SEARCH · PubMed Health

Results for “disability”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

PubMed2000

Is sexual abuse of children with disabilities disclosed? A retrospective analysis of child disability and the likelihood of sexual abuse among those attending Norwegian hospitals.

OBJECTIVE: According to North American studies disabled children are at 2-3 times greater risk of being sexually abused than non-disabled. If the risk ratio for disabled children in Norway is similar, and the disclosure of sexual abuse is the same for disabled as for non-disabled, one should expect disabled children to constitute 2-3 times the 11% they constitute in the general population. This research aimed to investigate if this is the case for Norwegian children, and to find characteristics within in the handicapped group suspected of being sexually assaulted. METHOD: A questionnaire was addressed to all Norwegian pediatric hospitals. Of interest were numbers of children having a medical examination for possible sexual assault in the years 1994-1996, the number with a smaller or severe disability, a description of the disability, age and gender, and the conclusion of the examination as to the likelihood of sexual abuse. RESULTS: The severely disabled children constituted only 1.7% of the examined 1293 children. Altogether, 6.4% of the children had a smaller or severe disability. These children were more often assessed as "probably assaulted" than the non-disabled. The disabled group had a larger part of boys than the non-disabled group. CONCLUSIONS: Children with disabilities make up a smaller part of children coming to pediatric hospitals with the suspicion of being sexually abused than expected. The results indicate that when a child has a severe disability, the caretakers do not seem to recognize it as sexual abuse before it is quite obvious.

Adolescent↗

PubMed1998

Visual behaviour and dyadic interaction between people with intellectual disability and people who are non-disabled.

Patterns of visual dominance in human interaction have been studied by a number of authors. The purpose of the present research was to investigate the implications of these studies for interaction between people who are disabled and people who are non-disabled. It was predicted that disability would differentiate the two groups, with non-disabled partners dominating the visual interaction. Two studies are reported. The first looked at visual interaction through the two looking modes of looking while listening and looking while speaking between 16 dyads where one partner was intellectually disabled and the other non-disabled. In the second study, eight subjects who were intellectually disabled and who had participated in the first study interacted with another person who had an intellectual disability. Their looking modes were then compared between conversing with a non-disabled partner in study 1 and with those of their partner with intellectual disability in study 2. The outcome of the studies showed that subjects who were intellectually disabled did not discriminate in looking mode between partners of different intellectual levels. Conversely, subjects who were non-disabled spoke and looked significantly more when conversing with their partner who was intellectually disabled. It has been argued that overlooking and overspeaking could arise from the need for the non-disabled person to gain some sign of affiliation from their partner, or alternatively, that it might reflect a dominant non-disabled person attempting to facilitate a cooperative style.

Adolescent↗

PubMed2000

Preclinical mobility disability predicts incident mobility disability in older women.

BACKGROUND: Physical disability and dependency are serious, and frequent, adverse health outcomes associated with aging and resulting from chronic disease. Reasoning has suggested that there might be a preclinical, intermediate phase of disablement which might develop in parallel with progression of underlying disease and precede and predict disability. Definition of this stage could provide a basis for screening and early intervention to prevent disability. The objective of this study was to determine preclinical functional predictors of incident mobility difficulty and provide evidence for a preclinical stage of disability. METHODS: A prospective, population-based cohort study was carried out in Baltimore, Maryland, with two evaluations 18 months apart. The participants were 436 community-dwelling women, 70-80 years of age at baseline, not cognitively impaired, and reporting difficulty in no areas, or only one area, of physical function (primarily mobility), who were participating in the Women's Health and Aging Study II. Participants were recruited from a population-based, age-stratified random sample. Incident mobility disability was studied in the subset without such disability at baseline. The main outcome measure was self-reported incident difficulty walking 1/2 mile or climbing up 10 steps. RESULTS: At baseline, 69.3% of the cohort reported no difficulty with mobility. After 18 months, 16.0 and 11.7% of this group reported incident difficulty walking 1/2 mile or climbing up 10 steps, respectively. Those reporting baseline task modification due to underlying health problems, our measure of preclinical disability, were at three- to fourfold higher odds of progressing to difficulty than were those without such modification. In multivariate logistic regression analyses, this self-report measure, task modification without difficulty, and objective measures of performance were independently and jointly predictive of incident mobility difficulty. Specifically, for incident difficulty walking 1/2 mile, self-reported task modification odds ratio (OR) = 3.67, walking speed (.5 m/s difference) OR = 2.16; for incident difficulty climbing up 10 stairs, OR for task modification = 3.84, for stair climb speed (1/3 step/s difference) = 2.08 (95% CI did not include 1 for any). Covariates, age, living alone, number of chronic diseases, depression score, knee strength, and balance by functional reach, were not significant predictors in either model. CONCLUSIONS: Two indicators of functional changes in older women without mobility difficulty, self-report of modification of method of doing a task in the absence of difficulty and performance measures, are independent and strong predictors of risk of incident mobility disability. The self-report measure provides substantial strength in predicting risk of incident disability across the full range of performance, and may identify a vulnerable point at which other risk factors act to cause transitions to disability. Together, the preclinical indicators identify a subset of high-functioning older women who are at high risk of mobility disability, and provide a potential basis for screening for disability risk and targeting interventions to prevent mobility disability.

