PubMed Health⌕ Search

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 145 records · Page 8Linked to original sources

[A debate about mental disability expertise of the disability evaluation criteria of traffic accident injurious].

In recent years, mental disability estimation are more than ever in the practice of forensic psychiatric expertise. The standards about mental disability estimation in the Disability Evaluation Criteria of Traffic Accident Injury are ambiguous and difficult to operate, it cause to different understanding in one case. This article discuss some common questions through 3 aspects in mental disability expertise according to some typical cases, there are the first, we should compare the IQ score before and after injurious in intelligence estimate. The second, the mental disability estimation should be done at least one year after the end of medicine treatment. The third, mental estimate scale should be used in mental disability estimation.

Accidents, Traffic↗

[Oligophrenia as a disability diagnosis. Disability pensions in the period 1967-1992 in a group from Bergen born in 1940].

The authors discuss the use of unspecified oligophrenia as a diagnosis for disability pension, and draw attention to unrecognized oligophrenia. The study is based on a cohort of 1,570 persons, comprising all live births from 1940 of the mothers then residing in Bergen. The cohort was followed up in the school system in Bergen at age 14 years, again at age 30 years (1971) and up to the end of 1992. Relevant information on disability pensions was extracted from the files of the National Insurance Administration. The results of medical and psychological examinations in 1971 of a random sample of the cohort are also included. In the cohort 180 persons became new pensioners during the years 1967-92. Of these 10.6% were diagnosed as disable due to oligophrenia. In the sample 69.6% of the IQ-group 55-69 were receiving a disability pension, two thirds with a diagnosis of oligophrenia. In the IQ-group 70-84, 46.4% had a disability pension, one third with the diagnosis oligophrenia. These findings suggest that the use of oligophrenia as a disability diagnosis is less frequent than the prevalence of oligophrenia would in fact seem to justify.

Adult↗

Prevalence of selected developmental disabilities in children 3-10 years of age: the Metropolitan Atlanta Developmental Disabilities Surveillance Program, 1991.

PROBLEM/CONDITION: Serious developmental disabilities affect approximately 2% of school-age children and are lifelong conditions that incur substantial financial and societal costs. REPORTING PERIOD: January 1991-December 1991. DESCRIPTION OF SYSTEM: The Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) monitors the prevalence of four serious developmental disabilities--mental retardation, cerebral palsy, vision impairment, and hearing impairment--among children 3-10 years of age in the five-county metropolitan-Atlanta area. Children who have at least one of the four developmental disabilities are ascertained through annual review of records at schools, hospitals, and other sources. RESULTS AND INTERPRETATION: During 1991, rates for mental retardation varied by age, race, and sex; rates ranged from 5.2 per 1,000 children to 16.6 per 1,000 children. Regardless of the absolute rate of mental retardation in each of the age-, race-, and sex-specific categories, severe mental retardation (i.e., an intelligence quotient of <50) accounted for one third of all cases. The overall crude rate of cerebral palsy was 2.4 per 1,000 children; however, the rate was higher among black children (3.1 per 1,000 children) than among white children (2.0 per 1,000 children). The rate of moderate to severe hearing impairment was 1.1 per 1,000 children, and the rate of vision impairment was 0.8 per 1,000 children. Rates of hearing impairment were higher among black males than among children in the other race and sex groups, whereas rates for vision impairment varied only slightly between these groups. The rates of the developmental disabilities were not adjusted for possible confounding factors (e.g., maternal education, family income, and various medical conditions). Consequently, the variation in rates may reflect social or other characteristics unique to the study population. ACTIONS TAKEN: MADDSP data will be used to direct early childhood intervention efforts to reduce the prevalence of these four developmental disabilities. MADDSP data also are being used to measure progress toward the year 2000 national objectives for the prevention of serious mental retardation.

Cerebral Palsy↗

Accessibility of primary care physicians' offices for people with disabilities. An analysis of compliance with the Americans With Disabilities Act.

