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PubMed1998

Incidence of disabilities among multi-bacillary cases after initiation of multidrug therapy and factors associated with the risk of developing disabilities.

Out of the 1724 new cases registered between 1985 to 1992, 1169 could be contacted. The overall incidence of disabilities was 6.8%. Age above 45 years, bacteriopositivity and thickening of three or more trunk nerves were associated with a higher risk of disabilities. Staff training, patient education and steroid availability in the field were the suggested methods of reducing the occurrence of disabilities in leprosy patients.

Adult↗

PubMed1999

[The war invalid laws of 1920 on support for disabled soldiers and their surviving relatives in the provinces of southern Jutland, and the disabled soldiers' board of Sønderborg].

After the reunion between Denmark and Southern Jutland in 1920, the Danish state took over the obligations towards disabled soldiers and surviving relatives to dead soldiers from this province, serving in the German army during World War I. In 1920, the regulations were fixed by law, giving rise to Invalide-noevnet (disabled soldiers' board) in Sonderborg. The board dealt with altogether 6400 applications for invalidity pension and 4000 applications from surviving relatives. In Sonderborg an institution for disabled soldiers (Krigsinvalideskolen) was founded, including a hospital department and workshops for training and rehabilitation as well as production of bandages. A survey is given of these activities. The author next uncovers the story behind one of 9 names on a war memorial tablet, representing soldiers from the parish of Lebol, Sydals, who died in German war service during World War I. The medical record for this dead soldier is given and the family's fruitless efforts for 18 years to obtain pension are reported in details.

Denmark↗

PubMedDate not supplied

Acute hospital discharges of patients with major disability: a review of patients admitted to a young disabled unit.

The aim of this study was to describe a young disabled unit (YDU). These units are increasingly required to serve the needs of people with severe disabilities. Forty-two patients were included in the study; the age range was 22 to 61 years. Traumatic brain injury was the most common diagnosis on admission (13), followed by sub-arachnoid haemorrhage and non-haemorrhagic stroke (11) and non-traumatic brain injury (7). For people with severe acquired brain injuries, the course of neurological recovery often exceeds two years. The prognosis made in the acute hospital setting may need to be revised in the YDU when input from a multidisciplinary rehabilitation team enables patients to further their independence. YDUs need to have their own multidisciplinary team and sessional support from specialists in rehabilitation medicine to provide slow-stream rehabilitation. It is necessary to adequately resource all services for disabled people including inpatient and outpatient rehabilitation services, community services and YDUs. Step-down services without specialised neurological rehabilitation input may fail to achieve the full potential for patients transferred out of acute hospitals.

Adult↗

PubMed1992

Coping with disability. Nurse administrators' obligations under the Americans with Disabilities Act.

Many nurses who have disabilities view the Americans with Disabilities Act of 1990 as a piece of legislation that will have significant implications for nurse administrators and managers at all levels. This legislation becomes fully operational in July 1992, and little has been written in nursing literature about its implications. As a nurse administrator, are you ready to "cope with disability?"

Adaptation, Psychological↗

PubMed1992

American Academy of Pediatrics Committee on Children with Disabilities: American Association for Pediatric Ophthalmology and Strabismus, and American Academy of Ophthalmology: Learning disabilities, dyslexia, and vision.

Dyslexia and other related learning disabilities are serious problems. The American Academy of Pediatrics, through its Committee on Children with Disabilities and the Section on Ophthalmology, the American Academy of Ophthalmology, and the American Association for Pediatric Ophthalmology and Strabismus strongly support the need for early diagnosis and educational remediation. There is no known eye or visual cause for dyslexia and learning disabilities, and no effective visual treatment. Multidisciplinary evaluation and management must be based on proven procedures demonstrated by valid research.

Child↗

PubMedDate not supplied

Development of a functional disability measurement tool to assess early arthritis: the Recent-Onset Arthritis Disability (ROAD) questionnaire.

OBJECTIVE: To develop a self-administered questionnaire, the ROAD (Recent-Onset Arthritis Disability), to probe physical disability in Italian patients with early arthritis (EA) of less than one year's duration. METHODS: The development of the ROAD follows a series of major steps: (1) identification of a specific patient population, (2) item pool development, (3) item reduction, (4) internal consistency, (5) pre-testing of the prototype instrument, and (6) a validation study which results in determination, reliability, validity and responsiveness. In this study we have verified the first five steps. Pre-defined areas of disability were culled from eight existing Italian version arthritis-specific questionnaires, and three generic global health measurement tools. Semi-structured interviews helped to derive a 76-item pool from an initial group of 122 items. This questionnaire was administered to 78 EA patients. RESULTS: For scale generation, a combination of frequency importance product (FIP = frequency x mean relevance score) and factor analysis was applied. The top 20 items based on the FIP were then subjected to further analysis. Each question was correlated with every other question. This allowed us to eliminate 8 questions that were therefore highly correlated and were measuring the same concept. The final instrument has 12 items, representing a combination of symptoms that are common, frequently recurring and of general importance to EA patients. Factor analysis provides a 3-factor health status model explaining 70.1% of the variance. The upper extremity function (5 items) is loaded on the first factor, which explains 45.4% of the total measured variance. The lower extremity function (4 items) formed the second factor (14.2% of the total variance). The third factor was determined by activities of daily living/work (3 items) and explain 10.5% of the total variance. The score of the different subscales can be presented graphically as a ROAD profile. CONCLUSION: Using a traditional development strategy, we have constructed a self-administered instrument for measuring physical functioning in patients with EA. The next stage includes reliability, validity and responsiveness testing of the 12-item questionnaire.

