Duryan, Meri; Nikolik, Dragan; van Merode, Godefridus; Curfs, Leopold
Organizations providing services to persons with intellectual disabilities (ID) are complex because of many interacting stakeholders with often different and competing interests. The combination of increased consumer demand and diminished resources makes organizational planning a challenge for the managers of such organizations. Such challenges…
Johnson, Clair; Viljoen, Nina
Background: Systemic approaches can be useful in working with people with learning disabilities and their network. The evidence base for these approaches within the field of learning disabilities, however, is currently limited. Materials and Methods: This article presents part of a service evaluation of systemic consultations in a Community…
Dossa, P A
The literature refers to older people with developmental disabilities as the "new service population." How and why this population emerged as a special category is discussed conceptually with reference to social systems theory. A brief review of social systems theory and some basic systemic tenets are presented. Systemic tenets are employed in examining the historical development of social gerontology and present trends in the service-delivery system. I show that the systemic variable of the economic model of human development has significantly impacted on the making of older people with developmental disabilities a dependent population. In the conclusion the systems perspective is explored in relation to recognizing the liminal, in-between parts between components. It is argued that such a perception minimizes the dichotomy between older people with developmental disabilities and the non-disabled population, paving the way for a genuine encounter.
The aim of this article is to examine the experiences of families with young adults with learning disabilities trying to access services. The landscape of disability services for this group is made up of day care, special vocational training and respite places. It aims to identify the extent of an implementation gap between government rhetoric and the degree to which services are characterised as being non-supportive interactions on the ground. Using Ireland as a case study, during a time when the economy is booming and government rhetoric claims unparalleled developments in allocating resources and extra respite 'places', this article identifies the main challenges faced by family carers associated with accessing appropriate services for their disabled adult child, in their attempt to achieve greater independence. This article reports the findings of a qualitative study in which individual semistructured interviews were held with family carers (n = 25) and representatives from national carer organisations (n = 6) in Ireland. These were people caring for an adult (18-30 years) with a learning disability and their experiences were also useful in cross-checking the carer organisation interviews. The findings show that there is limited flexibility, choice and availability in meeting the preferences of the service-users, and throughout the study, services were characterised as being non-supportive interactions. This is not simply symptomatic of a lack of resources. Despite improved funding, supportive attitudes and flexibility are still crucial in meeting user requirements at the level of delivery; thus highlighting that often the system works for the system, not for the user.
State Employees Division of Senior and Disabilities Services DHSS State of Alaska Home Divisions and ; Assistance Senior Benefits Program Medicare Substance Abuse Treatment Alaska Tribal Child Welfare Compact ; Senior and Disabilities Services Page Content Director Duane Mayes photo image. Duane Mayes Director
Lai, Jin-Shei; Hammel, Joy; Jerousek, Sara; Goldsmith, Arielle; Miskovic, Ana; Baum, Carolyn; Wong, Alex W; Dashner, Jessica; Heinemann, Allen W
To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life. Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity. Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place. Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking. Not applicable. An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities. We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation. The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure
Graungaard, Anette Hauskov; Skov, Liselotte; Andersen, John Sahl
Parents of a young child with severe disabilities are facing a large range of new challenges; furthermore, most of these families have extended social needs regarding information, financial support, day care facilities, disability aids, etc. Many parents with disabled children have been found to be dissatisfied with social services. This study explores parents' experiences with Danish social services during their transition to a new daily life after the birth of a severely disabled child. Repeated qualitative interviews were performed individually with 16 parents of a severely disabled young child during the first two years after the diagnosis of the child's disabilities. Data were analysed using grounded theory. We found that the encounter with the social services increased stress in the families. Parental expectations were not met, especially regarding information; parents felt clientized, and obtaining social support was very resource consuming. Parents' needs regarding practical support and empathic case-working were not met and they spent much time and effort due to lacking continuity between sectors. Parents have specific needs when becoming clients in the social service system whose organisation of social services needs improvement. Health care professionals are advised to identify problems and support cooperation between the parents and the social service system, as well as to report the health-related consequences of prolonged and inefficient case-working for the child and its parents. was received from Socialministeriet, Landsforeningen LEV, Ronald McDonalds Børnefond, Susie og Peter Robinsohns fond, Rosalie Petersens fond, PLU-fonden, Ville Heises fond, Sygesikringens forskningsfond, Helsefonden, Elsass fonden. not relevant.
