been shown to improve cognitive task performance in persons with brain injury but little is known about its usefulness for improving novel motor task learning. A 44-year-old man with traumatic spinal cord and brain injuries from a motor vehicle accident was admitted to an inpatient rehabilitation hospital. His spinal cord injury was classified as T4 American Spinal Injury Association Impairment Scale (AIS) A, and his cognitive status was level IV on the Ranchos Los Amigos Scale. Initially, the patient required maximal assistance from 2 clinicians to complete a slide board transfer, propelled his wheelchair 25 ft with minimal assistance, and scored 9/56 on the Function in Sitting Test. The therapist applied traditional motor-learning approaches during the first 37 days of the patient's inpatient rehabilitation facility stay without meaningful gains in functional mobility. A subsequent change to errorless learning was made for the following 32 days until discharge. After use of errorless learning, the patient performed novel mobility-related tasks of slide board transfers with minimal assistance and wheelchair propulsion without physical assistance up to 150 ft; the Function in Sitting Test score improved to 18/56. His sensorimotor system progressed to an AIS classification of AIS B, while his cognition emerged to a level V on the Ranchos Los Amigos Scale. Errorless learning may have facilitated acquisition of novel transfer and mobility skills in this individual with dual diagnoses. This approach may have value for patients with neurologic conditions who have both motor and cognitive impairment.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A201).

  12. 32 CFR 536.155 - Claims payable involving tortfeasors other than nonappropriated fund employees.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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 one...

  13. 32 CFR 536.155 - Claims payable involving tortfeasors other than nonappropriated fund employees.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 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 one...

  14. 32 CFR 536.155 - Claims payable involving tortfeasors other than nonappropriated fund employees.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 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 one...

  15. 32 CFR 536.155 - Claims payable involving tortfeasors other than nonappropriated fund employees.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 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 one...

  16. 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 one...

  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 to...

  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 to...

  20. 5 CFR 180.105 - Claims not allowed.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...' PERSONAL PROPERTY CLAIMS § 180.105 Claims not allowed. (a) A claim is not allowable if: (1) The damage or... claimant or otherwise provided in kind by the United States; (3) Possession of the property lost or damaged... articles acquired at the request of others and articles for sale. (9) Property used for business. Claims...

  1. 5 CFR 180.105 - Claims not allowed.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...' PERSONAL PROPERTY CLAIMS § 180.105 Claims not allowed. (a) A claim is not allowable if: (1) The damage or... claimant or otherwise provided in kind by the United States; (3) Possession of the property lost or damaged... articles acquired at the request of others and articles for sale. (9) Property used for business. Claims...

  2. 5 CFR 180.105 - Claims not allowed.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...' PERSONAL PROPERTY CLAIMS § 180.105 Claims not allowed. (a) A claim is not allowable if: (1) The damage or... claimant or otherwise provided in kind by the United States; (3) Possession of the property lost or damaged... articles acquired at the request of others and articles for sale. (9) Property used for business. Claims...

  3. 5 CFR 180.105 - Claims not allowed.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...' PERSONAL PROPERTY CLAIMS § 180.105 Claims not allowed. (a) A claim is not allowable if: (1) The damage or... claimant or otherwise provided in kind by the United States; (3) Possession of the property lost or damaged... articles acquired at the request of others and articles for sale. (9) Property used for business. Claims...

  4. 45 CFR 35.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 35.3 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION TORT CLAIMS... person legally entitled to assert such a claim under applicable state law. (d) A claim for loss wholly compensated by an insurer with the rights of a subrogee may be presented by the insurer. A claim for loss...

  5. The Relationship between Age and Work Injury in British Columbia: Examining Differences across Time and Nature of Injury.

    PubMed

    Smith, Peter; Bielecky, Amber; Mustard, Cam; Beaton, Dorcas; Hogg-Johnson, Sheilah; Ibrahim, Selahadin; Koehoorn, Mieke; McLeod, Chris; Saunders, Ron; Scott-Marshall, Heather

    2013-01-01

    The aim of this study was to examine the relationship between age and the lost-time workers' compensation claims in British Columbia, Canada, over three time periods (1997-98, 2001-02 and 2005-06). We examined if the relationship between age and risk of lost-time claims is consistent over time and for different nature of injury categories. Secondary analyses of lost-time workers' compensation claims combined with estimates of person-years of exposure generated from the Canadian Labour Force Survey were performed. Analyses examined the relationship between age and claim risk using sex-stratified regression models, adjusting for time period, occupational characteristics and whether the claimant was employed in the goods or service industry. Multiplicative interaction terms were used to examine if the relationship between age and lost-time claim risk changed over time. Seven separate regression models were generated to explore the variation in the effect of age across nature of injury groups. We observed important differences in the relationship between age and risk of injury depending on the nature of injury examined. A negative relationship was observed between age and lost-time claims for open wounds, while a positive relationship was observed for traumatic injuries to bones, nerves and the spinal cord. We found no evidence that the relationship between age and risk of lost-time claims changed over time periods. The association between age and risk of lost-time claims depends on the nature of injury under investigation. We found no evidence that the relationship between age and overall lost-time claim risk has changed over time in British Columbia.

  6. 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

  7. Upper limb muscle activation during sports video gaming of persons with spinal cord injury.

    PubMed

    Jaramillo, Jeffrey P; Johanson, M Elise; Kiratli, B Jenny

    2018-04-04

    Video gaming as a therapeutic tool has largely been studied within the stroke population with some benefits reported in upper limb motor performance, balance, coordination, and cardiovascular status. To date, muscle activation of upper limb muscles in persons with spinal cord injuries (SCI) has not been studied during video game play. In this paper, we provide descriptive and comparative data for muscle activation and strength during gaming for players with tetraplegia and paraplegia, as well as, compare these results with data from traditional arm exercises (ie, biceps curl and shoulder press) with light weights which are commonly prescribed for a home program. Fourteen individuals with chronic SCI (9 tetraplegia, 5 paraplegia). We measured upper limb muscle activation with surface electromyography (EMG) during Wii Sports video game play. Muscle activation was recorded from the playing arm during 4 selected games and normalized to a maximum voluntary contraction (MVC). Heart rate and upper limb motion were recorded simultaneously with EMG. Wilcoxon signed rank tests were used to analyze differences in muscle activation between participants with paraplegia versus tetraplegia and compare gaming with traditional arm exercises with light weights. A Friedman 2-way analysis of variance identified key muscle groups active during game play. Overall muscle activation across the games was not different between those with paraplegia and tetraplegia. Heart rate during video game play for tennis and boxing were on average 10 to 20 beats/minute above resting heart rate. The magnitude of EMG was relatively greater for traditional arm exercises with light weights compared with game play. The selected Wii games were able to elicit upper extremity muscle activation and elevated heart rates for individuals with SCI that may be used to target therapeutic outcomes.

  8. Wheelchair configuration and postural alignment in persons with spinal cord injury.

    PubMed

    Hastings, Jennifer D; Fanucchi, Elaine Rogers; Burns, Stephen P

    2003-04-01

    To determine whether postural alignment and shoulder flexion range differ for persons with spinal cord injury (SCI) seated in wheelchairs with standard configurations versus wheelchairs with posterior seat inclination and a low backrest set perpendicular to the floor. Prospective repeated-measures study. Outpatient SCI clinic. Fourteen subjects with C6-T10 motor-complete SCI. Subjects sat in 3 manual wheelchairs: standard setup E&J Premier (S1), standard setup Quickie Breezy (S2), and test configuration Quickie TNT (T) with posterior seat inclination and a low backrest set perpendicular to the floor. Shoulder and neck alignment and pelvic tilt were determined from sagittal plane digital photographs at rest and with maximal vertical reach. At rest, T produced less shoulder protraction than either standard configuration (difference between the mean values, S1: 1.6 cm, P=.048; S2: 1.2 cm, P=.013). S1 and S2 showed a greater head-forward position than T (differences between the mean values, S1: 6.5 degrees, P=.008; S2: 6.3 degrees, P=.013). T allowed greater humeral flexion than S2 (difference between the mean values: 3.7 degrees, P=.036) and greater vertical reach above the seat plane than either conventional configuration (differences between the mean values, S1: 4.7 cm, P=.005; S2: 4.1cm, P=.002). The indirect pelvic tilt measurement showed a trend (P=.06) toward greater posterior pelvic tilt with S1 and S2. The alternate configuration produces more vertical postural alignment and greater reach ability versus the standard factory setup wheelchairs.

  9. Post-acute care referral and inpatient rehabilitation admission criteria for persons with brain injury across two Canadian provinces.

    PubMed

    Swaine, Bonnie; Cullen, Nora; Messier, Frédéric; Bayley, Mark; Lavoie, André; Marshall, Shawn; Sirois, Marie-Josée; Turgeon-Fournier, Alexis; Lamoureux, Julie; Lam Wai Shun, Priscilla

    2018-03-01

    Investigate health care providers' perceptions of referral and admission criteria to brain injury inpatient rehabilitation in two Canadian provinces. Health care providers (n = 345) from brain injury programs (13 acute care and 16 rehabilitation facilities) participated in a cross-sectional web-based survey. The participants rated the likelihood of patients (traumatic brain injury and cerebral hypoxia) to be referred/admitted to rehabilitation and the influence of 19 additional factors (e.g., tracheostomy). The participants reported the perceived usefulness of referral/admission policies and assessment tools used. Ninety-one percent acute care and 98% rehabilitation participants reported the person with traumatic brain injury would likely or very likely be referred/admitted to rehabilitation compared to respectively 43% and 53% for the patient with hypoxia. Two additional factors significantly decreased the likelihood of referral/admission: older age and the combined presence of minimal learning ability, memory impairment and physical aggression. Some significant inter-provincial variations in the perceived referral/admission procedure were observed. Most participants reported policies were helpful. Similar assessment tools were used in acute care and rehabilitation. Health care providers appear to consider various factors when making decisions regarding referral and admission to rehabilitation. Variations in the perceived likelihood of referral/admission suggest a need for standardized referral/admission practices. Implications for Rehabilitation Various patient characteristics influence clinicians' decisions when selecting appropriate candidates for inpatient rehabilitation. In this study, acute care clinicians were less likely to refer patients that their rehabilitation counter parts would likely have admitted and a patient with hypoxic brain injury was less likely to be referred or admitted in rehabilitation than a patient with a traumatic brain injury

  10. The quality of upper extremity orthopedic care in liability claims filed and claims paid.

    PubMed

    Matsen, Frederick A; Stephens, Linda; Jette, Jocelyn L; Warme, Winston J; Huang, Jerry I; Posner, Karen L

    2014-01-01

    To review a series of closed liability claims for upper extremity conditions to guide improvements for upper extremity care and thereby reduce the frequency of paid claims. The authors, a team of 3 orthopedic surgeons and 3 nonphysician investigators experienced in closed claims research, investigated 108 closed upper extremity liability claims from a large United States-wide insurer for events that occurred between 1996 and 2009. We sought to determine the types of conditions, treatments, and surgeon factors common to claims made and claims paid. Liability claims were primarily for the care of common problems, such as fractures (n = 52; 48%) or degenerative conditions (n = 24; 26%), rather than complex challenging conditions or disorders, such as deficiencies treated with replantations or tissue transfers. The most common adverse outcomes in these claims were nonunion or malunion of fractures (n = 29; 27%), nerve injury (n = 20; 19%), and infection (n = 13; 12%). Most claims (n = 57; 53%) involved a permanent injury. The surgeon's operative skills were more commonly an issue in paid claims (n = 13; 45%) than in claims without payment (n = 14; 19%). Claims for mismanagement of fractures (n = 52; 48% of all claims) were more likely to result in payment (n = 20; 38%) than nonfracture claims (n = 10; 18%). This analysis suggests that the incidence of upper extremity claims made and claims paid may be reduced if surgeons acquire and maintain the knowledge and skills necessary for the care of the common conditions they encounter, including fractures. Prognostic II. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  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. The Virginia Community Cadre Network: Community Reintegration of Persons with Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Wilson, Walter C.; Thompson, Donald D.

    1983-01-01

    The Community Cadre Network in Virginia is a local support network for helping individuals with spinal cord injuries make the transition from an institutional setting to home and community life. Cadre members are people who have been through the experience of traumatic injury, rehabilitation, and return home. (SEW)

  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. 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)…

  17. 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…

  18. 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

  19. 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.

  20. Early-Claim Modifiable Factors Associated With Return-to-Work Self-Efficacy Among Workers Injured at Work: Are There Differences Between Psychological and Musculoskeletal Injuries?

    PubMed

    Black, Oliver; Sim, Malcolm R; Collie, Alexander; Smith, Peter

    2017-12-01

    The objective of this study was to investigate modifiable early-injury factors which are associated with self-efficacy to return-to-work (RTW-SE) and explore whether these factors are different for people with psychological or upper-body musculoskeletal (UB-MSK) injuries. The study used a sample of workers with a UB-MSK (N = 244) or psychological (N = 113) injury who were off work. Differences between injury types were investigated across variables related to: (1) communication with RTW stakeholders; and (2) components of the job itself. A stratified and multigroup analysis was conducted using structural equation modeling (SEM). Injury-stratified models revealed no significant differences. In a combined model, higher job autonomy and low-stress contact from the RTW coordinator remained significantly associated with higher RTW-SE. Job autonomy and low-stress contact from the RTW coordinator are possible areas to target to increase self-efficacy among injured workers.

  1. 49 CFR 370.3 - Filing of claims.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... FOR THE INVESTIGATION AND VOLUNTARY DISPOSITION OF LOSS AND DAMAGE CLAIMS AND PROCESSING SALVAGE § 370.3 Filing of claims. (a) Compliance with regulations. A claim for loss or damage to baggage or for loss, damage, injury, or delay to cargo, shall not be voluntarily paid by a carrier unless filed, as...

  2. 12 CFR 793.3 - Administrative claim; who may file.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Administrative claim; who may file. 793.3 Section 793.3 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS... Administrative claim; who may file. (a) A claim for injury to or loss of property may be presented by the owner...

  3. 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.

  4. Health Condition and Quality of Life in Persons with Spinal Cord Injury.

    PubMed

    Trgovcevic, Sanja; Milicevic, Milena; Nedovic, Goran; Jovanic, Goran

    2014-09-01

    During the last few decades, focus of rehabilitation outcome has been redirected to the lifetime monitoring of quality of life. The purpose of this study was to investigate the differences in quality of life perceptions between participants with spinal cord injury and participants of typical population. This cross-sectional controlled study of 100 adults aged 18-65 years was based on two questionnaires, Short Form-36 Health Survey (SF-36) and Spinal Cord Injury Quality of Life Questionnaire (QL-23), completed by 23 participants with paraplegia, 21 participants with tetraplegia, and 56 participants of typical population. Mann-Whitney U-test for planned comparison between groups and χ(2) test were used to analyze the differences between research groups. Participants from control group perceived their general quality of life at higher level in comparison to participants with spinal cord injury (U=415.000, z=-5.804, P<0.000). Negative influence of spinal cord injury was detected in six domains (physical functioning, physical role, bodily pain, vitality, social functioning, mental health). Statistical differences between participants with paraplegia and participants with tetraplegia only in domain of functional limitations (U=103.000, z=-3.256, P<0.005). The participants with spinal cord injury perceived both health-related and general quality of life at a lower level in comparison to controls. However, the injury level only partially determined the estimated quality of life.

  5. Personal identity narratives of therapeutic songwriting participants following Spinal Cord Injury: a case series analysis.

