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PubMed2003

A comparison of anxiety and depression in sex offenders with intellectual disability and a control group with intellectual disability.

The aims of this study were to employ modified versions of the 21-item Beck Anxiety and Depression Inventories with a group of 16 sex offenders with mild intellectual disability and borderline intelligence and 16 control participants with similar levels of intellectual disability. Test-retest correlations found high reliability for both assessments across all participants. There was a significant differences between the scores of the 2 groups with the sex offenders reporting significantly lower levels of anxiety and depression than the control participants. The results are discussed by presenting hypotheses on the emotional stability in each group.

Adult↗
PubMed2002

Beyond disability: perceived participation in people with a chronic disabling condition.

OBJECTIVE: To describe the impact of a chronic disabling condition on participation and to identify variables that may explain perceived restrictions in participation. STUDY DESIGN: Cross-sectional. SETTING: People were recruited from the outpatient clinics of two rehabilitation centres and the rehabilitation department of an academic hospital. SUBJECTS: One hundred and twenty-six people from five diagnostic groups (neuromuscular disease, rheumatoid arthritis, spinal cord injury, stroke, fibromyalgia) participated in the study. METHOD: The IPA (Impact on Participation and Autonomy) questionnaire was used to describe perceived participation. Explanatory variables were studied in terms of sociodemographic factors and health status variables. RESULTS: Some restrictions in participation seem comparable among diagnostic groups, others are specific to one or two groups. People with stroke, rheumatoid arthritis or fibromyalgia perceived more restrictions in participation than people with spinal cord injury or neuromuscular disorders. Emotional distress was the most important factor contributing to restrictions in participation. CONCLUSIONS: Perceived participation remains a complex concept in which many factors are involved. To make a contribution to meaningful participation of people with a chronic disabling condition, rehabilitation treatment should address physical, social, emotional and environmental aspects.

Adult↗
PubMed1988

Veracity of disability claimants' self-reports of current smoking status. Comparison of carboxyhemoglobin levels from disability claimant and reference population.

Carboxyhemoglobin level (%COHB) obtained during pulmonary function testing was used as a measure of recent tobacco smoking among persons claiming to be nonsmokers and ex-smokers. Asbestos disability applicants and reference routine clinical patients had similar mean %COHB (2.09 +/- 1.34 and 1.99 +/- 0.88, respectively) and proportions with abnormally elevated %COHB (35 and 46 percent, respectively, had %COHB greater than 2 percent). However, comparisons of persons claiming to be ex-smokers and nonsmokers showed that the ex-smokers had higher mean %COHB (p less than 0.001 by analysis of variance) and proportions with elevated %COHB. This study suggests that disability applicants and routine clinical patients do not differ in veracity of self-stated smoking information, but many persons claiming to be ex-smokers are actually not.

Asbestosis↗
PubMed2007

Use of International Classification of Functioning, Disability and Health (ICF) to describe patient-reported disability in multiple sclerosis and identification of relevant environmental factors.

OBJECTIVE: To use the International Classification of Functioning, Disability and Health (ICF) to describe patient-reported disability in multiple sclerosis and identify relevant environmental factors. METHODS: Cross-sectional survey of 101 participants in the community. Their multiple sclerosis-related problems were linked with ICF categories (second level) using a checklist, consensus between health professionals and the "linking rules". The impact of multiple sclerosis on health areas corresponding to 48 ICF categories was also assessed. RESULTS: A total of 170 ICF categories were identified (mean age 49 years, 72 were female). Average number of problems reported was 18. The categories include 48 (42%) for body function, 16 (34%) body structure, 68 (58%) activities and participation and 38 (51%) for environmental factors. Extreme impact in health areas corresponding to ICF categories for activities and participation were reported for mobility, work, everyday home activities, community and social activities. While those for the environmental factors (barriers) included products for mobility, attitudes of extended family, restriction accessing social security and health resources. CONCLUSION: This study is a first step in the use of the ICF in persons with multiple sclerosis and towards development of the ICF Core set for multiple sclerosis from a broader international perspective.

Activities of Daily Living↗
PubMed1993

Nondiscrimination on the basis of disability by public accommodations and in commercial facilities; Americans With Disabilities Act accessibility guidelines for buildings and facilities--Department of Justice. Final rule: technical amendment.