OBJECTIVE: To determine if primary care physicians are in compliance with the Americans With Disabilities Act of 1990 (ADA) and to what extent offices of primary care physicians are usable for persons with disabilities. DESIGN: Cross-sectional survey. SETTING: Members listed in the Harris County (Texas) Medical Society roster. SUBJECTS: Sixty-two general practitioners, family practitioners, internists, and obstetrician-gynecologists. MAIN OUTCOME MEASURE: A 15-page questionnaire with 57 items and 136 variables. RESULTS: Eleven (18%) of the primary care physicians in this study were unable to serve their patients with disabilities in the last year for reasons that could be interpreted as noncompliant with the ADA. Two physicians (3%) had offices that patients with disabilities could not enter because of physical barriers, and 1 physician (2%) had inaccessible equipment. Fourteen physicians (22%) were improperly referring patients with disabilities although they generally treat such patients. In measuring the level of compliance with regard to structural features that enhance the accessibility of the physicians' offices, only 8 (13%) had a low level of compliance. Thirty-nine (63%) of the physicians supplied auxiliary aids and services to their patients with disabilities. The most common aid was printed materials. CONCLUSIONS: A substantial portion of primary care physicians' offices are not in compliance with the ADA, and some informational tools will be required to inform physicians about the nondiscriminatory requirements of the statute.

Cross-Sectional Studies↗

The Framingham Disability Study: physical disability among community-dwelling survivors of stroke.

The relationship between stroke and physical disability was examined in a cohort of adult, Framingham, Massachusetts, residents who, between 1948 and 1951, were assembled for a longitudinal examination of cardiovascular disease. Multivariate analyses examined the amount of residual disability attributable to stroke among 2540 community-dwelling survivors, 27 years after their initial examination, after controlling for age, cardiovascular risk factors, other cardiovascular diseases, and eight general health conditions related to physical disability. Among men living in the community, a history of stroke explained 12% of the variance in physical disability. Suffering a stroke, however, was not as strongly related to physical disability among women living in the community, accounting for only 3% of the variance. Results suggest that although older men and women die from the same major causes, they may not be disabled by the same conditions.

Activities of Daily Living↗

Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability.

There is growing evidence for the idea that in back pain patients, pain-related fear (fear of pain/physical activity/(re)injury) may be more disabling than pain itself. A number of questionnaires have been developed to quantify pain-related fears, including the Fear-Avoidance Beliefs Questionnaire (FABQ), the Tampa Scale for Kinesiophobia (TSK), and the Pain Anxiety Symptoms Scale (PASS). A total of 104 patients, presenting to a rehabilitation center or a comprehensive pain clinic with chronic low back pain were studied in three independent studies aimed at (1) replicating that pain-related fear is more disabling than pain itself (2) investigating the association between pain-related fear and poor behavioral performance and (3) investigating whether pain-related fear measures are better predictors of disability and behavioral performance than measures of general negative affect or general negative pain beliefs (e.g. pain catastrophizing). All three studies showed similar results. Highest correlations were found among the pain-related fear measures and measures of self-reported disability and behavioral performance. Even when controlling for sociodemographics, multiple regression analyses revealed that the subscales of the FABQ and the TSK were superior in predicting self-reported disability and poor behavioral performance. The PASS appeared more strongly associated with pain catastrophizing and negative affect, and was less predictive of pain disability and behavioral performance. Implications for chronic back pain assessment, prevention and treatment are discussed.

Adult↗

Helping clinicians in work disability prevention: the work disability diagnosis interview.

Recent evidence has demonstrated that disability from musculoskeletal disorders is a multifactorial problem that is not only due to workers' characteristics but also closely related to environmental factors, such as the workplace, the health care system, the compensation system, and the interactions among all stakeholders regarding the disability problem. The Work Disability Diagnosis Interview (WoDDI) was developed following a systematic method in order to help clinicians detect possible disability prognostic factors in subacute or chronic musculoskeletal pain patients. A structured literature review, followed by expert input and a second round of revisions after 4-year's usage led to the current version. The WoDDI is composed of open-ended questions on physical, psychosocial, occupational, and administrative factors, collated into an interview form used at the first encounter with the disabled worker. It enables clinicians to develop a rehabilitation plan and focus on disability resolution in patients absent from work due to a musculoskeletal disorder. Initial application demonstrated a high prevalence of sociodemographic, work-related, and psychosocial factors that may contribute to prolonged work absence.

Absenteeism↗

Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland.

