Science.gov

Sample records for personal injury claims

  1. 29 CFR 100.401 - Claims under the Federal Tort Claims Act for loss of or damage to property or for personal injury...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  2. 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.

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Duration of time injuries prevented or limited employment, (4) Past, present, and future limitations on employment, (5) Duration and extent of pain and suffering and of any disability or physical disfigurement, (6...

  4. 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

    ... on negligence, wrongful act or omission. Authority: 12 U.S.C. 5492(a)(1), (11); 28 U.S.C. 2672; 28 CFR 14.11. Sec. 1076.101 Claims against a Bureau employee based on negligence, wrongful act or... representative may present a claim against a Bureau employee based on negligence, or wrongful act or omission, as...

  5. MMPI-2 validity, clinical and content scales, and the Fake Bad Scale for personal injury litigants claiming idiopathic environmental intolerance.

    PubMed

    Staudenmayer, Herman; Phillips, Scott

    2007-01-01

    Idiopathic environmental intolerance (IEI) is a descriptor for nonspecific complaints that are attributed to environmental exposure. The Minnesota Multiphasic Personality Inventory 2 (MMPI-2) was administered to 50 female and 20 male personal injury litigants alleging IEI. The validity scales indicated no overreporting of psychopathology. Half of the cases had elevated scores on validity scales suggesting defensiveness, and a large number had elevations on Fake Bad Scale (FBS) suggesting overreporting of unauthenticated symptoms. The average T-score profile for females was defined by the two-point code type 3-1 (Hysteria-Hypochondriasis), and the average T-score profile for males was defined by the three-point code type 3-1-2 (Hysteria, Hypochondriasis-Depression). On the content scales, Health Concerns (HEA) scale was significantly elevated. Idiopathic environmental intolerance litigants (a) are more defensive about expressing psychopathology, (b) express distress through somatization, (c) use a self-serving misrepresentation of exaggerated health concerns, and (d) may exaggerate unauthenticated symptoms suggesting malingering.

  6. 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... Medical attention and injury claims. (a) Medical attention and hospitalization. The school shall be... employees shall look to the State alone for pay, allowances, compensation and other benefits during injury...

  7. 46 CFR 310.9 - Medical attention and injury claims.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Medical attention and injury claims. 310.9 Section 310.9... Medical attention and injury claims. (a) Medical attention and hospitalization. The school shall be... employees shall look to the State alone for pay, allowances, compensation and other benefits during injury...

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Medical attention and injury claims. 310.9 Section 310.9... Medical attention and injury claims. (a) Medical attention and hospitalization. The school shall be... employees shall look to the State alone for pay, allowances, compensation and other benefits during injury...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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

  16. 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

  17. Injury and Compensation Claims Module Maintenance Manual

    DTIC Science & Technology

    1989-01-01

    DUTY* 15. IF INTERRUPTED, SHOW DATES RESUMED HEALTH BENEFIT OPTIONAL INSURANCE 16. IF HEALTH BENEFITS 6oPTION HAS CHANGED FEHB NUMBER DATE 17. *Press...INCLUSIVE DATES OF COP, FROM: .......... TO: 24. HEALTH BENEFIT (HBS) CODE, IF ENROLLED 25. SHOW DATE THROUGH WHICH HBS LAST MADE 26. ATTENDING...TO INJURY? 24. DUTY AFFORDED 11 MONTHS WORK? 25. TOTAL LENGTH FEDERAL CIVIL SERVICE, YRS. MOS. HEALTH BENEFITS AND OPTIONAL LIFE INSURANCE 26

  18. 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.

  19. 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.

  20. Trends in Personal Injury Suits.

    ERIC Educational Resources Information Center

    van der Smissen, Betty

    1985-01-01

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

  1. 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

  2. Age-related injury and compensation claim rates in heavy industry.

    PubMed

    Guest, M; Boggess, M M; Viljoen, D A; Duke, J M; Culvern, C N

    2014-03-01

    Although ageing workers face specific health and safety concerns, conflicting evidence exists regarding the effects of age on workplace injury rates and workers' compensation claims. To examine injury and workers' compensation claim rates by age and injury type in an aluminium smelter over a 9-year period. Routinely collected data for workplace injuries and workers' compensation claims were retrieved for the period from 1997 to 2005. The study included a total of 709 workers who experienced 2281 at-work injuries and submitted 446 claims. In 1997, 16% of employees were aged 50 or over; by 2005 that proportion had more than doubled to 35%. Injury and claim rates in all age groups did not change significantly during this period. Workers younger than 30 years of age had the highest injury rates, with differences most significant for injuries other than sprains and strains. Claim rates were not significantly different across age groups. These findings do not provide evidence to support the notion that older workers sustain more injuries and are more likely to claim compensation for their injuries. Our findings demonstrate that in this workplace, older workers were able to maintain their ability to work safely. This contrasts with the finding that younger workers had the highest injury and claim rates. While adapting to the needs of an ageing workforce, employers should not lose sight of the need to nurture a strong culture of working safely among their youngest workers.

  3. Body mass index as a predictor of firefighter injury and workers' compensation claims.

    PubMed

    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

    2012-05-01

    To determine the relationship between lifestyle variables including body mass index and filing a workers' compensation claim due to firefighter injury. A cross-sectional evaluation of firefighter injury related to workers" compensation claims occurring 5 years after the original Promoting Healthy Lifestyles: Alternative Models' Effects study intervention. A logistic regression analysis for variables predicting filing a workers' compensation claim due to an injury was performed with a total of 433 participants. The odds of filing a compensation claim were almost 3 times higher for firefighters with a body mass index of more than 30 kg/m than firefighters with a normal body mass index (odds ratio, 2.89; P < 0.05). This study addresses a high-priority area of reducing firefighter injuries and workers' compensation claims. Maintaining a healthy body weight is important to reduce injury and workers' compensation claims among firefighters.

  4. 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.

  5. Personality and psychosocial function after brain injury.

    PubMed

    Malia, K; Powell, G; Torode, S

    1995-10-01

    A total of 74 brain-injured patients and 46 non-neurologically matched controls consecutively admitted to a specialist medical rehabilitation unit, were administered the 'Headley Court psychosocial rating scale' and four questionnaires examining personality traits of 'locus of control', 'use of humour', 'optimism' and 'easy-going disposition'. Both pre- and post-injury personality ratings were obtained. The relatives of all participants were sent the same scales. Personality changes are reported in each of the four areas; however, time post-injury appears to be a significant factor in the type of change reported; in this cross-sectional study, at 6 and 12 months post-injury, changes are noted in all variables except locus of control, whereas at 18 months post-injury only 'easy-going disposition' showed significant change, at 24 months post-injury changes were noted in all variables except optimism, and at 30 months post-injury no changes were noted. In the present study, examining a period of 2.5 years post-injury, the personality changes remain static once they have occurred. Despite widespread reports in the literature on the importance of pre- and post-trauma personality to good psychosocial functioning, the present study found that it was only an 'easy-going disposition' post-trauma that was consistently related to good psychosocial functioning. Reasons for this are discussed.

  6. 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.

  7. 20 CFR 429.103 - Who may file my claim?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... representative may file the claim. (b) Claims for personal injury. If you suffered the injury, you, your duly... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Who may file my claim? 429.103 Section 429... Who may file my claim? (a) Claims for damage to or loss of property. If you are the owner of the...

  8. 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

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0104] Agency Information Collection (Report of Accidental Injury in Support of Claim for Compensation or Pension/Statement of Witness to Accident... of Claim for Compensation or Pension/Statement of Witness to Accident, VA Form 21- 4176. OMB Control...

  9. 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

  10. 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.

  11. Using Workers' Compensation Claims Data to Characterize Occupational Injuries in the Commercial Grain Elevator Industry.

    PubMed

    Ramaswamy, Sai K; Mosher, Gretchen A

    2017-07-31

    Workplace injuries in the grain handling industry are common, yet little research has characterized worker injuries in grain elevators across all hazard types. Learning from past injuries is essential for preventing future occurrences, but the lack of injury information for the grain handling industry hinders this effort. The present study addresses this knowledge gap by using data from over 7000 workers' compensation claims reported from 2008 to 2016 by commercial grain handling facilities in the U.S. to characterize injury costs and severity. The total amount paid for each claim was used as a measure of injury severity. The effects of employee age and tenure, cause of injury, and body part injured on the cost of work-related injuries were investigated. Contingency tables were used to classify the variable pairs. The chi-square test and chi-square residuals were employed to evaluate the relationship between the variable pairs and identify the at-risk groups. Results showed that the employee age and tenure, cause of injury, and body part injured have a significant influence on the cost paid for the claim. Several at-risk groups were identified as a result of the analyses. Findings from the study will assist commercial grain elevators in the development of targeted safety interventions and assist grain elevator safety managers in mitigating financial and social losses from occupational injuries. Copyright© by the American Society of Agricultural Engineers.

  12. 32 CFR 536.74 - Scope for claims under the Military Claims Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... (normally a resident) of the United States at the time of the incident giving rise to the claim. See § 536... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the Military Claims Act § 536.74... claims against the United States for death or personal injury, or damage to, or loss or destruction of...

  13. 32 CFR 536.74 - Scope for claims under the Military Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (normally a resident) of the United States at the time of the incident giving rise to the claim. See § 536... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the Military Claims Act § 536.74... claims against the United States for death or personal injury, or damage to, or loss or destruction of...

  14. Ergonomic and socioeconomic risk factors for hospital workers' compensation injury claims.

    PubMed

    Boyer, Jon; Galizzi, Monica; Cifuentes, Manuel; d'Errico, Angelo; Gore, Rebecca; Punnett, Laura; Slatin, Craig

    2009-07-01

    Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers' compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions. A single community hospital provided workforce demographics and WC claim records for 2003-2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the O*NET online database. Occupational exposures and SES categories were assigned to workers through their O*NET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES. The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims. Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings.

  15. Ergonomic and Socioeconomic Risk Factors for Hospital Workers’ Compensation Injury Claims

    PubMed Central

    Boyer, Jon; Galizzi, Monica; Cifuentes, Manuel; d’Errico, Angelo; Gore, Rebecca; Punnett, Laura; Slatin, Craig

    2018-01-01

    Background Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers’ compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions. Methods A single community hospital provided workforce demographics and WC claim records for 2003–2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the O*NET online database. Occupational exposures and SES categories were assigned to workers through their O*NET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES. Results The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims. Conclusions Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings. PMID:19479820

  16. Claims for compensation after injuries related to airway management: a nationwide study covering 15 years.

    PubMed

    Fornebo, I; Simonsen, K A; Bukholm, I R K; Kongsgaard, U E

    2017-08-01

    Securing the airway is one of the most important responsibilities in anaesthesia. Injuries related to airway management can occur. Analysis from closed claims can help to identify patterns of injury, risk factors and areas for improvement. All claims to The Norwegian System of Compensation to Patients from 1 January 2001 to 31 December 2015 within the medical specialty of anaesthesiology were studied. Data were extracted from this database for patients and coded by airway management procedures. Of 400 claims for injuries related to airway management, 359 were classified as 'non-severe' and 41 as 'severe'. Of the severe cases, 37% of injuries occurred during emergency procedures. Eighty-one claims resulted in compensation, and 319 were rejected. A total of €1,505,344 was paid to the claimants during the period. Claims of dental damage contributed to a numerically important, but financially modest, proportion of claims. More than half of the severe cases were caused by failed intubation or a misplaced endotracheal tube. Anaesthesia procedures are not without risk, and injuries can occur when securing the airway. The most common injury was dental trauma. Clear patterns of airway management that resulted in injuries are not apparent from our data, but 37% of severe cases were related to emergency procedures which suggest the need for additional vigilance. Guidelines for difficult intubation situations are well established, but adherence to such guidelines varies. Good planning of every general anaesthesia should involve consideration of possible airway problems and assessment of pre-existing poor dentition. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. 32 CFR 842.46 - Who may file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... property or their authorized agents may file claims for property damage. (b) Injured persons or their duly authorized agents may file claims for personal injury. (c) Duly appointed guardians of minor children or any...

  18. 32 CFR 842.46 - Who may file a claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... property or their authorized agents may file claims for property damage. (b) Injured persons or their duly authorized agents may file claims for personal injury. (c) Duly appointed guardians of minor children or any...

  19. 32 CFR 842.46 - Who may file a claim.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... property or their authorized agents may file claims for property damage. (b) Injured persons or their duly authorized agents may file claims for personal injury. (c) Duly appointed guardians of minor children or any...

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... property or their authorized agents may file claims for property damage. (b) Injured persons or their duly authorized agents may file claims for personal injury. (c) Duly appointed guardians of minor children or any...

  1. 32 CFR 842.46 - Who may file a claim.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... property or their authorized agents may file claims for property damage. (b) Injured persons or their duly authorized agents may file claims for personal injury. (c) Duly appointed guardians of minor children or any...

  2. 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.

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

    PubMed

    Wuellner, Sara E; Adams, Darrin A; Bonauto, David K

    2016-04-01

    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. 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. 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). 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. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

  4. 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

  5. How many work-related injuries requiring hospitalization in British Columbia are claimed for workers' compensation?

    PubMed

    Alamgir, Hasanat; Koehoorn, Mieke; Ostry, Aleck; Tompa, Emile; Demers, Paul A

    2006-06-01

    Workplace compensation claims datasets represent an important source of information on work-related injuries. This study investigated the concordance between hospital discharge records and workers' compensation records for work-related serious injuries among a cohort of sawmill workers in British Columbia (BC), Canada. It also examined the extent to which workers' compensation capturing patterns varied by cause, severity of injuries, and demographic characteristics of workers. Work-related injuries were identified in hospitalization records between April 1989 and December 1998, and were matched by dates and description of injury to compensation records. The agreement between the hospital records and compensation records was good (kappa = 0.84, P < 0.01). A lower claim reporting rate for work-related hospitalization was observed for older and non-white workers. More serious injuries defined by longer length of stay and emergency admissions were more likely to be reported. Falls, struck against, and overexertion injuries had lower reporting rates; whereas, machinery-related, cutting/piercing, and caught in/between injuries had higher reporting rates. When compared with hospital discharge records, the compensation agency underreported incidents of serious work-related injuries by 10-15% among the sawmill workers.

  6. 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

  7. 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

  8. 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

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0104] Proposed Information Collection (Report of Accidental Injury in Support of Claim for Compensation or Pension/Statement of Witness to Accident... for Compensation or Pension/Statement of Witness to Accident, VA Form 21- 4176. OMB Control Number...

  9. 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

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

    PubMed

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

    2012-12-01

    The aim of this study was to explore (a) whether and how consumers may (over-) interpret satiety claims, and (b) whether and to what extent consumers recognize that personal efforts are required to realize possible satiety-related or weight loss benefits. Following means-end chain theory, we explored for a number of satiety claims the extent of inference-making to higher-level benefits than actually stated in the claim, using internet-based questions and tasks. Respondents (N=1504) in U.K., France, Italy and Germany participated in the study. The majority of these respondents correctly interpret satiety-related claims; i.e. they largely limit their interpretation to what was actually stated. They do not expect a "magic bullet" effect, but understand that personal efforts are required to translate product attributes into potential weight control benefits. Less-restrained eaters were at lower risk for over-interpreting satiety-related claims, whilst respondents with a stronger belief that their weight is something that they can control accept more personal responsibility, and better understand that personal efforts are required to be effective in weight control. Overall, these results indicate there is likely to be a relatively low level of consumer misinterpretation of satiety-related claims on food products. Copyright © 2012 International Life Sciences Institute. Published by Elsevier Ltd.. All rights reserved.

  11. 22 CFR 511.5 - Who may file claim.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Who may file claim. 511.5 Section 511.5 Foreign Relations BROADCASTING BOARD OF GOVERNORS FEDERAL TORT CLAIMS PROCEDURE § 511.5 Who may file claim. (a... representatives. Claims for personal injury or death may be made by the injured person or a legal representative...

  12. 32 CFR 842.61 - Who may file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Who may file a claim. 842.61 Section 842.61... ADMINISTRATIVE CLAIMS Foreign Claims (10 U.S.C. 2734) § 842.61 Who may file a claim. (a) Owners of the property... personal injury. (c) Executors or administrators of a decedent's estate, or any other person legally...

  13. 32 CFR 842.61 - Who may file a claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Who may file a claim. 842.61 Section 842.61... ADMINISTRATIVE CLAIMS Foreign Claims (10 U.S.C. 2734) § 842.61 Who may file a claim. (a) Owners of the property... personal injury. (c) Executors or administrators of a decedent's estate, or any other person legally...

  14. 22 CFR 511.5 - Who may file claim.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Who may file claim. 511.5 Section 511.5 Foreign Relations BROADCASTING BOARD OF GOVERNORS FEDERAL TORT CLAIMS PROCEDURE § 511.5 Who may file claim. (a... representatives. Claims for personal injury or death may be made by the injured person or a legal representative...

  15. Non-fatal work-related motor vehicle traffic crash injuries in New Zealand: analysis of a national claims database.

    PubMed

    Sultana, Shaheen; Robb, Gillian; Ameratunga, Shanthi; Jackson, Rod T

    2007-12-14

    This study describes event rates and associated costs from non-fatal work-related motor vehicle traffic crash (WR MVTC) injuries on public roads in New Zealand based on an analysis of the Accident Compensation Corporation (ACC) entitlement claims database. WR MVTC injury claims between July 2004 and June 2006 were identified from the ACC Motor Vehicle Account. Cross-sectional analyses were performed to describe the characteristics of the claims. Injury rates were estimated where appropriate. The overall age-standardised rate of non-fatal WR MVTC injury claims during the study period was 109 per 100,000 workers per year. The majority of claimants were male (75%) and New Zealand (NZ) European (67%), and one in three of these injuries occurred among plant and machine operators and assemblers. In contrast to rates of road traffic injury resulting in deaths and hospital admissions in NZ, younger and older workers had similar proportionate representation in the claims data. The total cost associated with the 1968 claims made during the 12 months from July 2004 to June 2005 was approximately NZ$6 million, with an average cost per claim of NZ$2884. To our knowledge this is the first published analysis of non-fatal WR MVTC injury claims in New Zealand. These analyses identify industry and demographic groups that appear to be at increased risk of WR MVTC injuries that could be targeted for preventive interventions. However, a number of limitations in the database, including uncertainties regarding the definition and coding of crashes deemed as "work-related", under-reporting of claims, and lack of a reliable indicator of injury severity significantly compromised our ability to interpret the results. Considerable improvement in the quality and reporting of claims data is required to facilitate the utility of this information to inform injury prevention strategies.

  16. 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.

  17. 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.

  18. 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.

  19. Prescription opioids for occupational injury: results from workers' compensation claims records.

    PubMed

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

    2014-09-01

    The objective of this study is to identify the prevalence of opioid prescription use in an Australian workers' compensation population and assess predictors of long-term use. Retrospective administrative data analysis. WorkSafe Victoria (Australia) workers' compensation. Workers with a workers' compensation claim were included if the injury/illness started in 2008 or 2009 (N = 54,931). Claim payments records dating up to 2 years postinjury were analyzed to determine receipt of prescription opioids. Long-term use was defined as use of any opioid beyond 1 year postinjury. Within the follow-up period, 8,933 (16.3%) workers claimed prescription opioids: 10.0% claimed opioids in the first year only, and 6.3% claimed opioids beyond the first year. The most commonly received opioids were codeine (10.4%), oxycodone (7.5%), and tramadol (5.0%). Dextropropoxyphene, which is considered unsafe in many countries because of potentially fatal side effects, was used by 1.9% of injured workers. Progression to long-term use of opioids was common (N = 3,446; 39%): age (35-64 years; the association with age followed an inverse U-shaped curve), women, laborers, lower socioeconomic status, greater work disability, and greater hospital expense were associated with opioid use beyond the first year postinjury. Prescription opioid use for workplace injury in Australia is common but not as common as reports from U.S. workers' compensation schemes. The type of opioid and number of repeat prescriptions are factors that should be carefully considered by practitioners prescribing opioids to injured workers: progression to long-term use is common and not fully explained by injury severity. Wiley Periodicals, Inc.

  20. 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.

  1. 22 CFR 72.28 - Claims for lost, stolen, or destroyed personal estate.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... pursuant to 22 U.S.C. 2669-1 and 2669 (f). (b) Any compensation paid to the estate shall be in lieu of the... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Claims for lost, stolen, or destroyed personal estate. 72.28 Section 72.28 Foreign Relations DEPARTMENT OF STATE PROTECTION AND WELFARE OF AMERICANS...

  2. 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

  3. 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.

  4. 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...: Statement of Person Claiming to Have Stood in Relation of a Parent, VA Form 21-524. OMB Control Number: 2900... relationship of the natural parent of a deceased veteran. The information is used to determine the claimant's...

  5. 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...

  6. 49 CFR 229.41 - Protection against personal injury.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Protection against personal injury. 229.41 Section... Requirements § 229.41 Protection against personal injury. Fan openings, exposed gears and pinions, exposed... breakers, contactors, relays, grid resistors, and fuses shall be in non-hazardous locations or equipped...

  7. 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... breakers, contactors, relays, grid resistors, and fuses shall be in non-hazardous locations or equipped...

  8. 32 CFR 842.106 - Who may file a claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... file a claim for personal injury. (c) Executors or administrators of a decedent's estate or any other... 32 National Defense 6 2011-07-01 2011-07-01 false Who may file a claim. 842.106 Section 842.106... ADMINISTRATIVE CLAIMS Claims Under the National Guard Claims Act (32 U.S.C. 715) § 842.106 Who may file a claim...

  9. 32 CFR 842.106 - Who may file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... file a claim for personal injury. (c) Executors or administrators of a decedent's estate or any other... 32 National Defense 6 2010-07-01 2010-07-01 false Who may file a claim. 842.106 Section 842.106... ADMINISTRATIVE CLAIMS Claims Under the National Guard Claims Act (32 U.S.C. 715) § 842.106 Who may file a claim...

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

    PubMed

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

    2010-10-01

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

  11. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ADMINISTRATIVE CLAIMS General Information § 842.7 Who may file a claim. (a) Property damage. The owner or owners of the property or their authorized agent may file a claim for property damage. (b) Personal injury... duly appointed guardian of a minor child or any other person legally entitled to do so under applicable...

  12. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ADMINISTRATIVE CLAIMS General Information § 842.7 Who may file a claim. (a) Property damage. The owner or owners of the property or their authorized agent may file a claim for property damage. (b) Personal injury... duly appointed guardian of a minor child or any other person legally entitled to do so under applicable...

  13. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... ADMINISTRATIVE CLAIMS General Information § 842.7 Who may file a claim. (a) Property damage. The owner or owners of the property or their authorized agent may file a claim for property damage. (b) Personal injury... duly appointed guardian of a minor child or any other person legally entitled to do so under applicable...

  14. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ADMINISTRATIVE CLAIMS General Information § 842.7 Who may file a claim. (a) Property damage. The owner or owners of the property or their authorized agent may file a claim for property damage. (b) Personal injury... duly appointed guardian of a minor child or any other person legally entitled to do so under applicable...

  15. 32 CFR 842.7 - Who may file a claim.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ADMINISTRATIVE CLAIMS General Information § 842.7 Who may file a claim. (a) Property damage. The owner or owners of the property or their authorized agent may file a claim for property damage. (b) Personal injury... duly appointed guardian of a minor child or any other person legally entitled to do so under applicable...

  16. Cumulative injury or disease claims: an attempt to define employers' liability for workers' compensation.

    PubMed

    LaDou, J; Mulryan, L E; McCarthy, K J

    1980-01-01

    The workers' compensation systems of several states have been expanded in recent years to include injuries and diseases caused by cumulative injury and occupational stress. This expansion has placed a financial burden on the respective systems, on employers, and on consumers, who ultimately must pay the cost of claims through higher priced products or services. This expansion may not be justified from a social perspective, however; extant medical and sociological evidence is not conclusive as to whether occupational-stress injuries or diseases--such as coronary heart disease, hypertension, stroke, and neuropsychiatric illness--are the direct result of stressful work environments. Using the California workers' compensation system as a model, the authors submit that the underlying premises of liability governing the expanded systems should be reassessed based (1) on economic factors, specifically, the increasing costs of workers' compensation; (2) on the capacity of the system to process an ever-increasing number of claims; and (3) on the principle on which workers' compensation systems were established, that of equity between the employer and the employee. On the basis of these three factors, the authors evaluated three legislative approaches to restructuring the expanded system: presumption of compensability, apportionment of liability, and threshold of compensability. The first recognizes that although certain health problems are related to the workplace, the degree of causation is difficult to prove; under this approach, therefore, causation is presumed, and injury compensated, for all diseases and injuries that the system defines as work related. The second holds that where a causal relationship between the work and the injury can be proved, the employer nevertheless should be responsible only for that portion of the disability actually caused by the workplace. The third directs that the injured employee be compensated only when a direct causal link between the

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. Are procedures codes in claims data a reliable indicator of intraoperative splenic injury compared with clinical registry data?