This document contains technical amendments to the regulations on nondiscrimination on the basis of disability by public accommodations and in commercial facilities, which implement title III of the Americans with Disabilities Act (ADA) and to appendix A to those regulations. This final rule makes some technical corrections to the regulations and amends the regulations to reference an Office and Management and Budget control number in compliance with the Paperwork Reduction Act of 1980, as amended.

Architectural Accessibility↗
PubMed1982

Federal Old-Age, Survivors, and Disability Insurance; revised medical criteria for the determination of disability--Social Security Administration. Proposed rules.

These proposed amendments revise the medical evaluation criteria for both the title II and title XVI disability programs. These criteria were last revised in 1979. The proposed revisions reflect advances in the medical treatment of some conditions and in the methods of evaluating certain impairments. These proposals will provide up-to-date medical criteria for use in the evaluation of disability claims.

Disability Evaluation↗
PubMed2000

Old-age, survivors, and disability insurance and Supplemental Security Income for the aged, blind, and disabled; substantial gainful activity amounts; "services" for trial work period purposes--monthly amounts; student child earned income exclusion. Social Security Administration. Final rules.

We are revising the rules to automatically adjust each year, based on any increases in the national average wage index, the average monthly earnings guideline we use to determine whether work done by persons with impairments other than blindness is substantial gainful activity; provide that we will ordinarily find that an employee whose average monthly earnings are not greater than the "primary substantial gainful activity amount," has not engaged in substantial gainful activity without considering other information beyond the employee's earnings; increase the minimum amount of monthly earnings and the minimum number of self-employed work hours in month that we consider shows that a person receiving title II Social Security benefits based on disability is performing or has performed "services" during a trial work period, and automatically adjust the earnings amount each year thereafter; increase the maximum monthly and yearly Student Earned Income Exclusion amounts we use in determining Supplemental Security Income (SSI) Program eligibility and payment amounts for student children, and automatically adjust the monthly and yearly exclusion amounts each year thereafter. We are revising these rules as part of our efforts to encourage individuals with disabilities to test their ability to work and keep working. We expect that these changes will provide greater incentives for many beneficiaries to attempt to work or, if already working, to continue to work or increase their work effort.

Child↗
PubMed2003

Association of the Japanese Orthopaedic Association score with the Oswestry Disability Index, Roland-Morris Disability Questionnaire, and short-form 36.

STUDY DESIGN: Cross-cultural translation and cross-sectional psychometric testing were performed. OBJECTIVES: To cross-culturally translate the Oswestry Disability Index (ODI) and the Roland-Morris Disability Questionnaire (RMDQ) into Japanese, and to compare the Japanese Orthopaedic Association (JOA) score with the ODI and the RMDQ score. SUMMARY OF BACKGROUND DATA: The two most widely used back-specific measures, the ODI and the RMDQ, have not been translated into Japanese. The JOA score has been used extensively in Japan. However, this score has not been tested in terms of its reliability and validity. METHODS: The ODI and RMDQ were translated into Japanese using the process of forward translation, synthesis of translation, backward translation, expert committee, test of the prefinal version, and submission of the documentation to the developers. The JOA score, ODI, and RMDQ were tested with 97 patients who had degenerative lumbar spinal disorders (average age, 51 years). The correlation among the three disease-specific measures (JOA score, ODI, and RMDQ) and eight subscales of a generic health measure, the Medical Outcomes Survey Short-Form 36 (SF-36), was calculated. The reproducibility of the JOA score also was investigated. RESULTS: Reliability, as estimated by internal consistency, reached a Cronbach alpha of 0.83 for the ODI and 0.86 for the RMDQ. The calculated test-retest reliability was 0.93 (P < 0.01; n = 20) for the ODI and 0.95 (P < 0.01; n = 20) for the RMDQ. The correlation of the JOA score with the ODI was -0.647 (P < 0.01), and with RMDQ was -0.568 (P < 0.01). There also was a significant correlation between the ODI and the RMDQ (r = 0.785; P < 0.01). There was a significant correlation between the three disease-specific measures (JOA score, ODI, and RMDQ) and all the subscales of the SF-36 (P < 0.01). The calculated reproducibility of the JOA score was as follows: interobserver error (r = 0.92, P < 0.01), test-retest reliability (r = 0.91, P < 0.01). CONCLUSIONS: The Japanese versions of the ODI and the RMDQ were reliable and valid. The use of these translated instruments can be recommended for future clinical trials in Japan. The results also showed the JOA score had acceptable psychometric properties of reliability and construct validity, suggesting that this score is reliable and valid. Further studies are needed to verify the validity and responsiveness of the JOA score.