Over the last 30 years there has been a considerable increase in the life expectancy of people with learning disabilities. This has resulted in changing patterns of morbidity and mortality and an increasing recognition of the health needs of people with learning disabilities. Major strides forward have been made in the reduction of preventable illnesses among the general population. However, among people with learning disabilities such illnesses have received only limited health promotion attention until recently. In the last decade major gaps have been identified in the ability of current primary health services to respond to the needs of people with learning disabilities. The need to respond effectively to this situation has been identified as a priority by the current United Kingdom Government. Following an overview of the literature in relation to the changing health profile of people with learning disabilities and the need for health screening, consideration is given to some of the key difficulties which may be encountered when attempting to utilize current primary health services. The analysis of data derived from the health screening of 373 people with learning disabilities by a community nursing service in Down and Lisburn Health and Social Services Trust reveals the need for further action in relation to cardiovascular status, sensory deficits, mobility and aspects of sexual health.

Activities of Daily Living↗

Daytime behaviour problems and maternal stress in children with Down's syndrome, their siblings, and non-intellectually disabled and other intellectually disabled peers.

The present study investigates the occurrence of daytime behaviour problems and maternal stress in a group of children with Down's syndrome (DS) compared with a group of their non-intellectually disabled siblings, a group of non-intellectually disabled children from the general population and a group of children with an intellectual disability other than Down's syndrome. The Aberrant Behavior Checklist (ABC) and the Malaise Inventory were completed by the mothers. Associations between daytime behaviour problems and maternal stress were also explored. Overall, the children with DS and the children with other intellectual disabilities showed significantly higher rates of behavioural disturbance on all five of the ABC subscales (Irritability, Lethargy, Stereotypies, Hyperactivity and Inappropriate Speech) and on the Total ABC score. However, the children with other intellectual disabilities also showed significantly higher scores than the children with DS on four of the ABC subscales: Irritability, Lethargy, Stereotypies and Hyperactivity, as well as the Total ABC score. The siblings and children from the general population showed very similar behaviour scores. A number of significant age and sex differences were found in the occurrence of daytime behaviour problems. Maternal stress was significantly higher in the group with other forms of intellectual disability than the other three groups, and a number of significant associations were found between parental ratings of daytime behaviour problems and maternal stress in all four samples. The implications of the findings are discussed, including the need for early assessment to minimize adverse effects on the child's development and on family life.

Adolescent↗

Workforce participation by persons with disabilities: the National Health Interview Survey Disability Supplement, 1994 to 1995.

Using the National Health Interview Survey Disability Supplement of 1994 to 1995, we examined the factors associated with employment among Americans with disabilities. Persons with disabilities who were more educated were more likely to be working. Married men were more likely to work than unmarried men (odds ratio [OR], 1.58). Blacks were less likely to work than whites (OR, 0.56). Persons with disabilities related to cardiovascular disease (OR, 0.23), musculoskeletal disease (OR, 0.37), and respiratory disease (OR, 0.23) were less likely to work than other Americans with disabilities. Among persons with psychiatric disorders, there was considerable variety in the propensity to work. Persons with schizophrenia (OR, 0.24) and paranoid delusional disorder (OR, 0.34) were markedly less likely to work; persons with bipolar disorder (OR, 0.60) and major depression (OR, 0.69) were also less likely to work. Lastly, persons with self-reported alcohol abuse (OR, 1.30) were more likely to work, and persons with self-reported drug abuse (OR, 0.93) were not less likely to work, than others in our study population of Americans with disabilities.

Adolescent↗

Teaching disability and rehabilitation to medical students. Steering Group on Medical Education and Disability.

A survey of UK medical schools was undertaken to determine the teaching that was being offered on disability and rehabilitation. In general, teaching on this topic appeared fragmented and inadequate but a number of interesting innovations were identified. These included: a drama workshop run by a group whose members mainly have learning disabilities at St George's Medical School, student-directed learning at the University of Dundee and structured teaching programmes at the Universities of Leeds and Edinburgh. The General Medical Council Education Committee's 1991 discussion document on the undergraduate curriculum specifically mentions disability as an important topic. A number of schools mentioned that they were in the process of revising their curriculum as a consequence. Recommendations arising from the findings of the survey include integration of disability and rehabilitation into clinical teaching, focus of teaching on those types of disability which are common in the community, greater emphasis on functional assessment in teaching the physical examination, and the wider use of standard assessment instruments, for example for activities of daily living, cognitive impairment and locomotor disability. There is a need for improved communication between medical schools to facilitate the spread of educational activities on this topic.