Graungaard, Anette Hauskov; Skov, Lotte; Andersen, John Sahl
parents of a severely disabled young child during the first two years after the diagnosis of the child's disabilities. Data were analysed using grounded theory. RESULTS: We found that the encounter with the social services increased stress in the families. Parental expectations were not met, especially......INTRODUCTION: Parents of a young child with severe disabilities are facing a large range of new challenges; furthermore, most of these families have extended social needs regarding information, financial support, day care facilities, disability aids, etc. Many parents with disabled children have...
Jeon, Boyoung; Noguchi, Haruko; Kwon, Soonman; Ito, Tomoko; Tamiya, Nanako
With rapid aging, many of the elderly suffer from poverty and high healthcare needs. In Korea, there is a means-tested and non-contributory public assistance, the National Basic Livelihood Security System (NBLSS). The purpose of this study is to show older population's condition of disability and poverty, to evaluate the impact of NBLSS on health services utilization, and to examine the differential effect of the NBLSS by disability status among the elderly. This study used the Korea Welfare Panel Study data 2005-2014 with the final sample of 40,365, who were 65 years and older. The participants were divided into people with mild disability, severe disability, and without disability according to the Korean disability registration system. The income-level was defined to the low-income with NBLSS, the low-income without NBLSS, and the middle and high income, using the relative poverty line as a proxy of the low-income. The dependent variables were the number of outpatient visits and inpatient days, experience of home care services, total healthcare expenditure, and financial burden of healthcare expenditure. We performed Generalized Estimating Equations population-averaged model using the ten years of panel data. The result showed that within the same disability status, the low-income without NBLSS group used the least amount of inpatient care, but their financial burden of health expenditure was the highest among the three income groups. The regression model showed that if the elderly with severe disability were in the low-income without NBLSS, they reduced the outpatient and inpatient days; but their financial burden of healthcare became intensified. This study shows that the low-income elderly with disability but without adequate social protection are the most disadvantaged group. Policy is called for to mitigate the difficulties of this vulnerable population. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
at the time of disability evaluation. 3. Include variables to indicate date of initial diagnosis, onset of symptom , or injury in service members...inflammation 161 5.1 Noninfectious enteritis and colitis 449 3.1 Paralysis 157 4.9 Diabetes mellitus 434 3.0 Noninfectious enteritis and colitis 152...6.9 1.4 Lungs and chest (includes breast) 33 6.9 1.4 Psychiatric 66 5.2 1.0 Skin , lymphatic, allergies 22 4.6 0.9 Lungs and chest (includes
Evaluation System (DES) process follows guidelines laid out by the Department of Defense (DoD) and public law. Disability evaluation is administered... osteoarthritis ) 13,738 12.2 Posttraumatic stress disorder 3,880 13.4 Musculoskeletal analogous code (5099) 13,160 11.7 Degenerative arthritis of the...spine 2,352 8.1 Musculoskeletal analogous code (5299) 7,794 6.9 Arthritis, degenerative (hypertrophic or osteoarthritis ) 1,814 6.3 Posttraumatic
Seval Cambaz Ulas
Full Text Available In Turkey there are approximately 8.5 million (% 12.3 disabled people. While the ratio of orthopedic, visual, auditory, speech, and talking disabilities and mental disability is 2.6%, the ratio of the people who have chronic diseases is 9.7% In our country, by the beginning of 1982 Constitution, there have been a lot of legal regulations. If the services for disabled persons considered as social security-related legislation for care, healthcare, education, employment and practices; the legal regulation on the year 2005 (The Disability Law no. 5378 has covered many blankness and also evolved the services to the disabled people. However, despite these recent legal regulation it is questionable that if the services for the disabled are adequate or not. In this review, the services, which offered to the disabled people, are evaluated as the topics mentioned above. [TAF Prev Med Bull 2012; 11(4.000: 483-488
Lauer, Emily; McCallion, Philip
Background: Monitoring population trends including mortality within subgroups such as people with intellectual and developmental disabilities and between countries provides crucial information about the population's health and insights into underlying health concerns and the need for and effectiveness of public health efforts. Methods: Data from…
Ruiz, Sarah; Urdapilleta, Oswaldo; Clark-Shirley, Leanne J; Howard, Jennifer; Poey, Judith
This article explores how rebalancing efforts can support the needs of individuals aging with a lifelong disability. The National Balancing Indicator project examined the overall long-term supports and services system (LTSS) progress in five indicators within the Sustainability, Coordination and Transparency, and Prevention principles toward a balanced LTSS system for those aging with a lifelong disability. In assessing state efforts to create a balanced participant-directed LTSS system with the National Balancing Indicators, the findings suggest states are better equipping the system to handle a burgeoning population of individuals aging with a lifelong disability, but more progress is still needed. Overall, states need to continue to create a seamless system that allows individuals with lifelong disabilities to transition smoothly through the life course.