Cross-Cultural Comparison↗
PubMed1992

Respiratory disability. The uncoupling of oxygen consumption and disability.

In the past it was believed that respiratory disability could be objectively assessed by comparing the measured O2 consumption requirement of the job with the subjects' measured or estimated maximal oxygen consumption. More recently, it has become clear that this "classic" paradigm does not completely apply to all situations. This article reviews recent aspects of respiratory disability assessment.

Asthma↗
PubMed2004

TRICARE; Individual Case Management Program; Program for Persons with Disabilities; extended benefits for disabled family members of active duty service members; custodial care. Final Rule.

The Department is publishing this final rule to implement requirements enacted by Congress in section 701(g) of the National Defense Authorization Act for Fiscal Year 2002 (NDAA-02), which terminates the Individual Case Management Program. The Department withdraws its proposed rule published at 66 FR 39699 on August 1, 2001, regarding the Individual Case Management Program. This rule also implements section 701(b) of the NDAA-02 which provides additional benefits for certain eligible active duty dependents by amending the TRICARE regulations governing the Program for Persons with Disabilities. The Program for Persons with Disabilities is now called the Extended Care Health Option. Other administrative amendments are included to clarify specific policies that relate to the Extended Care Health Option, custodial care, and to update related definitions.

Case Management↗
PubMed2005

Training the next generation of researchers in work disability prevention: the Canadian Work Disability Prevention CIHR Strategic Training Program.

INTRODUCTION: There is a need to create, disseminate, and implement new knowledge in the work disability prevention (WDP) field. Training programs attracting high-quality applicants and taking into account the complexity of this emerging field are urgently needed. METHODS: An advanced training program, funded by the Canadian Institutes of Health Research (CIHR), was developed by 24 mentors affiliated with nine different universities. The main objective of this program is to develop transdisciplinary knowledge, skills, and attitudes regarding WDP. This program has been developed for PhD students or post-doctoral fellows already registered full-time in a Canadian or recognized foreign university whose main interest is WDP, regardless of the health problem. RESULTS: Since its implementation, the program received two successive cohorts of 10 students. They were registered in 13 universities in five countries and trained in nine different disciplines. CONCLUSIONS AND SIGNIFICANCES: Appropriate WDP research may save major societal costs attributable to prolonged work disability. The proposed training program will contribute to developing tomorrow's research workforce.

Attitude of Health Personnel↗
PubMed2002

American Academy of Disability Evaluating Physicians (AADEP) position paper: complex regional pain syndrome I (RSD): impairment and disability issues.

OBJECTIVE: To provide an overview and methodology for the evaluation of impairment and functional residual capacity in complex regional pain syndrome I (CRPS I, RSD). This paper is intended to provide assistance to physicians asked to evaluate impairment- and disability-related issues and is not primarily geared to guide treatment of the CRPS I patient. METHOD: Conference and literature review by neurology, anesthesiology, pain medicine, physiatry, and disability evaluating physicians followed by description of issues, options, and recommendations based upon the committee's deliberations and the widely used AMA Guides to the Evaluation of Permanent Impairment, fourth and fifth editions. The authors present functional criteria for assessing the severity of CRPS. These criteria were developed by committee consensus opinion based on multidisciplinary clinical experience considering daily functional issues. They can be used in conjunction with CRPS-ADL Classes of Impairment in order to categorize an individual into a specific class for purposes of permanent impairment rating. Future reliability and validity studies of this rating scale are pending future use, acceptance and, hopefully, additional studies. RESULTS: Evaluators should perform a comprehensive assessment of patients with CRPS I to make an accurate diagnosis and exclude other conditions that could explain the symptoms and signs of the condition. While radiological, laboratory, and other diagnostic studies may be of assistance in making the diagnosis, in the final analysis, this is a clinical diagnosis. Impairment is based on objectively validated limitation in activities of daily living (ADL).

Journal Article↗
PubMed1982

Federal Old-Age, Survivors, and Disability Insurance and Supplemental Security Income for the Aged, Blind and Disabled; representative payment--SSA. Final rule.

These final regulations reorganize and restate in simpler language our regulations on representative payment under titles II, Old-Age, Survivors, and Disability Insurance (OASDI), and XVI, Supplemental Security Income for the Aged, Blind, and Disabled (SSI) of the Social Security Act. These regulations (1) explain representative payment; (2) state when title II and title XVI benefits will be paid to a representative payee rather than directly to the entitled person; (3) indicate the procedure we follow in selecting a representative payee; (4) specify the responsibilities of a representative payee; and (5) clarify our responsibilities to the beneficiary when we make payments to a representative payee on his or her behalf.