Curriculum↗

Impact of disablement due to rheumatic disorders in a British population: estimates of severity and prevalence from the Calderdale Rheumatic Disablement Survey.

A survey of rheumatic disablement in the population has enabled the comparative impact of self reported causes of disability to be studied. One in three households in Calderdale, West Yorkshire, United Kingdom was screened in 1986 with a postal questionnaire (87% response rate), followed by in depth interviews with a sample of subjects reporting disability in conjunction with a rheumatic disorder (608 interviews). Severity of disablement was assessed using the physical independence handicap classification. The estimated prevalence of disability in conjunction with reported rheumatic disorders is 82/1000 population aged at least 16 years (95% confidence interval (CI) 77 to 87). Arthritis (mainly osteoarthritis) is the most commonly reported cause (47/1000 population; 95% CI 43 to 51), followed by back or neck disorders (25/1000; 95% CI 23 to 28), soft tissue disorders (18/1000; 95% CI 15 to 20), and rheumatoid arthritis (RA) (4/1000; 95% CI 3 to 5). A total of 30% reported more than one category of rheumatic disorder (mean number 1.3) and 63% reported non-rheumatic comorbidity. Current joint symptoms were reported by 98%, current antirheumatic drugs (including analgesics) by 70%, and severe pain by 62%. Overall 82% of subjects had seen their general practitioner in the past year, and 71% reported having attended an outpatient clinic; 26% reported current outpatient clinic attendance, and 15% a hospital inpatient stay during the previous year. Forty six per cent reported some dependence, with 12% reporting being dependent on a daily basis. Rheumatoid arthritis was the most disabling disorder with 73% dependent. Taking into account prevalence, osteoarthritis and back disorders are the most, and RA the least, common causes of dependence and incapacitating pain in the population. This challenges stereotypes and raises questions about the organisation and priorities for specialist services and for research.

Adolescent↗

Assessment of disability with the World Health Organisation Disability Assessment Schedule II in patients with ankylosing spondylitis.

OBJECTIVE: To investigate in ankylosing spondylitis (AS) whether the newly developed World Health Organisation Disability Assessment Schedule II (WHODAS II) is a useful instrument for measuring disability, to assess its responsiveness in relation to other traditional disease specific instruments, and to identify factors that are associated with both short term and long term scores on the WHODAS II. METHODS: Patients with AS from a randomised controlled trial assessing the efficacy of spa treatment (n=117) and from a five year longitudinal observational study (n=97) participated. The patients completed several questionnaires, including the WHODAS II. After a three week course of spa treatment, 31 patients again completed all questionnaires to assess responsiveness. To determine to what degree the WHODAS II reflects some AS oriented measures on disease activity, functioning, and quality of life, correlation coefficients between the WHODAS II and these other questionnaires were calculated. Responsiveness was calculated by the effect size (ES) and standardised response mean (SRM). Linear regression analysis was performed to explore which factors might be associated with short term changes on the WHODAS II and to investigate (in the observational study) which factors of WHODAS II might predict disability five years later. RESULTS: Mean score on the WHODAS II was 23.9 (SD 15.5 (range 0.0-76.1)). Scores on the WHODAS II were significantly correlated with all disease specific questionnaires measured (all p<0.001). The WHODAS II showed a comparable short term responsiveness score (SRM 0.41; ES 0.39). In regression analysis these short term changes on the WHODAS II were significantly associated with changes in functioning (beta coefficient 4.25, 95% confidence interval (95% CI) 1.24 to 7.26, p=0.007). In the observational study, disease activity (beta coefficient 0.35, 95% CI 0.17 to 0.53, p<0.000) as well as functioning (beta coefficient 0.23, 95% CI 0.09 to 0.38, p=0.002) seemed to significantly predict disability (WHODAS II) after five years. CONCLUSION: The WHODAS II is a useful instrument for measuring disability in AS in that it accurately reflects disease specific instruments and that it shows similar responsiveness scores. In AS, a short term change on the WHODAS II is associated with a change in physical function. At the group level, disease activity and physical functioning may predict disability after five years.

Activities of Daily Living↗

The student with a visual disability and a learning disability.