    PubMed

    Stey, Anne M; Ko, Clifford Y; Hall, Bruce Lee; Louie, Rachel; Lawson, Elise H; Gibbons, Melinda M; Zingmond, David S; Russell, Marcia M

    2014-08-01

    Identifying iatrogenic injuries using existing data sources is important for improved transparency in the occurrence of intraoperative events. There is evidence that procedure codes are reliably recorded in claims data. The objective of this study was to assess whether concurrent splenic procedure codes in patients undergoing colectomy procedures are reliably coded in claims data as compared with clinical registry data. Patients who underwent colectomy procedures in the absence of neoplastic diagnosis codes were identified from American College of Surgeons (ACS) NSQIP data linked with Medicare inpatient claims data file (2005 to 2008). A κ statistic was used to assess coding concordance between ACS NSQIP and Medicare inpatient claims, with ACS NSQIP serving as the reference standard. A total of 11,367 colectomy patients were identified from 212 hospitals. There were 114 patients (1%) who had a concurrent splenic procedure code recorded in either ACS NSQIP or Medicare inpatient claims. There were 7 patients who had a splenic injury diagnosis code recorded in either data source. Agreement of splenic procedure codes between the data sources was substantial (κ statistic 0.72; 95% CI, 0.64-0.79). Medicare inpatient claims identified 81% of the splenic procedure codes recorded in ACS NSQIP, and 99% of the patients without a splenic procedure code. It is feasible to use Medicare claims data to identify splenic injuries occurring during colectomy procedures, as claims data have moderate sensitivity and excellent specificity for capturing concurrent splenic procedure codes compared with ACS NSQIP. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  2. 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.

  3. 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

  4. 32 CFR 536.92 - Claims payable under the Non-Scope Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... negligent or wrongful acts or omissions of Department of Defense or Department of the Army (DA) military... or regulation available to the DA for the administrative settlement of claims. (b) Personal injury or...

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

    PubMed

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

    2006-08-01

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

  6. 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.…

  7. 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…

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

    PubMed Central

    Brannigan, Vincent M.

    1980-01-01

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

  9. 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...

  10. 32 CFR 536.35 - Unique issues related to environmental claims.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 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... geographical jurisdiction over the claim and USARCS. Claims for personal injury from contamination frequently...

  11. 32 CFR 536.35 - Unique issues related to environmental claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 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... geographical jurisdiction over the claim and USARCS. Claims for personal injury from contamination frequently...

  12. 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.

  13. Acute Kidney Injury in Elderly Persons

    PubMed Central

    Coca, Steven G.

    2010-01-01

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

  14. Acute kidney injury in elderly persons.

    PubMed

    Coca, Steven G

    2010-07-01

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

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

    ERIC Educational Resources Information Center

    Heinemann, Allen W.; And Others

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

  16. 49 CFR 238.117 - Protection against personal injury.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  17. 29 CFR 15.4 - Administrative claim; where to file.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Administrative claim; where to file. 15.4 Section 15.4 Labor... to file. (a) For the purposes of this subpart, a claim shall be deemed to have been presented when... accompanied by a claim for money damages in a sum certain for injury to or loss of property or personal injury...

  18. 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

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

    PubMed Central

    Ruseckaite, Rasa; Collie, Alex

    2013-01-01

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

  1. 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

  2. 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.

  3. 77 FR 65048 - Privacy Act; System of Records: Personal Property Claims, State-27

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... cyber security awareness training which covers the procedures for handling Sensitive but Unclassified... Property Claims. SECURITY CLASSIFICATION: Unclassified. SYSTEM LOCATION: Department of State, SA-3, Suite... which can include information such as names, birthdates, social security numbers (SSNs), employee IDs...

  4. Modeling social reintegration in persons with spinal cord injury.

    PubMed

    Song, Hee-Young

    2005-02-04

    This study was undertaken to identify and develop a model of the factors related to social reintegration in persons with spinal cord injury (SCI). A convenience sample of 145 persons with SCI living in two cities in South Korea anonymously completed a questionnaire that comprised the assessment of social reintegration, a tool developed to measure the degree of adjustment to community living in persons with SCI. Structural equation modeling was used to examine the direct and indirect effects of self-esteem, social barriers, physical function, family support, informational support, perceived stress, emotion-focused coping (EFC), and problem-focused coping (PFC) on social reintegration. The model explained 65% of the variance in social reintegration in persons with SCI. The results indicated that the social integration of persons with SCI was influenced most by EFC. Family support, informational support, perceived stress and social barriers were also significantly related to social reintegration. These findings suggest implications for developing the interventions at various levels including family and community and specific to individual coping strategies to enhance social reintegration in persons with SCI.

  5. 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

  6. 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...

  7. 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.

  8. 31 CFR 3.2 - Filing of claims.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Filing of claims. 3.2 Section 3.2 Money and Finance: Treasury Office of the Secretary of the Treasury CLAIMS REGULATIONS AND... to or loss of property, or personal injury, or death alleged to have occurred by reason of the...

  9. 31 CFR 3.2 - Filing of claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Filing of claims. 3.2 Section 3.2 Money and Finance: Treasury Office of the Secretary of the Treasury CLAIMS REGULATIONS AND... to or loss of property, or personal injury, or death alleged to have occurred by reason of the...

  10. 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

  11. Patterns of healthcare service utilisation following severe traumatic brain injury: an idiographic analysis of injury compensation claims data.

    PubMed

    Collie, A; Prang, K-H

    2013-11-01

    The rate and extent of recovery after severe traumatic brain injury (TBI) is heterogeneous making prediction of likely healthcare service utilisation (HSU) difficult. Patterns of HSU derived from nomothetic samples do not represent the diverse range of outcomes possible within this patient group. Group-based trajectory model is a semi-parametric statistical technique that seeks to identify clusters of individuals whose outcome (however measured) follows a similar pattern of change over time. To identify and characterise patterns of HSU in the 5-year period following severe TBI. Detailed healthcare treatment payments data in 316 adults with severe TBI (Glasgow Coma Scale score 3-8) from the transport accident compensation system in the state of Victoria, Australia was accessed for this analysis. A semi-parametric group-based trajectory analytical technique for longitudinal data was applied to monthly observation counts of HSU data to identify distinct clusters of participants' trajectories. Comparison between trajectory groups on demographic, injury, disability and compensation relevant outcomes was undertaken. Four distinct patterns (trajectories) of HSU were identified in the sample. The first trajectory group comprised 27% of participants and displayed a rapid decrease in HSU in the first year post-injury. The second group comprised 24% of participants and showed a sharp peak in HSU during the first 12 months post-injury followed by a decline over time. The third group comprised 32% of participants and showed a slight peak in HSU in the first few months post-injury and then a slow decline over time. The fourth group comprised 17% of participants and displayed a steady rise in HSU up to 30 months post-injury, followed by a gradual decline to a level consistent with that received in the first months post-injury. Significant differences were observed between groups on factors such as age, injury severity, and use of disability services. There is substantial

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. Patterns of technical error among surgical malpractice claims: an analysis of strategies to prevent injury to surgical patients.

    PubMed

    Regenbogen, Scott E; Greenberg, Caprice C; Studdert, David M; Lipsitz, Stuart R; Zinner, Michael J; Gawande, Atul A

    2007-11-01

    To identify the most prevalent patterns of technical errors in surgery, and evaluate commonly recommended interventions in light of these patterns. The majority of surgical adverse events involve technical errors, but little is known about the nature and causes of these events. We examined characteristics of technical errors and common contributing factors among closed surgical malpractice claims. Surgeon reviewers analyzed 444 randomly sampled surgical malpractice claims from four liability insurers. Among 258 claims in which injuries due to error were detected, 52% (n = 133) involved technical errors. These technical errors were further analyzed with a structured review instrument designed by qualitative content analysis. Forty-nine percent of the technical errors caused permanent disability; an additional 16% resulted in death. Two-thirds (65%) of the technical errors were linked to manual error, 9% to errors in judgment, and 26% to both manual and judgment error. A minority of technical errors involved advanced procedures requiring special training ("index operations"; 16%), surgeons inexperienced with the task (14%), or poorly supervised residents (9%). The majority involved experienced surgeons (73%), and occurred in routine, rather than index, operations (84%). Patient-related complexities-including emergencies, difficult or unexpected anatomy, and previous surgery-contributed to 61% of technical errors, and technology or systems failures contributed to 21%. Most technical errors occur in routine operations with experienced surgeons, under conditions of increased patient complexity or systems failure. Commonly recommended interventions, including restricting high-complexity operations to experienced surgeons, additional training for inexperienced surgeons, and stricter supervision of trainees, are likely to address only a minority of technical errors. Surgical safety research should instead focus on improving decision-making and performance in routine

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

    PubMed

    Gernsbacher, Morton Ann; Pripas-Kapit, Sarah R

    2012-01-01

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

  19. Resilient, undercontrolled, and overcontrolled personality prototypes among persons with spinal cord injury.

    PubMed

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

    2007-12-01

    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.

  20. 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

  1. 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…

  2. 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... from gross income for amounts received on account of personal physical injuries or physical sickness...

  3. 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.

  4. 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

  5. 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...

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2010-02-01

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

  8. 32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

  9. 32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

  10. 32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

  11. 32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

  12. 32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

  13. 33 CFR 25.117 - Proof of amount claimed for personal injury or death.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... employment, (5) Duration and extent of pain and suffering and of any disability or physical disfigurement, (6...) Time lost from work as a result of the incident, and (6) Claimant's actual period of employment, full...

  14. 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

  15. 32 CFR 842.5 - Claims forms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... certain is sufficient to file a claim. The claimant should use these forms when filing a claim: (a) Claim... of or Damage to Personal Property Incident to Service, or DD Forms 1842, Claim for Personal Property Against the United States, and 1844, Schedule of Property and Claim Analysis Chart, to file the claim. (b...

  16. 32 CFR 842.5 - Claims forms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... certain is sufficient to file a claim. The claimant should use these forms when filing a claim: (a) Claim... of or Damage to Personal Property Incident to Service, or DD Forms 1842, Claim for Personal Property Against the United States, and 1844, Schedule of Property and Claim Analysis Chart, to file the claim. (b...

  17. Personal Injury and Property Damage in the Moral Judgments of Children

    ERIC Educational Resources Information Center

    Elkind, David; Dabek, Ruth F.

    1977-01-01

    A total of 72 elementary school students responded to six moral judgment story pairs which corresponded to all the possible combinations of intentionality (intentional/unintentional) and type of damage (personal injury/property damage). (Author/JMB)

  18. 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…

  19. 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

  20. The synergic role of sociotechnical and personal characteristics on work injuries in mines.

    PubMed

    Paul, P S; Maiti, J

    2008-05-01

    Occupational injuries in mines are attributed to many factors. In this study, an attempt was made to identify the various factors related to work injuries in mines and to estimate their effects on work injuries to mine workers. An accident path model was developed to estimate the pattern and strength of relationships amongst the personal and sociotechnical variables in accident/injury occurrences. The input data for the model were the correlation matrix of 18 variables, which were collected from the case study mines. The case study results showed that there are sequential interactions amongst the sociotechnical and personal factors leading to accidents/injuries in mines. Amongst the latent endogenous constructs, job dissatisfaction and safe work behaviour show a significant positive and negative direct relationship with work injury, respectively. However, the construct safety environment has a significant negative indirect relationship with work injury. The safety environment is negatively affected by work hazards and positively affected by social support. The safety environment also shows a significant negative relationship with job stress and job dissatisfaction. However, negative personality has no significant direct or indirect effect on work injury, but it has a significant negative relationship with safe work behaviour. The endogenous construct negative personality is positively influenced by job stress and negatively influenced by social support.

  1. Personal Characteristics Associated with Episodes of Injury in a Residential Facility.

    ERIC Educational Resources Information Center

    Konarski, Edward A., Jr.; Sutton, Kelly; Huffman, Alice

    1997-01-01

    Investigation of episodes of injury and personal characteristics among 412 individuals with mental retardation living in Intermediate Care Facilities found that 16% of the group experienced 67% of injuries. Individuals taking antipsychotics, having higher maladaptive behavior scores, and having relatively higher levels of adaptive behavior were…

  2. 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…

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... claim for personal injury, including pain and suffering, you may be required to submit the following... statement of how much it cost you to hire someone to do the same work you were doing at the time of the...) If damages for pain and suffering prior to death are claimed, a physician's detailed statement...

  4. 29 CFR 15.5 - Administrative claim; evidence or information to substantiate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of a claim for personal injury, including pain and suffering, the claimant is required to submit the... or would cost the claimant to hire someone else to do the same work he or she was doing at the time... for such expenses. (7) If damages for pain and suffering prior to death are claimed, a physician's...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

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

    PubMed

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

    2011-03-01

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

  10. 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…

  11. Health behavior in persons with spinal cord injury: development and initial validation of an outcome measure.

    PubMed

    Pruitt, S D; Wahlgren, D R; Epping-Jordan, J E; Rossi, A L

    1998-10-01

    To describe the development and initial psychometric properties of a new outcome measure for health behaviors that delay or prevent secondary impairments associated with spinal cord injury (SCI). Persons with SCI were surveyed during routine annual physical evaluations. Veterans Affairs Medical Center Spinal Cord Injury Unit, which specializes in primary care for persons with SCI. Forty-nine persons with SCI, aged 19-73 years, 1-50 years post-SCI. The newly developed Spinal Cord Injury Lifestyle Scale (SCILS). Internal consistency is high (alpha = 0.81). Correlations between clinicians' ratings of participants' health behavior and the new SCILS provide preliminary support for construct validity. The SCILS is a brief, self-report measure of health-related behavior in persons with SCI. It is a promising new outcome measure to evaluate the effectiveness of clinical and educational efforts for health maintenance and prevention of secondary impairments associated with SCI.

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

    PubMed

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

    2017-05-01

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

  13. 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…

  14. 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.

  15. Enhancing work outcome for three persons with traumatic brain injury.

    PubMed

    Target, P; Wehman, P; Petersen, R; Gorton, S

    1998-03-01

    A case study approach is used to illustrate how three survivors of severe traumatic brain injury were able to gain and maintain employment with the assistance of a supported employment programme. Emphasis on the different types of accommodations, including the design and implementation of compensatory strategies, is provided for each case. Finally, on overview of steps that can be taken to enhance the use of such strategies on the job is presented.

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

    PubMed

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

    1998-01-01

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

  17. Pain assessment in self-injurious patients with borderline personality disorder using signal detection theory.

    PubMed

    Kemperman, I; Russ, M J; Clark, W C; Kakuma, T; Zanine, E; Harrison, K

    1997-05-30

    Signal detection theory measures of thermal responsivity were examined to determine whether differences in reported pain experienced during self-injurious behavior in female patients with borderline personality disorder (BPD) are explained by neurosensory factors and/or attitudinal factors (response bias). Female patients with BPD who do not experience pain during self-injury (BPD-NP group) were found to discriminate more poorly between noxious thermal stimuli of similar intensity, low P(A), than female patients with BPD who experience pain during self-injury (BPD-P group), female patients with BPD who do not have a history of self-injury (BPD-C group), and age-matched normal women. The BPD-NP group also had a higher response criterion, B (more stoical) than the BPD-C group. These findings suggest that 'analgesia' during self-injury in patients with BPD is related to both neurosensory and attitudinal/psychological abnormalities.

  18. Work-related injuries in minors.

    PubMed

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

    1988-01-01

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

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

    PubMed

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

    2014-03-01

    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. Cross-sectional study. A total of 97 persons with traumatic SCI were recruited from the non-profit national organization, RG Active Rehabilitation in Sweden. 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. 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. 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.

  20. 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

  1. 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.

  2. 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

    SUBJECT TERMS Spinal cord injury, pressure ulcer prevention, biomarkers, personalized healthcare 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...ulcer prevention, biomarkers, personalized healthcare 3. Accomplishments Major Project Goals Task 1: Subject Recruitment and Data Collection

  3. Personality change following head injury: assessment with the NEO Five-Factor Inventory.

    PubMed

    Lannoo, E; de Deyne, C; Colardyn, F; de Soete, G; Jannes, C

    1997-11-01

    We evaluated personality change following head injury in 68 patients at 6 months postinjury using the NEO Five-Factor Inventory to assess the five personality dimensions of the Five-Factor Model of Personality. All items had to be rated twice, once for the preinjury and once for the current status. Twenty-eight trauma patients with injuries to other parts of the body than the head were used as controls. For the head-injured group, 63 relatives also completed the questionnaire. The results showed no differences between the ratings of head-injured patients and the ratings of trauma control patients. Both groups showed significant change in the personality dimensions Neuroticism, Extraversion, and Conscientiousness. Compared to their relatives, head-injured patients report a smaller change in Extraversion and Conscientiousness. Changes were not reported on the Openness and Agreeableness scales, by neither the head-injured or their relatives, nor by the trauma controls.

  4. 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.

  5. Mental health claims management and return to work: qualitative insights from Melbourne, Australia.

    PubMed

    Brijnath, Bianca; Mazza, Danielle; Singh, Nabita; Kosny, Agnieszka; Ruseckaite, Rasa; Collie, Alex

    2014-12-01

    Mental health conditions (MHC) are an increasing reason for claiming injury compensation in Australia; however little is known about how these claims are managed by different gatekeepers to injury entitlements. This study, drawing on the views of four stakeholders-general practitioners (GPs), injured persons, employers and compensation agents, aims to describe current management of MHC claims and to identify the current barriers to return to work (RTW) for injured persons with a MHC claim and/or mental illness. Ninety-three in-depth interviews were undertaken with GPs, compensation agents, employers and injured persons. Data were collected in Melbourne, Australia. Thematic techniques were used to analyse data. MHC claims were complex to manage because of initial assessment and diagnostic difficulties related to the invisibility of the injury, conflicting medical opinions and the stigma associated with making a MHC claim. Mental illness also developed as a secondary issue in the recovery process. These factors made MHC difficult to manage and impeded timely RTW. It is necessary to undertake further research (e.g. guideline development) to improve current practice in order to enable those with MHC claims to make a timely RTW. Further education and training interventions (e.g. on diagnosis and management of MHC) are also needed to enable GPs, employers and compensation agents to better assess and manage MHC claims.

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

    DTIC Science & Technology

    2015-04-01

    Award Number: W81XWH-11-2-0129 TITLE: PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury...TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-11-2-0129 PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic...health problems. PHIT for Duty integrates self-report and physiological sensor instruments to assess health status via brief weekly screening

  7. [Neuropsychological evaluation of a case of organic personality disorder due to penetrating brain injury].

    PubMed

    Sanz de la Torre, J C; Pérez-Ríos, M

    1996-06-01

    In this paper, an organic personality disorder case by penetrating brain injury, predominantly localized in the right frontal lobe, is presented. Neuropsychological and neuroimaging (CT scan studies) were performed. We assessed the main cognitive aspect: orientation, attention, memory, intelligence, language, visual-spatial functioning, motor functioning, executive functioning and personality. The results obtained, point out disorders in the patient's behavior and in the executive functions. Likewise, other cognitive functions as: attention, memory, language and visual-spatial functioning, show specific deficits.

  8. Rectal injury caused by personal watercraft accident: report of a case.

    PubMed

    Descottes, Bernard; Lachachi, Fouzi; Moumouni, Issifou; Durand-Fontanier, Sylvaine; Geballa, Ramy

    2003-07-01

    A 16-year-old male riding as a passenger on a personal watercraft fell behind the jet nozzle while jumping waves. An unusual rectal injury caused by the accident and resulting in the death of the patient is presented. The surgical management and postoperative course is discussed. Attention is drawn to the need for adequate protective clothes for all passengers of personal watercraft and to the necessity of a complete examination for correct diagnosis and treatment.

  9. 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.

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

    PubMed

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

    2015-09-01

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

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

    PubMed

    Hureau, Jacques

    2006-03-01

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

  12. Pharmacological Treatment of Mood Disturbances, Aggression, and Self-Injury in Persons with Pervasive Developmental Disorders.

    ERIC Educational Resources Information Center

    King, Bryan H.

    2000-01-01

    This article reviews the psychopharmacological treatment of aggression, mood disturbances, and self-injurious behavior in persons with autistic disorder. It highlights the use of dopaminergic drugs, serotonergic drugs, opioidergic drugs, adrenergic drugs, thymoleptic drugs, and glutamatergic drugs for their potential utility in treating…

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

    ERIC Educational Resources Information Center

    Degeneffe, Charles Edmund; Lynch, Ruth Torkelson

    2006-01-01

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

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

    ERIC Educational Resources Information Center

    Frank, Robert G.; And Others

    1987-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Ruedrich, Stephen L.; And Others

    1990-01-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  18. Institutional Impact on Self Concept among Persons with Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Yoshida, Karen K.

    1994-01-01

    This article discusses how experiences during rehabilitation may influence self-concept among individuals who have sustained a traumatic spinal cord injury (SCI). Experiences are illustrated by personal accounts of 35 individuals (28 men and 7 women) with SCI. Data suggest that aspects of the rehabilitation process may need to be restructured.…

  19. Nutritional Health Considerations for Persons with Spinal Cord Injury.

    PubMed

    Bigford, Gregory; Nash, Mark S

    2017-01-01

    Chronic spinal cord injury (SCI) often results in morbidity and mortality due to all-cause cardiovascular disease (CVD) and comorbid endocrine disorders. Several component risk factors for CVD, described as the cardiometabolic syndrome (CMS), are prevalent in SCI, with the individual risks of obesity and insulin resistance known to advance the disease prognosis to a greater extent than other established risks. Notably, adiposity and insulin resistance are attributed in large part to a commonly observed maladaptive dietary/nutritional profile. Although there are no evidence-based nutritional guidelines to address the CMS risk in SCI, contemporary treatment strategies advocate more comprehensive lifestyle management that includes sustained nutritional guidance as a necessary component for overall health management. This monograph describes factors in SCI that contribute to CMS risks, the current nutritional profile and its contribution to CMS risks, and effective treatment strategies including the adaptability of the Diabetes Prevention Program (DPP) to SCI. Establishing appropriate nutritional guidelines and recommendations will play an important role in addressing the CMS risks in SCI and preserving optimal long-term health.

  20. 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.

  1. Temperament as a prospective predictor of self-injury among patients with borderline personality disorder.

    PubMed

    Chapman, Alexander L; Derbidge, Christina M; Cooney, Emily; Hong, Phan Y; Linehan, Marsha M

    2009-04-01

    This study examined the association of novelty seeking, harm avoidance, and reward dependence with different types (suicide attempts vs. nonsuicidal self-injury) and aspects (medical risk, impulsiveness, suicide intent) of self-injury over a 12-month period. Fifty-five female patients with borderline personality disorder enrolled in clinical trials completed Cloninger's Temperament and Character Inventory at pretreatment as well as the Suicide Attempt Self-Injury Interview at four-month intervals starting from the pretreatment assessment. Regression analyses indicated that the reward dependence subscale of attachment, a protective factor, was most consistently and uniquely associated with aspects of self-injury, including prestudy and prospective nonsuicidal self-injury and suicide intent, and prospective suicide attempts. After controlling for prestudy self-injury, few temperament variables predicted prospective self-injury. Higher scores on both the novelty seeking subscale of impulsiveness and the reward dependence attachment subscale were associated with lower prospective suicide intent even after controlling for pre-study suicide intent.

  2. The five-factor model of personality: findings in males with spinal cord injury.

    PubMed

    Rohe, D E; Krause, J S

    1999-09-01

    The purpose of this study was to identify common personality traits in males with traumatic spinal cord injury (SCI). One hundred and five participants with SCI completed the NEO Personality Inventory (NEO-PI). The participants averaged 41.1 years of age and 17.9 years since injury onset. Compared with the NEO-PI normative sample, the SCI sample scored significantly lower on the Conscientiousness factor and the Activity and Assertiveness facet scales. They scored significantly higher on the Excitement-Seeking scale. These results suggest that males with SCI are less determined, have lower energy levels, are socially retiring, and that they tend to seek stimulation. These findings may reflect the contribution of both preinjury personality traits and adaptation to the limitations imposed by SCI.

  3. Components of quality of life for persons with a quadriplegic and paraplegic spinal cord injury.

    PubMed

    Manns, P J; Chad, K E

    2001-11-01

    This investigation determined the themes that represented quality of life for persons with a spinal cord injury. Fifteen people (6 females, 9 males; 7 persons with quadriplegia, 8 with paraplegia) participated in this study, which used naturalistic inquiry methodologies. Results showed that quality of life for this population, regardless of severity of impairment, consisted of nine themes: (a) physical function and independence, (b) accessibility, (c) emotional well-being, (d) stigma, (e) spontaneity, (f) relationships and social function, (g) occupation, (h) finances, and (i) physical well-being. The themes of life quality were similar for quadriplegics and paraplegics; however, physical function and independence and physical well-being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life.

  4. Resilience in family caregivers of persons with acquired brain injury.

    PubMed

    Las Hayas, Carlota; López de Arroyabe, Elena; Calvete, Esther

    2015-08-01

    The authors' purpose was to develop the Questionnaire of Resilience in Caregivers of Acquired Brain Injury (QRC-ABI) and explore its psychometric properties The QRC-ABI was developed to measure the process of resilience, including resilient factors that, according to the literature, are the most relevant for caregivers. This is a cross-sectional study of Spanish primary caregivers of individuals with ABI. It included 237 caregivers (77.6% women and 21.1% men) who completed the QRC-ABI, the Posttraumatic Growth Inventory (Weiss & Berger, 2006), the World Health Organization Quality of Life-BREF (Skevington, Lotfy, O'Connell, & the WHOQOL Group, 2004) assessment, and the Positive Aspects of Caregiving (Tarlow et al., 2004) assessment. An item pool of 36 items was developed, from which 17 were finally selected based on a consensus among researchers and adequate symmetry indexes and kurtoses. Confirmatory factor analysis of the QRC-ABI confirmed a hierarchical solution in which 4 resilience dimensions were explained by a broader general resilience factor. The internal consistency of each scale was >.80. Convergent validity was supported through positive correlations of the QRC-ABI with quality of life, positive aspects of caregiving, and posttraumatic growth, and a negative correlation with perceived burden. The new QRC-ABI showed good reliability and validity. Our results are consistent with previous studies that have argued that resilient qualities are important for a healthy and positive adaptation to the challenging adversities faced by caregivers of individuals with ABI. Future interventions based on resilience should promote these factors in caregivers. (c) 2015 APA, all rights reserved).