Aron, Laudan; Loprest, Pamela
Education is important for all children, but even more so for children with disabilities, whose social and economic opportunities may be limited. In this article, Laudan Aron and Pamela Loprest assess how well the nation's education system is serving students with disabilities. Aron and Loprest trace the evolution of the special education system in the United States from its origins in the civil rights movement of the mid-twentieth century. They note the dual character of federal legislation, which both guarantees eligible children with disabilities the right to a "free, appropriate public education in the least restrictive setting" and establishes a federal funding program to help meet this goal. They then review the types of services and accommodations these children receive from infancy through young adulthood. The special education system has given children with disabilities much greater access to public education, established an infrastructure for educating them, helped with the earlier identification of disabilities, and promoted greater inclusion of these children alongside their nondisabled peers. Despite these advances, many problems remain, including the over- and underidentification of certain subgroups of students, delays in identifying and serving students, and bureaucratic, regulatory, and financial barriers that complicate the program for everyone involved. More important, the authors show that special education students still lag behind their nondisabled peers in educational achievements, are often held to lower expectations, are less likely to take the full academic curriculum in high school, and are more likely to drop out of school. Only limited evidence is available on the effectiveness of specific special education services or on how to improve student achievement for this important subgroup of students. Improving the system will require better ways of understanding and measuring both ends of the special education continuum, namely, what
What and whom we choose to celebrate says a lot about us. As I thought about celebrating systemic practice, I wondered about how and when those with whom I most often practice, men and women with intellectual disabilities, have been celebrated?
The book takes account of the key fact that to maximize their potential, people must have lifelong access to the information and services offered through books and libraries. Whether to address concerns of an ageing population or to enable all citizens to contribute fully through meaningful education and work opportunities, more emphasis is being given to promoting library services to people who have disabilities. This book is a compendium of articles focused on serving adults with disabilities in an international setting. From this book, librarians, policy makers and constituents will underst
Army and Air Force had higher percentages of reserve component disability evaluations, likely due to the inclusion of National Guard service members...Annual Report 2015 Disability Evaluation Systems Analysis and Research Prepared by Accession Medical Standards Analysis and Research Activity...Preventive Medicine Branch Walter Reed Army Institute of Research Silver Spring, Maryland Disability Evaluation Systems Analysis and Research
Castro, Shamyr Sulyvan; Lefèvre, Fernando; Lefèvre, Ana Maria Cavalcanti; Cesar, Chester Luiz Galvão
To analyze the difficulties in accessibility to health services experienced by persons with disabilities. A qualitative study was performed with individuals who reported having a certain type of disability (paralysis or amputation of limbs; low vision, unilateral or total blindness; low hearing, unilateral or total deafness). A total of 25 individuals (14 women) were interviewed in the city of São Paulo, Southeastern Brazil, between June and August 2007, responding to questions about transportation and accessibility to health services. Collective Subject Discourse was the methodology used to analyze results and analyses were performed with the Qualiquantisoft software. The analysis of discourses on transportation to health services revealed a diversity in terms of the user going to the service alone or accompanied; using a private car, public transportation or ambulance or walking; and requiring different times to arrive at the service. With regard to the difficulties in accessibility to health services, there were reports of delayed service, problems with parking, and lack of ramps, elevators, wheelchairs, doctors and adapted toilets. Individuals with a certain type of disability used various means of transportation, requiring someone to accompany them in some cases. Problems with accessibility to health services were reported by persons with disabilities, contradicting the principle of equity, a precept of the Brazilian Unified Health System.