Activities of Daily Living↗

PubMedDate not supplied

[Disability: a proposal for an anamnestic questionnaire in the evaluation of the degree of disability caused by disorders of equilibrium].

Correct identification and evaluation of balance disorders and an assessment of their repercussions on a patient's life are common problems faced by the otoneurologist. These symptoms may not infrequently have a chronic or recurrent course and can lead to in restrictions in the patient's everyday life and even have consequences for the patient' mental health. In the doctor-patient relationship anamnesis is of crucial importance in diagnosis as well as in establishing a relationship of professional confidence with the patient which may influence the outcome of the treatment. An awareness of those situations of daily life which bring about or aggravate the symptoms provides the doctor with valuable information in formulating an etiopathogenetic hypothesis. This observation led us to design the anamnestic self-questionnaire "Disability" whose purpose is to describe the type of disability or impairment to daily life suffered by the patient as a result of the pathology, while at the some time measuring their effects. Our history questionnaire has confirmed the importance of careful history in assessing balance disorders, has highlighted the striking extent of disability and impairment caused by these disorders, and has enabled us to identify the chief features of all pathologies encountered in the specific field of balance disorders. The questionnaire enables us, in particular, to highlight the interference of extra-vestibular factors (muscle-strain, states of irritation, phobias, drugs, dietary factors, etc.). The use of this questionnaire has proved to be of great assistance, therefore, in carrying out routine clinical diagnosis, in the absence of complex technical equipment. Moreover, it constitutes a valuable method in monitoring the outcome of the therapy, or the natural course of the balance disorders.

Activities of Daily Living↗

PubMed1994

[The extent of disability pensions based on educational background. Disability pensions in the period 1967-1992 in a group born 1949 in Bergen].

The authors discuss recruitment to disability pension in groups of former pupils of different types of school in the school system in Bergen in the 1950s. The study is based on a cohort of 1,570 persons, all live births from 1940 of the mothers then residing in Bergen. This birth-cohort was followed up in the school system in Bergen at the age of 14 years and up to the end of 1992. Information on disability pensions was extracted from the files of the National Insurance Administration for the years 1967-92. The prevalence of disability pension of former pupils of different types of school reached a peak at the end of 1992, i.e. at the age of 52 years, as follows: Former pupils of the regular secondary schools, i.e. junior high school and continuation school, 6.8% and 12.7% respectively, former pupils of elementary school classes for slow learners 25.9%, of special schools for the educable mentally retarded 59.6% and for those receiving the services for the mentally retarded, 100%.

Cohort Studies↗

PubMed1996

The role of the pediatrician in implementing the Americans with Disabilities Act: subject review. American Academy of Pediatrics Committee on Children with Disabilities.

In this statement, the American Academy of Pediatrics reaffirms the importance of the Americans With Disabilities Act (ADA), which guarantees people with disabilities certain rights to enable them to participate more fully in their communities. Pediatricians need to know about the ADA provisions to be able to educate and counsel their patients and patients' families appropriately. The ADA mandates changes to our environment, including reasonable accommodation to the needs of individuals with disabilities, which has application to schools, hospitals, physician offices, community businesses, and recreational programs. Pediatricians should be a resource to their community by providing information about the ADA and the special needs of their patients, assisting with devising reasonable accommodation, and counseling adolescents about their expanded opportunities under the ADA.

Persons with Disabilities↗

PubMed2001

Concurrent validity of the Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disabilities Inventory in children with developmental disabilities and acquired brain injuries.

The Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disability Inventory (PEDI) are the most commonly used measures of functional performance in children. The purpose of this study was to determine the concurrent validity of the instruments when used with children with developmental disabilities and acquired brain injury. The subjects were 41 children, age 1.3 to 9.5 years, who were receiving inpatient or outpatient services at a pediatric rehabilitation unit in Brisbane, Australia. Spearman correlation coefficients between the two tests were greater than 0.88 for self care, transportation/locomotion, and communication/social function. The high correlations indicate that the two tests measure similar constructs. Choosing between the tests depends on situational requirements and depth of information required.

Brain Injuries↗

PubMed1999

A video-based performance in noise test for measuring audio-visual disability in young school children: test development, with validation by trained teachers, parents and audiometry as relative standards for disability.