  5. Impact of comprehensive day treatment on societal participation for persons with acquired brain injury.

    PubMed

    Malec, J F

    2001-07-01

    To evaluate comprehensive day treatment (CDT) for survivors of brain injury by time since injury and to identify outcome predictors. Before and after. Rehabilitation center. Ninety-six program graduates; 17 dropouts with acquired brain injury. Comprehensive Day Treatment Program: daily group sessions to build cognitive and behavioral skills through a transdisciplinary approach, supportive feedback, and a variety of therapeutic modalities. Obtained outcome measures before and after the program, and at 1-year follow-up. Independent living status, vocational independence scale at program end and 1-year follow-up; and Rasch-analyzed Mayo-Portland Adaptability Inventory (MPAI-22) and goal attainment scaling (GAS) at program end. age, education, severity of initial injury, time since injury, and preadmission MPAI-22. Significant goal achievement on GAS and improvement on MPAI-22; increased societal participation at 1-year follow-up for those treated postacutely and many years after injury: 72% of graduates living independently; 39% working independently, 10% in transitional placements, and 18% in supported or volunteer work. Long-term outcomes were modestly related linearly to preadmission MPAI-22 and nonlinearly to time since injury. CDT improves societal participation even among persons with a long history of limited participation after brain injury. This de facto extended baseline analysis indicates the effectiveness of CDT and paves the way for randomized control trials of active treatment components. Relationships of predictors to outcomes are not sufficiently strong for patient selection. More effective interventions for vocational reintegration are needed for those most severely disabled after brain injury. Copyright 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

  6. Examining the Correlation between Objective Injury Parameters, Personality Traits, and Adjustment Measures among Burn Victims

    PubMed Central

    Weissman, Oren; Domniz, Noam; Petashnick, Yoel R.; Gilboa, Dalia; Raviv, Tal; Barzilai, Liran; Farber, Nimrod; Harats, Moti; Winkler, Eyal; Haik, Josef

    2015-01-01

    Background: Burn victims experience immense physical and mental hardship during their process of rehabilitation and regaining functionality. We examined different objective burn-related factors as well as psychological ones, in the form of personality traits that may affect the rehabilitation process and its outcome. Objective: To assess the influence and correlation of specific personality traits and objective injury-related parameters on the adjustment of burn victims post-injury. Methods: Sixty-two male patients admitted to our burn unit due to burn injuries were compared with 36 healthy male individuals by use of questionnaires to assess each group’s psychological adjustment parameters. Multivariate and hierarchical regression analysis was conducted to identify differences between the groups. Results: A significant negative correlation was found between the objective burn injury severity (e.g., total body surface area and burn depth) and the adjustment of burn victims (p < 0.05, p < 0.001, Table 3). Moreover, patients more severely injured tend to be more neurotic (p < 0.001), and less extroverted and agreeable (p < 0.01, Table 4). Conclusion: Extroverted burn victims tend to adjust better to their post-injury life while the neurotic patients tend to have difficulties adjusting. This finding may suggest new tools for early identification of maladjustment-prone patients and therefore provide them with better psychological support in a more dedicated manner. PMID:25874193

  7. 29 CFR 15.42 - Claim procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Are there limits on claims under the MPCECA? 15.205 What types of claims for property damage are... a claim for loss of or damages to personal property under the WIA? 15.304 Are there limits to claims for loss of or damages to personal property under the WIA? Authority: 28 U.S.C. 2672; 28 CFR § 14.11...

  8. Coping with spinal cord injury: personal and marital adjustment in the Hong Kong Chinese setting.

    PubMed

    Chan, R C; Lee, P W; Lieh-Mak, F

    2000-11-01

    A cross-sectional retrospective study was carried out with structured questionnaires and semi-structured interviews on 66 persons with spinal cord injury (SCI) and 40 spouses. The study aimed to explore the psychosocial adjustment of Hong Kong Chinese couples at the post SCI stage. An important study interest was the impact of care-giving in spouses of persons with SCI. Three major regional rehabilitation centres and one community resource centre in Hong Kong. A set of psychometric measures tapping different aspects of psychological functioning was included. These were locus of control (Levenson's Internality, Powerful Others, and Chance Scale), perceived social support (Provision of Social Relationship), coping strategies (Ways of Coping Checklist), marital adjustment (Dyadic Adjustment Scale), caregiving burden (Caregiver Burden Inventory), depression (Beck Depression Inventory), life satisfaction (Satisfaction with Life Situation), and social role adjustment (Katz Adjustment Scale - Relative Form). Persons with SCI with pre-injury marriage were more depressed (P<0.05) as compared with those with post-injury marriage. However, the two groups did not differ in terms of satisfaction with life situation and social role dissatisfaction. The spouses in the preinjury marriage reported a significantly higher score in time-dependent burden than those in the post-injury marriage (P<0.05). Care-giving burden was associated with locus of control, social support, and modes of coping (P<0.05). The impact of SCI is a long-lasting effect not limited to the patients but also extending to their spouses. Findings from the adjustment outcomes and coping styles of persons with SCI and their spouses indicate that they are not passive victims. A similar injury may produce different outcomes in different individuals. Rehabilitation professionals should thus be alert to both the couple's differing needs and idiosyncrasies in their helping process.

  9. 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.

  10. 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

  11. Chronic pain experience and pain management in persons with spinal cord injury in Nepal.

    PubMed

    Thapa, Sagun; Kitrungrote, Luppana; Damkliang, Jintana

    2018-04-25

    Chronic pain is the frequent and significantly challenging complications in persons with spinal cord injury (SCI). Socio-cultural background may lead people perceive and manage pain differently. The study aims to describe the chronic pain experience and pain management of SCI persons in Nepal. A descriptive cross sectional study was conducted among purposively selected sample of 120 SCI persons with chronic pain living in the eight districts of Bagmati Zone of Nepal. The data were collected using the International Spinal Cord Injury Pain Basic Data Set Version 2 (ISCIPBDS-2) and Open-ended Pain Management Questionnaire. The data were analyzed using descriptive statistics and content analysis method. The back (n=84), lower legs/feet (n=63) and buttocks/hips (n=51) was found as the common pain locations. In common, the onset of pain was found within the first 6 month of the injury. Overall pain intensity and pain interference were found to be at the moderate level. The SCI persons used pain medications and non-pharmacological pain management. Ibuprofen was the commonly used pain medication and commonly used non-pharmacological pain management methods included physical support (e.g. massage, exercise), relaxation (e.g. distraction, substance abuse), coping (e.g. acceptance, praying), and traditional herbs. SCI persons had chronic pain experience which interfered with their daily living. They used pain medications and non-pharmacological pain management methods based on their beliefs, knowledge, and community resources in Nepal. This study provides some evidence to help the team of rehabilitation professional to plan and help SCI persons with chronic pain. Based on these findings, chronic pain management intervention for SCI persons should be developed and supported continuously from hospital to home based community context of Nepal.

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

    PubMed

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

    2010-10-01

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

  13. Personality characteristics and cognitive appraisals associated with self-discrepancy after severe traumatic brain injury.

    PubMed

    Beadle, Elizabeth Jane; Ownsworth, Tamara; Fleming, Jennifer; Shum, David H K

    2018-05-09

    Although changes to self-identity or self-discrepancy are common after severe traumatic brain injury (TBI), the mechanisms underlying these changes are poorly understood. This study aimed to examine the influence of personality characteristics and cognitive appraisals on self-discrepancy. Participants were 51 adults (74% male) with severe TBI (M age = 36.22 years; SD = 12.65) who were on average 34 months (SD = 40.29) post-injury. They completed self-report measures of personality style (optimism and defensiveness), cognitive appraisals (threat appraisals, rumination and reflection and perceived coping resources), and self-discrepancy (Head Injury Semantic Differential Scale - III). Correlation analyses identified that higher levels of optimism, defensiveness and perceived coping resources were significantly associated with more positive self-discrepancy (r = .29-.47, p < .05), whereas higher threat appraisals and rumination were significantly related to more negative self-discrepancy (r = -.50-.57, p < .001). After controlling for personality characteristics, cognitive appraisals significantly accounted for self-discrepancy (R 2 change = .15). Moreover, rumination significantly mediated the relationship between optimism and self-discrepancy. In summary, cognitive appraisals were found to be related to self-discrepancy, independent of personality characteristics. Rumination in particular may be an important target of psychological intervention for individuals experiencing negative self-discrepancy.

  14. 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.

  15. Post-injury personality in the prediction of outcome following severe acquired brain injury.

    PubMed

    Cattran, Charlotte Jane; Oddy, Michael; Wood, Rodger Llewellyn; Moir, Jane Frances

    2011-01-01

    The aim of the study was to examine the utility of five measures of non-cognitive neurobehavioural (NCNB) changes that often occur following acquired brain injury, in predicting outcome (measured in terms of participation and social adaptation) at 1-year follow-up. The study employed a longitudinal, correlational design. Multiple regression was employed to investigate the value of five new NCNB measures of social perception, emotional regulation, motivation, impulsivity and disinhibition in the prediction of outcome as measured by the Mayo-Portland Adaptability Inventory (MPAI). Two NCNB measures (motivation and emotional regulation) were found to significantly predict outcome at 1-year follow-up, accounting for 53% of the variance in MPAI total scores. These measures provide a method of quantifying the extent of NCNB changes following brain injury. The predictive value of the measures indicates that they may represent a useful tool which could aid clinicians in identifying early-on those whose symptoms are likely to persist and who may require ongoing intervention. This could facilitate the planning of rehabilitation programmes.

  16. 32 CFR 751.10 - Form of claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Claims Against the United States § 751.10 Form of claim. The claim should be submitted on DD Form 1842 (Claim for Personal Property) accompanied by DD Form 1844 (List of Property). If DD Forms 1842 and 1844 1...

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. Accelerated death rate in population-based cohort of persons with traumatic brain injury.

    PubMed

    Selassie, Anbesaw W; Cao, Yue; Church, Elizabeth C; Saunders, Lee L; Krause, James

    2014-01-01

    To determine the influence of preexisting heart, liver, kidney, cancer, stroke, and mental health problems and examine the influence of low socioeconomic status on mortality after discharge from acute care facilities for individuals with traumatic brain injury. Population-based retrospective cohort study of 33695 persons discharged from acute care hospital with traumatic brain injury in South Carolina, 1999-2010. Days elapsing from the dates of injury to death established the survival time (T). Data were censored at the 145th month. Multivariable Cox regression was used to examine the independent effect of the variables on death. Age-adjusted cumulative probability of death for each chronic disease of interest was plotted. By the 70th month of follow-up, rate of death was accelerated from 10-fold for heart diseases to 2.5-fold for mental health problems. Adjusted hazard ratios for diseases of the heart (2.13), liver-renal (3.25), cancer (2.64), neurological diseases and stroke (2.07), diabetes (1.89), hypertension (1.43), and mental health problems (1.59) were highly significant (each with P < .001). Compared with persons with private insurance, the hazard ratio was significantly elevated with Medicaid (1.67), Medicare (1.54), and uninsured (1.27) (each with P < .001). Specific chronic diseases strongly influenced postdischarge mortality after traumatic brain injury. Low socioeconomic status as measured by the type of insurance elevated the risk of death.

  2. 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

    ... death benefits. DATES: Written comments and recommendations on the proposed collection of information... is used to gather information from claimants seeking service-connected death benefits as persons who...

  3. Participation in recreation and sports for persons with spinal cord injury: review and recommendations.

    PubMed

    Slater, Daniel; Meade, Michelle A

    2004-01-01

    Recreation and sports following Spinal Cord Injury (SCI) are beneficial, but under-studied, aspects of community integration. Previous studies have shown that sports and recreation can offer numerous physiological and psychological benefits to those who participate. This manuscript critically reviews available literature focused upon participation in recreation and sports among persons with SCI. Issues of participation, technology and safety are discussed and recommendations are provided.

  4. Validity of deterministic record linkage using multiple indirect personal identifiers: linking a large registry to claims data.

    PubMed

    Setoguchi, Soko; Zhu, Ying; Jalbert, Jessica J; Williams, Lauren A; Chen, Chih-Ying

    2014-05-01

    Linking patient registries with administrative databases can enhance the utility of the databases for epidemiological and comparative effectiveness research. However, registries often lack direct personal identifiers, and the validity of record linkage using multiple indirect personal identifiers is not well understood. Using a large contemporary national cardiovascular device registry and 100% Medicare inpatient data, we linked hospitalization-level records. The main outcomes were the validity measures of several deterministic linkage rules using multiple indirect personal identifiers compared with rules using both direct and indirect personal identifiers. Linkage rules using 2 or 3 indirect, patient-level identifiers (ie, date of birth, sex, admission date) and hospital ID produced linkages with sensitivity of 95% and specificity of 98% compared with a gold standard linkage rule using a combination of both direct and indirect identifiers. Ours is the first large-scale study to validate the performance of deterministic linkage rules without direct personal identifiers. When linking hospitalization-level records in the absence of direct personal identifiers, provider information is necessary for successful linkage. © 2014 American Heart Association, Inc.

  5. 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

  6. 32 CFR 536.120 - Claims payable as maritime claims.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... claim is cognizable under this subpart if it arises in or on a maritime location, involves some... scope of employment. This class of claims includes, but is not limited to: (a) Damage to a ship, boat, barge, or other watercraft; (b) An injury that involves a ship, boat, barge, or other watercraft; (c...

  7. 32 CFR 536.120 - Claims payable as maritime claims.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... claim is cognizable under this subpart if it arises in or on a maritime location, involves some... scope of employment. This class of claims includes, but is not limited to: (a) Damage to a ship, boat, barge, or other watercraft; (b) An injury that involves a ship, boat, barge, or other watercraft; (c...

  8. 32 CFR 536.120 - Claims payable as maritime claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... claim is cognizable under this subpart if it arises in or on a maritime location, involves some... scope of employment. This class of claims includes, but is not limited to: (a) Damage to a ship, boat, barge, or other watercraft; (b) An injury that involves a ship, boat, barge, or other watercraft; (c...

  9. 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…

  10. Premorbid personality characteristics and attachment style moderate the effect of injury severity on occupational outcome in traumatic brain injury: another aspect of reserve.

    PubMed

    Sela-Kaufman, Michal; Rassovsky, Yuri; Agranov, Eugenia; Levi, Yifat; Vakil, Eli

    2013-01-01

    The concept of "reserve" has been proposed to account for the mismatch between brain pathology and its clinical expression. Prior efforts to characterize this concept focused mostly on brain or cognitive reserve measures. The present study was a preliminary attempt to evaluate premorbid personality and emotional aspects as potential moderators in moderate-to-severe traumatic brain injury. Using structural equation modeling and multiple regression analyses, we found that premorbid personality characteristics provided the most robust moderator of injury severity on occupational outcome. Findings offer preliminary support for premorbid personality features as another relevant reserve construct in predicting outcome in this population.

  11. 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…

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

    DTIC Science & Technology

    2015-10-01

    AWARD NUMBER: W81XWH-14-1-0618 TITLE: Development of a Personalized Model for Pressure Ulcer Prevention Acutely Following Spinal Cord Injury...Model for Pressure Ulcer Prevention Acutely Following Spinal Cord Injury: Biomarkers of Muscle Composition and Resilience 5a. CONTRACT NUMBER...military and veterans. All persons with SCI are at increased risk of pressure ulcer development which remains one of the most significant secondary

  13. 14 CFR 1261.304 - Place of filing claim.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Place of filing claim. 1261.304 Section... Injury or Death-Accruing On or After January 18, 1967 § 1261.304 Place of filing claim. A claim arising... activities are believed to have given rise to the claimed injury, loss, or death. If the identity of such...

  14. 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.

  15. Wellness perception in persons with traumatic brain injury and its relation to functional independence.

    PubMed

    Bezner, J R; Hunter, D L

    2001-06-01

    To test the reliability and validity of a perceptual wellness measure in persons after traumatic brain injury (TBI) and to determine whether a relation exists between functional independence and wellness perceptions in the same population. Survey research. A private, residential brain injury program. A convenience sample of 49 patients (43 men, 6 women) with TBI whose mean age was 32.1 years (range, 18-61yr) and mean time since injury was 10.47 years (range, 1-21yr). The Perceived Wellness Survey (PWS) assessed wellness. The PWS has 6 subscales measuring physical, psychologic, emotional, intellectual, spiritual, and social wellness. The FIM instrument was used to measure functional status. The mean PWS score (15.99) for the sample was comparable to published samples of adults (mean, 15.31-16.51); however, the reliability of the composite score (alpha = .58) and the subscales (alpha = .32-.64) was less than that obtained in previous samples (composite alpha = 0.91; subscale alpha = .64-.81). The correlations between the PWS and the FIM scores were not significant. The PWS in its composite form is a reliable measure for use with persons with TBI. The finding that perceived wellness and functional independence were not related suggests that these constructs are unique and thus should both be measured. The measurement of perceptions will enable the provider to consider a client holistically and to develop programs that address quality of life issues. Further, because perceptions influence behaviors, understanding a person's perceptions in multiple dimensions may provide a useful and necessary framework for developing intervention programs that address behavioral and cognitive issues that are important to that person.

  16. 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.

  17. 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

  18. Personal bankruptcy after traumatic brain or spinal cord injury: the role of medical debt.

    PubMed

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

    2009-03-01

    To estimate the prevalence of medical debt among traumatic brain injury (TBI) and spinal cord injury (SCI) patients who discharged their debts through bankruptcy. A cross-sectional comparison of bankruptcy filings of injured versus randomly selected bankruptcy petitioners. Patients hospitalized with SCI or TBI (1996-2002) and personal bankruptcy petitioners (2001-2004) in western Washington State. Subjects (N=186) who filed for bankruptcy, comprised of 93 patients with previous SCI or TBI and 93 randomly selected bankruptcy petitioners. Not applicable. Medical and nonmedical debt, assets, income, expenses, and employment recorded in the bankruptcy petition. 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). Medical debt plays an important role in some bankruptcies after TBI or SCI. We discuss policy options for reducing financial distress after serious injury.

  19. 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

  20. 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

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

    PubMed

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

    2015-01-01

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

  2. Sleep and Psychiatric Disorders in Persons With Mild Traumatic Brain Injury.

    PubMed

    Mollayeva, Tatyana; D'Souza, Andrea; Mollayeva, Shirin

    2017-08-01

    Mild traumatic brain injury (mTBI) frequently challenges the integrity of sleep function by affecting multiple brain areas implicated in controlling the switch between wakefulness and sleep and those involved in circadian and homeostatic processes; the malfunction of each causes a variety of disorders. In this review, we discuss recent data on the dynamics between disorders of sleep and mental/psychiatric disorders in persons with mTBI. This analysis sets the stage for understanding how a variety of physiological, emotional and environmental influences affect sleep and mental activities after injury to the brain. Consideration of the intricate links between sleep and mental functions in future research can increase understanding on the underlying mechanisms of sleep-related and psychiatric comorbidity in mTBI.

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

    PubMed

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

    2014-11-01

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

  4. 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.

  5. Do falls and falls-injuries in hospital indicate negligent care -- and how big is the risk? A retrospective analysis of the NHS Litigation Authority Database of clinical negligence claims, resulting from falls in hospitals in England 1995 to 2006.

    PubMed

    Oliver, D; Killick, S; Even, T; Willmott, M

    2008-12-01

    Accidental falls are very common in older hospital patients -- accounting for 32% of reported adult patient safety incidents in UK National Health Service (NHS) hospitals and occurring with similar frequency in settings internationally. In countries where the population is ageing, and care is provided in inpatient settings, falls prevention is therefore a significant and growing risk-management issue. Falls may lead to a variety of harms and costs, are cited in formal complaints and can lead to claims of clinical negligence. The NHS Litigation Authority (NHSLA) negligence claims database provides a novel opportunity to systematically analyse such (falls-related) claims made against NHS organisations in England and to learn lessons for risk-management systems and claims recording. To describe the circumstances and injuries most frequently cited in falls-related claims; to investigate any association between the financial impact (total cost), and the circumstances of or injuries resulting from falls in "closed" claims; to draw lessons for falls risk management and for future data capture on falls incidents and resulting claims analysis; to identify priorities for future research. A keyword search was run on the NHSLA claims database for April 1995 to February 2006, to identify all claims apparently relating to falls. Claims were excluded from further analysis if, on scrutiny, they had not resulted from falls, or if they were still "open" (ie, unresolved). From the narrative descriptions of closed claims (ie, those for which the financial outcome was known), we developed categories of "principal" and "secondary" injury/harm and "principal" and "contributory" circumstance of falls. For each category, it was determined whether cases had resulted in payment and what total payments (damages and costs) were awarded. The proportions of contribution-specific injuries or circumstances to the number of cases and to the overall costs incurred were compared in order to identify

  6. A Seven-Year Longitudinal Claim Analysis to Assess the Factors Contributing to the Increased Severity of Work-Related Injuries.

    PubMed

    Kalia, Nimisha; Lavin, Robert A; Yuspeh, Larry; Bernacki, Edward J; Tao, Xuguang Grant

    2016-09-01

    In recent decades, the frequency of Medical Only (MO) and Lost Time (LT) workers' compensation claims has decreased, while average severity (medical and indemnity costs) has increased. The aim of this study was to compare claim frequency, mix, and severity (cost) over two periods using a claim cohort follow-up method. Sixty-two thousand five hundred thirty-three claims during two periods (1999 to 2002 and 2003 to 2006) were followed seven years postinjury. Descriptive analysis and significant testing methods were used to compare claim frequency and costs. The number of claims per $1 M of premium decreased 50.4% for MO claims and 35.6% for LT claims, consequently increasing the LT claim proportion. The average cost of LT claims did not increase. The severity increase is attributable to the proportional change in LT and MO claims. While the number of LT claims decreased, the inflation-adjusted average cost of LT claims did not increase.

  7. 45 CFR 504.4 - Place of filing claims.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Place of filing claims. 504.4 Section 504.4 Public... WAR CLAIMS ACT OF 1948, AS AMENDED FILING OF CLAIMS AND PROCEDURES THEREFOR § 504.4 Place of filing claims. Claims must be mailed or delivered in person to the Foreign Claims Settlement Commission, 600 E...

  8. Personal narrative approaches in rehabilitation following traumatic brain injury: A synthesis of qualitative research.

    PubMed

    D'Cruz, Kate; Douglas, Jacinta; Serry, Tanya

    2017-08-09

    Although narrative storytelling has been found to assist identity construction, there is little direct research regarding its application in rehabilitation following traumatic brain injury (TBI). The aim of this review was to identify published evidence on the use of personal narrative approaches in rehabilitation following TBI and to synthesise the findings across this literature. A systematic search of four databases was conducted in December 2016. No limit was set on the start date of the search. Personal narrative approaches were defined as direct client participation in sharing personal stories using written, spoken or visual methods. The search retrieved 12 qualitative research articles on the use of personal narrative approaches in TBI rehabilitation. Thematic synthesis of the narrative data and authors' reported findings of the 12 articles yielded an overall theme of building a strengths-based identity and four sub-themes: 1) expressing and communicating to others; 2) feeling validated by the act of someone listening; 3) reflecting and learning about oneself; and 4) being productive. The findings of this review support the use of personal narrative approaches in addressing loss of identity following TBI. Healthcare professionals and the community are encouraged to seek opportunities for survivors of TBI to share their stories.

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

    PubMed

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

    2015-03-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

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

    Code of Federal Regulations, 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...

  13. 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.

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

    PubMed Central

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

    2016-01-01

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

  15. 26 CFR 403.36 - Interest claimed.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Interest claimed. 403.36 Section 403.36... ADMINISTRATION DISPOSITION OF SEIZED PERSONAL PROPERTY Remission or Mitigation of Forfeitures § 403.36 Interest claimed. Any person claiming an interest in property seized by an officer of the Internal Revenue Service...

  16. 26 CFR 403.36 - Interest claimed.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Interest claimed. 403.36 Section 403.36... ADMINISTRATION DISPOSITION OF SEIZED PERSONAL PROPERTY Remission or Mitigation of Forfeitures § 403.36 Interest claimed. Any person claiming an interest in property seized by an officer of the Internal Revenue Service...

  17. 26 CFR 403.36 - Interest claimed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Interest claimed. 403.36 Section 403.36... ADMINISTRATION DISPOSITION OF SEIZED PERSONAL PROPERTY Remission or Mitigation of Forfeitures § 403.36 Interest claimed. Any person claiming an interest in property seized by an officer of the Internal Revenue Service...

  18. 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.

  19. 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

  20. 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

    ..., Room 2400, St. Louis, MO 63155-9948. FOR FURTHER INFORMATION CONTACT: Ruth A. Przybeck, Chief Counsel... Center, USPS National Tort Center, 1720 Market Street, Room 2400, St. Louis, MO 63155-9948'' in its place... Counsel, Torts, General Law Service Center, USPS National Tort Center, 1720 Market Street, Room 2400, St...

  1. 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

  2. 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...

  3. 32 CFR 757.18 - Asserting the claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... there is no prescribed form or content for investigating these claims, the claims file will contain...'s claim as an item of special damages with the injured person's claim or suit. (ii) An agreement... through the injured person against the liable third person or brings an original suit in its own name or...

  4. 32 CFR 757.18 - Asserting the claim.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... there is no prescribed form or content for investigating these claims, the claims file will contain...'s claim as an item of special damages with the injured person's claim or suit. (ii) An agreement... through the injured person against the liable third person or brings an original suit in its own name or...

  5. 32 CFR 757.18 - Asserting the claim.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... there is no prescribed form or content for investigating these claims, the claims file will contain...'s claim as an item of special damages with the injured person's claim or suit. (ii) An agreement... through the injured person against the liable third person or brings an original suit in its own name or...