Hinton, Cynthia F; Kraus, Lewis E; Richards, T Anne; Fox, Michael H; Campbell, Vincent A
Approximately 40 million people in the U.S. identify as having a serious disability, and people with disabilities experience many health disparities compared with the general population. The Guide to Community Preventive Services (The Community Guide) identifies evidence-based programs and policies recommended by the Community Preventive Services Task Force (Task Force) to promote health and prevent disease. The Community Guide was assessed to answer the questions: are Community Guide public health intervention recommendations applicable to people with disabilities, and are adaptations required? An assessment of 91 recommendations from The Community Guide was conducted for 15 health topics by qualitative analysis involving three data approaches: an integrative literature review (years 1980-2011), key informant interviews, and focus group discussion during 2011. Twenty-six recommended interventions would not need any adaptation to be of benefit to people with disabilities. Forty-one recommended interventions could benefit from adaptations in communication and technology; 33 could benefit from training adaptations; 31 from physical accessibility adaptations; and 16 could benefit from other adaptations, such as written policy changes and creation of peer support networks. Thirty-eight recommended interventions could benefit from one or more adaptations to enhance disability inclusion. As public health and healthcare systems implement Task Force recommendations, identifying and addressing barriers to full participation for people with disabilities is important so that interventions reach the entire population. With appropriate adaptations, implementation of recommendations from The Community Guide could be successfully expanded to address the needs of people with disabilities. Published by Elsevier Inc.
Aron, Laudan; Loprest, Pamela
Education is important for all children, but even more so for children with disabilities, whose social and economic opportunities may be limited. In this article, Laudan Aron and Pamela Loprest assess how well the nation's education system is serving students with disabilities. Aron and Loprest trace the evolution of the special education system…
Blatter, L A; Cloetta, B
The incidence and prevalence of patients with musculoskeletal disorders benefiting from the Swiss invalidity insurance system in the Canton of Berne, Switzerland, are studied. During a 5-year period 1252 such patients (393 women) first received either payments or were supported by rehabilitation measures (incidence). The correlation of this incidence with sociodemographic factors such as sex, age, disease pattern, place of residence and occupation, as well as the type of service delivered, are analyzed and discussed. At a given date (March 1982) 2754 patients with musculoskeletal disorders were receiving insurance pension (prevalence). By relating these figures to census data (total population), a 1.37% 5-year benefit incidence and a 3.02% pension prevalence can be calculated.
Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony
Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…
Social Security Administration — DICARS is the legacy system supporting business processes in the Disability Quality Branches (DQBs). It supports quality reviews of DDS disability determinations....
Ling, Bin; Allison, Colin; Nicholl, J. Ross; Moodley, Luke; Roberts, Dave
The Disabilities Information Flow (DIF) project at the University of St Andrews has sought to provide a means of efficiently managing all student disabilities information within the institution and provide appropriate role-based service interfaces for all staff who need to routinely interact with this information. This paper describes the software…
Samant, Deepti; Soffer, Michal; Hernandez, Brigida; Adya, Meera; Akinpelu, Omolara; Levy, Joel M; Repoli, Elizabeth; Kramer, Michael; Blanck, Peter
Corporate culture reflects an organization's value system and impacts the recruitment, retention, and promotion of employees. Individuals with disabilities are positively impacted by a corporate culture that espouses and establishes a diverse workforce as a priority. This article provides an overview of corporate culture and the employment of individuals with disabilities, and presents a case example of the corporate culture of a large not-for-profit disability service organization. With an in-depth understanding of corporate culture and disability issues, social workers can be particularly helpful to applicants and employees with disabilities as well as employers.
females, other race, enlisted and active duty service members for all services and time periods. • Rates increase as age increases in the Army. For the...Annual Report 2017 Disability Evaluation Systems Analysis and Research Prepared by Accession Medical Standards Analysis and Research Activity ...50 History of hospitalization among active duty service
Full Text Available The purpose of this study is to improve library promotional marketing for the disabled by identifying requirements of public library disability services. This study aimed to investigate librarian service providers' awareness of library programs for the disabled in order to prepare a systematic plan for promoting such library services. Research methods used are a literature analysis and survey. First, the ratio of respondents with experience promoting activities and services for the disabled was less than 50%. Second, regarding methods for promoting library disability services, the respondents used library homepages, press releases, library user guides, library newsletters, and library pamphlets in that order. Third, when asked what kind of PR media the library disability service providers had experience with and how often they use it, library boards and banners were the most common response. Fourth, suggested improvements to the current design and content of PR materials included: clearer word choice (or greater understandability, more detailed descriptions, simpler layouts, and more interesting or eye-catching content in that order. Fifth, the library disability services which are in the most need of public relations were guide information for library disability services, Library and Information Service (DOI services and search services, using alternative materials and the library collection, and aiding the information search. Overall, when evaluating the promotion of disability services in Korea, the library's public relations for disabled services needs to improve because currently neither librarians nor the disabled community they are targeting has frequent or quality experience with it. Thus, the policy department for the library disability services must develop a variety of promotional strategies adjusted for each type of the disability and distribute PR materials to service providers individually, making sure to utilize effective PR
Cummings, Katrina P.; Hardin, Belinda J.