BACKGROUND: impaired ability to detect target sounds in noisy surroundings is a particular feature of children with a history of otitis media with effusion (OME). Children with current OME are also likely to experience difficulty in speech reception in classrooms where a high level of background noise has been recorded. No tests are currently available which are feasible in primary care and which objectively measure school-related disabilities. The effects of speech in noise and the extent to which this is offset by speech reading contribute important dimensions to disability. METHODS: a video-based speech reception test has been developed using the same principles in 227 English and 182 Danish 4-8 year-old children. Distribution data was collected for both language versions of the test. The test has been compared with audiometry and teacher and parents assessments to establish its validity. INTERPRETATION: there are no gold standards for audio-visual disability in current clinical use. The poor positive predictive value of audiometry for likely classroom functioning is a cause for concern, particularly in relation to inappropriate referral of children by primary care physicians.

Audiometry↗

PubMed1991

The effects of sampling conditions on sentence production in normal, reading-disabled, and language-learning-disabled children.

This study explored the effects of contextual support, discourse genre, and the listener's knowledge of information on syntactic and phonologic production and fluency. Subjects were language-learning-disabled, reading-disabled, and normal primary school children. Clause structure complexity, fluency, and grammatical and phonemic accuracy tended to be highest when children were discussing absent referents, providing explanations and stories, and giving unshared information. These effects were generally the same across all groups, although some effects were significant for only the language-learning-disabled children. Several explanations for these findings are considered.

Child↗

PubMed1999

Strategies in disability management. Corporate disability management programs implemented at the work site.

Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

Accidents, Occupational↗

PubMed2006

The general picture of supportive health environments for persons with intellectual disabilities among 121 disability welfare institutions in Taiwan.

BACKGROUND: Little information is available on the provision of supportive health environments for persons with intellectual disabilities (ID) in institutions. The aim of this study was to present an overview of supportive environments for health in institutions in Taiwan. METHODS: A cross-sectional survey was conducted to examine the perceptions of 121 Taiwanese Institutional Directors on their setting's implementation of supportive healthy physical, social, and economic environments. RESULTS: Analyses showed that first-aid kits (97.5%) and medicine cabinets (85.5%) were the most common health facilities in institutions. Seventy-three per cent of institutions had set up specific areas to be used for rehabilitation practice, while only 43.1% thought their rehabilitation equipment/devices adequate for their real needs. Eighty-eight per cent of institutions implemented health promotion plans for people with ID, while 76.6% had appropriated specific health promotion plans. Sixty-three institutions (52.1%) reported employment of skilled nurses to serve people with ID, and these institutions showed statistically significant differences in implementation of each health facility. CONCLUSIONS: The present paper is the first to analyze supportive environments for health in disability institutions in Taiwan. An important focus of future research will be the extension of the present findings to consider the appropriateness of each area of supportive environments for improving the quality of institutional care for people with ID.

Attitude of Health Personnel↗

PubMed1995

The social construction of ability and disability: I. Profile types of Latino children identified as language learning disabled.

During the course of an ethnographic study of a bilingual special education classroom, three profile types of students emerged, ranging from students with severe language learning disabilities to students with normal abilities. The study points out the inadequacy of a medical model view of student abilities and disabilities--a view that underestimates the communicative and academic competence of bilingual students. Concurrently, the results support a contextual performance view--a view that acknowledges the role of instructional context in revealing the upper or lower range of students' communicative and academic competence. The study further suggests some contextual features of instruction that are associated with students from all profile types showing their best in terms of language and literacy skills.

Aptitude↗

PubMed1987

Impairment, disability, and the ICIDH (International Classification of Impairments, Disabilities, and Handicaps) model. II: The nature of the underlying condition and patterns of impairment.

This paper presents a further exploration of the conceptual scheme proposed in the International Classification of Impairments, Disabilities, and Handicaps which links underlying condition, impairment and disability. It examines the proposal that three general patterns of impairment profile might be expected depending on whether the underlying condition affects control (as in stroke or multiple sclerosis), mechanical performance (as in arthritis) or energy (as in cardiorespiratory conditions). Examination of patterns of functional limitation shows more resemblance between conditions in each of these groups than between the groups lending support to the proposal.

Activities of Daily Living↗

PubMedDate not supplied

Increased physician disability claims causing 'crisis'. High utilization of disability insurance may leave physician groups fewer options in the future.

With physician claims on the rise, disability insurers are adjusting rates, provisions and benefit plans that are offered to those in the medical field. Physicians are being hit the hardest, experiencing premium increases, benefit reductions and stricter qualifications for coverage. There are only a few carriers who have not changed their rate structures and benefit plans. Now is the time to review the quality of your disability programs and establish how your carrier is reacting to this trend.

Disability Evaluation↗

PubMed1999

Federal old-age, survivors and disability insurance; determining disability and blindness; extension of expiration dates for several body system listings. Social Security Administration (SSA). Final rule.

SSA adjudicates claims at the third step of its sequential evaluation process for evaluating disability using the Listing of Impairments (the Listings) under the Social Security and supplemental security income (SSI) programs. This final rule extends the dates on which several body system listings will no longer be effective. We have made no revisions to the medical criteria in these listings; they remain the same as they now appear in the Code of Federal Regulations. These extensions will ensure that we continue to have medical evaluation criteria in these listings to adjudicate claims for disability based on impairments in these body systems at step three of our sequential evaluation process.

Disability Evaluation↗