Social Security↗
PubMed1999

Grant award to the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska. Center for Substance Abuse Treatment (CSAT), Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), HHS. Availability of grant funds for the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska.

This notice is to inform the public that CSAT and CMHS are making available approximately $5,000,000 for an award in FY 1999 to the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska to support development, implementation, and evaluation of a comprehensive, seamless system of care for persons with co-occurring substance abuse (including alcohol and other drugs) and mental health disorders in Anchorage, Alaska, and its environs. CSAT and CMHS will make this award if the application is recommended for approval by the Initial Review Group and the CSAT and CMHS National Advisory Councils. This is not a formal request for applications; assistance will be provided only to the Alaska Division of Mental Health and Developmental Disabilities. Eligibility for this program is limited to the State of Alaska, as specified in Congressional report language, in recognition of primacy of its responsibility for, and interest in, providing for the needs of its citizens, and because the success of the program will depend upon the authority and ability to broadly coordinate the variety of resources essential for full program success. The State has committed itself to moving certain mental health services from their extant institutional bases to community bases, and, simultaneously, changing from parallel systems of service delivery--for substance abuse and mental health problems--to an approach designed to deliver services seamlessly to persons with comorbidity. Alaska needs a high level of systemic competence in delivering these services due, in great part, to its climate (resulting in deaths of homeless comorbid persons), and to the requirements of its proposed systems changes. The proposed project presents a unique opportunity for SAMHSA and its Centers to learn, first hand, how the transition from parallel systems to a seamless system of care can be accomplished in a small city in a rural/frontier State, and at what costs. The project promises to yield learnings on the factors and circumstances that facilitate and/or retard systemic change in complex treatment systems. This "Anchorage Comorbidity Services" project is also part of SAMHSA's commitment to improving services, and relates directly to the resolution unanimously adopted by its National Advisory Council earlier this year. Funding from CSAT and CMHS will support some services to persons with co-occurring disorders; continuing planning, review, management, and infrastructure development for the effort; and a tripartite evaluation of the project, including process, outcome, and impact evaluations. This is a unique opportunity to evaluate significant change in a State system of care for persons with co-occurring disorders.

Alaska↗
PubMed1999

Psychiatric disability, employment and the Americans with Disabilities Act.

Understanding the ADA as it applies to employment is necessary for a psychiatrist to be useful in the assessment of disability under the ADA. As more claims are brought into the courtroom, the growing body of case law will further elucidate the fine points of interpretation of the ADA.

American Dental Association↗
PubMed1999

A systematic review of the evidence base for lifestyle planning in adults with learning disabilities: implications for other disabled populations.

OBJECTIVE: To carry out the first systematic review of the evidence base for lifestyle planning (LP) approaches in adults with learning disability/developmental disorder and to discuss implications for other handicapped/disabled groups. METHOD: Exhaustive review of relevant electronic databases, supplemented by appropriate hand-searching of journals and correspondence with key researchers. We gathered information from any papers reporting clear outcome measures. Quantitative and qualitative aspects of relevant studies are appraised. RESULTS: There are no randomized controlled trials of lifestyle planning in adults with learning disability/developmental disorder. There was one controlled trial. Five studies, with a total of 108 subjects clearly identified, report on some outcome data. CONCLUSIONS: There is surprisingly little evidence to support any form of lifestyle planning or lifestyle planning in general in the learning disability population. No statistically significant findings on positive outcomes with good statistical power exist. Limited data are presented to suggest certain desirable features of some methods of lifestyle planning in terms of process or outcome. However, there may be good ethical reasons for pursuing lifestyle planning with certain patient groups. Suggestions are made as to how further research may add to the evidence base for or against effective outcomes in different forms of lifestyle planning.

Adult↗
PubMed2000

The role of the pediatrician in transitioning children and adolescents with developmental disabilities and chronic illnesses from school to work or college. American Academy of Pediatrics. Committee on Children With Disabilities.

The role of the pediatrician in transitioning children with disabilities and chronic illnesses from school to work or college is to provide anticipatory guidance and to promote self-advocacy and self-determination. Knowledge of the provisions of the key federal laws affecting vocational education is essential for the pediatrician's successful advocacy for patients.

Adolescent↗