Cultural beliefs, values, language differences, and unfamiliar educational infrastructures and practices can impact immigrant parents' capacity to support their children with disabilities in their new country. This study presents perspectives of disability and experiences with special education services based on interviews with eight immigrant…
Agustín Huete García
Full Text Available At present, there are several alternatives to support daily life of people with disabilities, which require different resources: human, institutional, technical, material, financial, etc. In addition, these alternatives involve different impacts on both the life of people with disabilites and their immediate environment. This paper presents a case study that compares an user of personal assistance services of the Program for Independent Living (PAVI with an user of a residential service. The study method used is based on the approach of Social Return on Investment (SROI. It also specifies the selection of cases, the partners consulted to gather concepts and values, data collection, variables and formulas for calculating and monetization. Despite its limited scope, it is possible to draw conclusions about the social return on investment in a “standard profile” receiving personal assistance services compared with a “standard profile” in a residential service.
aggravation of disease) and third element (nexus between in-service occurrence/aggravation of disease and current disease) of the prima facie case for...occurring within two years of separation from active duty military service. In the following years, additions to the presumptive list were made by...the change of mission for U.S. forces in Iraq. 4 Veterans Benefits Disability Commission, Honoring the Call to Duty : Veterans’ Disability Benefits in
Cartwright, J Daniel
Children and adolescents with chronic diseases and disabling conditions often need educationally related services. As medical home providers, physicians and other health care professionals can assist children, adolescents, and their families with the complex federal, state, and local laws, regulations, and systems associated with these services. Expanded roles for physicians and other health care professionals in individualized family service plan, individualized education plan, and Section 504 plan development and implementation are recommended. Recent updates to the Individuals With Disabilities Education Act will also affect these services. Funding for these services by private and nonprivate sources also continue to affect the availability of these educationally related services. The complex range of federal, state, and local laws, regulations, and systems for special education and related services for children and adolescents in public schools is beyond the scope of this statement. Readers are referred to the American Academy of Pediatrics policy statement "The Pediatrician's Role in Development and Implementation of an Individual Education Plan (IEP) and/or an Individual Family Service Plan (IFSP)" for additional background materials. The focus of this statement is the role that health care professionals have in determining and managing educationally related services in the school setting. This policy statement is a revision of a previous statement, "Provision of Educationally Related Services for Children and Adolescents With Chronic Diseases and Disabling Conditions," published in February 2000 by the Committee on Children With Disabilities (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;105/2/448).
Brown, Jason D.; Moraes, Sabrina; Mayhew, Janet
We examined the service needs of foster families with children who have disabilities. Foster parents in a large Canadian city were asked "What services or supports would be helpful to you?" The responses to this question were edited for clarity and to eliminate redundancies, and sorted into piles of like statements by a group of 15…
The American disability service system is predicated on underlying assumptions and beliefs which are dominant in the majority culture. Consequently, minority families, such as families from India, living in America sometimes experience dissonance with respect to the services provided to their family due to their varying cultural values. As such,…
Conclusions: There are statistical differences of disability prevalence attributed to mental disorders by people and region in China. Service use in disabled people with mental disorders is insufficient.
Choi, Nari; Ostendorf, Raymond
Parents' perception of disabilities and special education services can impact the way they interact with professionals providing services for their children with disabilities. In addition, the cultural background of parents plays an important role in their perception of disabilities, as well as how they communicate with professionals. Thus, it is…
To evaluate the application of one particular quality measurement tool, the SERVQUAL instrument, as a potential mechanism to measure quality in services for children with disabilities Staff and family of children with an intellectual disability in two organisations providing specialist therapy and day completed an adapted SERVQUAL questionnaire. A total of 81 SERVQUAL questionnaires were distributed and 59 questionnaires were returned (response rate of 73 per cent). The SERVQUAL instrument can be considered as a useful diagnostic tool to identify particular strengths and areas for improvement in services for people with disabilities as the instrument lends itself for the monitoring of the effectiveness of quality improvement initiatives over time. The findings also showed relatively high customer expectations and the organisations involved in this research are currently not meeting all of these high expectations as significant quality gaps were found in the areas of reliability and responsiveness. The sample size was relatively small and the measurement of quality using the SERVQUAL instrument remains a challenge, due to the conceptual and empirical difficulties. The SERVQUAL instrument is probably most be attractive to service managers and funding organisations because of its ability to identify gaps in the quality of the service. The tool had been used to measure quality in services for people with disabilities and the research has shown that this tool might be an important additional quality measurement tool for services.