    PubMed

    Roddy, Chantal; Rickard, Nikki; Tamplin, Jeanette; Baker, Felicity Anne

    2017-08-24

    Spinal Cord Injury (SCI) patients face unique identity challenges associated with physical limitations, higher comorbid depression, increased suicidality and reduced subjective well-being. Post-injury identity is often unaddressed in subacute rehabilitation environments where critical physical and functional rehabilitation goals are prioritized. Therapeutic songwriting has demonstrated prior efficacy in promoting healthy adjustment and as a means of expression for post-injury narratives. The current study sought to examine the identity narratives of therapeutic songwriting participants. Case-series analysis of the individual identity trajectories of eight individuals. Subacute rehabilitation facility, Victoria, Australia. Eight individuals with an SCI; 7 males and 1 female. Six-week therapeutic songwriting intervention facilitated by a music therapist to promote identity rehabilitation. Identity, subjective well-being and distress, emotional state. Three participants demonstrated positive trajectories and a further three showed negative trajectories; remaining participants were ambiguous in their response. Injury severity differentiated those with positive trajectories from those with negative trajectories, with greater injury severity apparent for those showing negative trends. Self-concept also improved more in those with positive trajectories. Core demographic variables did not however meaningfully predict the direction of change in core identity or wellbeing indices. Identity-focused songwriting holds promise as a means of promoting healthy identity reintegration. Further research on benefits for those with less severe spinal injuries is warranted.

  6. 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.

  7. Level of agreement of occupational titles between persons with traumatic brain injury and their informants.

    PubMed

    Harris, J E; Mays, J; Ratcliff, G; Chase, S; Vemich, L; Colantonio, A

    2015-01-01

    Returning to work is one of the most important goals cited by individuals with traumatic brain injury (TBI). However, they may have difficulty evoking past work history. The ability to recall work history is integral to the rehabilitation process of return to work. The aim of this study was to determine 1) the level of agreement on the reporting of occupations and 2) if agreement is affected when specific occupational details are required in recall between adults with traumatic brain injury and their informants. This is a retrospective cohort study of 259 individuals, with moderate to severe traumatic brain injury, and their selected informants (e.g. spouse, parent). Interviews were conducted separately for the individual and respective informant to gather information on type of occupation at time of injury and at time of interview. Reported occupations were coded using a standard classification system. Level of agreement was analyzed by interclass correlation coefficients and percent agreement, and the significance of bias was calculated. Participants were a mean age of 44.5 at time of study with 40% employed compared to 77% at time of injury. Agreement between participants and their informants for occupational title was high for both time periods though more so at the time of injury compared to current status. Level of agreement for specificity was moderate to high however, decreased as need for specificity of detail increased. While participant-informant responses appear to be reliable for occupational classification, when detailed information is required corroborating information is likely needed.

  8. 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.

  9. 38 CFR 14.665 - Claims.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... writing on VA Form 2-4760, Employee's Claim for Reimbursement for Personal Property Damaged or Lost... years after it accrues except that if the claim accrues in time of war or in time of armed conflict in which any Armed Force of the United States is engaged or if such war or armed conflict intervenes within...

  10. 38 CFR 14.665 - Claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... writing on VA Form 2-4760, Employee's Claim for Reimbursement for Personal Property Damaged or Lost... years after it accrues except that if the claim accrues in time of war or in time of armed conflict in which any Armed Force of the United States is engaged or if such war or armed conflict intervenes within...

  11. 38 CFR 14.665 - Claims.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... writing on VA Form 2-4760, Employee's Claim for Reimbursement for Personal Property Damaged or Lost... years after it accrues except that if the claim accrues in time of war or in time of armed conflict in which any Armed Force of the United States is engaged or if such war or armed conflict intervenes within...

  12. 38 CFR 14.665 - Claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... writing on VA Form 2-4760, Employee's Claim for Reimbursement for Personal Property Damaged or Lost... years after it accrues except that if the claim accrues in time of war or in time of armed conflict in which any Armed Force of the United States is engaged or if such war or armed conflict intervenes within...

  13. 38 CFR 14.665 - Claims.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... writing on VA Form 2-4760, Employee's Claim for Reimbursement for Personal Property Damaged or Lost... years after it accrues except that if the claim accrues in time of war or in time of armed conflict in which any Armed Force of the United States is engaged or if such war or armed conflict intervenes within...

  14. 27 CFR 24.29 - Claims.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TREASURY LIQUORS WINE Administrative and Miscellaneous Provisions Authorities § 24.29 Claims. The appropriate TTB officer may require the proprietor or other person liable for the tax on wine or spirits to file a claim and to submit evidence of loss in any case where wine or spirits are lost or destroyed...

  15. 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...

  16. 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

    NONE

    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 andmore » 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.« less

  17. 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…

  18. Health care utilization in persons with spinal cord injury: part 2-determinants, geographic variation and comparison with the general population.

    PubMed

    Ronca, E; Scheel-Sailer, A; Koch, H G; Gemperli, A

    2017-09-01

    Cross-sectional survey. To investigate annual rates and geographic variation of health care utilization in persons with spinal cord injury (SCI), and to identify factors associated with health care utilization. Community setting, entire country of Switzerland. Annual rates of planned and emergency visits to the general practitioner (GP), planned and emergency outpatient clinic visits and in-patient hospitalizations were compared between individuals with chronic SCI, over 16 years of age residing in Switzerland between late 2011 and early 2013 and a population sample (2012) of the Swiss general population. Risk factors for increased health service utilization were identified by means of regression models adjusted for spatial variation. Of 492 participants (86.2% response rate), 94.1% visited a health care provider in the preceding year, with most persons visiting GPs (88.4%) followed by outpatient clinics (53.1%) and in-patient hospitals (35.9%). The increase in utilization as compared with the general population was 1.3-, 4.0- and 2.9-fold for GP, outpatient clinic and in-patient hospital visit, respectively. GP utilization was highest in persons with low income (incidence rate ratio (IRR) 1.85) and old age (IRR 2.62). In the first 2 years post injury, health service visits were 1.7 (GP visits) to 5.8 times (emergency outpatient clinic visits) more likely compared with those later post injury. People with SCI more frequently use health services as compared with the general population, across all types of medical service institutions. GP services were used most often in areas where availability of specialized outpatient clinic services was low.

  19. 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

  20. Neonatal hypoglycaemia: learning from claims.

    PubMed

    Hawdon, Jane M; Beer, Jeanette; Sharp, Deborah; Upton, Michele

    2017-03-01

    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. 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. NHS LA. Anonymised documentation relating to 30 neonates for whom claims were made relating to neonatal hypoglycaemia. Dates of birth were between 1995 and 2010. Review of documentation held on the NHS LA database. Identifiable risk factors for hypoglycaemia, presenting clinical signs, possible deficits in care, financial costs of litigation. 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. 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. 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/.

  1. Risk factors for serious injury in Finnish agriculture.

    PubMed

    Rautiainen, Risto H; Ledolter, Johannes; Donham, Kelley J; Ohsfeldt, Robert L; Zwerling, Craig

    2009-05-01

    Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries. We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of 2000 euros). A total of 5,507 compensated injuries occurred in 2002 (rate 5.9/100 person-years), and 1,167 or 21% of them (rate 1.25/100 person-years) were serious. The causes/sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service (OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury. Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls. Copyright 2009 Wiley-Liss, Inc.

  2. Spinal injury

    MedlinePlus

    ... head. Alternative Names Spinal cord injury; SCI Images Skeletal spine Vertebra, cervical (neck) Vertebra, lumbar (low back) Vertebra, thoracic (mid back) Vertebral column Central nervous system Spinal cord injury Spinal anatomy Two person roll - ...

  3. 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…

  4. 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.

  5. 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.

  6. 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…

  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. 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,…

  9. 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.

  10. 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. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. 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

  12. Pedestrian road traffic injuries in urban Peruvian children and adolescents: case control analyses of personal and environmental risk factors.

    PubMed

    Donroe, Joseph; Tincopa, Monica; Gilman, Robert H; Brugge, Doug; Moore, David A J

    2008-09-10

    Child pedestrian road traffic injuries (RTIs) are an important cause of death and disability in poorer nations, however RTI prevention strategies in those countries largely draw upon studies conducted in wealthier countries. This research investigated personal and environmental risk factors for child pedestrian RTIs relevant to an urban, developing world setting. This is a case control study of personal and environmental risk factors for child pedestrian RTIs in San Juan de Miraflores, Lima, Perú. The analysis of personal risk factors included 100 cases of serious pedestrian RTIs and 200 age and gender matched controls. Demographic, socioeconomic, and injury data were collected. The environmental risk factor study evaluated vehicle and pedestrian movement and infrastructure at the sites in which 40 of the above case RTIs occurred and 80 control sites. After adjustment, factors associated with increased risk of child pedestrian RTIs included high vehicle volume (OR 7.88, 95%CI 1.97-31.52), absent lane demarcations (OR 6.59, 95% CI 1.65-26.26), high vehicle speed (OR 5.35, 95%CI 1.55-18.54), high street vendor density (OR 1.25, 95%CI 1.01-1.55), and more children living in the home (OR 1.25, 95%CI 1.00-1.56). Protective factors included more hours/day spent in school (OR 0.52, 95%CI 0.33-0.82) and years of family residence in the same home (OR 0.97, 95%CI 0.95-0.99). Reducing traffic volumes and speeds, limiting the number of street vendors on a given stretch of road, and improving lane demarcation should be evaluated as components of child pedestrian RTI interventions in poorer countries.

  13. Change in neuroplasticity-related proteins in response to acute activity-based therapy in persons with spinal cord injury.

    PubMed

    Harness, Eric T; Astorino, Todd A; Knoblach, Susan M; Feather, Jillenne

    2014-01-01

    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. The primary aim of this study was to examine acute alterations in neuroplasticity-related proteins during ABT in persons with SCI. 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. 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. 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.

  14. Behavioral treatment for pathological gambling in persons with acquired brain injury.

    PubMed

    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 one-on-one client-patient format, a treatment program was developed in which the patient learned about the antecedents, consequences, and motivating operations that controlled the emission of gambling behavior. Data were collected on both self-report of gambling urges and behavior following therapy and during in situ gambling opportunities. The therapy program reduced urges to gamble and actual gambling for all patients. The potential of behavior-analytic therapy for reducing the pathological gambling of patients with and without brain injury is discussed.

  15. [Therapeutic outcome in penetrating craniocerebral injuries in children. Personal experiences during war conditions].

    PubMed

    Vranković, D; Kristek, B; Mursić, B; Takac, I

    1997-01-01

    During the war period 1991-1992 in Croatia, ten wounded children (16 years of age or younger) with war injuries to the brain were admitted to the Division of Neurosurgery, Osijek Clinical Hospital. Six of them had been wounded by shrapnel and four by pistol or rifle bullets. All but one were managed surgically (i.e. by craniotomy). The outcome was: as follows three children had a good recovery, four retained a moderate neurological deficit, and three died (injured by shrapnel). Five of the wounded (four injured by shrapnel and one by bullets) had associated injuries (fractures of the leg bones, eye lesion, amputation of the right leg) which influenced morbidity, and in one case mortality. Children wounded with shrapnel had brain edema on admission to hospital. Our experience indicates that the thermal effect from heated shrapnel, as well as velocity, mass, size and shape of the shrapnel, could be an additional factor for the development of severe brain edema.

  16. 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.

  17. [Emotional regulation in aspect of action vs. state orientation, stress and self - injurious behavior among people with borderline personality disorder].

    PubMed

    Blasczyk-Schiep, Sybilla; Rabska, Ewelina; Jaworska-Andryszewska, Paulina; Laso, Agnieszka

    2015-06-01

    In the bordeline personality disorder a large role ascribe to biopsychosocial factors. Studies have shown that more than 70% patients BPD reported experiencing traumatic events in childhood. The findings are confirming that making self-harming is a frequent symptom of bordeline disorder and 70-75% patients show at least one act of self-harming. Selfharming can be a reaction to maladaptive emotional regulation. Moreover a lowered tolerance level is characteristic of them to the stress and determined course learning dysfunctional patterns of behavior. The aim of this study is to determine the level of emotional regulation through the variable action vs state orientation and to investigate their relation to stress, self-harming and suicidal behavior. In study participated 45 persons with emotionally unstable borderline personality diagnosis. In the group was 33 women and 12 men in age 19-43. A Polish adaptation of standardized questionnaires was used to measure stress and action vs state orientation (SSI-K), self-injurious behavior (SHI) and suicidal tendencies (RFL-I). By patients with borderline personality disorder the level of action control, reasons for living and stress are predictors of selfharming behavior. The mediation analyze showed, that stress and reasons for living are mediators between action vs. state control and the level of self-harming behavior. A high level of stress correlates positively with self-harming and negatively with action control in patients with borderline personality disorder, and a high level of reasons for living correlates positively with action control and negatively with self-harming in people with BPD. © 2015 MEDPRESS.

  18. The role of occupational activities and work environment in occupational injury and interplay of personal factors in various age groups among Indian and French coalminers.

    PubMed

    Bhattacherjee, Ashis; Kunar, Bijay Mihir; Baumann, Michele; Chau, Nearkasen

    2013-12-01

    The role of occupational hazards in occupational injury may be mediated by individual factors across various age groups. This study assessed the role of occupational hazards as well as contribution of individual factors to injuries among Indian and French coalminers. We conducted a case-control study on 245 injured workers and on 330 controls without any injuries from Indian coal mines using face-to-face interviews, and a retrospective study on 516 French coalminers using a self-administered questionnaire including potential occupational and personal factors. Data were analyzed using logistic models. The annual rate of injuries was 5.5% for Indian coalminers and 14.9% for the French ones. Logistic model including all occupational factors showed that major injury causes were: hand-tools, material handling, machines, and environment/work-geological/strata conditions among Indian miners (adjusted odds-ratios 2.01 to 3.30) and biomechanical exposure score among French miners (adjusted odds-ratio 3.01 for score the 1-4, 3.47 for the score 5-7, and 7.26 for score ≥ 8, vs. score 0). Personal factors among Indian and French coalminers reduced/exacerbated the roles of various occupational hazards to a different extent depending on workers' age. We conclude that injury roles of occupational hazards were reduced or exacerbated by personal factors depending on workers' age in both populations. This knowledge is useful when designing prevention which should definitely consider workers' age.

  19. Predictive factors of long-term mortality of persons with tetraplegic spinal cord injury: an 11-year French prospective study.

    PubMed

    Espagnacq, M F; Albert, T; Boyer, F C; Brouard, N; Delcey, M; Désert, J-F; Lamy, M; Lemouel, M-A; Meslé, F; Ravaud, J-F

    2011-06-01

    Longitudinal study with mortality follow-up. Identify predictive factors for long-term mortality following tetraplegic spinal cord injury (TSCI). The Tetrafigap survey is a multi-centre epidemiological survey on the long-term outcome of persons with TSCI, initiated in France in 1995 with the participation of 35 rehabilitation centres. The mortality follow-up involves 1241 persons with TSCI who were admitted to one of the study rehabilitation units at the initial phase and who completed the initial self-administered questionnaire. There were 226 observed deaths (18.2%) during an 11-year period. Logistic regression methods, with estimates of odds ratios (ORs), incorporating clinical, functional and social participation data were used to determine the factors related to mortality. This was followed by multivariate analysis to determine the best predictive factors for long-term mortality. Risk of death increases significantly with age but not with the time elapsed since the accident. The risk of death is higher in men. Interestingly, clinical variables are not the best predictors of long-term mortality. Instead, the significant effect of poor social participation (being single, infrequent contact with friends) and functional limitations (full assistance required with dressing or eating) persists after adjustment for other variables. Once the medical situation becomes more stable, factors related to the long-term mortality of persons with TSCI are not exactly identical to those observed in the short acute-phase and during the first year after the accident. Social participation has a significant effect on mortality.

  20. 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 qualified...

  1. 28 CFR 7.4 - Procedure for claiming reward.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Procedure for claiming reward. 7.4 Section 7.4 Judicial Administration DEPARTMENT OF JUSTICE REWARDS FOR CAPTURE OF ESCAPED FEDERAL PRISONERS § 7.4 Procedure for claiming reward. A person claiming a reward under this part shall present his...