Activities of Daily Living↗

PubMed1997

Addressing barriers: disabled rights and the implications for nursing of the social construct of disability.

Drawing upon the writings of disabled people, this paper explores some of the issues which nurses working with disabled people are trying to address, in particular the barriers model of disability. Traditionally disability has been regarded as a personal tragedy afflicting the individual, hence the response to disability has been via the charity, health and welfare systems. Disabled people over the past two decades have substantially challenged this view of disability and the responses it prompts, arguing that disability is created by social barriers and barriers in the built environment. This requires a different response. Nurses working with disabled people, such as learning disability nurses, have struggled to develop more appropriate responses to disability, for example by developing working alliances with people with learning difficulties in order to both promote health and address disabling barriers. The issues these nurses face and some of the lessons disabled people have taught them are relevant to the nursing profession's wider struggle to shed its medical and dependency image.

Attitude of Health Personnel↗

PubMed2005

What does "disability" mean for medical students? An exploration of the words medical students associate with the term "disability".

CONTEXT: Disability teaching is a core theme in undergraduate medical education. Medical students bring a range of experiences of disability to their medical training. AIM: The principal aim of this study was to explore the words that medical students associate with the term "disability" and to consider how the resulting information could inform teaching. A secondary aim was to see if a short disability course changed the word associations. METHODS: Students were asked to write down 2 words that came to mind when they heard the word "disability", before and after a 4-day course in disability. Words from 4 cohorts were analysed by frequency and the following word dichotomies: visual icons/personal attributes; loss/enabling, and medical model/social model. A random sample of students took part in focus groups at the beginning and end of the course. RESULTS: A total of 381 students provided 667 before-course words and 189 students provided 336 after-course words. Before the course, words denoting visual icons of disability, and loss were prominent, accounting for 85% of the words, and 74% of the words describing personal attributes were negative. Focus group responses at this stage reflected an eagerness to help but patronising terms were prominent, along with concern about political correctness. Students also expressed nervousness about encountering disabled people. In response, teaching was adapted to make it more learner-focused, to offer a safe environment in which students can test out their language, to build on the positive associations and to develop a range of pre-course creative activities with disabled people. After the course a considerable and significant shift in emphasis was observed, with a reduction in the use of visual icon words, an increase in words denoting enablement, and an increase in words relating to the social model of disability and to positive personal attributes (P < 0.001). Focus group participants at this stage reported greater confidence in approaching disabled people but continued to question political correctness. CONCLUSIONS: Medical students associate disability predominantly with depersonalised or negative words. A short disability course appears to change these associations. Reasons for this and implications for teaching are discussed.

Attitude of Health Personnel↗

PubMed2000

[Measuring disability of patients with low-back pain--validation of a German version of the Roland & Morris disability questionnaire].