  6. 32 CFR 757.18 - Asserting the claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... there is no prescribed form or content for investigating these claims, the claims file will contain...'s claim as an item of special damages with the injured person's claim or suit. (ii) An agreement... through the injured person against the liable third person or brings an original suit in its own name or...

  7. 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.

  8. 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

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

    PubMed

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

    1998-01-01

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

  10. 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.

  11. Thermodysregulation in persons with spinal cord injury: case series on use of the autonomic standards.

    PubMed

    Handrakis, John P; Trbovich, Michelle; Hagen, Ellen Merete; Price, Michael

    2017-01-01

    The ability to maintain core body temperature (Tcore) within a narrow range (37 ± 0.6 °C), despite exposure to a wide range of ambient temperatures, is essential in order to provide an optimal environment for vital organs, the central nervous system (CNS), and cellular processes to function. High-level (above T6) spinal cord injury (SCI) interrupts the autonomic nervous system's ability to carry out hypothalamic regulation of thermoregulatory mechanisms for both heat dissipation and conservation. This interruption leaves persons with high-level SCI vulnerable to hyper and hypothermia even during exposure to relatively mild ambient temperatures. The goal of the Autonomic Standards is to enable the clinician to quickly identify those individuals with SCI who may be most at risk for thermoregulatory dysfunction. Case 1: Heat Exhaustion, Case 2: Heat Stroke in absence of CNS symptoms, Case 3: Heat Exhaustion. The three cases demonstrate the signs and symptoms that may accompany hyperthermia in persons with SCI. The onset may be quite rapid and the condition persistent, despite ambient temperatures being much less intense than expected to be necessary to induce similar conditions in able-bodied (AB) persons. The responses of the persons in the case studies to the temperature regulation and autonomic control of sweating sections of the Autonomic Standards would identify them as being vulnerable and warrant providing appropriate exposure guidelines and precautions to them and their caregivers.

  12. Legal Services: Claims

    DTIC Science & Technology

    1997-12-31

    waive such exemp- tions or privileges and direct release of the protected documents, upon balancing all pertinent factors, including finding that...injury causing death until expiration of decedent’s worklife ex- pectancy. When requested, the previous five years Federal income tax forms must be...knowing at all times how much of the CEA has been obligated, its remaining balance , and assessing each month whether the balance will cover claims

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

    PubMed

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

    2015-03-01

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

  14. Participation in sport in persons with spinal cord injury in Switzerland.

    PubMed

    Rauch, A; Fekete, C; Oberhauser, C; Marti, A; Cieza, A

    2014-09-01

    Secondary data analysis of a questionnaire-based, cross-sectional survey in persons with spinal cord injury (SCI) in Switzerland. To describe the frequency of participation in sport (PiS) and to identify correlates for PiS in persons with SCI in Switzerland. Community sampleMethods:Frequency of PiS was assessed retrospectively for the time before the onset of SCI and the time of the survey using a single-item question. A comprehensive set of independent variables was selected from the original questionnaire. Descriptive statistics, bivariate analyses and ordinal regressions were carried out. Data from 505 participants were analyzed. Twenty independent variables were selected for analyses. PiS decreased significantly from the time before the onset of SCI to the time of the survey (P<0.001). Sport levels were significantly lower in women than men for the time of the survey (P<0.001), whereas no difference was observed before onset of SCI (P=0.446). Persons with tetraplegia participated significantly less often in sport than persons with paraplegia (P<0.001). Lesion level, active membership in a club, frequency of PiS before the onset of SCI and the subjective evaluation of the importance of sport correlate with PiS. When controlling for gender differences, only the subjective importance of sport for persons with SCI determines PiS, particularly among women. Persons with tetraplegia and women need special attention when planning interventions to improve PiS. Furthermore, the subjective importance of sport is important for PiS, particularly among women, whereas most other factors were only weakly associated with PiS.

  15. 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

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

    PubMed

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

    2016-03-01

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

  17. 7 CFR 160.71 - Delinquent claims.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... thereof shall be brought to the attention of the interested person. After a claim becomes delinquent, the... pay his claim after issuance of such notice of delinquency. [11 FR 14665, Dec. 27, 1946, as amended at...

  18. 7 CFR 160.71 - Delinquent claims.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... thereof shall be brought to the attention of the interested person. After a claim becomes delinquent, the... pay his claim after issuance of such notice of delinquency. [11 FR 14665, Dec. 27, 1946, as amended at...

  19. 7 CFR 160.71 - Delinquent claims.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... thereof shall be brought to the attention of the interested person. After a claim becomes delinquent, the... pay his claim after issuance of such notice of delinquency. [11 FR 14665, Dec. 27, 1946, as amended at...

  20. 7 CFR 160.71 - Delinquent claims.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... thereof shall be brought to the attention of the interested person. After a claim becomes delinquent, the... pay his claim after issuance of such notice of delinquency. [11 FR 14665, Dec. 27, 1946, as amended at...

  1. 7 CFR 160.71 - Delinquent claims.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... thereof shall be brought to the attention of the interested person. After a claim becomes delinquent, the... pay his claim after issuance of such notice of delinquency. [11 FR 14665, Dec. 27, 1946, as amended at...

  2. 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.

  3. Prognostic indicators of social outcomes in persons who sustained an injury in a road traffic crash.

    PubMed

    Gopinath, Bamini; Jagnoor, Jagnoor; Harris, Ian A; Nicholas, Michael; Casey, Petrina; Blyth, Fiona; Maher, Christropher G; Cameron, Ian D

    2015-05-01

    There is a lack of longitudinal studies with adequate sample size and follow-up period which have objectively assessed social outcomes among those with mild or moderate musculoskeletal injury or that are not limited to hospital inpatients. We aimed to address this gap by prospectively assessing the potential predictors of return to pre-injury work and daily activities. Persons with mild/moderate musculoskeletal injuries from a vehicle-related crash were surveyed within the first 3 months after the crash (baseline; n=364), and at 12 (n=284) and 24 months (n=252). Participants self-reported return to work, and whether it was return to full or modified duties at work. Analyses were restricted to 170 participants who reported being in pre-injury paid work and had provided information at either 12 months only or at both 12 and 24 months. Return to usual activities was assessed using the European Quality of Life-5 Dimensions (EQ-5D) scale 'Usual Activities' dimension. Twenty-four months after injury 82% (n=121) had returned to work. After multivariable adjustment, not being admitted to hospital was associated with 44% higher likelihood of returning to work at 24 months. Not having any pre-injury chronic illness was associated with returning to work after 24 months, multivariable-adjusted risk ratio (RR), 1.21 (95% confidence intervals, CI: 1.02-1.45). Each 1-SD increase in Medical Outcomes Survey Short Form-12 Mental Component Summary (SF-12 MCS) score at baseline was associated with returning to work at 24 months RR 1.13 (95% CI: 1.02-1.25). Younger age, higher SF-12 physical component summary (PCS), and EQ-5D visual analogue scale (VAS) scores were mutually independent predictors of returning to usual activities 24 months later. A range of bio-psychosocial factors, particularly quality of life measures, independently predicted social outcomes including return to work and return to usual daily activities. These determinants could be measured early in the recovery

  4. 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.

  5. The effects of a heat acclimation protocol in persons with spinal cord injury.

    PubMed

    Trbovich, Michelle B; Kiratli, Jenny B; Price, Mike J

    2016-12-01

    Persons without spinal cord injury (SCI) physiologically acclimate between seven to fourteen consecutive days of exercise in the heat. Decreased resting and exercise core temperature, decreased heart rate, increased plasma volume and increased thermal comfort during exercise are changes consistent with heat acclimation. Autonomic dysfunction after SCI impairs heat dissipation through sweating and vasodilation. The purpose of this study is to determine if seven consecutive days of exercise in the heat would result in physiologic changes consistent with heat acclimation in persons with SCI. Ten persons with SCI divided into two groups: tetraplegia (n=5) and paraplegia (n=5) exercised in 35°C using an arm ergometer at 50% W peak for 30min followed by 15min rest. This protocol was repeated over seven consecutive days. Heart rate (HR), skin temperature, aural temperature (T aur ), rate of perceived exertion (RPE), rate of perceived thermal strain (RPTS), and plasma volume (PV) were measured throughout the protocol. There were no significant differences in resting T aur exercise T aur , mean skin temperature, HR, PV, RPE or RPTS over the 7 days for either the tetraplegic or paraplegic group. Participants with SCI did not demonstrate the ability to dissipate heat more efficiently over 7 days of exercise at 35°C. The lack of heat acclimation seen in persons with SCI has implications for the athlete and non-athlete alike. For the SCI athlete, inability to acclimate will impair performance and endurance especially in warm environments, compared to the person without SCI. For the SCI non-athlete, there is a greater risk of heat-related illness in warm environments that can negatively affect participation in outdoor activities and thus quality of life. Published by Elsevier Ltd.

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

    PubMed Central

    2010-01-01

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

  7. Community reintegration in rehabilitated South Indian persons with spinal cord injury.

    PubMed

    Samuelkamaleshkumar, Selvaraj; Radhika, Somasundaram; Cherian, Binu; Elango, Aarumugam; Winrose, Windsor; Suhany, Baby T; Prakash, M Henry

    2010-07-01

    To explore community reintegration in rehabilitated South Indian persons with spinal cord injury (SCI) and to compare the level of community reintegration based on demographic variables. Survey. Rehabilitation center of a tertiary care university teaching hospital. Community-dwelling persons with SCI (N=104). Not applicable. Craig Handicap Assessment and Reporting Technique (CHART). The mean scores for each CHART domain were physical independence 98+/-5, social Integration 96+/-11, cognitive independence 92+/-17, occupation 70+/-34, mobility 65+/-18, and economic self sufficiency 53+/-40. Demographic variables showed no statistically significant difference with any of the CHART domains except for age and mobility, level of education, and social integration. Persons with SCI in rural South India who have completed comprehensive, mostly self-financed, rehabilitation with an emphasis on achieving functional ambulation, family support, and self-employment and who attend a regular annual follow-up show a high level of community reintegration in physical independence, social integration, and cognitive independence. CHART scores in the domains of occupation, mobility, and economic self-sufficiency showed lower levels of community reintegration. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2010-03-01

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

  10. 42 CFR 456.722 - Electronic claims management system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... verifications, claims data capture, adjudication of claims, and to assist pharmacists and other authorized... pharmacist (or other authorized person, such as the dispensing physician) about the claim status. (iii...

  11. 42 CFR 456.722 - Electronic claims management system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... verifications, claims data capture, adjudication of claims, and to assist pharmacists and other authorized... pharmacist (or other authorized person, such as the dispensing physician) about the claim status. (iii...

  12. 42 CFR 456.722 - Electronic claims management system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... verifications, claims data capture, adjudication of claims, and to assist pharmacists and other authorized...) Notifying the pharmacist (or other authorized person, such as the dispensing physician) about the claim...

  13. 42 CFR 456.722 - Electronic claims management system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... verifications, claims data capture, adjudication of claims, and to assist pharmacists and other authorized...) Notifying the pharmacist (or other authorized person, such as the dispensing physician) about the claim...

  14. 42 CFR 456.722 - Electronic claims management system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... verifications, claims data capture, adjudication of claims, and to assist pharmacists and other authorized...) Notifying the pharmacist (or other authorized person, such as the dispensing physician) about the claim...

  15. 20 CFR 10.7 - What forms are needed to process claims under the FECA?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... Form No. Title (1) CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay.... (8) CA-7 Claim for Compensation Due to Traumatic Injury or Occupational Disease. (9) CA-7a Time... claims under the FECA? (a) Notice of injury, claims and certain specified reports shall be made on forms...

  16. 20 CFR 10.7 - What forms are needed to process claims under the FECA?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... Form No. Title (1) CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay.... (8) CA-7 Claim for Compensation Due to Traumatic Injury or Occupational Disease. (9) CA-7a Time... claims under the FECA? (a) Notice of injury, claims and certain specified reports shall be made on forms...

  17. 20 CFR 10.7 - What forms are needed to process claims under the FECA?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... Form No. Title (1) CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay.... (8) CA-7 Claim for Compensation Due to Traumatic Injury or Occupational Disease. (9) CA-7a Time... claims under the FECA? (a) Notice of injury, claims and certain specified reports shall be made on forms...

  18. 20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION...

  19. 20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION...

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION...

  1. 20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION...

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

    PubMed

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

    2015-04-01

    The purpose of this study was to characterize the operating characteristics of the Personality Assessment Inventory (PAI) validity scales in distinguishing simulators feigning symptoms of traumatic brain injury (TBI) while completing the PAI (n = 84) from a clinical sample of patients with TBI who achieved adequate scores on performance validity tests (n = 112). The simulators were divided into two groups: (a) Specific Simulators feigning cognitive and somatic symptoms only or (b) Global Simulators feigning cognitive, somatic, and psychiatric symptoms. The PAI overreporting scales were indeed sensitive to the simulation of TBI symptoms in this analogue design. However, these scales were less sensitive to the feigning of somatic and cognitive TBI symptoms than the feigning of a broad range of cognitive, somatic, and emotional symptoms often associated with TBI. The relationships of TBI simulation to consistency and underreporting scales are also explored. © The Author(s) 2014.

  3. In-Person versus Telehealth Assessment of Discourse Ability in Adults with Traumatic Brain Injury

    PubMed Central

    Turkstra, Lyn S.; Quinn-Padron, Maura; Johnson, Jacqueline E.; Workinger, Marilyn S.; Antoniotti, Nina

    2011-01-01

    Objectives To compare in-person (IP) vs. telehealth (TH) assessment of discourse ability in adults with chronic traumatic brain injury (TBI). Design Repeated-measures design with random order of conditions. Participants Twenty adults with moderate-to-severe TBI. Method Participants completed conversation, picture description, story-generation, and procedural description tasks. Sessions were video-recorded and transcribed. Measures Measures of productivity and quality of discourse. Results Significant differences between conditions were not detected in this sample, and feedback from participants was positive. Conclusions These preliminary results support the use of TH for the assessment of discourse ability in adults with TBI, at least for individuals with sufficient cognitive skills to follow TH procedures. PMID:22190010

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

    PubMed

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

    2013-08-01

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

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

    PubMed Central

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

    2016-01-01

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

  6. Identifying depression severity risk factors in persons with traumatic spinal cord injury.

    PubMed

    Williams, Ryan T; Wilson, Catherine S; Heinemann, Allen W; Lazowski, Linda E; Fann, Jesse R; Bombardier, Charles H

    2014-02-01

    Examine the relationship between demographic characteristics, health-, and injury-related characteristics, and substance misuse across multiple levels of depression severity. 204 persons with traumatic spinal cord injury (SCI) volunteered as part of screening efforts for a randomized controlled trial of venlafaxine extended release for major depressive disorder (MDD). Instruments included the Patient Health Questionnaire-9 (PHQ-9) depression scale, the Alcohol Use Disorders Identification Test (AUDIT), and the Substance Abuse in Vocational Rehabilitation-Screener (SAVR-S), which contains 3 subscales: drug misuse, alcohol misuse, and a subtle items scale. Each of the SAVR-S subscales contributes to an overall substance use disorder (SUD) outcome. Three proportional odds models were specified, varying the substance misuse measure included in each model. 44% individuals had no depression symptoms, 31% had mild symptoms, 16% had moderate symptoms, 6% had moderately severe symptoms, and 3% had severe depression symptoms. Alcohol misuse, as indicated by the AUDIT and the SAVR-S drug misuse subscale scores were significant predictors of depression symptom severity. The SAVR-S substance use disorder (SUD) screening outcome was the most predictive variable. Level of education was only significantly predictive of depression severity in the model using the AUDIT alcohol misuse indicator. Likely SUD as measured by the SAVR-S was most predictive of depression symptom severity in this sample of persons with traumatic SCI. Drug and alcohol screening are important for identifying individuals at risk for depression, but screening for both may be optimal. Further research is needed on risk and protective factors for depression, including psychosocial characteristics. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  7. Urine specific gravity and water hardness in relation to urolithiasis in persons with spinal cord injury.

    PubMed

    Chen, Y; Roseman, J M; Funkhouser, E; DeVivo, M J

    2001-11-01

    A matched case-control study. To clarify the influence of urine specific gravity and drinking water quality on the formation of urinary stones in persons with spinal cord injury (SCI). A rehabilitation center within a university hospital. Between 1992 and 1998, 63 stone cases (31 kidney, 27 bladder, and five both) and 289 age-duration-matched controls were recruited from a cohort of SCI patients enrolled in an on-going longitudinal study. Data on urine specific gravity and other characteristics of study participants were retrieved from the database and medical charts. Community water supply information was provided by the Alabama Department of Environmental Management. Multivariable conditional logistic regression analysis was performed to evaluate the association with stone formation. SCI individuals who had urinary stones were more likely than control subjects to use indwelling catheters and have decreased renal function. The occurrence of stones was not significantly related to gender, race, severity of injury, urinary tract infection, nor urine pH. After controlling for the potential confounding from other factors, a continuously increasing stone occurrence with increasing specific gravity was observed (P=0.05); this association was stronger for kidney (odds Ratio [OR]=1.8 per 0.010 g/cm(3)) versus bladder stones (OR=1.2) and for recurrent (OR=2.0) versus first stones (OR=1.5). Increased water hardness was not significantly associated with a decreased stone occurrence. Study results suggest that maintaining urine specific gravity below a certain level might reduce the occurrence of urinary stones. This could be easily achieved by using a dipstick for self-feedback along with appropriate fluid intake. For persons with SCI who are at an increased risk of a devastating stone disease, this prophylactic approach could be very cost-effective; however, this requires further confirmation.

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

    PubMed

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

    2016-11-01

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

  9. 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.

  10. Groupings of Persons With Traumatic Brain Injury: A New Approach to Classifying Traumatic Brain Injury in the Post-Acute Period.

    PubMed

    Sherer, Mark; Nick, Todd G; Sander, Angelle M; Melguizo, Maria; Hanks, Robin; Novack, Thomas A; Tulsky, David; Kisala, Pamela; Luo, Chunqiao; Tang, Xinyu

    To (1) identify groups of persons with traumatic brain injury (TBI) who differ on 12 dimensions of cognitive function: cognitive, emotional, and physical symptoms; personal strengths; physical functioning; environmental supports; and performance validity; and (2) describe patterns of differences among the groups on these dimensions and on participation outcome. Three centers for rehabilitation of persons with TBI. A total of 504 persons with TBI living in the community who were an average (standard deviation) of 6.3 (6.8) years postinjury and who had capacity to give consent, could be interviewed and tested in English, and were able to participate in an assessment lasting up to 4 hours. Observational study of a convenience sample of persons with TBI. Selected scales from the Traumatic Brain Injury Quality of Life measures, Neurobehavioral Symptom Inventory, Economic Quality of Life Scale, Family Assessment Device General Functioning Scale, measures of cognitive function, Word Memory Test, and Participation Assessment with Recombined Tools-Objective (PART-O) scale. Cluster analysis identified 5 groups of persons with TBI who differed in clinically meaningful ways on the 12 dimension scores and the PART-O scale. Cluster groupings identified in this study could assist clinicians with case conceptualization and treatment planning.

  11. 10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... entity requesting indemnification for a particular claim must: (1) Notify the Field Office Manager in... Office Manager, or such other DOE official as the Field Office Manager designates, with evidence or proof of the claim; (3) Furnish the Field Office Manager, or such other DOE official as the Field Office...

  12. 10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... entity requesting indemnification for a particular claim must: (1) Notify the Field Office Manager in... Office Manager, or such other DOE official as the Field Office Manager designates, with evidence or proof of the claim; (3) Furnish the Field Office Manager, or such other DOE official as the Field Office...

  13. Secondary health conditions in persons with spinal cord injury: a longitudinal study from one to five years post-discharge.

    PubMed

    Adriaansen, Jacinthe J E; Post, Marcel W M; de Groot, Sonja; van Asbeck, Floris W A; Stolwijk-Swüste, Janneke M; Tepper, Marga; Lindeman, Eline

    2013-11-01

    To assess the occurrence of secondary health conditions and their potential risk factors in persons with spinal cord injury from 1 to 5 years after discharge from initial inpatient rehabilitation. Multicentre longitudinal study. A total of 139 wheelchair-dependent persons with spinal cord injury. The occurrence of secondary health conditions and their potential risk factors were assessed in a clinical interview with a rehabilitation physician at 1 and 5 years after discharge from inpatient rehabilitation and by a telephone interview 2 years after discharge. Self-report questionnaires were used for the assessment of musculoskeletal and neuropathic pain. Neuropathic pain (83.7-92.1%), musculoskeletal pain (62.3-87.1%) and urinary tract infection (56.5-58.9%) were the most frequently reported secondary health conditions. The occurrence of several secondary health conditions was higher among women and individuals with a complete lesion, tetraplegia, and with a higher body mass index. Secondary health conditions are common in the first years post-discharge following spinal cord injury, and their course seems to be relatively stable. These results emphasize the number of health issues that must be considered during post-injury care of persons with spinal cord injury living in the community, and the importance of a well-coordinated interdisciplinary approach from specialized rehabilitation centres.

  14. 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.

  15. 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.

  16. Service patterns related to successful employment outcomes of persons with traumatic brain injury in vocational rehabilitation.

    PubMed

    Catalano, Denise; Pereira, Ana Paula; Wu, Ming-Yi; Ho, Hanson; Chan, Fong

    2006-01-01

    This study analyzed the Rehabilitation Services Administration (RSA) case service report (RSA-911) data for fiscal year 2004 to examine effects of demographic characteristics, work disincentives, and vocational rehabilitation services patterns on employment outcomes of persons with traumatic brain injuries (TBI). The results indicated that European Americans (53%) had appreciably higher competitive employment rates than Native American (50%), Asian Americans (44%), African Americans (42%), and Hispanic/Latino Americans (41%). Clients without co-occurring psychiatric disabilities had a higher employment rate (51%) than those with psychiatric disabilities (45%). Clients without work disincentives showed better employment outcomes (58%) than those with disincentives (45%). An important finding from this analysis was the central role of job search assistance, job placement assistance, and on-the-job support services for persons with TBI in predicting employment outcomes. A data mining technique, the exhaustive CHAID analysis, was used to examine the interaction effects of race, gender, work disincentives and service variables on employment outcomes. The results indicated that the TBI clients in this study could be segmented into 29 homogeneous subgroups with employment rates ranging from a low of 11% to a high of 82%, and these differences can be explained by differences in work disincentives, race, and rehabilitation service patterns.

  17. 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…

  18. 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…

  19. Claiming Copernicus.

    PubMed

    Fara, Patricia

    2005-12-01

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

  20. 32 CFR 536.15 - Claims policies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  1. 32 CFR 536.15 - Claims policies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  2. 32 CFR 536.15 - Claims policies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  3. 27 CFR 72.32 - Interest claimed.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Interest claimed. 72.32 Section 72.32 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... Remission or Mitigation of Forfeitures § 72.32 Interest claimed. Any person claiming an interest in property...

  4. 27 CFR 72.32 - Interest claimed.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Interest claimed. 72.32 Section 72.32 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... Remission or Mitigation of Forfeitures § 72.32 Interest claimed. Any person claiming an interest in property...

  5. 27 CFR 72.32 - Interest claimed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Interest claimed. 72.32 Section 72.32 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... Remission or Mitigation of Forfeitures § 72.32 Interest claimed. Any person claiming an interest in property...

  6. 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

  7. 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.