  2. 28 CFR 7.4 - Procedure for claiming reward.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Procedure for claiming reward. 7.4 Section 7.4 Judicial Administration DEPARTMENT OF JUSTICE REWARDS FOR CAPTURE OF ESCAPED FEDERAL PRISONERS § 7.4 Procedure for claiming reward. A person claiming a reward under this part shall present his...

  3. 28 CFR 7.4 - Procedure for claiming reward.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Procedure for claiming reward. 7.4 Section 7.4 Judicial Administration DEPARTMENT OF JUSTICE REWARDS FOR CAPTURE OF ESCAPED FEDERAL PRISONERS § 7.4 Procedure for claiming reward. A person claiming a reward under this part shall present his...

  4. 28 CFR 7.4 - Procedure for claiming reward.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Procedure for claiming reward. 7.4 Section 7.4 Judicial Administration DEPARTMENT OF JUSTICE REWARDS FOR CAPTURE OF ESCAPED FEDERAL PRISONERS § 7.4 Procedure for claiming reward. A person claiming a reward under this part shall present his...

  5. 28 CFR 7.4 - Procedure for claiming reward.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Procedure for claiming reward. 7.4 Section 7.4 Judicial Administration DEPARTMENT OF JUSTICE REWARDS FOR CAPTURE OF ESCAPED FEDERAL PRISONERS § 7.4 Procedure for claiming reward. A person claiming a reward under this part shall present his...

  6. 39 CFR 912.10 - Action on approved claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Action on approved claims. 912.10 Section 912.10 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURES TO ADJUDICATE CLAIMS FOR PERSONAL... approved claims. In any case where the General Counsel or the General Counsel's designee, upon...

  7. 32 CFR 756.9 - Claims by employees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Property. Claims by employees of NAFIs for loss, damage, or destruction of personal property incident to... 32 National Defense 5 2010-07-01 2010-07-01 false Claims by employees. 756.9 Section 756.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS PROCEDURES FOR PROCESSING...

  8. 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 Conflict...

  9. 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 Conflict...

  10. 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 Conflict...

  11. 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 Conflict...

  12. 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 Conflict...

  13. 5 CFR 180.108 - Settlement of claims.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Settlement of claims. 180.108 Section 180.108 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYEES' PERSONAL PROPERTY CLAIMS § 180.108 Settlement of claims. (a) Authority. Associate Directors and Regional Directors are authorized to settle and pay any...

  14. 5 CFR 180.106 - Claims involving carriers and insurers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 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) Claimants must comply with the following before...

  15. 5 CFR 180.106 - Claims involving carriers and insurers.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 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) Claimants must comply with the following before...

  16. 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 qualified...

  17. 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 qualified...

  18. 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 qualified...

  19. Iatrogenic nerve injury in a national no-fault compensation scheme: an observational cohort study.

    PubMed

    Moore, A E; Zhang, J; Stringer, M D

    2012-04-01

    Iatrogenic nerve injury causes distress and disability, and often leads to litigation. The scale and profile of these injuries has only be estimated from published case reports/series and analyses of medicolegal claims.   To determine the current spectrum of iatrogenic nerve injury in New Zealand by analysing treatment injury claims accepted by a national no-fault compensation scheme. The Accident Compensation Corporation (ACC) provides national no-fault personal accident insurance cover, which extends to patients who have sustained a treatment injury from a registered healthcare professional. Nerve injury claims identified from 5227 treatment injury claims accepted by the ACC in 2009 were analysed. From 327 claims, 292 (89.3%) documenting 313 iatrogenic nerve injuries contained sufficient information for analysis. Of these, 211 (67.4%) occurred in 11 surgical specialties, particularly orthopaedics and general surgery; the remainder involved phlebotomy services, anaesthesia and various medical specialties. The commonest causes of injury were malpositioning (n = 40), venepuncture (n = 26), intravenous cannulation (n = 21) and hip arthroplasty (n = 21). Most commonly injured were the median nerve and nerve roots (n = 32 each), brachial plexus (n = 26), and the ulnar nerve (n = 25). At least 34 (11.6%) patients were referred for surgical management of their nerve injury. Iatrogenic nerve injuries are not rare and occur in almost all branches of medicine, with malpositioning under general anaesthesia and venepuncture as leading causes. Some of these injuries are probably unavoidable, but greater awareness of which nerves are at risk and in what context should facilitate the development and/or wider implementation of preventive strategies. © 2012 Blackwell Publishing Ltd.

  20. Forensic epidemiologic and biomechanical analysis of a pelvic cavity blowout injury associated with ejection from a personal watercraft (jet-ski).

    PubMed

    Freeman, Michael D; Everson, Todd M; Kohles, Sean S

    2013-01-01

    Jet-propelled personal watercraft (PWC) or jet-skis have become increasingly popular. The means of propulsion of PWC, which is a jet of water forced out of small nozzle at the rear of the craft, combined with a high risk of falling off of the seat and into close proximity with the water jet stream, raise the potential for a unique type of injury mechanism. The most serious injuries associated with PWC falls are those that occur when the perineum passes in close proximity to the jet nozzle and the high-pressure water stream enters the vaginal or rectal orifice. We describe the forensic investigation into a case of an anovaginal "blowout" injury in a passenger who was ejected from the rear seat position of a PWC and subsequently suffered life-threatening injuries to the pelvic organs. The investigation included a biomechanical analysis of the injury mechanism, a summary of prior published reports of internal pelvic injuries resulting from PWC falls as well as other water sports and activities, and a comparison of the severity of the injuries resulting from differing mechanisms using the New Injury Severity Score (NISS). The mean (± standard deviation [SD]) NISS values for reported PWC injuries [not including the NISS of 38 in this case study] were 11.2 (± 9.5), while the mean value for reported water-skiing falls was half that of the PWC group at 5.6 (± 5.2). It was concluded that the analyzed injuries were unique to a PWC ejection versus other previously described non-PWC-associated water sport injuries. It is recommended that PWC manufacturers help consumers understand the potential risks to passengers with highly visible warnings and reduce injury risk with revised seat design, and/or passenger seat "deadman" switches. © 2012 American Academy of Forensic Sciences.

  1. Hip Arthroplasty Malpractice Claims in the Netherlands: Closed Claim Study 2000-2012.

    PubMed

    Zengerink, Imme; Reijman, Max; Mathijssen, Nina M C; Eikens-Jansen, Manon P; Bos, P Koen

    2016-09-01

    A total hip arthroplasty (THA) is a successful and reliable operation with few complications. These complications however, do form a potential source for compensation claims. In the Netherlands, there are no studies available concerning filed claims after THA. The aim of this study was to determine the incidence of claims related to THAs in the Netherlands and the reasons to claim, which claims lead to compensation, the costs involved for the insurer, and the demographics of the claimants. In this observational study, we analyzed all closed claims from 2000 to 2012 from the national largest insurer of medical liability and compared it to data from our national implant registry in the Netherlands. With the intention to contribute to prevention, we have identified the demographics of the claimant, the reasons for filing claims, and the outcome of claims. Overall, 516 claims were expressed in 280 closed claim files after THA. Claims were most often related to sciatic nerve injury (19.6%). Most claimants were women (71.6%) with an average age of 63.1 years. The median cost per compensated claim is €5.921. The claimant is more likely to be female and to be younger than the average patient receiving a THA. The incidence of a claim after a THA is 0.14%-0.30%. Nerve damage is the most common reason to file for compensation. The distribution in reasons to claim does not resemble the complication rate in literature after a THA. The outcome of this study can be used to improve patient care, safety, and costs. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Rotator cuff surgery in persons with spinal cord injury: relevance of a multidisciplinary approach.

    PubMed

    Fattal, Charles; Coulet, Bertrand; Gelis, Anthony; Rouays-Mabit, Hélène; Verollet, Christine; Mauri, Cécile; Ducros, Jean-Luc; Teissier, Jacques

    2014-09-01

    This article is a prospective review of patients with spinal cord injury who underwent multidisciplinary consultation from January 2005 to September 2013 for pain in one or both shoulders. We performed clinical, functional, and lesion evaluations of 38 patients with paraplegia and quadriplegia presenting with rotator cuff pathologies. Surgery was indicated and performed on 38 shoulders in 28 patients. The lesion assessment during surgery showed injuries that were more severe than one would have thought based on imaging data. The mean pain intensity rating in the operative and nonoperative groups was 0 and 1.6, respectively, at rest and 2 and 4.9, respectively, during paroxysmal peaks. On average, for patients who had surgery, the Functional Independence Measure score decreased by 2.3. The mean satisfaction index in operated patients was 8.5 of 10. When the surgical indication was based on a multidisciplinary decision, no negative results were reported that could have challenged the validity of this decision. Pain relief was the primary benefit reported after surgery. The functional status was modified because of the technical aids needed to prevent shoulder overuse. There are several arguments in favor of rotator cuff surgery for wheelchair-bound patients with spinal cord injury. Because of their functional impairments, wheelchair-bound patients will continue to overburden their shoulders after rotator cuff surgery. A multidisciplinary approach emerges as the solution to inform and educate patients to limit the risk of recurrence. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  3. Hyperkyphotic posture and risk of injurious falls in older persons: the Rancho Bernardo Study.

    PubMed

    Kado, Deborah M; Huang, Mei-Hua; Nguyen, Claude B; Barrett-Connor, Elizabeth; Greendale, Gail A

    2007-06-01

    Falls among older adults can have serious physical and emotional consequences, ultimately leading to a loss of independence. Improved identification of those at risk for falls could lead to effective interventions. Because hyperkyphotic posture is associated with impaired physical functioning, we hypothesized that kyphosis may also be associated with falls. Participants were 1883 older adults from the Rancho Bernardo Study. Between 1988 and 1991, kyphosis was measured using a system of 1.7-cm blocks placed under the participants' heads if they were unable to lie flat without neck hyperextension. Data on falls including injurious falls, demographics, health, and habits were obtained from a self-administered questionnaire completed at the same visit. Hyperkyphosis was defined as requiring the use of > or = 1 blocks (n = 595, 31.6%). In this cohort, men were more likely to be hyperkyphotic than were women (p <.0001). Of those who fell, 36.3% were hyperkyphotic, versus 30.2% among those who did not fall (p =.015). Those who fell were older, more likely to be women, had lower body mass index, did not exercise, did not drink alcohol, and had poor self-reported physical and emotional health. In age- and sex-adjusted models, those with hyperkyphosis were at 1.38-fold increased odds of experiencing an injurious fall (95% confidence interval [CI], 1.05-1.91; p =.02) that increased to 1.48 using a cutoff of > or = 2 blocks versus < or = 1 blocks (95% CI, 1.10-2.00; p =.01). Although women were more likely to fall, after adjustment for possible confounders, men with moderate hyperkyphosis were at greatest fall risk. Moderate hyperkyphotic posture may signify an easily identifiable independent risk factor for injurious falls in older men, with the association being less pronounced in older women.

  4. Psychological adjustment and marital satisfaction following head injury. Which critical personal characteristics should both partners develop?

    PubMed

    Blais, Marie Claude; Boisvert, Jean-Marie

    2007-04-01

    PRIMARY OBJECTIVE AND RESEARCH DESIGN: Using a correlational design, this study verifies the relationships between personal characteristics of individuals with TBI and their spouses and their level of psychological and marital adjustment. Seventy individuals with TBI and their spouses in the post-acute rehabilitation phase completed self-report questionnaires assessing the predictive variables (coping and social problem-solving strategies; perceived communication skills) and the criteria variables of psychological and marital adjustment. In the target group, the characteristics most strongly related to adjustment variables were an effective attitude towards problems, infrequent use of avoidance coping strategies, and a positive perception of one's spouse's communication skills. Individuals with TBI and their spouses report significantly lower scores on some of these personal characteristics, compared to those of a matched control group of 70 couples from the general population. Specific personal characteristics are critical for psychological and marital adjustment following TBI. This knowledge may be of relevance for detecting couples at risk for developing difficulties in the post-acute rehabilitation phase. Rehabilitation interventions targeting the personal characteristics identified as critical for the adjustment process could help to prevent these difficulties.

  5. Perception of Personal Well-Being and Workers’ Compensation Injuries in Federal Correctional Workers

    DTIC Science & Technology

    2001-01-01

    correctional officers had higher levels of PWB than non- correctional officer staff. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...correctional officers had higher levels of PWB than non- correctional officer staff. iv Perception of Personal Well-Being and Workers... correctional officer , associate warden, or warden. Staff regularly perform as law enforcement officers during training, emergency situations, staff

  6. Using virtual reality driving simulators in persons with spinal cord injury: three screen display versus head mounted display.

    PubMed

    Carlozzi, Noelle E; Gade, Venkata; Rizzo, Albert Skip; Tulsky, David S

    2013-03-01

    Virtual reality (VR) is a relatively new technology that is currently utilized in a wide variety of settings to test and train individuals in specialized skills. This study examines methods for improving driver retraining protocols for persons with spinal cord injury (SCI). We compared a VR driving simulator, under two different display conditions, a head mounted display (HMD) and a three screen display (TSD) to identify the best method for retraining driving skills following SCI. Although there was minimal evidence for driving performance difficulties in the HMD condition relative to the TSD condition (e.g. greater number of times for being off course and longer stopping latencies for the HMD condition), rates of simulator sickness did not differ between display conditions. Taken together, findings suggest that both the HMD and the TSD are reasonable simulator options for driver retraining in SCI.

  7. Endourethral prosthesis for treatment of detrusor sphincter dyssynergia: impact on quality of life for persons with spinal cord injury.

    PubMed

    Joseph, A C; Juma, S; Niku, S D

    1994-12-01

    Neurogenic bladders with detrusor sphincter dyssynergia (DSD) are common in persons with spinal cord injury and with multiple sclerosis. Treatment options such as sphincterotomy, urethral foley and suprapubic catheters are not without complications or failure; however, they are recommended for patients who are unable to do intermittent catheterization. An endourethral prosthesis for DSD has been developed for experimental use in the United States. We report one year results of the clinical trials with endourethral prostheses implanted in ten patients. Initial subjective and objective results show an 80% success rate. At present, preliminary data show that an endourethral prosthesis, which is simple to insert and has few complications, appears to offer an alternative to conventional treatment. A key to success is to prepare for changes in life style that impact the patient's quality of life. Both patient and staff education are necessary pre-operatively to achieve successful outcomes post-operatively.

  8. Evaluating a Surprising Claim

    NASA Astrophysics Data System (ADS)

    Hayden, Howard C.

    2013-11-01

    A television advertisement and a website present an interesting question: can rail company CSX really move a ton of freight 468 miles on a gallon of fuel, or is the claim preposterous? Let us examine the claim, first by understanding what is meant, looking at their data, and then converting units to examine the claim quantitatively.

  9. Evaluating a Surprising Claim

    ERIC Educational Resources Information Center

    Hayden, Howard C.

    2013-01-01

    A television advertisement and a website present an interesting question: can rail company CSX "really" move a ton of freight 468 miles on a gallon of fuel, or is the claim preposterous? Let us examine the claim, first by understanding what is meant, looking at their data, and then converting units to examine the claim quantitatively.

  10. Persons with brain injury and employment supports: Long-term employment outcomes and use of community-based services.

    PubMed

    Grigorovich, Alisa; Stergiou-Kita, Mary; Damianakis, Thecla; Le Dorze, Guylaine; Lemsky, Carolyn; Hebert, Debbie

    2017-01-01

    To understand how employment services (ES) are provided to persons with brain injuries (PWBIs) in Ontario, Canada, and the impact service delivery has on competitive-employment outcomes. A mixed-method case study of one community-based agency that provides specialized services to PWBIs. Relationships between demographic, service-related variables and employment outcomes (2009-2014) were analysed using chi-squares and analyses of variance. In addition, 14 interviews were conducted and analysed using thematic analysis. PWBIs accessed services on average of 16 years post injury; 64% secured at least one competitive-employment job, which was how employment success was defined in this study. Average job tenure was 368 days, and average job intensity was 3.8 hours/day. Employment success was significantly associated (p < 0.05) with use of job development, job coaching, case management and job retention services. Interviews revealed that PWBIs were provided five services: job goal(s) identification, assessment of work-related abilities/skills, job development, on-the-job supports and job retention assistance. Challenges to ES delivery included lack of suitable jobs and hiring incentives, and difficulties in establishing natural supports at the workplace. PWBIs' employment outcomes may be supported through provision of ES to assist with: the development of realistic job goals and job-finding skills, securing work, on-the-job coaching and advocacy with employers.