INTRODUCTION: In this study three instruments measuring disability of patients with low-back pain are presented and evaluated: (1) the Behinderungsfragebogen (RM) - a German version of the Roland & Morris disability questionnaire (RDQ) (2) a numerical rating scale measuring disability in general and (2) eight numerical rating scales measuring specific dimensions of disability (standing, sitting, walking, driving a car, carrying light loads, carrying heavy loads, sleeping, and sexual intercourse). METHODS: The psychometric evaluation, including the item analysis, test reliability, test validity, and responsiveness of the instruments, is based on two samples. Sample A comprises 345 patients with low-back pain: 282 of these patients took part in the Swiss multicentre intervention study testing the effectiveness of in-patient rehabilitation of sub-chronic and chronic low-back pain under an integrative group treatment program. The instruments were administered at different times in the therapeutic process (t1: at hospital admission; t4: follow-up after one year). 63 patients were hospitalized (orthopedic or rheumatological units) for medical examinations (myelography or infiltration of facets) or rehabilitation of low-back pain. The instruments were administered twice within 24 h to measure test-retest correlation. In order to determine the psychometric parameters as accurately as possible, the two samples were examined jointly. Sample B is composed of 41 patients with low-back pain participating in the study "Prädiktoren des Erfolgs bei stabilisierenden Wirbelsäuleneingriffen" (Success predictors of effectiveness of surgical interventions for spinal stabilization). RESULTS: All instruments proved to be generally reliable and valid (high or medium correlations with each other and with a German version of the Oswestry Disability Questionnaire) as well as responsive tools for measuring the momentary disability of patients with back pain. The psychometric examination of the test validity showed that patients' perceptions of their disability were influenced by their psychological well-being. The correlation between the 3 instruments and physical tests was low. The RM is not a homogeneous instrument. Factor analysis (principal component analysis, rotation Varimax) indicated 6 factors. Because of the small number of items for each factor it is not appropriate to treat RM in terms of dimensions of disability. CONCLUSIONS: The RM is an instrument measuring patients' perception of their disability that offers simple, fast practicability for patients and tester. The 2 rating scales: The 8 numerical rating scales measuring specific dimensions of disability (QL3) offer all the advantages of the numerical rating scale measuring disability in general (QL1) (simple instruction, high plausibility for the patients, and simple, fast practicability), but they provide more information about the patient's disability, which allows comparisons of disability at different times in the therapeutic process. Numerical rating scales are not suitable for patients with poor ability to abstract. For these patients it is necessary to use a questionnaire which asks concretely about what the patient can or cannot do (e. g. RM). Because of its better psychometric properties, the QL3 should be favored over the RM.

English Abstract↗

PubMed1995

Disability and the transition to adulthood: issues for the disabled child, the family, and the pediatrician.

The pediatrician treating a child with a disability must focus not only on the physical needs of the child but also on the emotional and social issues associated with being disabled in our society. This dual focus becomes increasingly important as the child matures through adolescence and transitions into adulthood. In addition, the pediatrician must understand the complex interrelationships between the family and their maturing, disabled child during the vital process of separation from the family. This transition is particularly difficult for an adolescent who is dependent on others for physical care and other independent living skills. Many of the transitional problems faced by disabled adolescents and their parents have roots in early childhood. With an awareness of the specific stressors on the parent caregivers and an understanding of the influence of disability on the developmental processes, the pediatrician can play a major role in easing the transition of a disabled adolescent into adulthood. By guiding the parents of a young child through the important tasks of childhood and adolescence, the pediatrician can set the stage for both the parents and their disabled child to have independent, yet supportive lives--lives that are focused not on the disability but on mutual respect and life satisfaction. It is recommended that disabled teens and young adults be given more help in independence skills, personal counseling services should be made available, and physicians should give teens age-appropriate information about disabilities. There are needs for sex education, preparation for parenthood, and genetic counseling. Other issues that should be addressed are early vocational awareness, alternatives to work, and leisure time use. Just because an adolescent is disabled, we cannot assume that he or she will have self-esteem and self-concept difficulties. To adjust to being devalued by society, the disabled person must challenge societal beliefs that strength, independence, and appearance are the essential aspects of a quality life. The importance of being kind, intelligent, and productive to one's capacity must become more important. (See Table 3 for additional resource information.)

