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PubMed1979

Blind and disabled persons awarded federally administered SSI payments, 1975.

State agencies made medical determinations on 975,000 applications filed by the blind and disabled in 1975. Forty percent were found eligible for federally administered payments, and 60 percent were found ineligible. Nine out of 10 of the awardees were adults. Forty percent of these adults either had no occupation or no occupation was reported. Among both adults and children, the leading cause of disability was mental illness. Nearly 1 out of 3 adults was awarded benefits on the basis of mental disorders. The proportion of children determined disabled by mental illness was about twice that of adults. More than one-half of all children awarded benefits were mentally retarded. Among adults, the second most frequent disabling impairment was cardio-vascular disease; among children, it was diseases of the nervous system and sense organs.

Adult↗
PubMed2005

Preventive strategies for aspiration pneumonia in elderly disabled persons.

Pneumonia is the fourth leading cause of death despite the availability of potent new antimicrobials in Japan. Aspiration of oropharyngeal bacterial pathogens to the lower respiratory tract is one of the most important risk factors for pneumonia. Impairments in swallowing and cough reflexes among disabled older persons, e.g., related to cerebrovascular disease, increase the risk of pneumonia. Thus, strategies to reduce the volumes and pathogenicity of aspirated material should be pursued. Since both swallowing and cough reflexes are mediated by endogenous substance P contained in the vagal and glossopharyngeal nerves, pharmacologic therapy using angiotensin-converting enzyme inhibitors, which decrease substance P catabolism, can improve both reflexes and result in the lowering of the risk of pneumonia. Similarly, since the production of substance P is regulated by dopaminergic neurons in the cerebral basal ganglia, treatment with dopamine analogs or potentiating drugs such as amantadine can reduce the incidence of pneumonia. Furthermore, since mortality from infections correlates with cutaneous anergy, interventions that reverse these age-associated changes in the immune system are also effective. The main theme of this review is to discuss how pneumonia develops in disabled older people and to suggest preventive strategies that may reduce the incidence of pneumonia among these subjects.

Amantadine↗
PubMed1997

[Assessment methods for vocational integration of disabled persons--from ERTOMIS methods to the IMBA information system].

The background for the development of actual assessments for evaluation of vocational integration of disabled people (i.e., EAM, IMBA) in Germany is described. Resulting perspectives for future procedural approaches are presented. So far, the EAM, Ertomis Assessment Method, approach has gained limited acceptance only. In light of WHO and European impulses, as well as the economic constraints at hand, it remains to be seen whether the IMBA information system will turn out a practical and problem-focussed tool. A critical review is done to provide constructive suggestions for further applications of IMBA.

Disability Evaluation↗
PubMed1982

World statistics on disabled persons.

This report presents summarizing statistical data on the present situation of disabled people in the world. Besides the total number of the disabled, national estimates are given. Special reports are dedicated to some groups of disabled people, like disabled children, disabled women, families of disabled people, the economic situation of such families, and the mentally disabled. In addition the situation in developed and developing countries is described. Starting from actual trends the tasks and objectives of research are reported.

Africa↗
PubMed2005

An exploratory study on the predictive elements of passing on-the-road tests for disabled persons.

OBJECTIVES: Driving evaluations are performed by Occupational Therapists to evaluate drivers with disability. They include both off-road and on-road assessments. Many aspects of driving are examined during the on-road assessment. The main objective of this study is to identify the elements of the Occupational Therapy on-road driving assessment that are most predictive of the overall driving evaluation. METHODS: This retrospective cohort study took place at a provincially approved Driving Assessment Program. Records of 700 participants with various disabilities who completed a driving assessment between 1995 and 2003 were reviewed. Only clients who completed the on-road assessment were included in the study. At our center, 11 driving elements comprised of 34 items were used as independent variables and rated as pass (acceptable or good) or fail (borderline or poor). Analysis was completed with descriptive statistics and use of logistic regression to identify elements that contributed most significantly to the overall driving evaluation. RESULTS: A total of 628 clients completed the on-road assessment with an overall pass rate of 50%. Logistic regression modeling identified poor anticipation of road hazards, observation of environment, improper stopping position, poor visual scanning, poor knowledge of the rules of the road, and increasing age as predictive of failure for all participants. Further analysis grouped subjects according to disability to identify similarities and differences between pass/fail predictors. Both similarities and differences in predictive elements were found between cognitive and physical diagnostic groupings. Most notably, the physical diagnostic grouping showed that cognitive, not physical elements of the on-road test, predicted failure of the overall driving evaluation. CONCLUSIONS: Of the 11 elements considered in the on-road evaluation, specific cognitive ones such as anticipates potential hazards, scanning, observes for pedestrians, and proper stopping position tend to contribute more to the prediction of pass or fail than others. These elements should be considered as components of on-road assessments by other Driving Assessment Programs.