  11. Pain catastrophizing and beliefs predict changes in pain interference and psychological functioning in persons with spinal cord injury.

    PubMed

    Hanley, Marisol A; Raichle, Katherine; Jensen, Mark; Cardenas, Diana D

    2008-09-01

    The current study sought to examine how changes in pain-related beliefs and coping responses are related to changes in pain interference and psychological functioning in individuals with spinal cord injuries (SCI) and pain. To measure longitudinal changes in these variables, respondents completed a survey that included measures of pain intensity, pain interference, and psychological functioning, as well as specific psychosocial variables (pain-related beliefs, coping, and social support) and then completed the same survey 6 months later; analyses included only the individuals who reported pain at both times (n = 40). Demographic and injury-related variables were also assessed, but none were found to be significantly associated with changes in functioning. Changes in catastrophizing and belief in one's ability to control pain were each significantly associated with changes in the outcome variables: Greater pain interference and poorer psychological functioning. Changes in specific coping strategies and social support were not predictors of changes in pain, interference, or psychological functioning. These findings support a biopsychosocial model of pain in persons with SCI. Intervention studies targeting maladaptive pain-related beliefs and catastrophizing may help to identify the causal nature of these relationships and may improve multidisciplinary treatment of pain in SCI. Intervention studies targeting catastrophizing and maladaptive pain-related beliefs may be the next step in determining which variables play a causal role in the pain interference and psychological functioning of individuals with pain and SCI.

  12. Nature of Medical Malpractice Claims Against Radiation Oncologists

    SciTech Connect

    Marshall, Deborah; Tringale, Kathryn; Connor, Michael

    2017-05-01

    Purpose: To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Methods and Materials: 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. Results: There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38more » 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. Conclusions: 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

  13. Temporal Indices of Ankle Clonus and Relationship to Electrophysiologic and Clinical Measures in Persons With Spinal Cord Injury.

    PubMed

    Manella, Kathleen J; Roach, Kathryn E; Field-Fote, Edelle C

    2017-10-01

    Clonus arising from plantar flexor hyperreflexia is a phenomenon that is commonly observed in persons with spastic hypertonia. We assessed the temporal components of a biomechanical measure to quantify ankle clonus, and validated these in persons with spasticity due to spinal cord injury. In 40 individuals with chronic (>1 year) spinal cord injury, we elicited ankle clonus using a standardized mechanical perturbation (drop test). We examined reliability and construct validity of 2 components of the drop test: clonus duration (timed with a stopwatch) and number of oscillations in the first 10-second interval (measured via optical motion capture). We compared these measures to the Spinal Cord Assessment Tool for Spastic reflexes (SCATS) clonus score and H-reflex/M-wave (H/M) ratio, a clinical and electrophysiologic measure, respectively. Intra- and interrater reliability of clonus duration measurement was good [intraclass correlation coefficient, ICC (2, 1) = 1.00]; test-retest reliability was good both at 1 hour [ICC (2, 2) = 0.99] and at 1 week [ICC (2, 2) = 0.99]. Clonus duration was moderately correlated with SCATS clonus score (r = 0.58). Number of oscillations had good within-session test-retest reliability [ICC (2, 1) > 0.90] and strong correlations with SCATS clonus score (r = 0.86) and soleus H/M ratio (r = 0.77). Clonus duration and number of oscillations as measured with a standardized test are reliable and valid measures of plantar flexor hyperreflexia that are accessible for clinical use. Tools for objective measurement of ankle clonus are valuable for assessing effectiveness of interventions directed at normalizing reflex activity associated with spasticity.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A179).

  14. 32 CFR Appendix C to Part 282 - Submitting a Claim

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Submitting a Claim C Appendix C to Part 282.... 282, App. C Appendix C to Part 282—Submitting a Claim (a) Who May Submit a Claim. Any person (“claimant”) may submit a claim who has a demand for money or property against the Government under 31 U.S.C...

  15. Roles of age, length of service and job in work-related injury: a prospective study of 63,620 person-years in female workers.

    PubMed

    Chau, Nearkasen; Dehaene, Dominique; Benamghar, Lahoucine; Bourgkard, Eve; Mur, Jean-Marie; Touron, Christian; Wild, Pascal

    2014-02-01

    The roles of age, length of service and job in various work-related injury types are unknown and deserve investigations among female workers. This study assessed their roles in the occurrence of injury. Three-year prospective study of all 22,952 permanently employed women at the French national railway company: 63,620 person-years, 756 injuries with working days lost, coded using the company's injury classification derived from that of the French health insurance scheme. We investigated the incidence of four types of injury: fall on same level, fall to lower level, materials/equipment/objects handling, and other injuries. Data were analyzed using negative binomial regression. Workers aged <25 were subject to a higher risk for all types of injuries. Older workers (45-55 years) were subject to a higher injury risk for fall on same level and fall to lower level. For fall on same level as for fall to lower level the relative risk decreased steadily with increasing length of service with the company, from 1.60 for 1 year to 0.50-0.60 for ≥30 years. For injuries due to materials/equipment/objects handling the relative risk decreased from 1.05 for one year to 0.49 for 5-9 years, and then increased to about 1.50 for 20-29 years and ≥30 years. Younger and shorter lengths of service were at risk for various types of injuries. Higher length of service was at risk for injury due to materials/equipment/objects handling. Preventive measures should consider the respective risks associated with age, years of employment and job. © 2013 Wiley Periodicals, Inc.

  16. 20 CFR 362.11 - Principal types of claims not allowable.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PROCEDURES EMPLOYEES' PERSONAL PROPERTY CLAIMS § 362.11 Principal types of claims not allowable. (a) Claims will be disallowed when: (1) The personal property was lost, stolen or damaged prior to August 31, 1964... least in part, by the negligence of the employee or his agent; (4) The personal property was acquired...

  17. 32 CFR 732.19 - Claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 6320/10 are required to adjudicate claims in each instance of sickness, injury, or maternity care when... certification that documentation has been entered in the member's Health Record as directed in article 16-24 of... seeking funds from health benefit plans or from insurance policies for which premiums are paid privately...

  18. Experiences of persons with spinal cord injury undertaking a physical activity programme as part of the SCIPA 'Full-On' randomized controlled trial.

    PubMed

    Calder, Allyson; Nunnerley, Jo; Mulligan, Hilda; Ahmad Ali, Nordawama; Kensington, Gemma; McVicar, Tim; van Schaik, Olivia

    2018-04-01

    For individuals with spinal cord injury the long term benefits of physical activity are well documented, however the majority of this population report inactivity secondary to participatory barriers. Research investigating physically intensive exercise programs for people with spinal cord injury is limited, with even less attention paid to the experience of the participants. To explore the experiences of persons with spinal cord injury of their participation in the New Zealand arm of the Spinal Cord Injury and Physical Activity (SCIPA) 'Full-On' randomized controlled trial. Eight participants recruited to SCIPA Full-On completed individual virtual video diary interviews three times across the duration of their twelve week Full-On trial. Expectations and highs and lows of the program were recorded via a webcam. The video diary data were transcribed verbatim and analyzed inductively for themes. Three independent themes were identified from the data: the participants' excitement of opportunity to participate in SCIPA Full-On' randomized controlled trial, personal rewards from participation and also the frustrations to participation they experienced. This study provides valuable information on factors that motivate participation in physical activity for individuals with spinal cord injury, within a research setting. The findings highlighted the importance of accessibility and a supportive network which may be a way to provide individuals with spinal cord injury the means to become self-efficacious to participate in community physical activity outside of the research environment. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Evaluation of a community reintegration outpatient program service for community-dwelling persons with spinal cord injury.

    PubMed

    Zinman, Alana; Digout, Nicole; Bain, Patricia; Haycock, Sylvia; Hébert, Debbie; Hitzig, Sander L

    2014-01-01

    Objective. To evaluate the effectiveness of a community reintegration outpatient (CROP) service for promoting well-being and community participation following spinal cord injury (SCI). Participants. Community-dwelling adults (N = 14) with traumatic and nontraumatic SCI. Interventions. The CROP service is a 12-week (1 × week; 120 minutes) interprofessional closed therapeutic education service. Main Outcome Measure(s). Moorong Self-Efficacy Scale (MSES); Impact on Participation and Autonomy (IPA); Positive Affect and Negative Affect Scale (PANAS); Coping Inventory of Stressful Situations (CISS); World Health Organization Quality of Life (WHOQOL-BREF); semistructured qualitative interviews. Methods. Twenty-one participants were recruited from two subsequent CROP services, with only 14 persons completing all data assessments. Data were collected at baseline (week 0), at exit (week 12), and at a three-month follow-up. Semistructured interviews were conducted at exit. Results. Self-efficacy (MSES) and positive affect (PANAS) improved from baseline to exit (P < .05), but the changes were not maintained at follow-up. Qualitative analysis identified four major themes related to therapeutic benefits: (1) role of self; (2) knowledge acquisition; (3) skill application; and (4) group processes. Conclusions. Participation in a therapeutic education service has the potential to improve well-being in persons with SCI, but there is a need to identify strategies to maintain long-term gains.

  20. The Minnesota Multiphasic Personality Inventory-2 Restructured Form in National Guard Soldiers Screening Positive for Posttraumatic Stress Disorder and Mild Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Arbisi, Paul A.; Polusny, Melissa A.; Erbes, Christopher R.; Thuras, Paul; Reddy, Madhavi K.

    2011-01-01

    The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the…

  1. 41 CFR 303-70.700 - When an employee dies as a result of personal injury sustained while in the performance of the...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true When an employee dies as a result of personal injury sustained while in the performance of the employee's law enforcement duties, either on official travel duties away from the official station, or at the current official station, must we provide transportation for the...

  2. Understanding therapeutic benefits of overground bionic ambulation: exploratory case series in persons with chronic, complete spinal cord injury.

    PubMed

    Kressler, Jochen; Thomas, Christine K; Field-Fote, Edelle C; Sanchez, Justin; Widerström-Noga, Eva; Cilien, Deena C; Gant, Katie; Ginnety, Kelly; Gonzalez, Hernan; Martinez, Adriana; Anderson, Kimberley D; Nash, Mark S

    2014-10-01

    To explore responses to overground bionic ambulation (OBA) training from an interdisciplinary perspective including key components of neuromuscular activation, exercise conditioning, mobility capacity, and neuropathic pain. Case series. Academic research center. Persons (N=3; 2 men, 1 woman) aged 26 to 38 years with complete spinal cord injury (SCI) (American Spinal Injury Association Impairment Scale grade A) between the levels of T1 and T10 for ≥1 year. OBA 3d/wk for 6 weeks. To obtain a comprehensive understanding of responses to OBA, an array of measures were obtained while walking in the device, including walking speeds and distances, energy expenditure, exercise conditioning effects, and neuromuscular and cortical activity patterns. Changes in spasticity and pain severity related to OBA use were also assessed. With training, participants were able to achieve walking speeds and distances in the OBA device similar to those observed in persons with motor-incomplete SCI (10-m walk speed, .11-.33m/s; 2-min walk distance, 11-33m). The energy expenditure required for OBA was similar to walking in persons without disability (ie, 25%-41% of peak oxygen consumption). Subjects with lower soleus reflex excitability walked longer during training, but there was no change in the level or amount of muscle activity with training. There was no change in cortical activity patterns. Exercise conditioning effects were small or nonexistent. However, all participants reported an average reduction in pain severity over the study period ranging between -1.3 and 1.7 on a 0-to-6 numeric rating scale. OBA training improved mobility in the OBA device without significant changes in exercise conditioning or in neuromuscular or cortical activity. However, pain severity was reduced and no severe adverse events were encountered during training. OBA therefore opens the possibility to reduce the common consequences of chronic, complete SCI such as reduced functional mobility and neuropathic

  3. Determinants of quality of life among community-dwelling persons with spinal cord injury: A path analysis.

    PubMed

    Ekechukwu, End; Ikrechero, J O; Ezeukwu, A O; Egwuonwu, A V; Umar, L; Badaru, U M

    2017-02-01

    Recent advancement in technology and medical care has resulted in an increase not only in disability arising from spinal cord injury (SCI) but also its attendant challenges such as poor quality of life (QoL). To test a theoretical model of predictors of QoL among persons with SCI. Study was conducted in the South Eastern Nigeria. A longitudinal study design was employed. A total of 64 persons with SCI discharged from in-hospital admission participated in this study. QoL, state self-esteem (SSE), social support satisfaction (SSS), and functional potentials (FPs) were assessed using short form health survey-12, SSE scale, social support questionnaire 6, and spinal cord independent measure III, respectively. Their motor function (MF) and sensory function (SF) were assessed using the motor and sensory subscales of American Spinal Cord Association impairment scale. Data obtained were analyzed using path analysis. The level of significance was set at α = 0.05. Most of the participants were male (92.3%) with incomplete type of SCI (65.4%). The selected variables (SSE, SSS, FP, MF, and SF) significantly predicted a large percentage (R2 = 0.861) of QoL. All the predictor variables except age had a direct significant effect on QoL (P < 0.05). The trimmed model revealed that SSS (β =3.04, P = 0.002) had the highest direct effect on QoL. This study revealed that the combined assessment of SSE, SSS, FP, MF, and SF can be used to predict QoL significantly. Moreover, psychosocial factors are as important as clinical (biological) factors in predicting the outcomes of SCI, especially their QoL. Thus, the study buttresses the need to emphasize on the biopsychosocial model in the rehabilitation of persons with SCI.

  4. Telephone and In-Person Cognitive Behavioral Therapy for Major Depression after Traumatic Brain Injury: A Randomized Controlled Trial

    PubMed Central

    Bombardier, Charles H.; Vannoy, Steven; Dyer, Joshua; Ludman, Evette; Dikmen, Sureyya; Marshall, Kenneth; Barber, Jason; Temkin, Nancy

    2015-01-01

    Abstract Major depressive disorder (MDD) is prevalent after traumatic brain injury (TBI); however, there is a lack of evidence regarding effective treatment approaches. We conducted a choice-stratified randomized controlled trial in 100 adults with MDD within 10 years of complicated mild to severe TBI to test the effectiveness of brief cognitive behavioral therapy administered over the telephone (CBT-T) (n=40) or in-person (CBT-IP) (n=18), compared with usual care (UC) (n=42). Participants were recruited from clinical and community settings throughout the United States. The main outcomes were change in depression severity on the clinician-rated 17 item Hamilton Depression Rating Scale (HAMD-17) and the patient-reported Symptom Checklist-20 (SCL-20) over 16 weeks. There was no significant difference between the combined CBT and UC groups over 16 weeks on the HAMD-17 (treatment effect=1.2, 95% CI: −1.5–4.0; p=0.37) and a nonsignificant trend favoring CBT on the SCL-20 (treatment effect=0.28, 95% CI: −0.03–0.59; p=0.074). In follow-up comparisons, the CBT-T group had significantly more improvement on the SCL-20 than the UC group (treatment effect=0.36, 95% CI: 0.01–0.70; p=0.043) and completers of eight or more CBT sessions had significantly improved SCL-20 scores compared with the UC group (treatment effect=0.43, 95% CI: 0.10–0.76; p=0.011). CBT participants reported significantly more symptom improvement (p=0.010) and greater satisfaction with depression care (p<0.001), than did the UC group. In-person and telephone-administered CBT are acceptable and feasible in persons with TBI. Although further research is warranted, telephone CBT holds particular promise for enhancing access and adherence to effective depression treatment. PMID:25072405

  5. 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

    ... medical, surgical, dental, or related functions by the contractor in carrying out self-determination... x-ray technicians, emergency medical technicians and other health care providers including...