Activities of Daily Living↗

PubMed2001

Time costs of caring for children with severe disabilities compared with caring for children without disabilities.

To assess time costs of caring for children with severe disabilities in the community compared to caring for children without disabilities, a diary- and questionnaire-based study was carried out. Sixteen complete data sets were obtained from families with children who have disabilities (mean age 8.7 years) and 31 complete data sets from families with normally developing children (mean age 4.9 years). Diagnoses in the study group included cerebral palsy, autism, Sanfillipo syndrome, lissencephaly, and osteogenesis imperfecta. Items of personal care per waking hour were significantly greater in children with disabilities than non-disabled children (p<0.001). In the study group, there was no correlation (r=-0.12) between age and frequency of care whereas a significant correlation was observed between degree of disability as measured by the Functional Independence Measure for children (WeeFIM) and frequency of care items (r=0.89). Twelve of the 16 mothers in the study group were not in paid employment. Twelve had little or no extended family support. Benefits awarded did not correlate with the degree of disability as measured by the WeeFIM (r=-0.11). Care needs of children with severe disabilities are significantly greater than those of non-disabled children and do not decrease with advancing age. Mothers of children with disabilities are unable to work outside the home because of these care needs. This brings the family income, even when benefits are included, to a level that is less than peer families with non-disabled children. A Functional Disability Score may help to achieve more appropriate allocation of state resources.

Child↗

PubMed2002

Disability, spiritual beliefs and the church: the experiences of adults with disabilities and family members.

AIMS: This paper reports the findings of a qualitative interpretive study that explored how people with disabilities and family members use their spiritual beliefs to establish meaning for disability, and to respond to the challenges of lived experience with disability. The participants' perceptions of the evangelical Christian church's influence on their spiritual experiences related to disability suggest recommendations for improved integration by the church. Applications are drawn for helping professionals and religious leaders who provide holistic care. BACKGROUND/RATIONALE: Although there is a well-established literature on coping in families with disabled children, little is known about how people use spiritual beliefs to establish meaning for and respond to life with disability. Even less is known about how people with a particular set of shared spiritual beliefs make meaning for lived experience with disability. DESIGN/METHODS: The author interviewed 30 persons, comprising two major groups: 13 parents of children with mixed developmental disabilities and nine adults with physical disabilities. Predominantly white, the participants lived in a south-western metropolitan area in the United States of America (USA) in 1998. FINDINGS: Trial or difficulty contributed to spiritual challenge, the breaking of self, reliance on God, and strengthened faith in God. The participants chose to live with thankfulness and joy despite difficulties common to experience with disability. The participants' spiritual beliefs stabilized their lives, providing meaning for the experience of disability, assistance with coping and other benefits. The participants' recommendations include increased assistance by the church in promoting theological understanding of disability, and religious support using a continuing model of caring. CONCLUSIONS: Although the study design limits the generalizability of the findings, applications can be drawn for helping professionals and religious leaders who provide holistic care

Adaptation, Psychological↗

PubMedDate not supplied

How does the severity of a learning disability affect working memory performance?

Working memory performance was examined in children aged 11-12 years who had borderline, mild, and moderate learning disabilities. Comparisons with children of average abilities were used to determine whether those with more severe learning disabilities had greater impairments in working memory. Seven measures of working memory span were used to assess temporary phonological short-term storage (digit span, word span), temporary visuo-spatial short-term storage (pattern span, spatial span), and temporary short-term storage with additional processing, or central executive, demands (listening span. odd one out span, reverse digit span). Children with mild and moderate learning disabilities were impaired on all measures of working memory compared to children of average abilities. Children with borderline learning disabilities were just as good as children with average abilities on visuo-spatial and complex span tasks, but showed an impairment on phonological span tasks. Children with moderate learning disabilities were indistinguishable from children with mild learning disabilities on simple span tasks, but were significantly poorer than the mild group on the more demanding complex span tasks. For the group as a whole, working memory was strongly related to mental age.

Case-Control Studies↗

PubMed2000

Effects of different forms of school contact on children's attitudes toward disabled and non-disabled peers.