  8. Need and use of assistive devices for personal mobility by individuals with spinal cord injury

    PubMed Central

    Florio, Jordanne; Arnet, Ursina; Gemperli, Armin; Hinrichs, Timo

    2016-01-01

    Objective To investigate the provision, use, and unmet need of assistive devices for personal mobility in the Swiss population with spinal cord injury (SCI). Design Community survey 2012 of the Swiss Spinal Cord Injury Cohort Study. Participants Individuals aged 16 or older with traumatic or non-traumatic SCI residing in Switzerland. Interventions Not applicable. Outcome Measures Provision, frequency of use, and unmet need (i.e. perceiving the need of a device but it not being provided) of 11 mobility devices were assessed by self-report and analyzed descriptively. Provision of devices was further analyzed by sex, age, SCI etiology, SCI severity, and time since SCI. Results Devices reported highest for provision (N = 492; mean age 55.3 ± 15.1 years; 28.9% female) were adapted cars (78.2%) and manual wheelchairs (69.9%). Provision of various devices markedly varied with age and SCI severity (e.g. 34.6% of those aged 76+ had a walking frame compared to 3.1% of those aged 31–45; 50.0% of participants with complete tetraplegia had a power wheelchair compared to 7.6% of those with complete paraplegia). Many devices were mostly used daily (e.g. manual wheelchair) while others were mostly used less frequently (e.g. handbikes). Unmet need was highest for arm braces (53.2% of those in need) and power assisted wheelchairs (47.3%), and lowest for crutches (11.4%) and manual wheelchairs (4.8%). Conclusion The devices individuals have or use is largely dependent on their age and SCI severity. While most participants have access to basic mobility devices, there is still a considerable degree of unmet need for certain devices. PMID:26666510

  9. Teleexercise for Persons With Spinal Cord Injury: A Mixed-Methods Feasibility Case Series.

    PubMed

    Lai, Byron; Rimmer, James; Barstow, Beth; Jovanov, Emil; Bickel, C Scott

    2016-07-14

    Spinal cord injury (SCI) results in significant loss of function below the level of injury, often leading to restricted participation in community exercise programs. To overcome commonly experienced barriers to these programs, innovations in technology hold promise for remotely delivering safe and effective bouts of exercise in the home. To test the feasibility of a remotely delivered home exercise program for individuals with SCI as determined by (1) implementation of the intervention in the home; (2) exploration of the potential intervention effects on aerobic fitness, physical activity behavior, and subjective well-being; and (3) acceptability of the program through participant self-report. Four adults with SCI (mean age 43.5 [SD 5.3] years; 3 males, 1 female; postinjury 25.8 [SD 4.3] years) completed a mixed-methods sequential design with two phases: an 8-week intervention followed by a 3-week nonintervention period. The intervention was a remotely delivered aerobic exercise training program (30-45 minutes, 3 times per week). Instrumentation included an upper body ergometer, tablet, physiological monitor, and custom application that delivered video feed to a remote trainer and monitored and recorded exercise data in real time. Implementation outcomes included adherence, rescheduled sessions, minutes of moderate exercise, and successful recording of exercise data. Pre/post-outcomes included aerobic capacity (VO 2 peak), the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), the Satisfaction with Life Scale (SWLS), and the Quality of Life Index modified for spinal cord injury (QLI-SCI). Acceptability was determined by participant perceptions of the program features and impact, assessed via qualitative interview at the end of the nonintervention phase. Participants completed all 24 intervention sessions with 100% adherence. Out of 96 scheduled training sessions for the four participants, only 8 (8%) were makeup sessions. The teleexercise

  10. Teleexercise for Persons With Spinal Cord Injury: A Mixed-Methods Feasibility Case Series

    PubMed Central

    Lai, Byron; Rimmer, James; Barstow, Beth; Jovanov, Emil

    2016-01-01

    Background Spinal cord injury (SCI) results in significant loss of function below the level of injury, often leading to restricted participation in community exercise programs. To overcome commonly experienced barriers to these programs, innovations in technology hold promise for remotely delivering safe and effective bouts of exercise in the home. Objective To test the feasibility of a remotely delivered home exercise program for individuals with SCI as determined by (1) implementation of the intervention in the home; (2) exploration of the potential intervention effects on aerobic fitness, physical activity behavior, and subjective well-being; and (3) acceptability of the program through participant self-report. Methods Four adults with SCI (mean age 43.5 [SD 5.3] years; 3 males, 1 female; postinjury 25.8 [SD 4.3] years) completed a mixed-methods sequential design with two phases: an 8-week intervention followed by a 3-week nonintervention period. The intervention was a remotely delivered aerobic exercise training program (30-45 minutes, 3 times per week). Instrumentation included an upper body ergometer, tablet, physiological monitor, and custom application that delivered video feed to a remote trainer and monitored and recorded exercise data in real time. Implementation outcomes included adherence, rescheduled sessions, minutes of moderate exercise, and successful recording of exercise data. Pre/post-outcomes included aerobic capacity (VO2 peak), the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), the Satisfaction with Life Scale (SWLS), and the Quality of Life Index modified for spinal cord injury (QLI-SCI). Acceptability was determined by participant perceptions of the program features and impact, assessed via qualitative interview at the end of the nonintervention phase. Results Participants completed all 24 intervention sessions with 100% adherence. Out of 96 scheduled training sessions for the four participants, only 8 (8

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

    PubMed

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

    2000-08-01

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

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. Delusional jealousy and person directed hostility: 5-year follow-up of a patient after anoxic brain injury.

    PubMed

    Shah, Rajendra; Faruqui, Rafey A

    2013-01-01

    This study presents a case report on the emergence of delusional jealousy and person-directed hostility in a patient following anoxic brain injury. The patient did not have a pre-injury history of mental illness, nor a family history of a psychotic disorder. This patient was followed-up over a 5-year period and his history of treatment response, violence risk management and successful rehabilitation are presented. This study also highlights issues in relation to continuation of treatment with antipsychotic medication, use of compulsory admission under the Mental Health Act and principles of risk assessment and risk management.

  17. Characteristics of persons with spinal cord injury who drive in Malaysia and its barriers: a cross sectional study.

    PubMed

    Lee, Richard Chee Houw; Hasnan, Nazirah; Engkasan, Julia Patrick

    2018-04-01

    Cross sectional study. To determine the prevalence, characteristics of and barriers to driving among persons with a spinal cord injury (SCI). SCI Rehabilitation Clinic, University Malaya Medical Centre (UMMC). This is a questionnaire-based study on persons with SCI who attended the UMMC SCI Rehabilitation Clinic between June 2015 and November 2016. The questionnaire comprised demographic data, clinical characteristics, driving variables, Spinal Cord Independence Measure III, WHOQOL-BREF, and Craig Handicap Assessment and Reporting Technique Short Form. Malaysians aged greater than 18 years old with any etiology and levels of SCI, had no other physical disabilities and not suffering from progressive illness were recruited. A single investigator administered the questionnaire via face-to-face interviews. A total of 160 participants were included in this study. Overall, 37% of persons with SCI drove and owned a modified vehicle. Almost half of persons with paraplegia (47%) drove, but only 12% of tetraplegia did. A majority (93%) of those who drove aged below 60 years, and had higher level of independence in activity of daily living. More drivers (81%) compared to non-drivers (24%) were employed; drivers also reported better community reintegration and quality of life. Three commonest barriers to driving included medical reasons (38%), fear and lack of confidence (17%), and inability to afford vehicle modifications (13%). The percentage of persons with SCI driving post injury is low. Based on the findings of this study, more efforts are needed to motivate and facilitate persons with SCI to drive.

  18. Relationship of life satisfaction to impairment, disability, and handicap among persons with spinal cord injury living in the community.

    PubMed

    Fuhrer, M J; Rintala, D H; Hart, K A; Clearman, R; Young, M E

    1992-06-01

    The level and correlates of the life satisfaction of persons with spinal cord injury who are residing in the community were investigated. One hundred men and 40 women were chosen randomly from a cohort of 640 persons with spinal cord injury residing in a 13-county area in southeast Texas. The mean Life Satisfaction Index-A (LSIA-A) was lower than reported previously for persons in the general population. The LSIA-A was not correlated significantly with chronologic variables, the ASIA Total Motor Index Score, or a self-report version of the Functional Independence Measure. The LSIA-A was associated positively with self-assessed health, perceived control, and social support, as well as with the Social Integration, Occupation, and Mobility dimensions of the Craig Handicap Assessment and Reporting Technique. From the standpoint of an augmented version of the World Health Organization model of disablement, the life satisfaction of persons with spinal cord injury appears to be influenced, albeit indirectly, by selective aspects of their social role performance (handicap), but not by their degree of impairment or disability.

  19. 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.

  20. Improving primary care for persons with spinal cord injury: Development of a toolkit to guide care.

    PubMed

    Milligan, James; Lee, Joseph; Hillier, Loretta M; Slonim, Karen; Craven, Catharine

    2018-05-07

    To identify a set of essential components for primary care for patients with spinal cord injury (SCI) for inclusion in a point-of-practice toolkit for primary care practitioners (PCP) and identification of the essential elements of SCI care that are required in primary care and those that should be the focus of specialist care. Modified Delphi consensus process; survey methodology. Primary care. Three family physicians, six specialist physicians, and five inter-disciplinary health professionals completed surveys. Importance of care elements for inclusion in the toolkit (9-point scale: 1 = lowest level of importance, 9 = greatest level of importance) and identification of most responsible physician (family physician, specialist) for completing key categories of care. Open-ended comments were solicited. There was consensus between the respondent groups on the level of importance of various care elements. Mean importance scores were highest for autonomic dysreflexia, pain, and skin care and lowest for preventive care, social issues, and vital signs. Although, there was agreement across all respondents that family physicians should assume responsibility for assessing mental health, there was variability in who should be responsible for other care categories. Comments were related to the need for shared care approaches and capacity building and lack of knowledge and specialized equipment as barriers to optimal care. This study identified important components of SCI care to be included in a point-of-practice toolkit to facilitate primary care for persons with SCI.

  1. Reproducibility and effect of posture on impulse oscillation parameters in persons with spinal cord injury

    PubMed Central

    Cirnigliaro, Christopher M.; Lesser, Marvin; Moyer, Jeremy; Kirshblum, Steven C.; Bauman, William A.; Spungen, Ann M.

    2012-01-01

    Background The impulse oscillation system (IOS) offers significant value in the assessment of airway dynamics in persons with spinal cord injury (SCI) because of minimal patient effort but measurement reproducibility in SCI is unknown. Objective To evaluate between-day reproducibility and the effect of posture on airway resistance [respiratory resistances at 5 Hz (R5) and 20 Hz (R20)] in subjects with tetraplegia, paraplegia and able-bodied controls. Methods Ten subjects with tetraplegia, 10 subjects with paraplegia and 11 able-bodied individuals were evaluated using IOS. Three 30 second trials were obtained in each while in the seated and supine position on Day 1, and repeated on Day 2. Results The within-day coefficient of variation (CV%) for R5 and R20 were comparable in the 3 study groups in the seated and supine positions. Compared to controls, the between-day CV% for the combined data was higher in subjects with tetraplegia and paraplegia for R5 seated, and was higher in subjects with tetraplegia for R5 supine. Conclusions IOS has applicability to the study of within-day respiratory resistance in SCI. However, performing longer-term studies in subjects with tetraplegia and paraplegia may be problematic because of the greater variability for R5 when compared to able-bodied individuals. PMID:22330188

  2. 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.

  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. Reliability and validity of the Persian version of the spinal cord injury lifestyle scale and the health behavior questionnaire in persons with spinal cord injury.

    PubMed

    Shabany, Maryam; Nasrabadi, Alireza Nikbakht; Rahimi-Movaghar, Vafa; Mansournia, Mohammad Ali; Mohammadi, Nooredin; Pruitt, Sheri D

    2018-05-01

    Cross-sectional psychometric study. To evaluate the reliability and validity of a spinal cord injury lifestyle scale (SCILS) and Health Behavior Questionnaire (HBQ) in the Persian language for persons with spinal cord injury (SCI). Participants were selected among those referred to health centers and the Brain and Spinal Cord Injury Research Center. In accordance with standard procedure for translation, two questionnaires, the SCILS and HBQ, were translated using a forward and backward translation approach by professional translators. Face validity of the questionnaires was assessed by ten persons with SCI and content validity was agreed upon by 12 professors from health care teaching universities. To test the final versions of both questionnaires, 97 persons with SCI were included using a consecutive sampling method. Other questionnaires were used to assess concurrent validity (secondary impairment checklist, as well as SCILS and HBQ) and convergent validity (impact of event scale revised, brief symptom inventory, beck depression inventory, and functional independence measure). Internal consistency of SCILS and HBQ, assessed by Cronbach's alpha, was 0.75 for SCILS and 0.85 for HBQ. Test-retest reliability intraclass correlations were 0.86 and 0.92 for SCILS and HBQ, respectively. The number of current secondary impairments had a significant and negative correlation with SCILS (r = -0.22, P < 0.001), but it was not correlated with HBQ. SCILS had a significant and strong correlation with HBQ (r = 0.65, P < 0.001). SCILS and HBQ can be used for measuring the health behavior of persons with SCI in Iran.

  5. 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.

  6. 44 CFR 11.76 - Claims procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... applicable case enumerated in § 11.73(c)(8). (h) Money. Claims for loss of money deposited for safekeeping... person or persons who received money and any others involved; (2) Name and designation of the authority... claimant. (i) Motor vehicles or mobile homes in transit. Claims for damage to motor vehicles or mobile...

  7. 44 CFR 11.76 - Claims procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... applicable case enumerated in § 11.73(c)(8). (h) Money. Claims for loss of money deposited for safekeeping... person or persons who received money and any others involved; (2) Name and designation of the authority... claimant. (i) Motor vehicles or mobile homes in transit. Claims for damage to motor vehicles or mobile...

  8. 44 CFR 11.76 - Claims procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... applicable case enumerated in § 11.73(c)(8). (h) Money. Claims for loss of money deposited for safekeeping... person or persons who received money and any others involved; (2) Name and designation of the authority... claimant. (i) Motor vehicles or mobile homes in transit. Claims for damage to motor vehicles or mobile...

  9. 44 CFR 11.76 - Claims procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... applicable case enumerated in § 11.73(c)(8). (h) Money. Claims for loss of money deposited for safekeeping... person or persons who received money and any others involved; (2) Name and designation of the authority... claimant. (i) Motor vehicles or mobile homes in transit. Claims for damage to motor vehicles or mobile...

  10. 44 CFR 11.76 - Claims procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... applicable case enumerated in § 11.73(c)(8). (h) Money. Claims for loss of money deposited for safekeeping... person or persons who received money and any others involved; (2) Name and designation of the authority... claimant. (i) Motor vehicles or mobile homes in transit. Claims for damage to motor vehicles or mobile...

  11. 32 CFR 1659.1 - Claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... from the date on which the expenses were incurred. (e) No such claim shall be allowed in case it is determined that the cause of injury, illness, or death was due to negligence or misconduct of the registrant... Service Act in any one case. (g) Payment of such claims when allowed shall be made only: (1) Directly to...

  12. 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

  13. 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.

  14. Verification testing to confirm VO2max attainment in persons with spinal cord injury.

    PubMed

    Astorino, Todd A; Bediamol, Noelle; Cotoia, Sarah; Ines, Kenneth; Koeu, Nicolas; Menard, Natasha; Nyugen, Brianna; Olivo, Cassandra; Phillips, Gabrielle; Tirados, Ardreen; Cruz, Gabriela Velasco

    2018-01-22

    Maximal oxygen uptake (VO 2 max) is a widely used measure of cardiorespiratory fitness, aerobic function, and overall health risk. Although VO 2 max has been measured for almost 100 yr, no standardized criteria exist to verify VO 2 max attainment. Studies document that incidence of 'true' VO 2 max obtained from incremental exercise (INC) can be confirmed using a subsequent verification test (VER). In this study, we examined efficacy of VER in persons with spinal cord injury (SCI). Repeated measures, within-subjects study. University laboratory in San Diego, CA. Ten individuals (age and injury duration = 33.3 ± 10.5 yr and 6.8 ± 6.2 yr) with SCI and 10 able-bodied (AB) individuals (age = 24.1 ± 7.4 yr). Peak oxygen uptake (VO 2 peak) was determined during INC on an arm ergometer followed by VER at 105 percent of peak power output (% PPO). Gas exchange data, heart rate (HR), and blood lactate concentration (BLa) were measured during exercise. Across all participants, VO 2 peak was highly related between protocols (ICC = 0.98) and the mean difference was equal to 0.08 ± 0.11 L/min. Compared to INC, VO 2 peak from VER was not different in SCI (1.30 ± 0.45 L/min vs. 1.31 ± 0.43 L/min) but higher in AB (1.63 ± 0.40 L/min vs. 1.76 ± 0.40 L/min). Data show similar VO 2 peak between incremental and verification tests in SCI, suggesting that VER confirms VO 2 max attainment. However, in AB participants completing arm ergometry, VER is essential to validate appearance of 'true' VO 2 peak.

  15. Determining the relation between quality of life, handicap, fitness, and physical activity for persons with spinal cord injury.

    PubMed

    Manns, P J; Chad, K E

    1999-12-01

    Determining relationships among fitness, physical activity, subjective quality of life, and handicap in persons with spinal cord injury (SCI). Cross-sectional exploratory study. University research laboratory setting. Twenty-eight men and 10 women (age 35.9+/-9.3 yrs) with SCI (17 quadriplegic, 21 paraplegic). Fitness (maximal incremental exercise test on arm ergometer), physical activity (leisure time exercise questionnaire), subjective quality of life (Quality of Life Profile: Physical and Sensory Disabilities Version), and level of handicap (Craig Handicap Assessment Reporting Technique). Correlational analyses examined relationships between the measures. Physical activity was correlated with composite handicap score in quadriplegic and paraplegic persons. Handicap domain scores for physical independence, mobility, and occupation were correlated with physical activity in quadriplegic persons. There was no relation between the subjective quality of life scores and fitness and physical activity in either group. Physical activity may play an important role in handicap for persons with SCI, particularly persons with quadriplegic injuries. The lack of a relation between activity variables and subjective quality of life may be related to the global nature of the measure used.

  16. Demographic and clinical characteristics of persons with spinal cord injury in Turkey: One-year experience of a primary referral rehabilitation center.

    PubMed

    Taşoğlu, Özlem; Koyuncu, Engin; Daylak, Rabia; Karacif, Derya Yumuşak; İnce, Zerrin; Yenigün, Didem; Özgirgin, Neşe

    2018-03-01

    To define the demographic and clinical characteristics of persons with spinal cord injury, rehabilitated in a primary referral rehabilitation center in Turkey. Retrospective study. Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey. Medical records of all patients with spinal cord injury (acute-subacute-chronic) at a single academic referral center over the course of one year were reviewed. Variables of each patient were recorded, including: age, sex, etiology, length of rehabilitation stay, neurological level of injury, level of neurological impairment and severity of injury. Among 262 persons with spinal cord injury, 69.8% were male (male:female ratio is 2.31 : 1). Mean age was 38.3 ± 17.6 years. Falls were the most common cause of injury. The majority of falls were falls from a height (93.3%). More than 20% of falls from a height were related to occupational injury. The most common neurological level of injury was L1. Of all persons 46.2% had thoracic, 27.5% had lumbar and 26.3% had cervical lesions. The mean length of rehabilitation stay was 52.1 ± 25.5 days. Persons with motor complete injury and with a shorter (<12 months) time since injury had longer length of rehabilitation stay. The mean age of SCI population is increasing. Falls constitute the majority of etiologic factors and are more common in persons >60 years old. More than 20% of falls from a height are related to occupational injury. Male-female ratio is decreasing. Thoraco-lumbar injures are more common than cervical injuries.

  17. Use of healthcare a long time after severe burn injury; relation to perceived health and personality characteristics.

    PubMed

    Wikehult, B; Willebrand, M; Kildal, M; Lannerstam, K; Fugl-Meyer, A R; Ekselius, L; Gerdin, B

    2005-08-05

    The aim of the study was to evaluate which factors are associated with the use of healthcare a long time after severe burn injury. After a review process based on clinical reasoning, 69 former burn patients out of a consecutive group treated at the Uppsala Burn Unit from 1980--1995 were visited in their homes and their use of care and support was assessed in a semi-structured interview. Post-burn health was assessed with the Burn-Specific Health Scale-Brief (BSHS-B) and personality was assessed with the Swedish universities Scales of Personality (SSP). The participants were injured on average eight years previously. Thirty-four had current contact with healthcare due to their burn injury and had significantly lower scores on three BSHS-B-domains: Simple Abilities, Work and Hand function, and significantly higher scores for the SSP-domain Neuroticism and the SSP-scales Stress Susceptibility, Lack of Assertiveness, and lower scores for Social Desirability. There was no relation to age, gender, time since injury, length of stay, or to the surface area burned. A routine screening of personality traits as a supplement to long-term follow-ups may help in identifying the patient's need for care.

  18. Enabling Work: Occupational Therapy Interventions for Persons with Occupational Injuries and Diseases: A Scoping Review.

    PubMed

    Blas, Alexa Jane T; Beltran, Kenneth Matthew B; Martinez, Pauline Gail V; Yao, Daryl Patrick G

    2018-06-01

    Purpose This review aims to map the scope of published research on occupational therapy (OT) interventions and pertinent work and work-related outcomes for persons with occupational injuries and diseases. Methods The scoping review adapted Arksey and O'Malley's framework. Six electronic databases were searched. Ancestral search was also done on five systematic reviews. The search was conducted from September 2015 to October 2015. Interventions and outcomes were coded using the International Classification of Functioning, Disability and Health Core Set for Vocational Rehabilitation to plot trends. Results Forty-six articles were included in the review. The top five intervention approaches included: acquiring skills (12.27%), health services, systems, and policies (10.43%), products and technology for employment (9.20%), handling stress and other psychological demands (7.98%), and apprenticeship (6.74%). The top five outcomes targeted included: remunerative employment (15.71%); sensation of pain (10.99%); emotional functions (5.76%); handling stress and other psychological demands (5.76%); economic self-sufficiency (4.71%); muscle endurance functions (4.71%); exercise tolerance functions (4.71%); undertaking multiple tasks (4.19%); acquiring, keeping, and terminating a job (4.19%); and looking after one's health (4.19%). Conclusion The trend in interventions show the use of activities and environment facilitators which are attuned to the conceptual nature of OT. Furthermore, the trend in outcomes show that there is substantial evidence that supports the use of OT to target work. This review may provide a platform for collaboration with other professionals and also help identify research directions to strengthen the evidence base for OT in work-related practice.

  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. 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...

  1. 20 CFR 10.7 - What forms are needed to process claims under the FECA?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... Form No. Title (1) CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay... Traumatic Injury or Occupational Disease (8) CA-7a Time Analysis Form (9) CA-7b Leave Buy Back (LBB... claims under the FECA? (a) Notice of injury, claims and certain specified reports shall be made on forms...

  2. 20 CFR 10.7 - What forms are needed to process claims under the FECA?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... Form No. Title (1) CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay... Traumatic Injury or Occupational Disease (8) CA-7a Time Analysis Form (9) CA-7b Leave Buy Back (LBB... claims under the FECA? (a) Notice of injury, claims and certain specified reports shall be made on forms...

  3. 44 CFR 11.74 - Claims not allowed.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... business. Claims are not payable for property normally used for business or profit. (9) Unserviceable... arose during the conduct of personal business are not payable. (2) Subrogation claims. Claims based upon..., insurance policies, money orders, and traveler's checks. (12) Government property. Claims are not payable...

  4. 40 CFR 14.5 - Who may file a claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Who may file a claim. 14.5 Section 14.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL EMPLOYEE PERSONAL PROPERTY CLAIMS § 14.5 Who may file a claim. A claim may be filed by an employee or by his/her authorized agent or legal...

  5. 40 CFR 14.7 - Where to file a claim.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Where to file a claim. 14.7 Section 14.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL EMPLOYEE PERSONAL PROPERTY CLAIMS § 14.7 Where to file a claim. An employee or his/her representative may file a claim with his/her...

  6. 40 CFR 14.7 - Where to file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Where to file a claim. 14.7 Section 14.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL EMPLOYEE PERSONAL PROPERTY CLAIMS § 14.7 Where to file a claim. An employee or his/her representative may file a claim with his/her...

  7. 40 CFR 14.5 - Who may file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Who may file a claim. 14.5 Section 14.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL EMPLOYEE PERSONAL PROPERTY CLAIMS § 14.5 Who may file a claim. A claim may be filed by an employee or by his/her authorized agent or legal...

  8. 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…

  9. 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...

  10. 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)

  11. 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…

  12. Examining the individual and perceived neighborhood associations of leisure-time physical activity in persons with spinal cord injury.

    PubMed

    Arbour-Nicitopoulos, Kelly P; Martin Ginis, Kathleen A; Wilson, Philip M

    2010-05-01

    Theory of Planned Behavior (TPB) constructs have been shown to be useful for explaining leisure-time physical activity (LTPA) in persons with spinal cord injury (SCI). However, other factors not captured by the TPB may also be important predictors of LTPA for this population. The purpose of this study is to examine the role of neighborhood perceptions within the context of the TPB for understanding LTPA in persons living with SCI. This is a cross-sectional analysis (n = 574) using structural equation modeling involving measures of the TPB constructs, perceived neighborhood esthetics and sidewalks, and LTPA. TPB constructs explained 57% of the variance in intentions and 12% of the variance in behavior. Inclusion of the neighborhood variables to the model resulted in an additional 1% of the variance explained in intentions, with esthetics exhibiting significant positive relationships with the TPB variables. Integrating perceived neighborhood esthetics into the TPB framework provides additional understanding of LTPA intentions in persons living with SCI.

  13. Neuropsychiatric disorders in persons with severe traumatic brain injury: prevalence, phenomenology, and relationship with demographic, clinical, and functional features.

    PubMed

    Ciurli, Paola; Formisano, Rita; Bivona, Umberto; Cantagallo, Anna; Angelelli, Paola

    2011-01-01

    To characterize neuropsychiatric symptoms in a large group of individuals with severe traumatic brain injury (TBI) and to correlate these symptoms with demographic, clinical, and functional features. The Neuropsychiatric Inventory (NPI), a frequently used scale to assess behavioral, emotional, and motivational disorders in persons with neurological diseases, was administered to a sample of 120 persons with severe TBI. Controls were 77 healthy subjects. A wide range of neuropsychiatric symptoms was found in the population with severe TBI: apathy (42%), irritability (37%), dysphoria/depressed mood (29%), disinhibition (28%), eating disturbances (27%), and agitation (24%). A clear relationship was also found with other demographic and clinical variables. Neuropsychiatric disorders constitute an important part of the comorbidity in populations with severe TBI. Our study emphasizes the importance of integrating an overall assessment of cognitive disturbances with a specific neuropsychiatric evaluation to improve clinical understanding and treatment of persons with TBI.

  14. 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

  15. Time and Effort Required by Persons with Spinal Cord Injury to Learn to Use a Powered Exoskeleton for Assisted Walking.

    PubMed

    Kozlowski, Allan J; Bryce, Thomas N; Dijkers, Marcel P

    2015-01-01

    Powered exoskeletons have been demonstrated as being safe for persons with spinal cord injury (SCI), but little is known about how users learn to manage these devices. To quantify the time and effort required by persons with SCI to learn to use an exoskeleton for assisted walking. A convenience sample was enrolled to learn to use the first-generation Ekso powered exoskeleton to walk. Participants were given up to 24 weekly sessions of instruction. Data were collected on assistance level, walking distance and speed, heart rate, perceived exertion, and adverse events. Time and effort was quantified by the number of sessions required for participants to stand up, walk for 30 minutes, and sit down, initially with minimal and subsequently with contact guard assistance. Of 22 enrolled participants, 9 screen-failed, and 7 had complete data. All of these 7 were men; 2 had tetraplegia and 5 had motor-complete injuries. Of these, 5 participants could stand, walk, and sit with contact guard or close supervision assistance, and 2 required minimal to moderate assistance. Walk times ranged from 28 to 94 minutes with average speeds ranging from 0.11 to 0.21 m/s. For all participants, heart rate changes and reported perceived exertion were consistent with light to moderate exercise. This study provides preliminary evidence that persons with neurological weakness due to SCI can learn to walk with little or no assistance and light to somewhat hard perceived exertion using a powered exoskeleton. Persons with different severities of injury, including those with motor complete C7 tetraplegia and motor incomplete C4 tetraplegia, may be able to learn to use this device.