  6. Unwanted pregnancy: The outer boundary of "treatment injury" in the New Zealand accident compensation scheme.

    PubMed

    Tobin, Rosemary

    2015-09-01

    The New Zealand accident compensation scheme has undergone many changes over the years and these changes are reflected in the way unwanted pregnancy claims have been dealt with under the regime. The New Zealand Supreme Court has now confirmed that pregnancy as a result of medical misadventure can be classified as a personal injury under the scheme with the result that the woman patient is entitled to the benefits of the scheme and may not pursue a common law claim against the medical practitioner. This article analyses two recent decisions in the context of consideration of the changing fortunes of the unwanted pregnancy claims.

  7. Hospital-acquired acute kidney injury in Chinese very elderly persons.

    PubMed

    Wen, Jing; Cheng, Qingli; Zhao, Jiahui; Ma, Qiang; Song, Ting; Liu, Sheng; Wang, Xiaodan; Li, Meihua; Zhang, Xiaoying

    2013-01-01

    To investigate the incidence, pathogenetic factors, the prognosis and correlation factors of the hospitalized very elderly patients(=80) with acute kidney injury (AKI). The clinical data of the patients older than 80 admitted in PLA General Hospital from June 1, 2008 to December 31, 2009 were collected. The patients with AKI were identified and their records of clinical characteristics were analyzed. The overall incidence of AKI in very elderly patients was 14.8%. Infection was the major cause of AKI in those patients. The multifactorial analysis showed that the most common causes of AKI were hypovolemia, nephrotoxic drugs, cardiac dysfunction and respiratory failure. Antibiotics were the most common factor in nephrotoxic drugs. Comparing with de novo AKI, the patients with Acute-on-Chronic AKI were older, the percent complication of multiple organ dysfunction syndrome (MODS), hyperlipidemia and the rate of recurring AKI was higher. Cox proportional hazard models showed variables of MODS, heart failure and gastrointestinal bleeding were independent risk factors for 90 days end outpoint, and MODS, malnutrition, gastrointestinal bleeding and absolute increase in SCR were independent risk factors for one year survival, the use of alpha-ketoacid was showed to be a protective factor(odd ratio=0.656). The incidence of AKI in the very elderly hospitalized patients was high. Infections, hypovolemia, nephrotoxic drugs and cardiovascular diseases were among the common causes. Active treatment of primary diseases, avoidance of complications and use of alpha-ketoacid were beneficial for improving the prognosis of the very elderly patients with AKI.

  8. Group psychotherapy for persons with traumatic brain injury: management of frustration and substance abuse.

    PubMed

    Delmonico, R L; Hanley-Peterson, P; Englander, J

    1998-12-01

    Residual emotional and behavioral difficulties in individuals who have sustained a traumatic brain injury (TBI) have been well documented in the literature. The issues are complex, interdependent, and often include substance abuse, depression, anxiety, chronic suicidal or homicidal ideation, poor impulse control, and significant degrees of frustration and anger. Often, preexisting psychological conditions and poor coping strategies are exacerbated by the trauma. Emotional and behavioral difficulties can interfere with the neurorehabilitation process at all levels. In acute rehabilitation, these issues have traditionally been addressed on an individual basis. However, in postacute settings, an interpersonal group format can be effectively implemented. The majority of individuals with TBI have minimal funding for long-term cognitive and behavioral remediation; often the only avenue available is support groups. This article will describe group psychotherapy models used with individuals with acute or postacute TBI within a comprehensive rehabilitation center. Interdisciplinary treatment of frustration and substance abuse and a continuum of care will be emphasized. Education, social support, skills development, interpersonal process, and cognitive-behavioral approaches will also be discussed. The psychotherapy groups focus on treatment of substance abuse and frustration management through education, social support, and development of interpersonal skills. Practical considerations of running such groups are presented.

  9. Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury

    PubMed Central

    Wu, Gary A.; Bogie, Kath M.

    2015-01-01

    A repeated-measures study of 13 adult full-time wheelchair users with spinal cord injury (SCI) was carried out to determine whether alternating-pressure air cushion (APAC) use compared with independent pressure relief (IPR) provides reliable, effective pressure relief for individuals with SCI. Bilateral mean ischial interface pressure (IP), transcutaneous oxygen tension (TcPO2), and unilateral laser Doppler blood flow were evaluated. Blood flow component contributions were determined using short-time Fourier transform (STFT)-based spectral analysis. IPR assessment was carried out at recruitment. Study participants then used an APAC for 2 wk every 3 mo for 18 mo. IPR weight-shifting decreased mean ischial IP (p < 0.05) and increased mean TcPO2 (p < 0.05). All variables rapidly returned to preintervention levels following weight-shifting except for the cardiac component of blood flow. APAC-induced weight-shifting decreased mean ischial IP (p < 0.05). Mean TcPO2 increased and was higher than for IPR. STFT analysis indicated that quiet sitting following APAC-induced weight-shifting produced a higher neurogenic component of blood flow than following IPR (p = 0.02). Thus, IPR positively affects multiple aspects of tissue health but produces transient improvements and must be repeated regularly. APAC activation dynamically and continuously alters IP distribution with more sustained positive tissue health effects. PMID:25629607

  10. Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury.

    PubMed

    Wu, Gary A; Bogie, Kath M

    2014-01-01

    A repeated-measures study of 13 adult full-time wheelchair users with spinal cord injury (SCI) was carried out to determine whether alternating-pressure air cushion (APAC) use compared with independent pressure relief (IPR) provides reliable, effective pressure relief for individuals with SCI. Bilateral mean ischial interface pressure (IP), transcutaneous oxygen tension (TcPO2), and unilateral laser Doppler blood flow were evaluated. Blood flow component contributions were determined using short-time Fourier transform (STFT)-based spectral analysis. IPR assessment was carried out at recruitment. Study participants then used an APAC for 2 wk every 3 mo for 18 mo. IPR weight-shifting decreased mean ischial IP (p < 0.05) and increased mean TcPO2 (p < 0.05). All variables rapidly returned to preintervention levels following weight-shifting except for the cardiac component of blood flow. APAC-induced weight-shifting decreased mean ischial IP (p < 0.05). Mean TcPO2 increased and was higher than for IPR. STFT analysis indicated that quiet sitting following APAC-induced weight-shifting produced a higher neurogenic component of blood flow than following IPR (p = 0.02). Thus, IPR positively affects multiple aspects of tissue health but produces transient improvements and must be repeated regularly. APAC activation dynamically and continuously alters IP distribution with more sustained positive tissue health effects.

  11. Neuroimaging of structural pathology and connectomics in traumatic brain injury: Toward personalized outcome prediction☆

    PubMed Central

    Irimia, Andrei; Wang, Bo; Aylward, Stephen R.; Prastawa, Marcel W.; Pace, Danielle F.; Gerig, Guido; Hovda, David A.; Kikinis, Ron; Vespa, Paul M.; Van Horn, John D.

    2012-01-01

    Recent contributions to the body of knowledge on traumatic brain injury (TBI) favor the view that multimodal neuroimaging using structural and functional magnetic resonance imaging (MRI and fMRI, respectively) as well as diffusion tensor imaging (DTI) has excellent potential to identify novel biomarkers and predictors of TBI outcome. This is particularly the case when such methods are appropriately combined with volumetric/morphometric analysis of brain structures and with the exploration of TBI-related changes in brain network properties at the level of the connectome. In this context, our present review summarizes recent developments on the roles of these two techniques in the search for novel structural neuroimaging biomarkers that have TBI outcome prognostication value. The themes being explored cover notable trends in this area of research, including (1) the role of advanced MRI processing methods in the analysis of structural pathology, (2) the use of brain connectomics and network analysis to identify outcome biomarkers, and (3) the application of multivariate statistics to predict outcome using neuroimaging metrics. The goal of the review is to draw the community's attention to these recent advances on TBI outcome prediction methods and to encourage the development of new methodologies whereby structural neuroimaging can be used to identify biomarkers of TBI outcome. PMID:24179732

  12. Analysis of clinical negligence claims following tonsillectomy in England 1995 to 2010.

    PubMed

    Mathew, Rajeev; Asimacopoulos, Eleni; Walker, David; Gutierrez, Tatiana; Valentine, Peter; Pitkin, Lisa

    2012-05-01

    We determined the characteristics of medical negligence claims following tonsillectomy. Claims relating to tonsillectomy between 1995 and 2010 were obtained from the National Health Service Litigation Authority database. The number of open and closed claims was determined, and data were analyzed for primary injury claimed, outcome of claim, and associated costs. Over 15 years, there were 40 claims of clinical negligence related to tonsillectomy, representing 7.7% of all claims in otolaryngology. There were 34 closed claims, of which 32 (94%) resulted in payment of damages. Postoperative bleeding was the most common injury, with delayed recognition and treatment of bleeding alleged in most cases. Nasopharyngeal regurgitation as a result of soft palate fistulas or excessive tissue resection was the next-commonest cause of a claim. The other injuries claimed included dentoalveolar injury, bums, tonsillar remnants, and temporomandibular joint dysfunction. Inadequate informed consent was claimed in 5 cases. Clinical negligence claims following tonsillectomy have a high success rate. Although postoperative bleeding is the most common cause of negligence claims, a significant proportion of claims are due to rare complications of surgery. Informed consent should be tailored to the individual patient and should include a discussion of common and serious complications.

  13. Padova Charter on personal injury and damage under civil-tort law : Medico-legal guidelines on methods of ascertainment and criteria of evaluation.

    PubMed

    Ferrara, Santo Davide; Baccino, Eric; Boscolo-Berto, Rafael; Comandè, Giovanni; Domenici, Ranieri; Hernandez-Cueto, Claudio; Gulmen, Mete Korkut; Mendelson, George; Montisci, Massimo; Norelli, Gian Aristide; Pinchi, Vilma; Ranavaya, Mohammed; Shokry, Dina A; Sterzik, Vera; Vermylen, Yvo; Vieira, Duarte Nuno; Viel, Guido; Zoja, Riccardo

    2016-01-01

    Compensation for personal damage, defined as any pecuniary or non-pecuniary loss causally related to a personal injury under civil-tort law, is strictly based on the local jurisdiction and therefore varies significantly across the world. This manuscript presents the first "International Guidelines on Medico-Legal Methods of Ascertainment and Criteria of Evaluation of Personal Injury and Damage under Civil-Tort Law". This consensus document, which includes a step-by-step illustrated explanation of flow charts articulated in eight sequential steps and a comprehensive description of the ascertainment methodology and the criteria of evaluation, has been developed by an International Working Group composed of juridical and medico-legal experts and adopted as Guidelines by the International Academy of Legal Medicine (IALM).

  14. Pediatric radiology malpractice claims - characteristics and comparison to adult radiology claims.

    PubMed

    Breen, Micheál A; Dwyer, Kathy; Yu-Moe, Winnie; Taylor, George A

    2017-06-01

    Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation. We hypothesize that the frequency, character and outcome of malpractice claims made against pediatric radiologists differ from those seen in general radiology practice. We searched the Controlled Risk Insurance Co. (CRICO) Strategies' Comparative Benchmarking System (CBS), a private repository of approximately 350,000 open and closed medical malpractice claims in the United States, for claims related to pediatric radiology. We further queried these cases for the major allegation, the clinical environment in which the claim arose, the clinical severity of the alleged injury, indemnity paid (if payment was made), primary imaging modality involved (if applicable) and primary International Classification of Diseases, 9th revision (ICD-9) diagnosis underlying the claim. There were a total of 27,056 fully coded claims of medical malpractice in the CBS database in the 5-year period between Jan. 1, 2010, and Dec. 31, 2014. Of these, 1,472 cases (5.4%) involved patients younger than 18 years. Radiology was the primary service responsible for 71/1,472 (4.8%) pediatric cases. There were statistically significant differences in average payout for pediatric radiology claims ($314,671) compared to adult radiology claims ($174,033). The allegations were primarily diagnosis-related in 70% of pediatric radiology claims. The most common imaging modality implicated in

  15. Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

    PubMed Central

    Courtois, Frédérique; Elliott, Stacy; Tepper, Mitchell

    2017-01-01

    Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic approach to working with patients with spinal cord injury (SCI) to improve their sexual functioning and response is presented. Nonjudgmental communication about sexual concerns is followed by a detailed pre- and postinjury medical, psychosocial, and sexual history. If preexisting sexual issues are present, it is recommended that the patient be referred for assessment and treatment of these separate from the patient's SCI-related concerns. Physical examination, with special attention to issues that could impact the patient's sexuality, is followed by a detailed neurologic assessment with specific attention to the T11-L2 and S3-5 spinal segments. Education of the patient with regard to his or her sexual potential and the need to be flexible in his or her sexual repertoire is followed by self-exploration and practice. Routine follow-up is suggested after patient's initial sexual exploration. Treatment of confounding and iatrogenic factors related to SCI is followed by more sexual experience. Afterwards the clinician is encouraged to use simple techniques to treat sexual issues and follow-up with the patient to assess the outcome. A structured program utilizing vibratory stimulation with or without midodrine is described as a way to achieve ejaculation and potentially orgasm, and techniques for treating severe autonomic dysreflexia are discussed. If these interventions do not alleviate the patient's sexual concerns, the clinician should refer the patient for more specialized consultation. PMID:29339878

  16. Treatments for chronic pain in persons with spinal cord injury: A survey study.

    PubMed

    Cardenas, Diana D; Jensen, Mark P

    2006-01-01

    To determine the degree and duration of pain relief provided by specific pain treatments used by individuals with spinal cord injury (SCI) who have chronic pain. Postal survey. Community. Participants were 117 individuals who had traumatic SCI, were 18 years of age or older, and reported a chronic pain problem. Questions assessing current or past use of 26 different pain treatments, the amount of relief each treatment provided, and the length of time that any pain relief usually lasts. The medications tried most often were nonsteroidal anti-inflammatory drugs (tried by 71%) and acetaminophen (tried by 70%); these medications were still being used by more than one half of the patients who had tried them. Opioids produced the greatest degree of pain relief on average (mean, 6.27 +/- 3.05 [SD] on a 0-10 scale, with 0 = no relief and 10 = complete relief) but were unlikely to be continued by those who tried them. Although 38% of respondents with pain had tried gabapentin, only 17% were still using it, and average pain relief was only moderate (mean, 3.32 +/- 3.03 on the 0-10 relief scale). Seventy-three percent of the respondents had tried at least 1 of 7 alternative pain treatments, and the most frequently tried were massage, marijuana, and acupuncture. The most relief was provided by massage (mean, 6.05 +/- 2.47] on the 0-10 relief scale) and marijuana (mean, 6.62 +/- 2.54 on the 0-10 relief scale). The relief from the various treatments, including most medications, tended to last only minutes or hours; however, pain relief from alternative treatments such as massage, acupuncture, and hypnosis was reported to last for days in 25% to 33% of those who tried these treatments. Many patients are not finding adequate pain relief from commonly prescribed medications. Alternative therapies should be considered as additional treatment options in this population.

  17. Potential of personal health record portals in the care of individuals with spinal cord injuries and disorders: Provider perspectives.