BACKGROUND: There have been fluctuations in research interest into the inclusion of children with disabilities in mainstream schools over the last twenty years. It is still not clear what methods, practices and types of contact are most likely to promote positive attitudes in children toward disabled peers and disability generally. AIMS: To consider two theoretical models of inter-group contact, both claiming to identify precursors for generalised attitude change, in relation to the attitudes of non-disabled children toward disabled peers as a function of different classroom contact. SAMPLE: Participants were 256 non-disabled school children aged 5-11 years (128 girls and 128 boys). METHODS: Measures of sociometric preference and the evaluation of psychological and physical attributes were used to ascertain children's perceptions of known and unknown peers with disabilities. RESULTS: A relationship was found between the type of contact the children had with disabled peers, and their perceptions of psychological and physical attributes (stereotypes) of groups of unknown disabled and non-disabled peers. CONCLUSIONS: Results show generalisation of stereotypic attitude/judgments from one type of disability to another as a consequence of the two types of contact situation. Findings have important implications for integrating disabled children into mainstream.

Attitude↗

PubMed2005

Disability assessment in mental illnesses using Indian Disability Evaluation Assessment Scale (IDEAS).

BACKGROUND & OBJECTIVE: Psychiatric disorders cause disability in individuals and pose significant burden on their families. In most of the cases residual disability and poor quality of life continue even after disability evaluation in patients with chronic mental illness in very important. The present study was undertaken to assess and compare the disability in patients with schizophrenia and obsessive-compulsive disorder (OCD) using Indian Disability Evaluation Assessment Scale (IDEAS). METHODS: Patients diagnosed to have schizophrenia and OCD with mild severity of illness were included in the study. Indian Disability Evaluation Assessment Scale (IDEAS) was applied. Disability was assessed in these patients on all domains of IDEAS. RESULTS: Majority of the patients with schizophrenia were from rural areas whereas most of the patients with OCD were from urban background. There was comparable disability in the patients with schizophrenia with duration of illness in the range of 2-5 yr and >5 yr. Significant disability in work and global score was seen in patients of obsessive-compulsive disorder with duration of illness >5 yr. Patients with schizophrenia had significantly higher disability in all domains than patients with OCD. INTERPRETATION & CONCLUSION: Schizophrenia causes greater disability than obsessive-compulsive disorder in patients. These illnesses affect all areas of daily functioning leading to greater disability, and thus increasing the burden on the family, pose greater challenge for the rehabilitation of patients and their inclusion in the mainstream of the family and society. Further studies on a larger sample need to be done to confirm the finding.

Adolescent↗

PubMed1998

Differences in contraceptive methods used by women with physical disabilities compared to women without disabilities.

Women with physical disabilities face unique challenges often not addressed by gynecologists regarding choices of contraceptive method. Interactions between some hormonal methods of contraception and disability-related medications, inability to use barrier methods because of limitations in manual dexterity, potentially elevated risk for DVT, and need for menstrual management are factors that complicate decisions about contraceptive methods for this growing population.Objective: This study assessed similarities and differences in the use of and satisfaction with different methods of birth control between women with disabilities and women without disabilities, while controlling for age at onset and severity of disability.Methods: As part of a national survey, 616 women of childbearing age (315 with a variety of physical disabilities, 301 without disabilities) reported their use of and satisfaction with various forms of contraception.Results: Women with physical disabilities were significantly less likely than women without disabilities to use hormonal (11.7%/19.6%) or barrier methods (11.1%/17.6). They were significantly more likely to have had a hysterectomy (8.9%/4.3%) or use no method (41.9%/33.4%). There were no significant differences in the use of surgical methods (22.9%/22.6%) or natural methods (3.5%/2.7%). Women with more severe disabilities were significantly more likely to have had hysterectomies or use surgical or no method of contraception. Women with disabilities were least satisfied with barrier methods.Conclusion: Women with disabilities are more likely to use permanent methods or no method of contraception. Further research is needed to understand the impact of functional limitations and other disability-related factors on the use of other contraceptive methods in this population.

Journal Article↗

PubMed2001

Permanent impairments, disabilities and disability pensions related to accidents in Norway.