  16. 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.

  17. Time and Effort Required by Persons with Spinal Cord Injury to Learn to Use a Powered Exoskeleton for Assisted Walking

    PubMed Central

    Bryce, Thomas N.; Dijkers, Marcel P.

    2015-01-01

    Background: Powered exoskeletons have been demonstrated as being safe for persons with spinal cord injury (SCI), but little is known about how users learn to manage these devices. Objective: To quantify the time and effort required by persons with SCI to learn to use an exoskeleton for assisted walking. Methods: A convenience sample was enrolled to learn to use the first-generation Ekso powered exoskeleton to walk. Participants were given up to 24 weekly sessions of instruction. Data were collected on assistance level, walking distance and speed, heart rate, perceived exertion, and adverse events. Time and effort was quantified by the number of sessions required for participants to stand up, walk for 30 minutes, and sit down, initially with minimal and subsequently with contact guard assistance. Results: Of 22 enrolled participants, 9 screen-failed, and 7 had complete data. All of these 7 were men; 2 had tetraplegia and 5 had motor-complete injuries. Of these, 5 participants could stand, walk, and sit with contact guard or close supervision assistance, and 2 required minimal to moderate assistance. Walk times ranged from 28 to 94 minutes with average speeds ranging from 0.11 to 0.21 m/s. For all participants, heart rate changes and reported perceived exertion were consistent with light to moderate exercise. Conclusion: This study provides preliminary evidence that persons with neurological weakness due to SCI can learn to walk with little or no assistance and light to somewhat hard perceived exertion using a powered exoskeleton. Persons with different severities of injury, including those with motor complete C7 tetraplegia and motor incomplete C4 tetraplegia, may be able to learn to use this device. PMID:26364280

  18. 40 CFR 14.9 - Approval and payment of claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... employee by persons specified in § 14.5 in the following order: (1) The spouse's claim. (2) A child's claim... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Approval and payment of claims. 14.9 Section 14.9 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL EMPLOYEE PERSONAL PROPERTY...

  19. A new perspective: a vulnerable population framework to guide research and practice for persons with traumatic brain injury.

    PubMed

    Bay, Esther; Kreulen, Grace J; Shavers, Clarissa Agee; Currier, Connie

    2006-01-01

    Recovery from traumatic brain injury (TBI) can be a tumultuous lifelong and expensive process. Guided therapies for community integration within community systems are a focus of treating therapists around the world, yet there are no published discussions concerning the most fitting community context. We propose a theoretical approach for practice and research using Flaskerud and Winslow's conceptual model of vulnerable populations. Using the model constructs of health status, resource availability, and increased relative risk, we offer empirical support for proposed construct relationships applied to persons with traumatic brain injury. We then propose that interventions for health promotion, acute care, and rehabilitation or chronic disease management have a community focus, and we identify relevant goals for community-based practice and research.

  20. One-leg balance is an important predictor of injurious falls in older persons.

    PubMed

    Vellas, B J; Wayne, S J; Romero, L; Baumgartner, R N; Rubenstein, L Z; Garry, P J

    1997-06-01

    To test the hypothesis that one-leg balance is a significant predictor of falls and injurious falls. Analysis of data from a longitudinal cohort study. Healthy, community-living volunteers older than age 60 enrolled in the Albuquerque Falls Study and followed for 3 years (N = 316; mean age 73 years). Falls and injurious falls detected via reports every other month. Baseline measures of demographics, history, physical examination, Iowa Self Assessment Inventory, balance and gait assessment, and one-leg balance (ability to stand unassisted for 5 seconds on one leg). At baseline, 84.5% of subjects could perform one-leg balance. (Impairment was associated with older age and gait abnormalities.) Over the 3-year follow-up, 71% experienced a fall and 22% an injurious fall. The only independent significant predictor of all falls using logistic regression was age greater than 73. However, impaired one-leg balance was the only significant independent predictor of injurious falls (relative risk: 2.13; 95% CI: 1.04, 4.34; P = .03). One-leg balance appears to be a significant and easy-to-administer predictor of injurious falls, but not of all falls. In our study, it was the strongest individual predictor. However, no single factor seems to be accurate enough to be relied on as a sole predictor of fall risk or fall injury risk because so many diverse factors are involved in falling.

  1. 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

    2018-07-01

    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.

  2. 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.

  3. Psychopathology and Borderline Personality Pathology Associated with Lifetime Self-Injurious Behavior in Adolescent Psychiatric Inpatients and Detainees.

    PubMed

    Koenig, Julian; Brunner, Romuald; Schmidt, Johannes Michael; Parzer, Peter; Resch, Franz; Kaess, Michael

    2017-11-01

    Self-injurious behavior (SIB) is a widespread phenomenon among adolescent psychiatric inpatients. It is also reported among delinquent adolescents detained in correctional facilities. While previous studies have addressed different functions of SIB within offender populations, here we investigate particular patterns of borderline personality pathology and psychopathology underlying SIB in both adolescent psychiatric inpatients and detainees. Adolescent psychiatric inpatients and detainees were recruited consecutively. Participants completed self-reports on SIB, suicidal thoughts and behavior, borderline personality pathology, and general psychopathology. Predictors of lifetime SIB by group were analyzed. Psychiatric inpatients (n = 77) and detainees (n = 50) did not differ with respect to lifetime SIB (57.14 % versus 54.00 %), whereas SIB within the past year did (67.53 % versus 14 %; χ2 (1) = 6.158, p = .013). Psychiatric inpatients reported greater emotional problems (t (125) = 5.109, p < .0001) and greater borderline personality pathology. Those with lifetime SIB were characterized by greater emotional problems and borderline personality pathology, independent of their group. Results from regression analyses suggest no group-specific predictors of lifetime SIB. Although psychiatric inpatients endorse greater psychopathological distress, lifetime SIB among adolescent psychiatric inpatients and detainees is associated with similar patterns of psychopathology and borderline personality pathology.

  4. Self-rated health among persons with spinal cord injury: What is the role of physical ability?

    PubMed Central

    Machacova, Katerina; Lysack, Cathy; Neufeld, Stewart

    2011-01-01

    Objectives Self-rated health (SRH) is a powerful concept that has greatly advanced our understanding of health and health outcomes. The SRH measure has become increasingly common in health research. Yet, puzzles remain about what shapes SRH ratings. The absence of knowledge is particularly acute in the context of disability. The aim of this study was to examine the relationship between SRH and self-rated physical ability in a sample of individuals with spinal cord injury (SCI). Methods Data from 140 eligible participants drawn from a study of life in the community after SCI were analyzed. The study, cross-sectional in design, was conducted in a large urban city in the mid-western United States. Basic statistics such as ANOVA and chi-square tests were performed as appropriate, and a multiple linear regression analysis modeled the relationship between SRH and physical ability adjusting for potential confounding variables. Results Self-rated physical ability was significantly associated with SRH after controlling for relevant covariates (P < 0.001). An analysis of the interaction between physical ability and level of injury revealed that the relationship was significant for persons with paraplegia but not for persons with tetraplegia. Conclusions This study provides evidence that self-rated physical ability is an important factor associated with SRH for persons with SCI, but that the strength of the relationship depends on level of injury (paraplegia vs. tetraplegia). The challenge for future research is to replicate the study using a more comprehensive measure of physical ability and to ask how beliefs in one's ability to do those activities that are most meaningful and desired shape SRH. Only in this way will our understanding of the physical ability–SRH relationship be clarified. PMID:21756564

  5. 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…

  6. 20 CFR 362.3 - Who may file a claim.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...' PERSONAL PROPERTY CLAIMS § 362.3 Who may file a claim. A claim may be filed by an employee, by his spouse... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Who may file a claim. 362.3 Section 362.3... or sister, or both, may file the claim and be entitled to payment in that order of priority. ...

  7. 20 CFR 362.3 - Who may file a claim.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...' PERSONAL PROPERTY CLAIMS § 362.3 Who may file a claim. A claim may be filed by an employee, by his spouse... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Who may file a claim. 362.3 Section 362.3... or sister, or both, may file the claim and be entitled to payment in that order of priority. ...

  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. 22 CFR 72.24 - Conflicting claims.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Conflicting claims. 72.24 Section 72.24 Foreign Relations DEPARTMENT OF STATE PROTECTION AND WELFARE OF AMERICANS, THEIR PROPERTY AND ESTATES DEATHS AND ESTATES Personal Estates of Deceased United States Citizens and Nationals § 72.24 Conflicting claims...

  10. 20 CFR 410.705 - Duplicate claims.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Administration—denied or pending with the Office of Workers' Compensation Programs. A person whose part B claim... the Office of Workers' Compensation Programs which is pending or has been denied shall be entitled to a review of the part C claim by the Office of Workers' Compensation Programs under the BLBRA of 1977...

  11. The effect of sports on level of community integration as reported by persons with spinal cord injury.

    PubMed

    Hanson, C S; Nabavi, D; Yuen, H K

    2001-01-01

    The purpose of this study was to determine whether participation in sports by persons with spinal cord injuries (SCIs) affected level of community integration as defined by the World Health Organization and as measured by the Craig Handicap Assessment and Reporting Technique (CHART). Forty-eight participants were recruited from a camp for persons with physical disabilities as well as from SCI support groups. Participants were divided into groups of athletes (n = 30) and nonathletes (n = 18) on the basis of their self-reported level of sports participation. Athletes scored significantly higher on four of five subsections of the CHART (physical independence, mobility, occupation, social integration), indicating greater levels of community integration than nonathletes. These findings extend the literature outlining the physical and psychological benefits of sports. Occupational therapists have a unique opportunity to use the occupation of sports to integrate the roots of the profession with the cultural demands of society.

  12. 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/.

  13. 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

  14. Prediction of limb lean tissue mass from bioimpedance spectroscopy in persons with chronic spinal cord injury

    PubMed Central

    Cirnigliaro, Christopher M.; La Fountaine, Michael F.; Emmons, Racine; Kirshblum, Steven C.; Asselin, Pierre; Spungen, Ann M.; Bauman, William A.

    2013-01-01

    Background Bioimpedance spectroscopy (BIS) is a non-invasive, simple, and inexpensive modality that uses 256 frequencies to determine the extracellular volume impedance (ECVRe) and intracellular volume impedance (ICVRi) in the total body and regional compartments. As such, it may have utility as a surrogate measure to assess lean tissue mass (LTM). Objective To compare the relationship between LTM from dual-energy X-ray absorptiometry (DXA) and BIS impedance values in spinal cord injury (SCI) and able-bodied (AB) control subjects using a cross-sectional research design. Methods In 60 subjects (30 AB and 30 SCI), a total body DXA scan was used to obtain total body and leg LTM. BIS was performed to measure the impedance quotient of the ECVRe and ICVRi in the total body and limbs. Results BIS-derived ECVRe yielded a model for LTM in paraplegia, tetraplegia, and control for the right leg (RL) (R2 = 0.75, standard errors of estimation (SEE) = 1.02 kg, P < 0.0001; R2 = 0.65, SEE = 0.91 kg, P = 0.0006; and R2 = 0.54, SEE = 1.31 kg, P < 0.0001, respectively) and left leg (LL) (R2 = 0.76, SEE = 1.06 kg, P < 0.0001; R2 = 0.64, SEE = 0.83 kg, P = 0.0006; and R2 = 0.54, SEE = 1.34 kg, P < 0.0001, respectively). The ICVRi was similarly predictive of LTM in paraplegia, tetraplegia, and AB controls for the RL (R2 = 0.85, SEE = 1.31 kg, P < 0.0001; R2 = 0.52, SEE = 0.95 kg, P = 0.003; and R2 = 0.398, SEE = 1.46 kg, P = 0.0003, respectively) and LL (R2 = 0.62, SEE = 1.32 kg, P = 0.0003; R2 = 0.57, SEE = 0.91 kg, P = 0.002; and R2 = 0.42, SEE = 1.31 kg, P = 0.0001, respectively). Conclusion Findings demonstrate that the BIS-derived impedance quotients for ECVRe and ICVRi may be used as surrogate markers to track changes in leg LTM in persons with SCI. PMID:23941792

  15. Investigating the over‐representation of older persons in do‐it‐yourself home maintenance injury and barriers to prevention

    PubMed Central

    Ashby, K; Ozanne‐Smith, J; Fox, B

    2007-01-01

    Objective To examine why older persons undertake high‐risk do‐it‐yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low‐risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Design Exploratory qualitative study using focus‐group methodology. Setting and subjects Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Results Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost‐effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. Conclusions This research is an important first step in understanding issues facing community‐dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs. PMID:17916890

  16. Investigating the over-representation of older persons in do-it-yourself home maintenance injury and barriers to prevention.

    PubMed

    Ashby, K; Ozanne-Smith, J; Fox, B

    2007-10-01

    To examine why older persons undertake high-risk do-it-yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low-risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Exploratory qualitative study using focus-group methodology. Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost-effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. This research is an important first step in understanding issues facing community-dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs.

  17. 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.

  18. Compensation for psychiatric injury: evolution of a law of nervous shock.

    PubMed

    Griffith, Richard

    2006-09-01

    District nurses will be well aware that if a person receives an injury because of someone else's negligence they are entitled to compensation for the harm that has been caused. However, where the injury is in the form of psychiatric harm the law has traditionally imposed rules that set out the conditions to be met before a successful claim for damages can be made. Even in today's enlightened society the law still does not always treat a psychiatric injury in the same way as a physical injury. In this article Richard Griffith outlines the development of the law in relation to psychiatric injury--historically called "nervous shock"--and considers the current approach to claims for damages where a person suffers psychiatric harm because of another's negligent act.

  19. Small Claims Court.

    ERIC Educational Resources Information Center

    McKitric, Eloise; Davis, Janet

    The study examined individuals and companies who used small claims courts and the results of decisions reached in small claims cases. A review of studies including an empirical study of two Ohio small claims courts monitored for 12 months made it clear that small claims courts need to be examined to determine if utilization and accessibility to…

  20. 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.

  1. 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.

  2. 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…

  3. 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,…

  4. 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…

  5. Functional electrical stimulation cycling improves body composition, metabolic and neural factors in persons with spinal cord injury.

    PubMed

    Griffin, L; Decker, M J; Hwang, J Y; Wang, B; Kitchen, K; Ding, Z; Ivy, J L

    2009-08-01

    Persons with spinal cord injury (SCI) are at a heightened risk of developing type II diabetes and cardiovascular disease. The purpose of this investigation was to conduct an analysis of metabolic, body composition, and neurological factors before and after 10 weeks of functional electrical stimulation (FES) cycling in persons with SCI. Eighteen individuals with SCI received FES cycling 2-3 times per week for 10 weeks. Body composition was analyzed by dual X-ray absorptiometry. The American Spinal Injury Association (ASIA) neurological classification of SCI test battery was used to assess motor and sensory function. An oral glucose tolerance (OGTT) and insulin-response test was performed to assess blood glucose control. Additional metabolic variables including plasma cholesterol (total-C, HDL-C, LDL-C), triglyceride, and inflammatory markers (IL-6, TNF-alpha, and CRP) were also measured. Total FES cycling power and work done increased with training. Lean muscle mass also increased, whereas, bone and adipose mass did not change. The ASIA motor and sensory scores for the lower extremity significantly increased with training. Blood glucose and insulin levels were lower following the OGTT after 10 weeks of training. Triglyceride levels did not change following training. However, levels of IL-6, TNF-alpha, and CRP were all significantly reduced.

  6. 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.

  7. 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

  8. 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

    ... REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.9 What conditions apply to... transfer of real property for economic development contains an indemnification provision, the person or... indemnification agreement if DOE determines that indemnification is essential for the purpose of facilitating...

  9. [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.

  10. Lower limb injuries in New Zealand Defence Force personnel: descriptive epidemiology.

    PubMed

    Davidson, Peter L; Chalmers, David J; Wilson, Barry D; McBride, David

    2008-04-01

    To describe the epidemiology of lower limb injuries in the New Zealand Defence Force (NZDF). Data from all NZDF lower limb injury claims from an 11-month period were examined for type, site, and circumstances of injury. Both injury codes and narratives were analysed, allowing each injury event to be classified according to mechanism of injury, object involvement, and activity at the time of injury, as well as type and site. The commonest lower limb musculoskeletal injuries were ankle sprains or strains (35%) and knee sprains or strains (16%). Most commonly, injuries were due to acute over-exertion (37%), involved no other person (50%), and occurred while running (28%) or playing team sports (25%). The injury rate for recruits was more than five times that of trained personnel. Potential interventions should target ankle sprains primarily, but also knee sprains and fractures. Fractures, while accounting for only 6% of lower limb injuries, should be a priority because of their high medical and time-lost costs. Interventions must also take into account the high incidence of injuries involving individuals alone and sustained during recruit training. The study also demonstrated that analysis of military injury narratives provides valuable extra information on injury causation and the circumstances of injury, and allows more accurate characterisation of the injury process. This study will provide the basis for development of an injury prevention strategy for lower limb training injuries in the NZDF.

  11. 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.

  12. 13 CFR 114.103 - Who may file a claim?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... THE FEDERAL TORT CLAIMS ACT AND REPRESENTATION AND INDEMNIFICATION OF SBA EMPLOYEES Administrative.... Death The executor, administrator, or legal representative of the decedent's estate, or any other person...

  13. 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.

  14. 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.

  15. Anthropometric and biomechanical characteristics of body segments in persons with spinal cord injury.

    PubMed

    Fang, Y; Morse, L R; Nguyen, N; Tsantes, N G; Troy, K L

    2017-04-11

    People with spinal cord injury (SCI) experience bone and muscle loss in their paralyzed limbs that is most rapid and severe in the first 3years after injury. Restoration of mechanical loading through therapeutic physical activity may potentially slow or reverse post-SCI bone loss, however, therapeutic targets cannot be developed without accurate biomechanical models. Obesity is prevalent among SCI population, and it alters body composition and further affects parameters of these models. Here, clinical whole body dual-energy X-ray absorptiometry data from people with acute (n=39) and chronic (n=61) SCI were analyzed to obtain anthropometric parameters including segment masses, center of mass location, and radius of gyration for both obese and non-obese individuals. Chronic SCI was associated with higher normalized trunk mass of 3.2%BW and smaller normalized leg mass of 1.8%BW in males, but no significant changes in segment centers of mass or radius of gyration. People with chronic SCI had 58.6% lean mass in the trunk, compared to 66.6% lean mass in those with acute SCI (p=0.01), with significant changes in all segments. Obesity was associated with an increase in trunk mass proportion of 3.1%BW, proximal shifts in thigh and upper arm center of mass, and changes to thigh and shank radius of gyration. The data presented here can be used to accurately represent the anthropometrics of SCI population in biomechanical studies, considering obesity and injury duration. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. 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.

  17. Stuck in the middle: The emotional labours of case managers in the personal injury compensation system.

    PubMed

    Newnam, Sharon; Petersen, Alan; Keleher, Helen; Collie, Alex; Vogel, Adam; McClure, Rod

    2016-10-17

    Case managers within injury compensation systems are confronted with various emotional demands. Employing the concept of emotional labour, this paper explores distinctive aspects of these demands. The findings are drawn from focus groups with 21 Australian case managers. Case managers work was characterised by extra-role commitments, emotional control, stress and balancing tensions arising from differing stakeholder expectations about outcomes related to compensation and return to work. By examining the experiences of case managers, the findings add to the literature on the emotional labour of front line service workers, especially with respect to the demands involved in managing the conflicting demands of work.

  18. 32 CFR 536.120 - Claims payable as maritime claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable as maritime claims. 536.120... ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.120 Claims payable as maritime claims. A claim is cognizable under this subpart if it arises in or on a maritime location, involves some...

  19. Effect of chronic activity-based therapy on bone mineral density and bone turnover in persons with spinal cord injury

    PubMed Central

    Harness, Eric T.; Witzke, Kara A.

    2014-01-01

    Purpose Osteoporosis is a severe complication of spinal cord injury (SCI). Many exercise modalities are used to slow bone loss, yet their efficacy is equivocal. This study examined the effect of activity-based therapy (ABT) targeting the lower extremities on bone health in individuals with SCI. Methods Thirteen men and women with SCI (age and injury duration = 29.7 ± 7.8 and 1.9 ± 2.7 years) underwent 6 months of ABT. At baseline and after 3 and 6 months of training, blood samples were obtained to assess bone formation (serum procollagen type 1 N propeptide (PINP) and bone resorption (serum C-terminal telopeptide of type I collagen (CTX), and participants underwent dual-energy X-ray absorptiometry scans to obtain total body and regional estimates of bone mineral density (BMD). Results Results demonstrated significant increases (p < 0.05) in spine BMD (+4.8 %; 1.27 ± 0.22–1.33 ± 0.24 g/cm2) and decreases (p < 0.01) in total hip BMD (−6.1 %; 0.98 ± 0.18–0.91 ± 0.16 g/cm2) from 0 to 6 months of training. BMD at the bilateral distal femur (−7.5 to −11.0 %) and proximal tibia (− 8.0 to −11.2 %) declined but was not different (p > 0.05) versus baseline. Neither PINP nor CTX was altered (p> 0.05) with training. Conclusions Chronic activity-based therapy did not reverse bone loss typically observed soon after injury, yet reductions in BMD were less than the expected magnitude of decline in lower extremity BMD in persons with recent SCI. PMID:24097172

  20. The Minnesota Multiphasic Personality Inventory-2-RF in Treatment-Seeking Veterans with History of Mild Traumatic Brain Injury.

    PubMed

    Jurick, S M; Crocker, L D; Keller, A V; Hoffman, S N; Bomyea, J; Jacobson, M W; Jak, A J

    2018-05-30

    This study examined the Minnesota Multiphasic Personality Inventory-Second Edition-Restructured Form (MMPI-2-RF) to better understand symptom presentation in a sample of treatment-seeking Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with self-reported history of mild traumatic brain injury (mTBI). Participants underwent a comprehensive clinical neuropsychological battery including performance and symptom validity measures and self-report measures of depressive, posttraumatic, and post-concussive symptomatology. Those with possible symptom exaggeration (SE+) on the MMPI-2-RF were compared with those without (SE-) with regard to injury, psychiatric, validity, and cognitive variables. Between 50% and 87% of participants demonstrated possible symptom exaggeration on one or more MMPI-2-RF validity scales, and a large majority were elevated on content scales related to cognitive, somatic, and emotional complaints. The SE+ group reported higher depressive, posttraumatic, and post-concussive symptomatology, had higher scores on symptom validity measures, and performed more poorly on neuropsychological measures compared with the SE- group. There were no group differences with regard to injury variables or performance validity measures. Participants were more likely to exhibit possible symptom exaggeration on cognitive/somatic compared with traditional psychopathological validity scales. A sizable portion of treatment-seeking OEF/OIF Veterans demonstrated possible symptom exaggeration on MMPI-2-RF validity scales, which was associated with elevated scores on self-report measures and poorer cognitive performance, but not higher rates of performance validity failure, suggesting symptom and performance validity are distinct concepts. These findings have implications for the interpretation of clinical data in the context of possible symptom exaggeration and treatment in Veterans with persistent post-concussive symptoms.

  1. Do Personal Factors or Types of Physical Tasks Predict Workplace Injury?

    PubMed

    Oranye, Nelson Ositadimma; Wallis, Bernadine; Roer, Kim; Archer-Heese, Gail; Aguilar, Zaklina

    2016-04-01

    Occupational health research has shown that certain worker and job characteristics are risk factors for workplace injuries. Workers who engage in physically demanding jobs, especially those jobs that involve repetitive motion, are at greater risk for work-related musculoskeletal disorders (WMSD). These risks are particularly prevalent in the health care sector. It is often reported that nurses are at higher risk of workplace musculoskeletal injury than other health care workers due to frequent lifting and transfer of patients and the prevalence of workplace violence. However, many analyses of the physical requirements of jobs do not consider the modifying effect of time spent on a physical task and the risk of WMSD. This study compared the risks of WMSD among workers in health care facilities based on the type of physical tasks and amount of time workers spent on such tasks. Workers who worked longer on a physical task reported more WMSD than those who spent less time on the same physical task. The risk of WMSD was twice as high (odds ratio [OR] = 2.3) among workers who sit less than 2 hours each day compared with those who sit longer. This study found that physical tasks associated with health care jobs and the amount of time spent on these tasks constitutes serious risk factors for WMSD. © 2016 The Author(s).