    PubMed

    Hill, Jennifer N; Smith, Bridget M; Weaver, Frances M; Nazi, Kim M; Thomas, Florian P; Goldstein, Barry; Hogan, Timothy P

    2018-05-01

    Although personal health record (PHR) portals are designed for patients, healthcare providers are a key influence in how patients use their features and realize benefits from them. A few studies have examined provider attitudes toward PHR portals, but none have focused on those who care for individuals with spinal cord injuries and disorders (SCI/D). We characterize SCI/D provider perspectives of PHR portals, including perceived advantages and disadvantages of PHR portal use in SCI/D care. Cross-sectional; semi-structured interviews. Spinal Cord Injury (SCI) Centers in the Veterans Health Administration. Twenty-six SCI/D healthcare providers. None. Perceived advantages and disadvantages of PHR portals. The complex situations of individuals with SCI/D shaped provider perspectives of PHR portals and their potential role in practice. Perceived advantages of PHR portal use in SCI/D care included the ability to coordinate information and care, monitor and respond to outpatient requests, support patient self-management activities, and provide reliable health information to patients. Perceived disadvantages of PHR portal use in SCI/D care included concerns about the quality of patient-generated health data, other potential liabilities for providers and workload burden, and the ability of individuals with SCI/D to understand clinical information accessed through a portal. Our study highlights advantages and disadvantages that should be considered when promoting engagement of SCI/D healthcare providers in use of PHR portals, and portal features that may have the most utility in SCI/D care.

  18. Borderline personality disorder features, emotion dysregulation and non-suicidal self-injury: Preliminary findings in a sample of community-dwelling Italian adolescents.

    PubMed

    Somma, Antonella; Sharp, Carla; Borroni, Serena; Fossati, Andrea

    2017-02-01

    In order to assess the relationships among borderline personality disorder features, non-suicidal self-injury (NSSI) and emotion dysregulation, 122 community-dwelling Italian adolescents were administered by the Italian translations of the Borderline Personality Features Scale for Children-11, the Deliberate Self-Harm Inventory and the Difficulties in Emotion Regulation Scale (DERS). Regression models showed that both Deliberate Self-Harm Inventory (DSHI) and DERS scores significantly predicted Borderline Personality Features Scale for Children-11 total score; moreover, the DSHI total score significantly predicted the DERS total score. Our findings suggest that borderline personality features in adolescence are moderately, albeit significantly related to NSSI, and that emotion dysregulation does not completely account for the association between borderline personality features and NSSI, although it seems to explain a non-trivial proportion of this relationship. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Predicting workers' compensation claims and disciplinary actions using SecureFit®: Further support for integrative models of workplace safety.

    PubMed

    O'Connell, Matthew; Delgado, Kristin; Lawrence, Amie; Kung, Mavis; Tristan, Esteban

    2017-06-01

    A growing body of applied research has identified certain psychological traits that are predictive of worker safety. However, most of these studies suffer from an overreliance on common method bias caused by self-report measures of both: (a) personal factors such as personality traits; and (b) outcomes such as safety behaviors and injuries. This study utilized archival data from 796 employees at a large U.S. automobile manufacturer. Data were gathered on a pre-employment assessment, SecureFit®, that measured key personality characteristics such as conscientiousness, locus of control, and risk taking. In addition, objective measures of workers' compensation claims and disciplinary actions were also gathered. The results indicated that disciplinary actions and workers' compensation claims were strongly correlated. It also demonstrated that the pre-employment assessment was able to predict both disciplinary actions and workers' compensation claims up to 12months in the future. Screening out just 8% of the applicant sample using the assessment would have resulted in a 35% reduction in disciplinary actions and 46% in workers' compensation claims, respectively. The study found a very strong relationship between counterproductive work behaviors (CWBs), such as not following rules, and workers' compensation claims. It also found a strong relationship between a combination of personality traits that have been shown to be associated with both variables, although the current study was able to demonstrate that relationship with objective measure of both variables. Individuals who receive disciplinary actions for things such as not following rules, not coming to work on time, etc. are significantly more likely to also be involved in serious safety incidents, and vice versa. Identifying those individuals early on in the hiring process and screening them out can significantly reduce the number of CWBs as well as workers' compensation claims. Copyright © 2017 Elsevier Ltd and

  20. Return to Work After Traumatic Injury: Increased Work-Related Disability in Injured Persons Receiving Financial Compensation is Mediated by Perceived Injustice.

    PubMed

    Giummarra, Melita J; Cameron, Peter A; Ponsford, Jennie; Ioannou, Liane; Gibson, Stephen J; Jennings, Paul A; Georgiou-Karistianis, Nellie

    2017-06-01

    Purpose Traumatic injury is a leading cause of work disability. Receiving compensation post-injury has been consistently found to be associated with poorer return to work. This study investigated whether the relationship between receiving compensation and return to work was associated with elevated symptoms of psychological distress (i.e., anxiety, depression, and posttraumatic stress disorder) and perceived injustice. Methods Injured persons, who were employed at the time of injury (n = 364), were recruited from the Victorian State Trauma Registry, and Victorian Orthopaedic Trauma Outcomes Registry. Participants completed the Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Checklist, Injustice Experience Questionnaire, and appraisals of pain and work status 12-months following traumatic injury. Results Greater financial worry and indicators of actual/perceived injustice (e.g., consulting a lawyer, attributing fault to another, perceived injustice, sustaining compensable injury), trauma severity (e.g., days in hospital and intensive care, discharge to rehabilitation), and distress symptoms (i.e., anxiety, depression, PTSD) led to a twofold to sevenfold increase in the risk of failing to return to work. Anxiety, post-traumatic stress and perceived injustice were elevated following compensable injury compared with non-compensable injury. Perceived injustice uniquely mediated the association between compensation and return to work after adjusting for age at injury, trauma severity (length of hospital, admission to intensive, and discharge location) and pain severity. Conclusions Given  that perceived injustice is associated with poor return to work after compensable injury, we recommend greater attention be given to appropriately addressing psychological distress and perceived injustice in injured workers to facilitate a smoother transition of return to work.

  1. Suicide attempts and self-injurious behaviours in adolescent and adult patients with borderline personality disorder.

    PubMed

    Goodman, Marianne; Tomas, Irene Alvarez; Temes, Christina M; Fitzmaurice, Garrett M; Aguirre, Blaise A; Zanarini, Mary C

    2017-08-01

    Prevalence data on self-mutilation and suicide attempts for adolescent borderline personality disorder (BPD) are currently not available. The purpose of this paper was to determine the frequency and methods of two forms of physically self-destructive acts (i.e. self-mutilation and suicide attempts) reported by adolescent borderline inpatients in one of the largest samples to date and to compare these results with a similarly diagnosed and assessed group of adult borderline inpatients. A total of 104 adolescent inpatients with BPD and 290 adult inpatients with BPD were interviewed about their lifetime history of physically self-destructive acts. The overall rates of self-mutilation (about 90%) and suicide attempts (about 75%) were similar during index admission for both adolescent and adult borderline patients. However, adolescents reported significantly higher rates of extreme levels of lifetime self-mutilation (e.g. >25 and >50 episodes) and cutting in particular, as compared with adult BPD. In contrast, borderline adults were significantly more likely to report a history of numerous (five or more) suicide attempts than adolescents with BPD. Self-mutilation and suicide attempts among adolescent borderline patients are prevalent and serious. Taken together, these results suggest that extreme levels of self-mutilation distinguish adolescent BPD from adults with BPD. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  2. A Rehabilomics framework for personalized and translational rehabilitation research and care for individuals with disabilities: Perspectives and considerations for spinal cord injury

    PubMed Central

    Wagner, Amy K.

    2014-01-01

    Despite many people having similar clinical presentation, demographic factors, and clinical care, outcome can differ for those sustaining significant injury such as spinal cord injury (SCI) and traumatic brain injury (TBI). In addition to traditional demographic, social, and clinical factors, variability also may be attributable to innate (including genetic, transcriptomic proteomic, epigenetic) biological variation that individuals bring to recovery and their unique response to their care and environment. Technologies collectively called “-omics” enable simultaneous measurement of an enormous number of biomolecules that can capture many potential biological contributors to heterogeneity of injury/disease course and outcome. Due to the nature of injury and complex disease, and its associations with impairment, disability, and recovery, rehabilitation does not lend itself to a singular “protocolized” plan of therapy. Yet, by nature and by necessity, rehabilitation medicine operates as a functional model of “Personalized Care”. Thus, the challenge for successful programs of translational rehabilitation care and research is to identify viable approaches to examine broad populations, with varied impairments and functional limitations, and to identify effective treatment responses that incorporate personalized protocols to optimize functional recovery. The Rehabilomics framework is a translational model that provides an “-omics” overlay to the scientific study of rehabilitation processes and multidimensional outcomes. Rehabilomics research provides novel opportunities to evaluate the neurobiology of complex injury or chronic disease and can be used to examine methods and treatments for person-centered care among populations with disabilities. Exemplars for application in SCI and other neurorehabilitation populations are discussed. PMID:25029659

  3. Comparison of training methods to improve walking in persons with chronic spinal cord injury: a randomized clinical trial

    PubMed Central

    Alexeeva, Natalia; Sames, Carol; Jacobs, Patrick L.; Hobday, Lori; DiStasio, Marcello M.; Mitchell, Sarah A.; Calancie, Blair

    2011-01-01

    Objective To compare two forms of device-specific training – body-weight-supported (BWS) ambulation on a fixed track (TRK) and BWS ambulation on a treadmill (TM) – to comprehensive physical therapy (PT) for improving walking speed in persons with chronic, motor-incomplete spinal cord injury (SCI). Methods Thirty-five adult subjects with a history of chronic SCI (>1 year; AIS ‘C’ or ‘D’) participated in a 13-week (1 hour/day; 3 days per week) training program. Subjects were randomized into one of the three training groups. Subjects in the two BWS groups trained without the benefit of additional input from a physical therapist or gait expert. For each training session, performance values and heart rate were monitored. Pre- and post-training maximal 10-m walking speed, balance, muscle strength, fitness, and quality of life were assessed in each subject. Results All three training groups showed significant improvement in maximal walking speed, muscle strength, and psychological well-being. A significant improvement in balance was seen for PT and TRK groups but not for subjects in the TM group. In all groups, post-training measures of fitness, functional independence, and perceived health and vitality were unchanged. Conclusions Our results demonstrate that persons with chronic, motor-incomplete SCI can improve walking ability and psychological well-being following a concentrated period of ambulation therapy, regardless of training method. Improvement in walking speed was associated with improved balance and muscle strength. In spite of the fact that we withheld any formal input of a physical therapist or gait expert from subjects in the device-specific training groups, these subjects did just as well as subjects receiving comprehensive PT for improving walking speed and strength. It is likely that further modest benefits would accrue to those subjects receiving a combination of device-specific training with input from a physical therapist or gait expert to

  4. Explicit and Inferred Motives for Non-suicidal Self Injurious Acts and Urges in Borderline and Avoidant Personality Disorders

    PubMed Central

    Snir, A.; Rafaeli, E.; Gadassi, R.; Berenson, K.; Downey, G.

    2015-01-01

    Non-suicidal self-injury (NSSI) is a perplexing phenomenon that may have differing motives. The present study employed experience sampling methods (ESM) which inquired explicitly about the motives for NSSI, but also enabled a temporal examination of the antecedents/consequences of NSSI, these allowed us to infer other motives which were not explicitly endorsed. Adults (N=152, aged 18–65) with borderline personality disorder (BPD), avoidant personality disorder (APD), or no psychopathology participated in a 3-week computerized diary study. We examined 5 classes of explicit motives for engaging in NSSI, finding support primarily for internally-directed rather than interpersonally-directed ones. We then used multi-level regression to examine changes in affect, cognition, and behavior surrounding moments of NSSI acts/urges compared to control moments (i.e., without NSSI). We examined changes in five scales of inferred motives, designed to correspond to the five classes of explicit motives. The results highlight differing motives for NSSI among individuals with BPD and APD, with some similarities (mostly in the explicit motives) and some differences (mostly in the inferred motives) between the disorders. Despite their infrequent explicit endorsement, fluctuations in interpersonally-oriented scales were found surrounding NSSI acts/urges. This highlights the need to continue attending to interpersonal aspects of NSSI in research and in clinical practice. Additionally, NSSI urges, like acts, were followed by decline in affective/interpersonal distress (although in a delayed manner). Thus, interventions that build distress tolerance and enhance awareness for affective changes, and for antecedent/consequence patterns in NSSI, could help individuals resist the urge to self-injure. PMID:25867834

  5. Developmental trajectories of self-injurious behavior, suicidal behavior and substance misuse and their association with adolescent borderline personality pathology.

    PubMed

    Nakar, Orit; Brunner, Romuald; Schilling, Oliver; Chanen, Andrew; Fischer, Gloria; Parzer, Peter; Carli, Vladimir; Wasserman, Danuta; Sarchiapone, Marco; Wasserman, Camilla; Hoven, Christina W; Resch, Franz; Kaess, Michael

    2016-06-01

    Adolescent risk-taking and self-harm behaviors are associated with affect dysregulation and impulsivity, both core features of borderline personality disorder (BPD). We hypothesized that the developmental courses of these behaviors i) tend to cluster rather than appear individually, and ii) might indicate adolescent BPD pathology. Therefore, we explored the developmental trajectories of self-injurious behavior (SIB), suicidal behavior (SB) and substance misuse (SM) in a community sample of adolescents; and we investigated the trajectories' overlap and its associations with BPD traits. 513 adolescents, aged 15-17 years, were followed for two years as part of the Saving and Empowering Young Lives in Europe study and its subsequent follow-up. Distinct developmental trajectories were explored using general growth mixture modeling. Three distinct classes were identified within each of the harmful behaviors SIB, SB and SM. Both the high-risk SIB trajectory and the high-risk SB trajectory demonstrated elevated initial degree of engagement, followed by a gradual decrease. The SM high-risk trajectory had a medium initial degree of engagement, which increased over time. There was a high degree of overlap (80-90%) among the high-risk trajectories for the three behaviors (SIB, SB and SM), and this overlap was significantly associated with elevated levels of BPD pathology. The data collection was based on participants' self-report. The findings indicate a similar pattern of reduction over time between SIB and SB for the high-risk trajectories, whereas the high-risk trajectories for SM show a pattern of increase over time. The observed symptom shift is associated with borderline personality pathology in adolescents. Therefore these behaviors might represent early indicators of risk supporting potential early detection. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Explicit and inferred motives for nonsuicidal self-injurious acts and urges in borderline and avoidant personality disorders.

    PubMed

    Snir, Avigal; Rafaeli, Eshkol; Gadassi, Reuma; Berenson, Kathy; Downey, Geraldine

    2015-07-01

    Nonsuicidal self-injury (NSSI) is a perplexing phenomenon that may have differing motives. The present study used experience sampling methods (ESM) which inquired explicitly about the motives for NSSI, but also enabled a temporal examination of the antecedents/consequences of NSSI; these allow us to infer other motives which were not explicitly endorsed. Adults (n = 152, aged 18-65) with borderline personality disorder (BPD), avoidant personality disorder (APD), or no psychopathology participated in a 3-week computerized diary study. We examined 5 classes of explicit motives for engaging in NSSI, finding support primarily for internally directed rather than interpersonally directed ones. We then used multilevel regression to examine changes in affect, cognition, and behavior surrounding moments of NSSI acts/urges compared with control moments (i.e., without NSSI). We examined changes in 5 scales of inferred motives, designed to correspond to the 5 classes of explicit motives. The results highlight differing motives for NSSI among individuals with BPD and APD, with some similarities (mostly in the explicit motives) and some differences (mostly in the inferred motives) between the disorders. Despite their infrequent explicit endorsement, fluctuations in interpersonally oriented scales were found surrounding NSSI acts/urges. This highlights the need to continue attending to interpersonal aspects of NSSI in research and in clinical practice. Additionally, NSSI urges, like acts, were followed by decline in affective/interpersonal distress (although in a delayed manner). Thus, interventions that build distress tolerance and enhance awareness for affective changes, and for antecedent/consequence patterns in NSSI, could help individuals resist the urge to self-injure. (c) 2015 APA, all rights reserved).

  7. Usability of a virtual reality environment simulating an automated teller machine for assessing and training persons with acquired brain injury.