The purpose of this study was to estimate the burden of accidents in terms of new disability pensioners related to accidental injuries in Norway and to use this information to supplement the picture of the epidemiology of accidents in Norway. The basis of the study was 7,241 new disability pensioners due to accidents in the Disability Register of the National Insurance Administration in Norway for 1992-1997. Included in the analyses are some data from health surveys in USA and Norway. The rate of disability pensioners (16-66 years old) due to accidents increased 4% annually during 1992-1997, and in the age group 16-44 years 8% annually. The increase is found in all types of accidents, except for home and the group other accidents, where the rate is constant. 45% had been injured in traffic accidents, 33% in occupational accidents, 16% in leisure accidents, 4% in home accidents and 2% in other accidents. The rates of disability pensionings due to occupational accidents are three to four times higher among 'blue collar' workers than among 'white collar' workers. While disability pensioning rate in the age group 16-66 years due to accidents has increased 4% annually, the accident mortality for the age group 15-64 years has decreased 3% annually. The relationship between disability pensioning and mortality in the age group 15-64 years is found to be approximately 2:1 for all accidents. For occupational accidents the relationship is 5:1, for traffic accidents 2.5:1, for leisure and other accidents 1:1 and for home accidents 1:2.7. The complete epidemiologic picture due to accidents in Norway per 100,000 of population seems to be: medically treated, 10,000; hospitalised, 1,200; permanently impaired, 800 (of whom probably 50% are treated as out-patients); disabled (restricted activity), 400; fatalities, 40; and disability pensioned in the age group 16-66 years, 50. Medically treated and hospitalised patients due to accidents seem to show a slightly decreasing rate, fatalities a higher decreasing rate. This supplement to the epidemiological picture of rates and trends of impairments, disability and disability pensionings (the more serious consequences of accidents), points to the need to focus on the current trends for accident prevention.

Accident Prevention↗

PubMed2004

Disability in society-medical and non-medical determinants for disability pension in a Norwegian total county population study.

The objective of this study was to describe sociomedical determinants and developments for the medically based disability pension in Norway by linking individual based data from a county health survey to data on disability from the National Insurance Administration. Two cross-sectional total population health surveys with an approximate 10-year interval were conducted in Nord-Trøndelag county, HUNT I (1984-86) and HUNT II (1995-97), which allows for analyses of changes over time, supplied with official incidence data on disability pension. The large-scale variations and overall increasing incidence rates of disability pension in Norway during the last 20 years also applied to the county of Nord-Trøndelag. The prevalence of disability pension generally increased in the population from the mid-1980s to the mid-1990s. A striking finding was a consistent pattern of increasing prevalence of disability pension with decreasing socio-economic status and education. A geographic pattern for disability pension prevalence on a municipality level suggested that structural and cultural factors were important in determining the level of disability in society. Medical determinants alone cannot explain either the dramatic variations or the overall increased incidence rates of disability pension in the last two decades in Norway. The results demonstrate the importance of social, non-medical and contextual determinants for disability pension, how these determinants result in important prevalence differences by socio-economic status, and their impact on the level of disability in society.

Adult↗

PubMed2005

The global burden of migraine: measuring disability in headache disorders with WHO's Classification of Functioning, Disability and Health (ICF).