Existing studies indicate that between 14% and 65% of students with visual disabilities also have learning disabilities. The similar symptoms of the two conditions and the earlier identification of a visual disability often mask the presence of a learning disability. This article addresses definition, assessment, intervention, and future implications related to educational practices with students who have both learning and visual disabilities. The definitions of the two conditions are compared, emphasizing features that make identification difficult. The article examines common assessment procedures, describing approaches that are inappropriate for students who have low vision or blindness. Intervention approaches are described, including adaptations of the environment, enhancement of vision, instruction in compensatory skills, the use of learning strategies, and the availability of learning opportunities. Future directions include refinement of diagnostic approaches, and research related to the characteristics and instructional needs of students who have both visual and learning disabilities.

Blindness↗

Disability, psychosocial, and demographic characteristics of abused women with physical disabilities.

In a sample of 415 predominantly minority women with physical disabilities recruited from private and public specialty outpatient clinics, we examined experiences of physical, sexual, and disability-related abuse within the past year and its associations with demographic, disability, and psychosocial characteristics. Logistic regression analyses identified 27% of the variance and indicated that women with disabilities who were younger, more educated, less mobile, more socially isolated, and who had higher levels of depression may have a higher likelihood of having experienced abuse in the past year. This model correctly identified 84% of the abused women with disabilities. Questions of directionality, the role of disability, and validity testing are discussed.

Adult↗

Psychiatric disabilities and the Americans with Disabilities Act: implications for policy and practice.

People with psychiatric disabilities are often victims of job discrimination. The Americans with Disabilities Act (ADA) of 1990 makes it very clear that job discrimination based on a psychiatric impairment is illegal. The Equal Employment Opportunity Commission (EEOC) reports that psychiatric disability is one of the leading causes why persons file discrimination complaints. Given this situation, an analysis is offered of what constitutes a psychiatric disability under the ADA. An overview, an analysis, and examples of the kinds of accommodations employers can be expected to provide people with psychiatric disabilities are offered. The policy and practice implications of the employment provisions (Title I) in the area of psychiatric disabilities are presented.

Civil Rights↗

Frequency of going outdoors as a good predictors for incident disability of physical function as well as disability recovery in community-dwelling older adults in rural Japan.

BACKGROUND: The clinico-epidemiologic relevance of the reduction in the frequency of going outdoors in older adults has not been well characterized. This study examined whether the frequency of going outdoors has predictive values for incident physical disability and recovery among community-dwelling elderly. METHODS: One thousand, two hundred and sixty-seven persons aged 65+ years who lived in a rural community in Niigata, Japan, and participated in the baseline survey were assessed again 2 years later in terms of mobility, and instrumental and basic activities of daily living (IADL and BADL). We compared the incident disability and recovery at follow-up among three subgroups classified by the baseline frequency of going outdoors: once a day or more often, once per 2-3 days, and once a week or less often. Multivariate analyses tested associations between the frequency of going outdoors and functional transition, independent of potential confounders. RESULTS: A lower frequency of going outdoors at baseline was associated with a greater incident disability, and a lower recovery at the two-year follow-up. Even after adjustment, the effects of going outdoors remained significant. Adjusted risks of incident mobility and IADL disabilities were significantly higher (odds ratio[OR]=4.02, 95% confidence interval [CI]: 1.77-9.14 and OR=2.65, 95% CI: 1.06-6.58), respectively, and recovery from mobility disability was significantly lower (OR=0.29, 95% CI: 0.08-0.99) for "once a week or less often" subgroup compared with "once a day or more often" subgroup. CONCLUSION: The frequency of going outdoors is a good predictor for incident physical disability and recovery among community-living elderly. Public health nurses and clinicians should pay more attention how often their senior clients usually go outdoors.

Aged↗

Symmetry in building block design for learning disabled and nonlearning disabled boys.

This study examined perceptual differences in symmetry with and without a model between 21 learning disabled boys with reading deficits and 28 learning disabled boys with deficits in mathematics. 55 nonlearning disabled boys served as controls. All boys were in Grades 3, 4, or 5. Without a model, all learning disabled boys built significantly more asymmetrical building block designs than nonlearning disabled boys. However, with a model, all learning disabled boys could imitate the model, but it took them longer to complete the task successfully. All boys appeared to have difficulty in modeling asymmetrical tasks, taking more time for task completion after seeing an asymmetrical model. This study suggests modeling perceptual tasks might be an effective teaching strategy for such children.

Attention↗