    PubMed

    Fong, Kenneth N K; Chow, Kathy Y Y; Chan, Bianca C H; Lam, Kino C K; Lee, Jeff C K; Li, Teresa H Y; Yan, Elaine W H; Wong, Asta T Y

    2010-04-30

    This study aimed to examine the usability of a newly designed virtual reality (VR) environment simulating the operation of an automated teller machine (ATM) for assessment and training. Part I involved evaluation of the sensitivity and specificity of a non-immersive VR program simulating an ATM (VR-ATM). Part II consisted of a clinical trial providing baseline and post-intervention outcome assessments. A rehabilitation hospital and university-based teaching facilities were used as the setting. A total of 24 persons in the community with acquired brain injury (ABI)--14 in Part I and 10 in Part II--made up the participants in the study. In Part I, participants were randomized to receive instruction in either an "early" or a "late" VR-ATM program and were assessed using both the VR program and a real ATM. In Part II, participants were assigned in matched pairs to either VR training or computer-assisted instruction (CAI) teaching programs for six 1-hour sessions over a three-week period. Two behavioral checklists based on activity analysis of cash withdrawals and money transfers using a real ATM were used to measure average reaction time, percentage of incorrect responses, level of cues required, and time spent as generated by the VR system; also used was the Neurobehavioral Cognitive Status Examination. The sensitivity of the VR-ATM was 100% for cash withdrawals and 83.3% for money transfers, and the specificity was 83% and 75%, respectively. For cash withdrawals, the average reaction time of the VR group was significantly shorter than that of the CAI group (p = 0.021). We found no significant differences in average reaction time or accuracy between groups for money transfers, although we did note positive improvement for the VR-ATM group. We found the VR-ATM to be usable as a valid assessment and training tool for relearning the use of ATMs prior to real-life practice in persons with ABI.

  8. Malpractice claims related to tooth extractions.

    PubMed

    Koskela, Sanna; Suomalainen, Anni; Apajalahti, Satu; Ventä, Irja

    2017-03-01

    The aim of this study was to analyze malpractice claims related to tooth extractions in order to identify areas requiring emphasis and eventually to reduce the number of complications. We compiled a file of all malpractice claims related to tooth extractions (EBA code) between 1997 and 2010 from the Finnish Patient Insurance Centre. We then examined the data with respect to date, tooth, surgery, injury diagnosis, and the authority's decision on the case. The material consisted of 852 completed patient cases. Most of the teeth were third molars (66 %), followed by first molars (8 %), and second molars (7 %). The majority of claims were related to operative extraction (71 %) followed by ordinary extraction (17 %) and apicoectomy of a single-rooted tooth (7 %) or multi-rooted tooth (2 %). The most common diagnosis was injury of the lingual or inferior alveolar nerve. According to the authority's decision, the patient received compensation more often in cases involving a third molar than other teeth (56 vs. 46 %, P < 0.05). The removal of a mandibular third molar was the basis for the majority of malpractice claims. To reduce the numbers of lingual and inferior alveolar nerve injuries, the removal of mandibular third molars necessitates recent and high-quality panoramic radiograph, preoperative assessment of the difficulty of removal, and consciousness of the variable anatomical course of the lingual nerve.

  9. 38 CFR 14.616 - Form and place of filing claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... applicable to the claim. (b) Place of filing claim. Claims arising in the Philippines under 38 U.S.C. 515(b... the Philippines. Claims arising in other foreign countries will be filed with the American Embassy or... documents in other than the English language will be accompanied by English translations. (2) Personal...

  10. 38 CFR 14.616 - Form and place of filing claim.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... applicable to the claim. (b) Place of filing claim. Claims arising in the Philippines under 38 U.S.C. 515(b... the Philippines. Claims arising in other foreign countries will be filed with the American Embassy or... documents in other than the English language will be accompanied by English translations. (2) Personal...

  11. 38 CFR 14.616 - Form and place of filing claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... applicable to the claim. (b) Place of filing claim. Claims arising in the Philippines under 38 U.S.C. 515(b... the Philippines. Claims arising in other foreign countries will be filed with the American Embassy or... documents in other than the English language will be accompanied by English translations. (2) Personal...

  12. 38 CFR 14.616 - Form and place of filing claim.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... applicable to the claim. (b) Place of filing claim. Claims arising in the Philippines under 38 U.S.C. 515(b... the Philippines. Claims arising in other foreign countries will be filed with the American Embassy or... documents in other than the English language will be accompanied by English translations. (2) Personal...

  13. 38 CFR 14.616 - Form and place of filing claim.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... applicable to the claim. (b) Place of filing claim. Claims arising in the Philippines under 38 U.S.C. 515(b... the Philippines. Claims arising in other foreign countries will be filed with the American Embassy or... documents in other than the English language will be accompanied by English translations. (2) Personal...

  14. 27 CFR 46.8 - Data to be shown in claim.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... CIGARETTE PAPERS AND TUBES Application of 26 U.S.C. 6423, as Amended, to Refund or Credit of Tax on Tobacco Products, and Cigarette Papers and Tubes Claim Procedure § 46.8 Data to be shown in claim. Claims to which... any manner whatsoever, the burden of the tax to any other person. (e) If the claim is for refund of a...

  15. 27 CFR 46.8 - Data to be shown in claim.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... CIGARETTE PAPERS AND TUBES Application of 26 U.S.C. 6423, as Amended, to Refund or Credit of Tax on Tobacco Products, and Cigarette Papers and Tubes Claim Procedure § 46.8 Data to be shown in claim. Claims to which... any manner whatsoever, the burden of the tax to any other person. (e) If the claim is for refund of a...

  16. 27 CFR 46.8 - Data to be shown in claim.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... CIGARETTE PAPERS AND TUBES Application of 26 U.S.C. 6423, as Amended, to Refund or Credit of Tax on Tobacco Products, and Cigarette Papers and Tubes Claim Procedure § 46.8 Data to be shown in claim. Claims to which... any manner whatsoever, the burden of the tax to any other person. (e) If the claim is for refund of a...

  17. 27 CFR 46.8 - Data to be shown in claim.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... CIGARETTE PAPERS AND TUBES Application of 26 U.S.C. 6423, as Amended, to Refund or Credit of Tax on Tobacco Products, and Cigarette Papers and Tubes Claim Procedure § 46.8 Data to be shown in claim. Claims to which... any manner whatsoever, the burden of the tax to any other person. (e) If the claim is for refund of a...

  18. Temperament and character traits in female adolescents with nonsuicidal self-injury disorder with and without comorbid borderline personality disorder.

    PubMed

    Tschan, Taru; Peter-Ruf, Claudia; Schmid, Marc; In-Albon, Tina

    2017-01-01

    Temperament and character traits of adolescents with nonsuicidal self-injury disorder (NSSI) might differentiate those- with and without comorbid borderline personality disorder (BPD). Participants were 57 female adolescents with NSSI disorder without BPD (NSSI - BPD), 14 adolescents with NSSI disorder and BPD (NSSI + BPD), 32 clinical controls (CC), and 64 nonclinical controls (NC). Temperament and character traits were assessed with the Junior Temperament and Character Inventory, and impulsivity with the Barratt Impulsiveness Scale and a Go/NoGo task. Adolescents with NSSI disorder scored significantly higher on novelty seeking and harm avoidance and lower on persistence, self-directedness, and cooperativeness than CC. The NSSI + BPD group scored even higher than the NSSI - BPD group on novelty seeking and harm avoidance and lower on persistence and cooperativeness (d ≥ 0.72). Adolescents with NSSI reported higher levels of impulsivity than the CC and NC group. However, this difference was not found in a Go/NoGo task. The results provide further evidence for a distinct diagnostic entity of NSSI disorder.

  19. Orbitofrontal overactivation in reward processing in borderline personality disorder: the role of non-suicidal self-injury.

    PubMed

    Vega, Daniel; Ripollés, Pablo; Soto, Àngel; Torrubia, Rafael; Ribas, Joan; Monreal, Jose Antonio; Pascual, Juan Carlos; Salvador, Raymond; Pomarol-Clotet, Edith; Rodríguez-Fornells, Antoni; Marco-Pallarés, Josep

    2018-02-01

    Borderline Personality Disorder (BPD) is a disabling and difficult-to-treat mental disease. One of its core features is a significant difficulty in affect regulation, which is often accompanied by Non-Suicidal Self-Injury (NSSI). It is suggested that this type of behavior elicits positive emotions and mitigates emotional distress, and therefore can ultimately be reinforced and promoted. In spite of the high prevalence of NSSI behaviors (also in non-BPD samples), their role in modulating reward-related processes has not yet been investigated in BPD patients. In the present study, this lack of research was addressed. A large sample of BPD patients (N = 40), divided into two groups depending on the presence of NSSI, and a group of matched healthy controls underwent functional Magnetic Resonance Imaging (fMRI) while performing a gambling task. Patients who committed NSSI acts exhibited enhanced activation of the orbitofrontal cortex following an unexpected reward, when compared with controls and BPD patients with no NSSI behavior. In addition, the NSSI group showed diminished functional connectivity between the left orbitofrontal cortex and the right parahippocampal gyrus. These findings might suggest impaired ability to update reward associations of potential choices when both BPD and NSSI are present. We propose that the presence of NSSI involves alterations in the reward system independently of BPD, and thus can be considered as a possible phenotype for reward-related alterations.

  20. Promoting adaptive behavior in persons with acquired brain injury, extensive motor and communication disabilities, and consciousness disorders.

    PubMed

    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 pressure microswitches (linked to preferred environmental stimuli) and eyelid, toe and finger responses. Study II involved three participants who were emerging from a minimally conscious state and were provided with intervention packages based on computer presentations of stimulus options (i.e., preferred stimuli, functional caregiver's procedures, and non-preferred stimuli) and pressure microswitches to choose among them. Intervention data of Study I showed that the participants acquired relatively high levels of microswitch responding (thus engaging widely with preferred environmental stimuli) and kept that responding consistent except for one case. Intervention data of Study II showed that the participants were active in choosing among preferred stimuli and positive caregivers' procedures, but generally abstained from non-preferred stimuli. The results were discussed in terms of the successful use of fairly new/infrequent microswitch-response arrangements (Study I) and the profitable inclusion of functional caregiver's procedures among the options available to choice (Study II). Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Borderline personality disorder in youth: The prospective impact of child abuse on non-suicidal self-injury and suicidality.

    PubMed

    Kaplan, Cynthia; Tarlow, Naomi; Stewart, Jeremy G; Aguirre, Blaise; Galen, Gillian; Auerbach, Randy P

    2016-11-01

    Borderline personality disorder (BPD) is characterized by greater engagement in non-suicidal self-injury (NSSI) and suicidality. The aim of the study is to test whether the occurrence of child abuse contributes to these high-risk behaviors in BPD youth. BPD female youth aged 13-21years with (n=29) and without (n=29) a history of child abuse were administered clinical interviews assessing diagnostic history, child abuse, NSSI and suicidality (i.e., ideation, plans, and attempts). NSSI and suicidality were subsequently reevaluated at the 1- and 2-month follow-up assessments. Several findings emerged. First, relative to BPD youth without abuse, the abuse group reported greater past NSSI; however, no significant differences emerged in the follow-up period. Second, the occurrence of child abuse was associated with a 5-fold increase in the rate of lifetime suicide attempts relative to the no abuse group and additionally, prospectively predicted suicide ideation (but not attempts). Last, exploratory analyses indicated that the co-occurrence of physical and sexual abuse was associated with greater past NSSI and suicidality as compared to the no abuse and sexual abuse only participants. As a whole, child abuse - particularly co-occurring physical and sexual abuse - increases risk for NSSI and suicidality among BPD youth, which may have important treatment implications in this high-risk population. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Immediate video feedback on ramp, wheelie, and curb wheelchair skill training for persons with spinal cord injury.

    PubMed

    Wang, Yong Tai; Limroongreungrat, Weerawat; Chang, Li-Shan; Ke, Xiang; Tsai, Liang-Ching; Chen, Yu-Ping; Lewis, James

    2015-01-01

    We hypothesized that the effects of immediate video feedback (IVF) on training ramp, wheelie, and curb wheelchair skills for persons with spinal cord injury (SCI) would be equivalent to or better than the traditional wheelchair skill training. Participants were manual wheelchair users with recent SCI (thoracic 1-lumbar 1) who were matched (9 pairs) on motor function level, age, and sex and randomly assigned to a control group (conventional training) or an experimental group (IVF training). Participants learned three wheelchair skills and then went through the wheelchair skill competency test, retention test, and transfer test. Paired t-tests were used to examine the differences in training time (minutes), spotter intervention needed (counts), and successful rate in performance between the two groups. A 2 (groups) x 3 (skills) x 3 (tests) repeated-measures analysis of variance and Bonferroni adjustment test were used to examine differences between groups on wheelchair skills and tests. No differences were found between two groups in training times (minutes) on three wheelchair skills (experimental vs control: ramp 14.92 +/- 5.80 vs 11.69 +/- 7.85; wheelie 17.79 +/- 6.03 vs 19.92 +/- 13.42; and curb 38.35 +/-23.01 vs 48.59 +/- 15.21). This study demonstrated that IVF for training manual wheelchair skills may produce similar results as the conventional training and may be an alternative training method for wheelchair skills.

  3. The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder.

    PubMed

    Naoum, Janina; Reitz, Sarah; Krause-Utz, Annegret; Kleindienst, Nikolaus; Willis, Franziska; Kuniss, Sarah; Baumgärtner, Ulf; Mancke, Falk; Treede, Rolf-Detlef; Schmahl, Christian

    2016-12-30

    Patients with Borderline Personality Disorder (BPD) often engage in non-suicidal self-injury (NSSI), to reduce arousal levels under stress. However, the importance of seeing blood for the effect of NSSI is yet unknown. The present pilot study examined 20 female BPD patients and 20 healthy controls (HC) to assess the role of seeing blood on arousal, pain, urge for NSSI (ratings) and heart rate (continuously measured). Participants completed two sessions consisting of stress induction (forced mental arithmetics with white noise), followed by a seven second non-invasive pain stimulus with a blade to the volar forearm. At one session, only the painful blade stimulus was applied, at the other, artificial blood was added. For arousal, a significantly stronger decrease was revealed in the BPD than in the HC group, however with no significant effects between blood and non-blood conditions. Concerning urge for NSSI, the BPD showed a significantly greater decrease in blood condition over time than the HC group. Interestingly, heart rate decreased stronger over time in the HC group during the blood condition than in BPD. For tension relief by non-damaging mechanical painful stimulus the addition of visible blood showed neither subjective (arousal, urge for NSSI), nor objective (heart rate) advantages. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Profiles of emotional and behavioral sequelae following acquired brain injury: cluster analysis of the Personality Assessment Inventory.

    PubMed

    Velikonja, Diana; Warriner, Erin; Brum, Christine

    2010-07-01

    Due to the multidimensional nature of symptom complaints within the acquired brain injury (ABI) population, emotional and behavioral profiles obtained from using comprehensive validated measures often yield more relevant information than tools that assess for symptoms of a single diagnostic disorder. The current study used the Personality Assessment Inventory (PAI) to detect emotional and behavioral profiles in a sample of 440 adult ABI patients. Using a rigorous three-step cluster analytic approach, seven clusters were identified, indicating that half of the sample (50%) showed clinically significant affective and behavioral symptoms typified by multiple Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I and/or II features. Two of the subtypes showed severe and diverse affective symptoms but were distinguished from each other by antisocial features and substance use. Two other subtypes, with predominantly internalized presentations, were characterized by mainly depressive and somatic features, and the second by mild anxiety and cognitive disturbance. One group, predominantly externalized presentation, showed high substance use and antisocial features. The other part of the sample (50%) had no significant affective or behavioral complaints but were characterized by two profile types classified as essentially normal, but distinguishable by one having an increased tendency to minimize symptoms. Sex, age, marital status, education/preinjury, and vocation typified various subtypes. The identified profiles taken in the context of important demographic information can provide descriptive insight into the nature of postinjury affective and behavioral symptoms, facilitating more comprehensive conceptualization of the client's needs that can be addressed through more tailored interventions.