  2. NeuroRecovery Network provides standardization of locomotor training for persons with incomplete spinal cord injury.

    PubMed

    Morrison, Sarah A; Forrest, Gail F; VanHiel, Leslie R; Davé, Michele; D'Urso, Denise

    2012-09-01

    To illustrate the continuity of care afforded by a standardized locomotor training program across a multisite network setting within the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN). Single patient case study. Two geographically different hospital-based outpatient facilities. This case highlights a 25-year-old man diagnosed with C4 motor incomplete spinal cord injury with American Spinal Injury Association Impairment Scale grade D. Standardized locomotor training program 5 sessions per week for 1.5 hours per session, for a total of 100 treatment sessions, with 40 sessions at 1 center and 60 at another. Ten-meter walk test and 6-minute walk test were assessed at admission and discharge across both facilities. For each of the 100 treatment sessions percent body weight support, average, and maximum treadmill speed were evaluated. Locomotor endurance, as measured by the 6-minute walk test, and overground gait speed showed consistent improvement from admission to discharge. Throughout training, the patient decreased the need for body weight support and was able to tolerate faster treadmill speeds. Data indicate that the patient continued to improve on both treatment parameters and walking function. Standardization across the NRN centers provided a mechanism for delivering consistent and reproducible locomotor training programs across 2 facilities without disrupting training or recovery progression. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. 27 CFR 70.123 - Claims for credit or refund.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., documentary evidence to establish the legal authority of the fiduciary need not accompany the claim, provided... necessary documentary evidence should accompany the claim. A claim may be executed by an agent of the person... Office of Management and Budget under control number 1512-0141) (26 U.S.C. 6402) [T.D. ATF-251, 52 FR...

  4. 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...

  5. 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.

  6. Incidence, patterns and severity of reported unintentional injuries in Pakistan for persons five years and older: results of the National Health Survey of Pakistan 1990-94.

    PubMed

    Fatmi, Zafar; Hadden, Wilbur C; Razzak, Junaid A; Qureshi, Huma I; Hyder, Adnan A; Pappas, Gregory

    2007-07-10

    National level estimates of injuries are not readily available for developing countries. This study estimated the annual incidence, patterns and severity of unintentional injuries among persons over five years of age in Pakistan. National Health Survey of Pakistan (NHSP 1990-94) is a nationally representative survey of the household. Through a two-stage stratified design, 18, 315 persons over 5 years of age were interviewed to estimate the overall annual incidence, patterns and severity of unintentional injuries for males and females in urban and rural areas over the preceding one year. Weighted estimates were computed adjusting for complex survey design using surveyfreq and surveylogistic option of SAS 9.1 software. The overall annual incidence of all unintentional injuries was 45.9 (CI: 39.3-52.5) per 1000 per year; 59.2 (CI: 49.2-69.2) and 33.2 (CI: 27.0-39.4) per 1000 per year among males and females over five years of age, respectively. An estimated 6.16 million unintentional injuries occur in Pakistan annually among persons over five years of age. Urban and rural injuries were 55.9 (95% CI: 48.1-63.7) and 41.2 (95% CI: 32.2-50.0) per 1000 per year, respectively. The annual incidence of injuries due to falls were 22.2 (95% CI: 18.0-26.4), poisoning 3.3 (95%CI: 0.5-6.1) and burn was 1.5 (95%CI: 0.9-2.1) per 1000 per year. The majority of injuries occurred at home 19.2 (95%CI: 16.0-22.4) or on the roads 17.0 (95%CI: 13.8-20.2). Road traffic/street, school and urban injuries were more likely to result in handicap. There is high burden of unintentional injuries among persons over five years of age in Pakistan. These results are useful to plan further studies and prioritizing prevention programs on injuries nationally and other developing countries with similar situation.

  7. Care needs of persons with long-term spinal cord injury living at home in the Netherlands.

    PubMed

    van Loo, M A; Post, M W M; Bloemen, J H A; van Asbeck, F W A

    2010-05-01

    Cross-sectional survey. To describe the care received, care needs and preventability of secondary conditions according to persons with long-term spinal cord injury (SCI) living at home. The Netherlands. A questionnaire was sent to all members of the Dutch SCI Patient Organisation. From a list of 26 SCI secondary conditions, participants chose the five conditions they perceived as most important. For each of these conditions, they described the type of care they received, their need for (extra) care and its preventability. Response rate was 45% (n=453) and mean time after injury was 13.3 years. In case of secondary conditions, participants were more likely to visit their general practitioner (58%) than another medical specialist (29%) or rehabilitation specialist (25%). For all most-important secondary conditions, care was received in 47% and care, or extra care, was needed in 41.3%. Treatment was the type of care most often received (29.5%) and needed (17.2%). However, for information and psychosocial care, the care needed (12.2 and 9.9%, respectively) was higher than the care received (7.6 and 5.9%, respectively). Thirty-four percent of all most-important secondary conditions were perceived as preventable, the rate increasing to 52.8% for pressure sores, of which 29.9% were considered to be preventable by the participants themselves. This study showed substantial unmet care needs in persons with long-term SCI living at home and underlines the further improvement of long-term care for this group. Information, psychosocial care and self-efficacy seem to be the areas to be enhanced.

  8. 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.

  9. 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.

  10. Claims, errors, and compensation payments in medical malpractice litigation.

    PubMed

    Studdert, David M; Mello, Michelle M; Gawande, Atul A; Gandhi, Tejal K; Kachalia, Allen; Yoon, Catherine; Puopolo, Ann Louise; Brennan, Troyen A

    2006-05-11

    In the current debate over tort reform, critics of the medical malpractice system charge that frivolous litigation--claims that lack evidence of injury, substandard care, or both--is common and costly. Trained physicians reviewed a random sample of 1452 closed malpractice claims from five liability insurers to determine whether a medical injury had occurred and, if so, whether it was due to medical error. We analyzed the prevalence, characteristics, litigation outcomes, and costs of claims that lacked evidence of error. For 3 percent of the claims, there were no verifiable medical injuries, and 37 percent did not involve errors. Most of the claims that were not associated with errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not result in compensation; most that involved injuries due to error did (653 of 889 [73 percent]). Payment of claims not involving errors occurred less frequently than did the converse form of inaccuracy--nonpayment of claims associated with errors. When claims not involving errors were compensated, payments were significantly lower on average than were payments for claims involving errors (313,205 dollars vs. 521,560 dollars, P=0.004). Overall, claims not involving errors accounted for 13 to 16 percent of the system's total monetary costs. For every dollar spent on compensation, 54 cents went to administrative expenses (including those involving lawyers, experts, and courts). Claims involving errors accounted for 78 percent of total administrative costs. Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant. Copyright 2006 Massachusetts Medical Society.

  11. Nature of Medical Malpractice Claims Against Radiation Oncologists

    SciTech Connect

    Marshall, Deborah; Tringale, Kathryn; Connor, Michael

    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

  12. Medical and social issues related to posttraumatic seizures in persons with traumatic brain injury.

    PubMed

    Bushnik, Tamara; Englander, Jeffrey; Duong, Thao

    2004-01-01

    The incidence of late posttraumatic seizures (LPTS) in individuals with traumatic brain injury (TBI) ranges anywhere from 5% to 18.9% in civilian populations up to 32% to 50% in military personnel. This article reviews the current knowledge about the incidence and prevalence of LPTS following a TBI, the risk factors for developing LPTS, and the options available for preventing the development of LPTS. The psychosocial ramifications of LPTS following a TBI have not been well explored. As a result, the psychosocial findings from the current literature on epilepsy will be reviewed with the hope that the need for future TBI outcomes research to investigate the impact of LPTS following a TBI or, at least, to include LPTS as a potential contributing factor will be recognized.

  13. Increased cardiovascular disease risk in Swedish persons with paraplegia: The Stockholm spinal cord injury study.

    PubMed

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

    2010-05-01

    Comparison of prevalence of cardiovascular disease risks in persons with chronic traumatic paraplegia with those in the general population. Cross-sectional comparative study. A total of 135 individuals, age range 18-79 years, with chronic (> or = 1 year) traumatic paraplegia. The prevalences of diabetes mellitus, dyslipidaemia, hypertension, overweight, and smoking, were assessed in the study population and were compared with an age- and gender-matched sample of the general population in the region under study. History of myocardial infarction and medication for dyslipidaemia, hypertension, and diabetes mellitus were also recorded. chi2 tests were used to compare the paraplegic cohort with the general population sample. Significantly more persons with paraplegia reported a history of myocardial infarction (5.9%) than those in the comparison group (0.7%). The prevalences of diabetes mellitus (5.9%), dyslipidaemia (11.1%), and hypertension (14.1%) were also significantly higher in the paraplegic group, as were drug treatment for these disorders. Persons with paraplegia report increased prevalences of diabetes mellitus, hypertension, and dyslipidaemia, in particular, compared with the general population. Population-based screening and therapeutic counter-measures for these conditions may therefore be particularly indicated for this patient group.

  14. Characteristics of balance control in older persons who fall with injury--a prospective study.

    PubMed

    Kurz, Ilan; Oddsson, Lars; Melzer, Itshak

    2013-08-01

    Older adults who have recently fallen demonstrate increased postural sway compared with non-fallers. However, the differences in postural control between older adults who were seriously injured (SI) as a result of a fall, compared with those who fell but were not injured (NSI) and non-fallers (NFs), has not been investigated. The objective of the present study was to investigate the underlying postural control mechanisms related to injuries resulting from a fall. Both traditional postural sway measures of foot center-of-pressure (CoP) displacements and fractal measures, the Stabilogram-Diffusion Analysis (SDA), were used to characterize the postural control. One hundred older adults aged 65-91years were tested during narrow base upright stance in eyes closed condition; falls were monitored over a 1-year period. Forty-nine older adults fell during the 1-year follow-up, 13 were seriously injured as a result of a fall (SI), 36 were not injured (NSI), and 49 were non-fallers (NFs); two passed away. The SDA showed significantly higher short-term diffusion coefficients and critical displacements in SI in the anterior-posterior direction compared with both NSI and NF. However, in the medio-lateral direction there were no statistically significant differences between groups. For the traditional measures of sway, the average anterior-posterior CoP range was also larger in SI individuals. This work suggests that older fallers with a deterioration of anterior-posterior postural control may be at higher risk of serious injury following fall events. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Evaluation of a Community Reintegration Outpatient Program Service for Community-Dwelling Persons with Spinal Cord Injury

    PubMed Central

    Bain, Patricia; 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. PMID:25574397

  16. 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...

  17. 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…

  18. 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

  19. [Negative experiences in childhood, stress and self-injurious behavior and suicidal tendencies in people with borderline personality].

    PubMed

    Blasczyk-Schiep, Sybilla; Jaworska-Andryszewska, Paulina

    2014-06-01

    In the bordeline personality disorder (BPD) a large role ascribe to psychological and psychosocial factors. Studies have shown that more than 70% patients BPD reported experiencing traumatic events in childhood. These people compare with patients with other psychiatric disorders often report history of sexual abuse and experience of violence or neglect. Making self-harming can be a reaction to negative experiences in childhood. The findings are confirming that making self-harming is a frequent symptom of BPD and 70-75% patients show at least one act self-harming. 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 childhood trauma such as sexual, psychological and physical abuse, emotional and physical neglect and to investigate their relation to stress, self-harming and suicidal behavior. In study participated 41 persons with emotionally unstable borderline personality diagnosis. In the group was 32 women and 9 men in age 19-43. The Polish adaptation of standardized questionnaires was used to measure childhood trauma (CTQ), stress (SSI-K), self-injurious behavior (SHI) and suicidal tendencies (RFL-I). In patients with BPD the level of childhood trauma and stress are predictors of self-harming behavior and suicidal tendencies. The mediation analyze showed, that self-harming was an important mediator between sexual abuse and suicidal tendencies. The high stress is the next mediator between sexual abuse and the level of self-harming behavior. A high level of childhood trauma correlates positively with stress, self-harming and suicidal behavior in patients with BPD.

  20. Return to the ED and hospitalisation following minor injuries among older persons treated in the emergency department: predictors among independent seniors within 6 months.

    PubMed

    Lee, Jacques; Sirois, Marie-Josee; Moore, Lynne; Perry, Jeffrey; Daoust, Raoul; Griffith, Lauren; Worster, Andrew; Lang, Eddy; Emond, Marcel

    2015-07-01

    minor traumatic injuries among independent older people have received little attention to date, but increasingly the impact of such injuries is being recognised. we assessed the frequency and predictors of acute health care use, defined as return to the emergency department (ED) or hospitalisation. national multicentre prospective observational study. eight Canadian teaching EDs between April 2009 and April 2013. a total of 1,568 patients aged 65-100 years, independent in basic activities of daily living, discharged from ED following a minor traumatic injury. trained assessors measured baseline data including demographics, functional status, cognition, comorbidities, frailty and injury severity. We then conducted follow-up telephone interviews at 6 months to assess subsequent acute health care use. We used log-binomial regression analyses to identify predictors of acute health care use, and reported relative risks and 95% CIs. participants' mean age was 77.0, 66.4% female, and their injuries included contusions (43.5%), lacerations (25.1%) and fractures (25.4%). The cumulative rate of acute health care use by 6 months post-injury was 21.5% (95% CI: 19.0-24.3%). The strongest predictors of acute health care use within 6 months were cognitive impairment, RR = 1.6 (95% IC: 1.2-2.1) and the mechanism of injury including pedestrian struck or recreational injuries, RR = 1.6 (95% CI 1.2-2.2). among independent community living older persons with a minor injury, cognitive impairment and mechanism of injury were independent risk factors for acute healthcare use. Future studies should look at whether tailored discharge planning can reduce the need for acute health care use. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. 25 CFR 900.190 - Is FTCA the exclusive remedy for a tort claim for personal injury or death resulting from the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION... medical, surgical, dental, or related functions by the contractor in carrying out self-determination...

  2. 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

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION... medical, surgical, dental, or related functions by the contractor in carrying out self-determination...

  3. Depressive symptomatology in persons with spinal cord injury who reside in the community.

    PubMed

    Fuhrer, M J; Rintala, D H; Hart, K A; Clearman, R; Young, M E

    1993-03-01

    Depressive symptomatology was studied in a community-based sample of 100 men and 40 women with spinal cord injury. The mean for the Center for Epidemiologic Studies Depression Scale was higher than that reported previously for the general population, and the mean for women was higher than that for men. Findings from the Mobility dimension of the Craig Handicap Assessment and Reporting Technique (CHART) suggested that differences between men and women in degree of mobility within home and community partly mediate the gender difference in depressive symptomatology. Other CHART dimensions, Social Integration and Occupation, were inversely related with depression scores, although these dimensions did not differentiate men and women. A statistically significant relationship was not obtained between depression and disability, assessed by a self-report version of the Functional Independence Measure, or between depression and impairment, reflected by the ASIA Total Motor Index Score. Depression was not related with the presence of either pressure ulcers or presumptive evidence of urinary tract infection.

  4. Factors Contributing to Failure of Rotator Cuff Surgery in Persons with Work-Related Injuries

    PubMed Central

    Lincoln, Sandra; Axelrod, Terry; Holtby, Richard

    2008-01-01

    Purpose: Shoulder pain is a major musculoskeletal and economic concern in industrialized countries, with the rate of surgical failure reportedly higher in patients injured at work. The purposes of this study were (1) to examine the prevalence of identifiable causes of rotator cuff surgery failure and (2) to examine the relationship among the existence of these causes and outcome scores, patient expectations, and overall satisfaction. Methods: This was a cross-sectional study of patients who experienced continued impairments following surgical treatment for work-related injuries. The primary outcome was a disease-specific measure, the Western Ontario Rotator Cuff (WORC) index. Patients were categorized into two groups based on the existence of an identifiable reason for surgical failure vs. no reason for failure, as demonstrated by clinical and radiologic investigations and decided upon by a shoulder surgeon and a physical therapist. Analyses included a t-test for independent sample means, linear regression, non-parametric Wilcoxon test, and Fisher's exact test. Results: Thirty-eight consecutive patients were included in the study, and 24 causes of surgical failure were identified in 19 patients (50%). Overall, patients with findings of failure were more disabled according to the total WORC index and had higher levels of symptoms, emotional difficulties, and limitations in sports and recreational activities. Expectations and satisfaction levels were not significantly different between groups. Conclusion: Our results indicate that 50% of patients who reported failed surgery had at least one reason to explain their ongoing symptoms, emotional difficulties, and functional limitations. PMID:20145776

  5. In-simulator training of driving abilities in a person with a traumatic brain injury.

    PubMed

    Gamache, Pierre-Luc; Lavallière, Martin; Tremblay, Mathieu; Simoneau, Martin; Teasdale, Normand

    2011-01-01

    This study reports the case of a 23-year-old woman (MC) who sustained a severe traumatic brain injury in 2004. After her accident, her driving license was revoked. Despite recovering normal neuropsychological functions in the following years, MC was unable to renew her license, failing four on-road evaluations assessing her fitness to drive. In hope of an eventual license renewal, MC went through an in-simulator training programme in the laboratory in 2009. The training programme aimed at improving features of MC's driving behaviour that were identified as being problematic in prior on-road evaluations. To do so, proper driving behaviour was reinforced via driving-specific feedback provided during the training sessions. After 25 sessions in the simulator (over a period of 4 months), MC significantly improved various components of her driving. Notably, compared to early sessions, later ones were associated with a reduced cognitive load, less jerky speed profiles when stopping at intersections and better vehicle control and positioning. A 1-year retention test showed most of these improvements were consistent. The learning principles underlying well conducted simulator-based education programmes have a strong scientific basis. A simulator training programme like this one represents a promising avenue for driving rehabilitation. It allows individuals without a driving license to practice and improve their skills in a safe and realistic environment.

  6. 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.

  7. Peripheral Quantitative Computed Tomography: Measurement Sensitivity in Persons With and Without Spinal Cord Injury

    PubMed Central

    Shields, Richard K.; Dudley-Javoroski, Shauna; Boaldin, Kathryn M.; Corey, Trent A.; Fog, Daniel B.; Ruen, Jacquelyn M.

    2012-01-01

    Objectives To determine (1) the error attributable to external tibia-length measurements by using peripheral quantitative computed tomography (pQCT) and (2) the effect these errors have on scan location and tibia trabecular bone mineral density (BMD) after spinal cord injury (SCI). Design Blinded comparison and criterion standard in matched cohorts. Setting Primary care university hospital. Participants Eight able-bodied subjects underwent tibia length measurement. A separate cohort of 7 men with SCI and 7 able-bodied age-matched male controls underwent pQCT analysis. Interventions Not applicable. Main Outcome Measures The projected worst-case tibia-length–measurement error translated into a pQCT slice placement error of ±3mm. We collected pQCT slices at the distal 4% tibia site, 3mm proximal and 3mm distal to that site, and then quantified BMD error attributable to slice placement. Results Absolute BMD error was greater for able-bodied than for SCI subjects (5.87mg/cm3 vs 4.5mg/cm3). However, the percentage error in BMD was larger for SCI than able-bodied subjects (4.56% vs 2.23%). Conclusions During cross-sectional studies of various populations, BMD differences up to 5% may be attributable to variation in limb-length–measurement error. PMID:17023249

  8. [Immobilize the person after injury - problems in the practice of the rescuer].

    PubMed

    Malinowski, Krzysztof

    2016-01-01

    The rescuer often has to deal with patients who have suffered trauma to the bone , including heads, spine, lower and upper limbs. Serious injuries or multiorgan grudges are a frequent result of communicative cases, and a fast but accurate examination is a condition of the success of a rescue operation, putting the preliminary diagnosis and implementing real rescue activities. Delays in a rescue operation or the lack appropriate the equipment is threatening the patient with the permanent disability or even a loss of life. It is important so that Teams of the Medical Rescue, the Aviation emergency ambulance service, individuals of the State Fire Service and Hospital accident wards have an equipment which will be compatible. With equipment which without no dilemmas will be used according to assigning him without anxiety that the use is equaling for loss of possessions or the exchange on worse or dirty. An next amendment to a bill about the National Medical rescue should obligatorily have regulations on the availability and compatibilities of equipment among others used in immobilizing traumatic and the National Health Fund should develop tough equipment principles in contracting services. All remarks and amendments to the provisions concerning the compatibility of equipment used in grudges they will have an intense influence on the quality of granted benefits in saving the health and the human life as well as will improve the comfort of the work of the paramedic.

  9. Percutaneous injuries among dental professionals in Washington State

    PubMed Central

    Shah, Syed M; Merchant, Anwar T; Dosman, James A

    2006-01-01

    Background Percutaneous exposure incidents facilitate transmission of bloodborne pathogens such as human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV). This study was conducted to identify the circumstances and equipment related to percutaneous injuries among dental professionals. Methods We used workers' compensation claims submitted to the Department of Labor and Industries State Fund during a 7-year period (1995 through 2001) in Washington State for this study. We used the statement submitted by the injured worker on the workers' compensation claim form to determine the circumstances surrounding the injury including the type of activity and device involved. Results Of a total of 4,695 accepted State Fund percutaneous injury claims by health care workers (HCWs), 924 (20%) were submitted by dental professionals. Out of 924 percutaneous injuries reported by dental professionals 894 (97%) were among dental health care workers in non-hospital settings, including dentists (66, 7%), dental hygienists (61, 18%) and dental assistants (667, 75%). The majority of those reporting were females (638, 71%). Most (781, 87%) of the injuries involved syringes, dental instruments (77, 9%), and suture needles (23%). A large proportion (90%) of injuries occurred in offices and clinics of dentists, while remainder occurred in offices of clinics and of doctors of medicine (9%), and a few in specialty outpatient facilities (1%). Of the 894 dental health care workers with percutaneous injuries, there was evidence of HBV in 6 persons, HCV in 30 persons, HIV in 3 persons and both HBV and HVC (n = 2) exposure. Conclusion Out of hospital percutaneous injuries are a substantial risk to dental health professionals in Washington State. Improved work practices and safer devices are needed to address this risk. PMID:17074095

  10. 14 CFR 1261.304 - Place of filing claim.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... United States should be submitted to the Chief Counsel of the NASA Installation whose activities are believed to have given rise to the claimed injury, loss, or death. If the identity of such installation is...

  11. 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).

  12. 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

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

    PubMed

    Alexander, Marcalee; 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.

  14. Subepidermal moisture surrounding pressure ulcers in persons with a spinal cord injury: A pilot study

    PubMed Central

    Harrow, Jeffrey John; Mayrovitz, Harvey N.

    2014-01-01

    Objective Characterization of a non-invasive method of quantifying subepidermal moisture (SEM) surrounding stages III and IV pressure ulcers (PrUs) in spinal cord injury (SCI). Design Prospective, single-visit, single-rater, observational study, using repeated-measures analysis. Method Setting-inpatient units of one VA SCI Center. Participants Convenience sample of 16 subjects with SCI with stage III or IV PrUs over sacrum or ischium. Interventions Measurement with the MoistureMeter-D, a hand-held device using 300 MHz electromagnetic waves. Outcome measures Dielectric constant, a dimensionless number which increases with the moisture content. Each subject had a PrU site and a control site. Measurements were made at each site, on intact skin, at four points spaced angularly around the site, in triplicate. Results (1) Short-term, single-rater relative error was 2.5%. (2) Order effect: first readings were higher than second readings in 55 of 64 measurement sets. Order effect was significant for control sites (P < 0.0001) but not for PrU sites. (3) Angular effect: SEM varied by angle at the PrU sites (P < 0.01); 12 o'clock position the highest and 6 o'clock the lowest. (4) Ability to differentiate PrUs from intact skin: SEM at PrU sites was greater by 9.0% than control sites (P < 0.05). (5) Site effect: SEM was higher at sacral locations than ischial at control sites by 20% (P < 0.005). Conclusions SEM differentiates PrUs from intact skin. Future study designs must take into account order, angular, and site effects on this measure. This information will inform designers of future studies of SEM in healing of PrUs. PMID:25398030

  15. 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.

  16. 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.

  17. Cumulative Injury

    PubMed Central

    LaDou, Joseph

    1978-01-01

    A few states, notably California, are experiencing large increases in the number and cost of disability settlements under workers' compensation. Claims of cumulative injury for coronary heart disease, hypertension, stroke, cancer and neuropsychiatric problems have all been interpreted as compensable under workers' compensation, even when these conditions are clearly related to the aging process. Legal precedents for such claims are building rapidly throughout the country. The resultant costs may lead to the demise of the workers' compensation system. The situation in California is discussed in detail including the legal aspects, cumulative injury claims by type of disease and age of claimants, legal costs to the individual and the employer, and the economic outlook for the workers' compensation insurance system. PMID:151986

  18. 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

  19. 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.

  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. Correlation of shoulder range of motion limitations at discharge with limitations in activities and participation one year later in persons with spinal cord injury.

    PubMed

    Eriks-Hoogland, Inge E; de Groot, Sonja; Post, Marcel W M; van der Woude, Lucas H V

    2011-02-01

    To study the correlation between limited shoulder range of motion in persons with spinal cord injury at discharge and the performance of activities, wheeling performance, transfers and participation one year later. Multicentre prospective cohort study. A total of 146 newly injured subjects with spinal cord injury. Shoulder range of motion was measured at discharge. One year later, Functional Independence Measure (FIM), transfer ability, wheelchair circuit and Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) were assessed. Corrections were made for possible confounding factors (age, gender, level and completeness of injury, time since injury and shoulder pain). All subjects with limited shoulder range of motion at discharge had a lower FIM motor score and were less likely (total group 5 times, and subjects with tetraplegia 10 times less likely) to be able to perform an independent transfer one year later. Subjects with limited shoulder range of motion in the total group needed more time to complete the wheelchair circuit. No significant associations with the PASIPD were found in either group. Persons with spinal cord injury and limited shoulder range of motion at discharge are more limited in their activities one year later than those without limited shoulder range of motion.

  2. Treatments for Chronic Pain in Persons With Spinal Cord Injury: A Survey Study

    PubMed Central

    Cardenas, Diana D; Jensen, Mark P

    2006-01-01

    Background/Objective: 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. Design: Postal survey. Setting: Community. Participants: Participants were 117 individuals who had traumatic SCI, were 18 years of age or older, and reported a chronic pain problem. Main Outcome Measures: 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. Results: 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. Conclusions: Many patients are not finding adequate pain relief from commonly prescribed medications. Alternative therapies should be considered as additional treatment options in this population. PMID:16739554

  3. 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.