This overview of the published epidemiological evidence of migraine helps to identify the size of the public-health problem that migraine represents. It also highlights the need for further epidemiological studies in many parts of the world to gain full understanding of the scale of clinical, economic and humanistic burdens attributable to it. This paper presents some of the work on migraine undertaken by the World Health Organization (WHO) in the Global Burden of Disease study conducted in 2000 and reported in the World Health Report 2001. Migraine was not included in the first Global Burden of Disease 1990. The paper also discussed the measurement of disability attributable to headache disorders using WHO ICF Classification. Using disability-adjusted life years (DALYs) as a summary measure of population health (which adds disability to mortality), WHO have shown that mental and neurological disorders collectively account for 30.8% of all years of healthy life lost to disability (YLDs) whilst migraine, one amongst these, alone accounts for 1.4% and is in the top 20 causes of disability worldwide. This information is combined with the increasingly widely accepted belief that disability and functioning are relevant parameters for monitoring the health of nations and that there is an increasing need to measure them. WHO's Classification of Functioning, Disability and Health (ICF) provides a model of human functioning and disability, as well as a classification system, that allows us to highlight and measure all dimensions of disability. ICF applied to headache disorders allows comparability with other health conditions as well as evaluation of the role of the environment as a cause of disability amongst people with headache. Migraine causes a large proportion of the non-fatal disease-related burden worldwide. Our knowledge of headache related burden is incomplete and it is necessary to add to it epidemiological studies in many parts of the world and to combine this with measurements of disability using both DALYs and WHO's ICF Classification. The work described here has been the base for the Global Campaign against Headache disorders: "Lifting the Burden", launched in 2004 jointly by WHO, IHS (International Headache Society), WHA (World Headache Alliance) and EHF (European Headache Federation).

Cost of Illness↗

PubMed2004

Veterans seeking disability benefits for post-traumatic stress disorder: who applies and the self-reported meaning of disability compensation.

Assumptions about the characteristics and motivations of individuals pursuing disability status are well known. However, policy, programming and interventions need to be based on information about the actual sociodemographic characteristics of disabled individuals, as well as their goals in seeking disability status. In this study, we focus on veterans seeking disability compensation for post-traumatic stress disorder (PTSD) from the United States Department of Veterans Affairs. We present information on their life circumstances and their self-reported reasons for valuing the obtainment of veterans' disability status on the basis of PTSD. There was considerable variability in the background of veterans seeking disability status on the basis of PTSD. Of concern, only about half of these individuals were receiving any mental health treatment at the time of application. Most claimants reported seeking disability compensation for symbolic reasons, especially for acknowledgement, validation and relief from self-blame. Reasons having to do with improved finances were less frequently endorsed, although the importance of obtaining improved solvency through disability status decreased as income increased. The sense of investment in obtaining a sense of self-acceptance and acceptance from others through disability status varied by sociodemographic variables. Overall, findings suggest that individuals seeking disability benefits may have unmet mental health care needs, and that policy makers, investigators and providers should consider material benefit as one of many possible reasons for engaging in a disability compensation system.

Disability Evaluation↗

PubMed2002

Serum leptin in disabled and non-disabled children in an Indian slum population.

OBJECTIVE: To assess the concentration of serum leptin in a population of malnourished children and to compare the leptin levels of disabled and non-disabled children in this population. DESIGN: Case-control study. SUBJECTS: Eighty-one children, comprising 41 children with mixed disabilities and 40 non-disabled controls, were selected from 425 children involved in a case-control study assessing the nutritional status of children with disabilities in an Indian slum population. METHODS: Leptin was measured in the serum samples and was compared with anthropometry (weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ), weight-for-height Z-scores (WHZ), body mass index (BMI), mid-upper-arm circumference (MUAC), sub-scapular skinfold thickness and triceps skinfold thickness) and serum acute phase proteins. RESULTS: The children were very malnourished with WAZ=-2.07 (s.d. 1.15), HAZ=-2.15 (s.d. 1.85) and WHZ=-1.07 (s.d. 0.83). Leptin was extremely low in both the disabled (1.44 ng/ml; 95% confidence interval, CI, 1.23-1.69) and the non-disabled (1.19 ng/ml; 95% CI 1.04-1.35) children. There were no differences between the disabled and non-disabled groups as a whole but 15 children with neurological disabilities had significantly higher (P<0.05) serum leptin (1.65 ng/ml; 95% CI 1.29-2.06) than the non-disabled children. Girls (1.55 ng/ml; 95% CI 1.29-1.87) had significantly higher concentrations of leptin than boys (1.11 ng/ml; 95% CI 1.02-1.22; P=0.002). Leptin did not correlate with any biochemical or anthropometric measures. CONCLUSIONS: In this population, where malnutrition was common, serum leptin levels were very low and did not correlate with anthropometry. SPONSORSHIP: UK Department for International Development; Virgin Airways through the Great Ormond Street Hospital Trustees.

Acute-Phase Proteins↗