  5. State Your Claim!

    ERIC Educational Resources Information Center

    Thypin, Marilyn; Glasner, Lynne

    A short fictional work for limited English speakers relates a young couple's experience in learning about small claims court through an incident involving damage to the husband's leather jacket. The damage to the jacket occurred when it was left at a dry clearner, but the dry cleaner claims that it sent the jacket to a special cleaner that handles…

  6. Formalizing Probabilistic Safety Claims

    NASA Technical Reports Server (NTRS)

    Herencia-Zapana, Heber; Hagen, George E.; Narkawicz, Anthony J.

    2011-01-01

    A safety claim for a system is a statement that the system, which is subject to hazardous conditions, satisfies a given set of properties. Following work by John Rushby and Bev Littlewood, this paper presents a mathematical framework that can be used to state and formally prove probabilistic safety claims. It also enables hazardous conditions, their uncertainties, and their interactions to be integrated into the safety claim. This framework provides a formal description of the probabilistic composition of an arbitrary number of hazardous conditions and their effects on system behavior. An example is given of a probabilistic safety claim for a conflict detection algorithm for aircraft in a 2D airspace. The motivation for developing this mathematical framework is that it can be used in an automated theorem prover to formally verify safety claims.

  7. Lipoprotein heterogeneity in persons with Spinal Cord Injury: a model of prolonged sitting and restricted physical activity.

    PubMed

    La Fountaine, Michael F; Cirnigliaro, Christopher M; Emmons, Racine R; Kirshblum, Steven C; Galea, Marinella; Spungen, Ann M; Bauman, William A

    2015-07-28

    Persons with spinal cord injury (SCI) often have low levels of physical activity, which predispose to increased adiposity and decreased high density lipoprotein cholesterol (HDL-C) concentrations, and, generally, normal low density lipoprotein cholesterol (LDL-C) concentrations. In spite of the mixed lipoprotein profile, the SCI population has been reported to have an elevated risk of cardiovascular-related morbidity and mortality. Nuclear magnetic resonance spectroscopy may permit a more precise quantification of lipoprotein particle (P) species, enabling a more accurate inference of risk for cardiovascular disease (CVD) in the SCI population. Fasting blood samples were obtained on 83 persons with chronic SCI and 62 able-bodied (AB) subjects. Fasting plasma insulin (FPI), triglycerides (TG), and P number and size of VLDL (very low density lipoprotein), LDL, and HDL subclasses were determined. AB and SCI subjects were stratified based on HDL-C (i.e., Low <40 and Normal ≥ 40 mg/dl): AB-Normal (n = 48), AB-Low (n = 14), SCI-Normal (n = 49), and SCI-Low (n = 34). Factorial analyses of variance were performed to identify group differences in lipoprotein measurements. Pearson correlations were performed between the number of P by lipoprotein subclass, size, FPI, and TG. The SCI-Normal group was not significantly different from the AB-Normal group for body composition, FPI, TG or LP-IR and had negligible differences in the lipoprotein P profile, except for fewer number and smaller size of HDL-P. The SCI-Low group had a similar lipoprotein profile to that of the AB-Low group, but with a lipid P composition associated with a heightened atherogenic risk and greater tendency toward insulin resistance by the Lipoprotein-Insulin Resistance (LP-IR) score. In the SCI-Low group, the decreased number and reduced size of lipoprotein P were more prevalent and may be associated with increased waist circumference (i.e., abdominal adiposity), relatively elevated TG values (compared

  8. The Role of Negative Affect and Self-Concept Clarity in Predicting Self-Injurious Urges in Borderline Personality Disorder Using Ecological Momentary Assessment.

    PubMed

    Scala, J Wesley; Levy, Kenneth N; Johnson, Benjamin N; Kivity, Yogev; Ellison, William D; Pincus, Aaron L; Wilson, Stephen J; Newman, Michelle G

    2018-01-01

    Deficits in identity as well as negative affect have been shown to predict self-injurious and suicidal behaviors in individuals with borderline personality disorder (BPD). However, less is known about the interactive effects of these two predictors. We examined the moderating effect of a particular component of identity, self-concept, on the relationship between negative affect and self-injurious urges utilizing ecological momentary assessments. Outpatients diagnosed with either BPD (n = 36) or any anxiety disorder but no BPD (n = 18) completed surveys throughout the day over a 21-day period. Higher levels of momentary negative affect predicted greater subsequent urges to self-injure, but only when self-concept clarity was low (z = -3.60, p < .01). This effect did not differ between diagnostic groups. The results suggest that self-concept clarity has a protective effect against self-injurious urges in light of high negative affect, and that this effect may be transdiagnostic.

  9. 20 CFR 725.305 - When a written statement is considered a claim.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... intention to claim benefits shall be considered to be the filing of a claim for the purposes of this part under the following circumstances: (1) The claimant or a proper person on his or her behalf (see § 725... specified in paragraph (b) of this section without filing a prescribed claim form, and a person acting on...

  10. Psychological distress and user experiences with health care provision in persons living with spinal cord injury for more than 20 years.

    PubMed

    Jakimovska, V M; Kostovski, E; Biering-Sørensen, F; Lidal, I B

    2017-09-01

    Descriptive cross-sectional and retrospective study. To gain more insight into the long-term health status in persons with traumatic spinal cord injury (SCI), especially perceived psychological distress as well as self-reports of utilization of healthcare services. Sunnaas Rehabilitation Hospital, Norway. In total, 147 persons with SCI were examined for more than 20 years and interviewed (in 2004/2005) using a self-administrated questionnaire and General Health Questionnaire (GHQ-20). Descriptive statistics and a logistic regression analysis were conducted to identify variables associated with psychological distress. Most participants had received SCI follow-up health services at least once after initial rehabilitation; 34% were satisfied, 51% neutral and 18% unsatisfied with the health services provided. Concerning psychological distress, 34 persons were cases according to the GHQ-20. The cases did not differ from non-cases concerning demography, time since injury, injury aetiology, injury severity, marital status or employment status. The regression analysis revealed that cases were associated (P<0.05) with more use of SCI-specific follow-ups. In a 20+ years' post-injury SCI population, psychological distress is common and associated with the use of follow-up services. The varying satisfaction of people with SCI about healthcare services is notable, as is the finding that 20% of people with paraplegia did not use specific SCI follow-up services. The experiences of people with SCI with healthcare services need further investigation, and there is also a need for studies that examine the effects of interventions aimed at improving services and patient satisfaction.

  11. Prospective outcomes of injury study.

    PubMed

    Derrett, S; Langley, J; Hokowhitu, B; Ameratunga, S; Hansen, P; Davie, G; Wyeth, E; Lilley, R

    2009-10-01

    In New Zealand (NZ), 20% of adults report a disability, of which one-third is caused by injury. No prospective epidemiological studies of predictors of disability following all-cause injury among New Zealanders have been undertaken. Internationally, studies have focused on a limited range of predictors or specific injuries. Although these studies provide useful insights, applicability to NZ is limited given the importance of NZ's unique macro-social factors, such as NZ's no-fault accident compensation and rehabilitation scheme, the Accident Compensation Corporation (ACC). (1) To quantitatively determine the injury, rehabilitation, personal, social and economic factors leading to disability outcomes following injury in NZ. (2) To qualitatively explore experiences and perceptions of injury-related outcomes in face-to-face interviews with 15 Māori and 15 other New Zealanders, 6 and 12 months after injury. Four geographical regions within NZ. Prospective cohort study with telephone interviews 1, 4 and 12 months after injury. 2500 people (including 460 Māori), aged 18-64 years, randomly selected from ACC's entitlement claims register (people likely to be off work for at least 1 week or equivalent). Telephone interviews, electronic hospital and ACC injury data. Exposures include demographic, social, economic, work-related, health status, participation and/or environmental factors. Primary: disability (including WHODAS II) and health-related quality of life (including EQ-5D). Secondary: participation (paid and unpaid activities), life satisfaction and costs. Separate regression models will be developed for each of the outcomes. Repeated measures outcomes will be modelled using general estimating equation models and generalised linear mixed models.

  12. Reliability associated with the abstraction of data from medical records for inclusion in an information system for persons with a traumatic brain injury.

    PubMed

    Labelle, Josée; Swaine, Bonnie R

    2002-08-01

    This article presents the intra- and inter-rater reliability associated with the extraction, from medical rehabilitation charts, of data to be included in a head injury information system currently under development. A data collection form was developed to facilitate and standardize the data extraction. Two clinicians extracted information pertaining to 231 variables of the system from 15 charts of persons receiving rehabilitation services following a head injury. Average percentage agreement was high and did not vary from one category of variables to the other (84-88%). Substantial intra-rater agreement (kappa = 0.66) and moderate inter-rater agreement (kappa = 0.56) were found to be associated with the extraction of the variables studied. The results suggest that clinicians using standardized procedures can reliably extract important data pertaining to personal history, impairments, and disabilities relating to sensorimotor function. Some potential sources of error are identified and recommendations are presented.

  13. 32 CFR 536.78 - Settlement authority for claims under the Military Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... satisfaction of the claim. (6) Authority to further delegate payment authority is set forth in § 536.3(g)(1) of... compensation of federal employees for job-related injuries (see § 536.44), or untimely filing, TJAG or TAJAG...

  14. 32 CFR 536.136 - Scope for claims arising under the Foreign Claims Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... injury, death, or property damage caused by service members or civilian employees, or claims that arise... either category. In a wrongful death case, if the decedent is an inhabitant of a foreign country, even... outside the U.S. involving foreign-born spouces, see DA Pam 27-20, paragraph 2-20a. (c) Effect of Army...

  15. 32 CFR 536.136 - Scope for claims arising under the Foreign Claims Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... injury, death, or property damage caused by service members or civilian employees, or claims that arise... either category. In a wrongful death case, if the decedent is an inhabitant of a foreign country, even... outside the U.S. involving foreign-born spouces, see DA Pam 27-20, paragraph 2-20a. (c) Effect of Army...

  16. Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged ≤19 years--United States, 2001-2009.

    PubMed

    2011-10-07

    Traumatic brain injuries (TBIs) from participation in sports and recreation activities have received increased public awareness, with many states and the federal government considering or implementing laws directing the response to suspected brain injury. Whereas public health programs promote the many benefits of sports and recreation activities, those benefits are tempered by the risk for injury. During 2001--2005, an estimated 207,830 emergency department (ED) visits for concussions and other TBIs related to sports and recreation activities were reported annually, with 65% of TBIs occurring among children aged 5--18 years. Compared with adults, younger persons are at increased risk for TBIs with increased severity and prolonged recovery. To assess and characterize TBIs from sports and recreation activities among children and adolescents, CDC analyzed data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for the period 2001--2009. This report summarizes the results of that analysis, which indicated that an estimated 173,285 persons aged ≤19 years were treated in EDs annually for nonfatal TBIs related to sports and recreation activities. From 2001 to 2009, the number of annual TBI-related ED visits increased significantly, from 153,375 to 248,418, with the highest rates among males aged 10--19 years. By increasing awareness of TBI risks from sports and recreation, employing proper technique and protective equipment, and quickly responding to injuries, the incidence, severity, and long-term negative health effects of TBIs among children and adolescents can be reduced.

  17. [The forensic medical evaluation of the injuries inflicted inside the passenger compartment of a moving car equipped with the modern personal safety systems].

    PubMed

    Pigolkin, Yu I; Dubrovin, I A; Mosoyan, A S; Bychkov, A A

    2018-01-01

    The objective of the present study was to elucidate the characteristic features of the injuries inflicted to the victims of a road traffic accident inside the passenger compartment of a moving car equipped with the modern personal safety systems. The materials available for the present work included the lesions documented in 210 drivers and 150 occupants of the car passenger compartments. Both comparative, morphometric and statistical methods were used to analyze the data obtained. The morphometric analysis included identification of the form of the injury, such as extravasation, wounds, fractures, and lesions of the internal organs (e.g. hemorrhages, ruptures, etc.), their number and localization. Special attention was given to the specific features of the injuries to the occupants of the cars equipped with the modern personal safety systems. The study has demonstrated that the form, frequency, and localization of the injuries inflicted to the victims of a road traffic accident inside the passenger car compartment (including the drivers and other occupants) can be used for determining the positions of the victims at the moment of the accident.

  18. Risk Factors for Fall-Related Injuries Leading to Hospitalization Among Community-Dwelling Older Persons: A Hospital-Based Case-Control Study in Thiruvananthapuram, Kerala, India.

    PubMed

    Ravindran, Rekha M; Kutty, V Raman

    2016-01-01

    This study intended to identify the risk factors for injurious falls that led to hospitalization of older persons living in the community. A hospital-based unmatched incident case-control study was done among 251 cases and 250 controls admitted at a tertiary care centre in Kerala. Mean age of cases was 71.6 ± 9.13 years and that of controls was 67.02 ± 6.17 years. Hip fractures were the predominant injury following falls. Falls were mostly a result of intrinsic causes. After adjusting for other variabes, the risk factors for all injuries were age above 70 years (odds ratio [OR] = 2.25; 95% confidence interval [CI] = 1.46-3.46), previous fall history (OR = 2.76; 95% CI = 1.08-7.08), impaired vision (OR = 4.49; 95% CI = 2.77-7.30), not living with spouse (OR = 1.97; 95% CI = 1.31-2.97), door thresholds (OR = 1.52; 95% CI = 1.01-2.29), and slippery floor (OR = 2.37; 95% CI = 1.31-4.32). The risk factors for hip fractures and other injuries were identified separately. Fall prevention strategies among older persons are warranted in Kerala. © 2015 APJPH.

  19. Court rejects claim of mental illness from needlestick.

    PubMed

    1998-05-29

    The Montana Supreme Court rejected the bid of a medical technician to remain on workers' compensation, based on his claims that he suffered from psychosis, depression, and hallucinations after pricking himself with a needle used on an HIV-positive patient. [Name removed], a respiratory therapist at Community Medical Center in Missoula, tested negative for HIV, but claimed that the psychological trauma from the needlestick injury caused him to become disabled. Based on expert testimony, the Workers' Compensation Court determined that [name removed] was faking his symptoms to collect benefits from his employer's insurer, EBI/Orion Group. [Name removed] appealed, and the Supreme Court remanded the case, stating that psychologists are not included among the medical professionals able to conduct medical reviews. The Workers' Compensation Court again found that [name removed] was faking his symptoms, and [name removed] unsuccessfully appealed. The compensation panel cited conflicting evidence from psychological tests, [name removed]'s friends' testimonies, and [name removed]'s personal diary. The Supreme Court upheld the verdict.

  20. Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury: An explorative analysis of data from a randomized controlled trial.

    PubMed

    Postma, Karin; Vlemmix, Lonneke Y; Haisma, Janneke A; de Groot, Sonja; Sluis, Tebbe A R; Stam, Henk J; Bussmann, Johannes B J

    2015-09-01

    To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury. Longitudinal analyses. Forty persons with recent spinal cord injury and impaired pulmonary function. Measurements were performed 4 weeks after the start of rehabilitation, 9 and 17 weeks after the first measurement, and one year after discharge from inpatient rehabilitation. Peak cough flow was measured with a spirometer. Maximum inspiratory and expiratory pressures (MIP and MEP), expressed in cmH2O, were measured at the mouth. Both MIP and MEP were significantly positively associated with peak cough flow. After correction for confounders and time 10 cmH2O higher MIP was associated with a 0.32 l/s higher peak cough flow, and a 10 cmH2O higher MEP was associated with a 0.15 l/s higher peak cough flow. The association between MIP and peak cough flow was mainly based on within-subject variance. The association between MIP and peak cough flow was stronger than between MEP and peak cough flow. Improvement in respiratory muscle strength is associated with improvement in cough capacity in persons with recent spinal cord injury who have impaired pulmonary function.