  4. 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

  5. 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).

  6. Non-suicidal Self-injury in Different Eating Disorder Types: Relevance of Personality Traits and Gender.

    PubMed

    Islam, Mohammed A; Steiger, Howard; Jimenez-Murcia, Susana; Israel, Mimi; Granero, Roser; Agüera, Zaida; Castro, Rita; Sánchez, Isabel; Riesco, Nadine; Menchón, José M; Fernández-Aranda, Fernando

    2015-11-01

    The study explored lifetime prevalence of non-suicidal self-injury (NSSI) in female and male individuals with eating disorders (ED) and compared ED symptoms, general psychopathology and personality traits across individuals with and without a history of NSSI. The incremental discriminative capacity of gender on the manifestation of lifetime NSSI was also studied. A total sample of 1649 consecutively admitted ED patients (1515 women and 134 men) participated in the current study [339 ED + NSSI (ED with NSSI) and 1310 ED - NSSI (ED without NSSI)]. Specific self-report measures were included and other clinical and psychopathological indices. The observed lifetime prevalence of NSSI was 20.6% (20.9% in women and 17.2% in men). NSSI was not associated with ED type or gender. However, ED + NSSI patients exhibited more impulsive behaviour, substance-abuse disorders and additional impulse-control disorders, were younger and had more previous treatments. Age was shown to affect the presentation of NSSI. Additionally, ED + NSSI patients exhibited more severe ED and general psychopathological symptoms and had more dysfunctional personality traits when compared with ED - NSSI. ED + NSSI was found to be positively associated with harm avoidance and self-transcendence but negatively with reward dependence, self-directedness and cooperativeness. Thus, the variables with stronger capacity to identify the presence of ED + NSSI were younger age, harm avoidance, self-directedness and self-transcendence. A lack of association between sex and ED subtype with the presence of NSSI was observed. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  7. 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.

  8. 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

  9. The relationship between physical activity facility proximity and leisure-time physical activity in persons with spinal cord injury.

    PubMed

    Arbour, Kelly P; Martin Ginis, Kathleen A

    2009-07-01

    Within the general able-bodied population, proximity of one's home to physical activity facilities is modestly associated with physical activity behavior. Currently, no research has examined whether facility proximity is related to physical activity among persons living with disabilities. To examine (1) the level of agreement between perceived and actual proximity to accessible physical activity facilities and (2) the relationship between facility proximity (perceived and actual) and leisure-time physical activity (LTPA) among persons with spinal cord injury (SCI). It was hypothesized that (1) perceived and actual proximity measures would exhibit low agreement and (2) a small, positive relationship would emerge between proximity (perceived and actual) and LTPA. Data from 50 Ontario residents living with SCI (70% male; 52% tetraplegia) were collected for proximity and LTPA. Perceived facility proximity was determined by a self-report "YES" versus "NO" presence measure, while actual facility proximity was assessed using Geographical Information Systems. An SCI-specific instrument, the PARA-SCI, was used to measure LTPA. Low agreement levels were found between perceived and actual proximity. LTPA status (active versus inactive) was shown to moderate the relationship, with higher agreement levels found for participants who reported engaging in mild or heavy LTPA versus their inactive counterparts, but only for the 30-minute wheeling boundary. Contrary to hypothesis, people living within a 30-minute wheel from an accessible facility were less likely to engage in heavy LTPA than were people who did not have an accessible facility located within a 30-minute wheel. No significant associations were found between LTPA and perceived proximity. Living in close proximity to a facility that provides accessible programming and equipment does not necessarily translate into greater physical activity behavior.

  10. 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.

  11. Malpractice claims for endoscopy

    PubMed Central

    Hernandez, Lyndon V; Klyve, Dominic; Regenbogen, Scott E

    2013-01-01

    AIM: To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure. METHODS: We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time. RESULTS: There were 1901 endoscopy-related closed claims against all providers from 1985 to 2008. The specialties include: internal medicine (n = 766), gastroenterology (n = 562), general surgery (n = 231), general and family practice (n = 101), colorectal surgery (n = 87), other specialties (n = 132), and unknown (n = 22). Colonoscopy represented the highest frequencies of closed claims (n = 788) and the highest total indemnities ($54 093 000). In terms of mean claims payment, endoscopic retrograde cholangiopancreatography (ERCP) ranked the highest ($374  794) per claim. Internists had the highest number of total claims (n = 766) and total claim payment ($70  730  101). Only total claim payments for colonoscopy and ERCP seem to have increased over time. Indeed, there was an average increase of 15.5% per year for colonoscopy and 21.9% per year for ERCP after adjusting for inflation. CONCLUSION: There appear to be differences in malpractice coverage costs among specialties and the type of endoscopic procedure. There is also evidence for secular trend in total claim payments, with colonoscopy and ERCP costs rising yearly even after adjusting for inflation. PMID:23596540

  12. 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

  13. Feasibility of robotic exoskeleton ambulation in a C4 person with incomplete spinal cord injury: a case report.

    PubMed

    Lester, Robert M; Gorgey, Ashraf S

    2018-01-01

    To determine whether an individual with C4 incomplete spinal cord injury (SCI) with limited hand functions can effectively operate a powered exoskeleton (Ekso) to improve parameters of physical activity as determined by swing-time, up-time, walk-time, and total number of steps. A 21-year-old male with incomplete chronic (>1 year postinjury) SCI C4, participated in a clinical exoskeleton program to determine the feasibility of standing up and walking with limited hand functions. The participant was invited to attend 3 sessions including fitting, familiarization and gait training separated by one week intervals. Walk-time, up-time and total number of steps were measured during each training session. A complete body composition assessment using dual-energy X-ray absorptiometry (DXA) of the spine, knees and hips was conducted before training.Using a platform walker and cuffing both hands, the participant managed to stand up and ambulate successfully using exoskeleton. Over the course of 2 weeks, maximum walk-time increased from 7 to 17 min and number of steps increased from 83 to 589 steps. The total up-time increased from 19 to 31 min. Exoskeleton training may be a safe and feasible approach for persons with higher levels of SCI after effectively providing a supportive assistive device for weight shifting. The current case study demonstrates the use of a powered exoskeleton for an individual with high level tetraplegia (C4 and above) and limited hand functions.

  14. Increase in interleukin-6 immediately after wheelchair basketball games in persons with spinal cord injury: preliminary report.

    PubMed

    Kinoshita, T; Nakamura, T; Umemoto, Y; Kojima, D; Moriki, T; Mitsui, T; Goto, M; Ishida, Y; Tajima, F

    2013-06-01

    Case series. To investigate the effects of wheelchair basketball game on plasma interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and blood cell counts in persons with spinal cord injury (SCI). The 2009 Mei-shin League of Wheelchair Basketball Games held at Wakayama, Japan. Five wheelchair basketball players with SCI voluntarily participated in this study. Blood samples were taken approximately 1 h before the player warm-up for the game and immediately after the game. IL-6, TNF-α, CRP and blood cell count were measured. Plasma IL-6 level and number of monocytes were significantly increased after the game, compared with pre-game measurements (P<0.05). No changes were observed in other measurements. There was a significant relationship between increased IL-6 levels and accumulated play duration. The lack of change in TNF-α and CRP levels suggested that the exercise-induced rise in IL-6 was not related to exercise-induced inflammatory response. Furthermore, the associated increase in the number of monocytes did not correlate with exercise-induced IL-6 changes, negating monocytes as the source of IL-6.

  15. 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.

  16. 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.

  17. Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with spinal cord injury.

    PubMed

    Krisa, L; Gaughan, J; Vogel, L; Betz, R R; Mulcahey, M J

    2013-01-01

    A prospective repeated measures multicenter study to determine reliability at individual spinal levels when applied to young persons with spinal cord injury (SCI). To evaluate intra- and inter-rater agreement of repeated motor and sensory scores at individual spinal levels. Shriners Hospitals for Children--Philadelphia and Chicago, USA. A total 189 youth with complete and incomplete SCI underwent four neurological exams by two different raters. Agreement between and within raters for each myotome and dermatome was evaluated for complete and incomplete SCI separately. Intraclass correlation coefficients and 95% confidence intervals were calculated. Overall, both intra- and inter-rater agreement resulted in moderate-to-high agreement among myotomes. Subjects with complete SCI had moderate agreement for light touch (LT) and pin prick (PP) testing, whereas subjects with incomplete SCI had >60.0% of dermatomes resulting in poor agreement for PP testing. Overall, moderate-to-high agreement was found for muscle strength comparisons and moderate-to-poor agreement was found for PP and LT.

  18. 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.

  19. That which doesn't kill us can make us stronger (and more satisfied with life): the contribution of personal and social changes to well-being after acquired brain injury.

    PubMed

    Jones, Janelle M; Haslam, S Alexander; Jetten, Jolanda; Williams, W Huw; Morris, Richard; Saroyan, Sonya

    2011-03-01

    This study examined the roles of personal and social changes on the relationship between injury severity and life satisfaction among individuals with acquired brain injury (ABI). Personal change (i.e. having developed a survivor identity, identity strength), social changes (i.e. improved social relationships, support from services), injury severity (i.e. length of time in coma) and well-being (i.e. life satisfaction) were assessed in a sample of 630 individuals with ABIs. A counterintuitive positive relationship was found between injury severity and life satisfaction. Bootstrapping analyses indicated that this relationship was mediated by personal and social changes. Although identity strength was the strongest individual mediator, both personal and social changes each explained unique variance in this relationship. These findings suggest that strategies that strengthen personal identity and social relationships may be beneficial for individuals recovering from ABIs.

  20. 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.

  1. 18 CFR 367.9250 - Account 925, Injuries and damages.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... company against injuries and damages claims of employees or others, losses of such character not covered by insurance, and expenses incurred in settlement of injuries and damages claims. It also must... against claims from injuries and damages by employees or others, such as public liability, property...

  2. 18 CFR 367.9250 - Account 925, Injuries and damages.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... company against injuries and damages claims of employees or others, losses of such character not covered by insurance, and expenses incurred in settlement of injuries and damages claims. It also must... against claims from injuries and damages by employees or others, such as public liability, property...

  3. 18 CFR 367.9250 - Account 925, Injuries and damages.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... company against injuries and damages claims of employees or others, losses of such character not covered by insurance, and expenses incurred in settlement of injuries and damages claims. It also must... against claims from injuries and damages by employees or others, such as public liability, property...

  4. 18 CFR 367.9250 - Account 925, Injuries and damages.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... company against injuries and damages claims of employees or others, losses of such character not covered by insurance, and expenses incurred in settlement of injuries and damages claims. It also must... against claims from injuries and damages by employees or others, such as public liability, property...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 27 CFR 46.8 - Data to be shown in claim.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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...

  10. 20 CFR 702.221 - Claims for compensation; time limitations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... which the injury or death occurred. The Social Security Number (SSN) of the injured employee and, in... year of the injury or death, or (where payment is made without an award) within one year of the date on... filing a claim does not begin to run until the employee receives an audiogram with the accompanying...

  11. [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

    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.

  12. 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...

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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. Oxygen consumption during functional electrical stimulation-assisted exercise in persons with spinal cord injury: implications for fitness and health.

    PubMed

    Hettinga, Dries M; Andrews, Brian J

    2008-01-01

    A lesion in the spinal cord leads in most cases to a significant reduction in active muscle mass, whereby the paralysed muscles cannot contribute to oxygen consumption (VO2) during exercise. Consequently, persons with spinal cord injury (SCI) can only achieve high VO2 values by excessively stressing the upper body musculature, which might increase the risk of musculoskeletal overuse injury. Alternatively, the muscle mass involved may be increased by using functional electrical stimulation (FES). FES-assisted cycling, FES-cycling combined with arm cranking (FES-hybrid exercise) and FES-rowing have all been suggested as candidates for cardiovascular training in SCI. In this article, we review the levels of VO2 (peak [VO2peak] and sub-peak [VO2sub-peak]) that have been reported for SCI subjects using these FES exercise modalities. A systematic literature search in MEDLINE, EMBASE, AMED, CINAHL, SportDiscus and the authors' own files revealed 35 studies that reported on 499 observations of VO2 levels achieved during FES-exercise in SCI. The results show that VO2peak during FES-rowing (1.98 L/min, n = 17; 24.1 mL/kg/min, n = 11) and FES-hybrid exercise (1.78 L/min, n = 67; 26.5 mL/kg/min, n = 35) is considerably higher than during FES-cycling (1.05 L/min, n = 264; 14.3 mL/kg/min, n = 171). VO2sub-peak values during FES-hybrid exercise were higher than during FES-cycling. FES-exercise training can produce large increases in VO2peak; the included studies report average increases of +11% after FES-rowing training, +12% after FES-hybrid exercise training and +28% after FES-cycling training. This review shows that VO2 during FES-rowing or FES-hybrid exercise is considerably higher than during FES-cycling. These observations are confirmed by a limited number of direct comparisons; larger studies to test the differences in effectiveness of the various types of FES-exercise as cardiovascular exercise are needed. The results to date suggest that FES-rowing and FES-hybrid are

  15. Work stress and quality of life in persons with disabilities from four European countries: the case of spinal cord injury.

    PubMed

    Fekete, Christine; Wahrendorf, Morten; Reinhardt, Jan D; Post, Marcel W M; Siegrist, Johannes

    2014-06-01

    Evidence on the adverse effects of work stress on quality of life (QoL) is largely derived from general populations, while respective information is lacking for people with disabilities. We investigated associations between work stress and QoL and the potentially moderating role of socioeconomic circumstances in employed persons with spinal cord injury (SCI). Cross-sectional data from 386 employed men and women with SCI (≥18 work h/week) from the Netherlands, Switzerland, Denmark, and Norway were analyzed. Work stress was assessed with the 'effort-reward imbalance' (ERI) model and the control component of the 'demand/control' model. QoL was operationalized with five WHOQoL BREF items. Socioeconomic circumstances were measured by years of formal education and perception of financial hardship. We applied ordinal and linear regressions to predict QoL and introduced interaction terms to assess a potential moderation of socioeconomic circumstances. Multivariate analyses showed consistent associations between increased ERI and decreased overall QoL (coefficient -1.55, p < 0.001), domain-specific life satisfaction (health -1.32, p < 0.001; activities of daily living -1.28, p < 0.001; relationships -0.84, p = 0.004; living conditions -1.05, p < 0.001), and the QoL sum score (-2.40, p < 0.001). Low job control was linked to decreased general QoL (0.13, p = 0.015), satisfaction with relationships (0.15, p = 0.004), and QoL sum score (0.15, p = 0.029). None of the tested interaction terms were significant. ERI was consistently related to all indicators of QoL, while associations with job control were less consistent. Our results do not support the notion that unfavorable socioeconomic circumstances moderate the association between work stress and QoL among persons with SCI.

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

    PubMed Central

    2010-01-01

    Objective 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. Design 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. Setting A rehabilitation hospital and university-based teaching facilities were used as the setting. Participants 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. Interventions 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. Outcome Measures 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. Results 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. Conclusion 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

  17. Determinants of escalating costs in low risk workers' compensation claims.

    PubMed

    Bernacki, Edward J; Yuspeh, Larry; Tao, Xuguang

    2007-07-01

    To identify and quantify attributes that lead to unanticipated cost escalation in workers' compensation claims. We constructed four claim categories: low initial reserve/low cost, migrated catastrophic (low initial reserve/high cost), high initial reserve/low cost, and catastrophic (high initial reserve/high cost). To assess the attributes associated with the increased cost of migrated catastrophic claims, we analyzed 36,329 Louisiana workers' compensation claims in the four categories over a 5-year period. In the 729 claims initially thought to be low-cost claims (migrated catastrophic), the most significant predictors for cost escalation were attorney involvement and claim duration, followed by low back disorder, married/single/divorced status, male gender, small company size, high premium, reporting delays, and older age. These injuries accounted for 2% of all claims but 32.3% of the costs. Accelerated escalation of costs occurred late in the claim cycle (2 years). Certain attributes, particularly attorney involvement and claim duration, are associated with unanticipated cost escalation in a small number of claims that drastically affect overall losses. The results of this study suggest that these cases may be identified and addressed before rapid escalation occurs.

  18. Acute Cardiorespiratory and Metabolic Responses During Exoskeleton-Assisted Walking Overground Among Persons with Chronic Spinal Cord Injury.

    PubMed

    Evans, Nicholas; Hartigan, Clare; Kandilakis, Casey; Pharo, Elizabeth; Clesson, Ismari

    2015-01-01

    Lower extremity robotic exoskeleton technology is being developed with the promise of affording people with spinal cord injury (SCI) the opportunity to stand and walk. The mobility benefits of exoskeleton-assisted walking can be realized immediately, however the cardiorespiratory and metabolic benefits of this technology have not been thoroughly investigated. The purpose of this pilot study was to evaluate the acute cardiorespiratory and metabolic responses associated with exoskeleton-assisted walking overground and to determine the degree to which these responses change at differing walking speeds. Five subjects (4 male, 1 female) with chronic SCI (AIS A) volunteered for the study. Expired gases were collected during maximal graded exercise testing and two, 6-minute bouts of exoskeleton-assisted walking overground. Outcome measures included peak oxygen consumption (V̇O2peak), average oxygen consumption (V̇O2avg), peak heart rate (HRpeak), walking economy, metabolic equivalent of tasks for SCI (METssci), walk speed, and walk distance. Significant differences were observed between walk-1 and walk-2 for walk speed, total walk distance, V̇O2avg, and METssci. Exoskeleton-assisted walking resulted in %V̇O2peak range of 51.5% to 63.2%. The metabolic cost of exoskeleton-assisted walking ranged from 3.5 to 4.3 METssci. Persons with motor-complete SCI may be limited in their capacity to perform physical exercise to the extent needed to improve health and fitness. Based on preliminary data, cardiorespiratory and metabolic demands of exoskeleton-assisted walking are consistent with activities performed at a moderate intensity.

  19. Acute Cardiorespiratory and Metabolic Responses During Exoskeleton-Assisted Walking Overground Among Persons with Chronic Spinal Cord Injury

    PubMed Central

    Hartigan, Clare; Kandilakis, Casey; Pharo, Elizabeth; Clesson, Ismari

    2015-01-01

    Background: Lower extremity robotic exoskeleton technology is being developed with the promise of affording people with spinal cord injury (SCI) the opportunity to stand and walk. The mobility benefits of exoskeleton-assisted walking can be realized immediately, however the cardiorespiratory and metabolic benefits of this technology have not been thoroughly investigated. Objective: The purpose of this pilot study was to evaluate the acute cardiorespiratory and metabolic responses associated with exoskeleton-assisted walking overground and to determine the degree to which these responses change at differing walking speeds. Methods: Five subjects (4 male, 1 female) with chronic SCI (AIS A) volunteered for the study. Expired gases were collected during maximal graded exercise testing and two, 6-minute bouts of exoskeleton-assisted walking overground. Outcome measures included peak oxygen consumption (V̇O2peak), average oxygen consumption (V̇O2avg), peak heart rate (HRpeak), walking economy, metabolic equivalent of tasks for SCI (METssci), walk speed, and walk distance. Results: Significant differences were observed between walk-1 and walk-2 for walk speed, total walk distance, V̇O2avg, and METssci. Exoskeleton-assisted walking resulted in %V̇O2peak range of 51.5% to 63.2%. The metabolic cost of exoskeleton-assisted walking ranged from 3.5 to 4.3 METssci. Conclusion: Persons with motor-complete SCI may be limited in their capacity to perform physical exercise to the extent needed to improve health and fitness. Based on preliminary data, cardiorespiratory and metabolic demands of exoskeleton-assisted walking are consistent with activities performed at a moderate intensity. PMID:26364281

  20. Five-year follow-up of persons with brain injury entering the French vocational and social rehabilitation programme UEROS: Return-to-work, life satisfaction, psychosocial and community integration.

    PubMed

    Cogné, M; Wiart, L; Simion, A; Dehail, P; Mazaux, J-M

    2017-01-01

    Social and vocational reintegration of persons with brain injury is an important element in their rehabilitation. To evaluate the 5-year outcome of persons with brain injury included in 2008 in the Aquitaine Unit for Evaluation, Training and Social and Vocational Counselling programme (UEROS). 57 persons with brain injury were recruited from those who completed the 2008 UEROS programme. Five years later, an interview was done to assess family and vocational status, autonomy and life satisfaction. These results were compared with those from persons completing the 1997-1999 programme. The typical person entered the 2008 UEROS programme 6 years after a severe brain injury (42%) and was male, single and 35 years. At the 5-year follow-up, more persons lived with a partner (+23%) and lived in their own home (+21%). 47% were working vs 11% on entering the programme. Approximately half were satisfied or very satisfied with their quality of life. Having a job in 2013 was associated with a high education level, less cognitive sequelae, having a job in 2008 and no health condition. The UEROS programme is effective with regard to return-to-work and improvement of autonomy in persons with brain injury, irrespective of length of time from injury.

  1. 20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

  2. 20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

  3. 20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

  4. 20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

  5. 20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

  6. Unfalsifiability of security claims.

    PubMed

    Herley, Cormac

    2016-06-07

    There is an inherent asymmetry in computer security: Things can be declared insecure by observation, but not the reverse. There is no observation that allows us to declare an arbitrary system or technique secure. We show that this implies that claims of necessary conditions for security (and sufficient conditions for insecurity) are unfalsifiable. This in turn implies an asymmetry in self-correction: Whereas the claim that countermeasures are sufficient is always subject to correction, the claim that they are necessary is not. Thus, the response to new information can only be to ratchet upward: Newly observed or speculated attack capabilities can argue a countermeasure in, but no possible observation argues one out. Further, when justifications are unfalsifiable, deciding the relative importance of defensive measures reduces to a subjective comparison of assumptions. Relying on such claims is the source of two problems: once we go wrong we stay wrong and errors accumulate, and we have no systematic way to rank or prioritize measures.

  7. Making Environmental Claims

    EPA Pesticide Factsheets

    The U.S. EPA's Green Power Partnership, in conjunction with the Federal Trade Commission, has put together this list of considerations organizations should consider when making environmental claims in regards to their green power usage.

  8. Court Disallows Damage Claims

    ERIC Educational Resources Information Center

    Tomson, Bernard; Coplan, Norman

    1976-01-01

    In rejecting claims for damages, the Court finds that contract's "increase or decrease of cost" language is not applicable to added overhead costs and loss of labor efficiency resulting from delays over which the contractor has no control. (Author)

  9. LCA-Based Product Claims

    EPA Science Inventory

    Product environmental claims include a wide range of marketing claims, labels, declarations, statements and reports that are generally intended to distinguish a product as environmentally friendly or ‘green’. They differ from organizational environmental claims in the...

  10. Solar Power Use Claims Guidance

    EPA Pesticide Factsheets

    The Toolbox for Renewable Energy Project Development's Solar Power Use Claims Guidance page helps electricity consumers understand the legal right that RECs offer their owners when making solar power use claims and provides resources for making claims.

  11. 44 CFR 62.20 - Claims appeals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (includes contractors' estimates), detailing unit cost and quantities for the items needing repair or replacement; replacement cost proofs of loss; Preliminary Report; Final Report; detailed damaged personal... wind policies and any claim information submitted to the other companies; Waiver, Letter of Map...

  12. 44 CFR 62.20 - Claims appeals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (includes contractors' estimates), detailing unit cost and quantities for the items needing repair or replacement; replacement cost proofs of loss; Preliminary Report; Final Report; detailed damaged personal... wind policies and any claim information submitted to the other companies; Waiver, Letter of Map...

  13. 29 CFR 15.41 - Allowable claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... persons or property arising out of an act or omission of a student enrolled in the Job Corps may be... omission which gave rise to the claim took place at the center to which the student involved was assigned, or (ii) If the student involved was not within the geographical limits of his hometown and was within...

  14. 36 CFR 222.22 - Ownership claims.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Section 222.22 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE RANGE MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.22 Ownership claims. (a) Any person... wild horse or burro territory or range on the National Forest System where such animals are not...

  15. 36 CFR 222.22 - Ownership claims.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Section 222.22 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE RANGE MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.22 Ownership claims. (a) Any person... wild horse or burro territory or range on the National Forest System where such animals are not...

  16. 36 CFR 222.62 - Ownership claims.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Section 222.62 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE RANGE MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.62 Ownership claims. (a) Any person... wild horse or burro territory or range on the National Forest System where such animals are not...

  17. 36 CFR 222.62 - Ownership claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Section 222.62 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE RANGE MANAGEMENT Management of Wild Free-Roaming Horses and Burros § 222.62 Ownership claims. (a) Any person... wild horse or burro territory or range on the National Forest System where such animals are not...

  18. 24 CFR 2700.335 - Claims.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... provide such information as specified by HUD. (b) Claims may be filed upon the homeowner's default on the... repayment of a loan is a person in “military service”, as such term is defined in the Servicemembers Civil Relief Act of 2003 (Pub. L. 108-189, approved December 19, 2003) (formerly known as Soldier's and Sailor...

  19. 24 CFR 2700.335 - Claims.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... provide such information as specified by HUD. (b) Claims may be filed upon the homeowner's default on the... repayment of a loan is a person in “military service”, as such term is defined in the Servicemembers Civil Relief Act of 2003 (Pub. L. 108-189, approved December 19, 2003) (formerly known as Soldier's and Sailor...

  20. 24 CFR 2700.335 - Claims.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... provide such information as specified by HUD. (b) Claims may be filed upon the homeowner's default on the... repayment of a loan is a person in “military service”, as such term is defined in the Servicemembers Civil Relief Act of 2003 (Pub. L. 108-189, approved December 19, 2003) (formerly known as Soldier's and Sailor...