Adult↗
PubMed2004

The relation between autonomy-based rights and profoundly mentally disabled persons.

A chapter from his forthcoming book "Deciding for the Profoundly Mentally Disabled," Professor Norman Cantor argues persuasively for the right of incompetent persons to have a surrogate make critical medical decisions on their behalf, particularly in the context of refusing life-sustaining treatment. While abusive surrogate decision-making is always a concern, Professor Cantor recommends both substantive and procedural protections in order to preserve intrinsic human dignity for the profoundly disabled.

Decision Making↗
PubMed1998

Changing attitudes about persons with disabilities: effects of a simulation.

The question of whether the use of a teaching strategy employing simulation influences attitudes toward disabled persons over time was addressed in this quasi-experimental intervention study. The experimental group participated in "Sensitivity Day" which incorporated a simulation activity. A total of 77 undergraduate baccalaureate nursing students completed the Attitudes Toward Disabled Persons scale four times: presimulation, immediate postsimulation, six week delayed postsimulation and six month delayed postsimulation. In general, the nursing students had relatively positive scores on the Attitudes Toward Disabled Persons scale in each testing period. The best indicator of postsimulation attitude scores was the presimulation attitude score. Personal and prior nursing experience had no statistical effects on attitude. Improvement that was significant at p = .07 level was noted in the experimental group at the six weeks delayed postsimulation when compared with the presimulation attitude scores. This study supplies data that is useful in constructing learning activities and contributes to the body of knowledge about simulation and attitudes toward persons with disabilities.

Activities of Daily Living↗
PubMed2002

Reintegration: public or private responsibility? Consequences of Dutch and Danish policies toward work-disabled persons.

The Scandinavian welfare states are known for their universal social security coverage and high labor-market participation rates for all groups in society. The institutional setup in continental European welfare states, on the other hand, is said to foster a divide between employed persons and persons outside the labor market. In the area of disability policies, The Netherlands and Denmark illustrate this distinction. In The Netherlands, strong ties exist between the employer and the sick-listed worker, both because of solid job-protection legislation and because the financing of sickness and disability benefits is closely linked to the individual employer. In contrast, employer responsibility is limited in Denmark, where an extensive responsibility rests with public authorities. The author investigates the consequences of these differences using panel data on Dutch and Danish long-term sick-listed workers. The findings show that the strong ties in The Netherlands between employers and sick-listed workers enhance labor-market reintegration of long-term sick-listed workers. A significant drawback of the Dutch policy, however, is that employers refrain from employing persons with a high risk of falling ill. As a result, Dutch disability policy leads to a bigger insider-outsider divide than Danish policy.

Adolescent↗
PubMed1999

[The Law on (Re)integration of Disabled Persons].

In spite of the growing economy, with diminishing unemployment and increasing scarcity of manpower, many people with chronic health problems remain unemployed. To promote their participation in the labour progress, the Law on (Re)integration of Incapacitated Persons (REA) was enacted on 1 July 1998. This law provides a number of facilities for those classified as 'unable to work'; These are persons impaired by chronic health problems in participating in the labour process. The existing allowances have been liberalized and simplified considerably. Employers in certain cases can expect substantial subsidies. In addition, there are more facilities like vocational re-education and psychological and other training courses. The concept of 'incapability' is rather vague. Fortunately, the Law makes it immediately clear who may be regarded as incapable. In other cases, physicians employed by Factories Act organizations, employment policy offices and social insurance will have to take part in the evaluation. The new law has a few paradoxical starting points, those incapable for work are given hardly any voice and there is a clear risk of stigmatization. On the other hand, failure of the (re)integration of handicapped persons into the labour process may lead to further encroaching upon the welfare state.

Adult↗
PubMed1995

Adapting work sites for disabled persons using advanced technology.

This paper describes the technical approach in the TUFFA (Technology Procurement for Disabled in Working Life) project and a model for cooperating areas of competence based on a holistic view of the individual's abilities, the environmental conditions at the work site, and technical solutions.

Computer Systems↗
PubMed1992

Use of computer network bulletin board systems by disabled persons.

Computer-based electronic support groups are being used by persons facing physical and emotional challenges. Twenty-six users of disability-related electronic support groups responded to a survey designed to determine computer network use and benefits users gain through their network use. The survey included questions about network use for general communication and support, enhancement of communication ability, attainment of knowledge on specific topics, and employment enhancement. Statistically significant results were obtained concerning the perceived benefits of emotional support and communication in relation to network use. Only a small number (n = 9) reported use of the network for employment purposes. These results demonstrate the feasibility of using networks to provide information, services, assistance, and support for disabled and their care providers.

Adolescent↗