Full Text Available To improve the service quality of service robots for the disabled, immune system is applied on robot for its advantages such as diversity, dynamic, parallel management, self-organization, and self-adaptation. According to the immune system theory, local environment condition sensed by robot is considered an antigen while robot is regarded as B-cell and possible node as antibody, respectively. Antibody-antigen affinity is employed to choose the optimal possible node to ensure the service robot can pass through the optimal path. The paper details the immune system applications on service robot and gives experimental results.
How useful are disability services in the current higher education for college students with psychiatric disabilities? The purpose of this research paper is to answer this question by exploring an agenda of accommodation and support at a disabilities service center for college students with psychiatric disabilities. Two studies were conducted using questionnaires to collect data from students （study 1） and staffs （teaching and clerical staff） （study 2） in higher education. The ...
Murphy, John W
Service delivery has traditionally been based on market forces. When this is the case, the community becomes a silent partner in this process. Services, accordingly, are directed mostly to correcting personal ills and have little to do with community uplift. Another model, based on the work of Amartya Sen, is available that conceptualizes interventions in a very different way. If understood in the context of community development, the focus of services is social change, rather than merely personal rehabilitation. This reorientation is discussed in this article.
Lees, Carolyn; Poole, Helen; Brennan, Michelle; Irvine, Fiona
Background: The government alongside other health and social care organisation have identified the need to improve the care provided for people with learning disabilities. Materials and Methods: This service evaluation aimed to explore the experiences of people with learning disabilities and their carers who accessed community dental services…
Dura-Vila, G.; Hodes, M.
Background: This study examined whether service utilisation among children with intellectual disability (ID) varied by ethnic cultural group. Method: Survey carried out in four special schools in London. Information was provided by school teachers using case files, and 242 children aged 7 to 17 years with mild and moderate ID were identified.…
Madaus, Joseph W.
In 2002, Brinckerhoff, McGuire, and Shaw observed that the field of postsecondary education and disability services had "moved through its adolescence and was embarking on adulthood" (xiii). Indeed, the field had undergone rapid expansion nationwide in the prior 30 years and grew into a full-fledged profession within higher education (Jarrow…
Stevens, Alissa C.; Courtney-Long, Elizabeth A.; Okoro, Catherine A.; Carroll, Dianna D.
Introduction Beginning in 2013, in addition to the 2-item disability question set asked since 2001, Behavioral Risk Factor Surveillance System (BRFSS) began using 5 of the 6 items from the US Department of Health and Human Services?recommended disability question set. We assess and compare disability prevalence using the 2-question and 5-question sets and describe characteristics of respondents who identified as having a disability using each question set. Methods We used data from the 2013 B...
McKenzie, Judith Anne; McConkey, Roy; Adnams, Colleen
Although intellectual disability (ID) is probably the largest impairment grouping on the African continent, few indigenous research and evaluation studies have been undertaken. This article is an initial attempt to relate service delivery issues to an African research agenda. We critically analysed the available literature, drawing on academic publications and those of non-governmental agencies. In this process we identified several key issues for further investigation, namely: understanding ID in African contexts, access to education and health care, the provision of appropriate assistance and support, and income generation. We relate our analysis to the recommendations made in the World Report on Disability but with a specific focus on ID in Africa. The need for mainstreaming and prioritising ID in non-disability related and across impairment programmes is highlighted. We note the importance of families and emphasise the need to draw on informal and traditional forms of care and participation. The need for reliable research evidence to support practice is highlighted. We conclude with a call to action by and on behalf of individuals with ID to be included in the development priorities of the continent. Implications for Rehabilitation Service provision for people with intellectual disabilities in Africa is not always well served by insights obtained from western research agendas. Appropriate and effective rehabilitation requires an understanding of the context and the environment in which the disabled person operates. Indigenous research into the provision of support to families and the inclusion of persons with intellectual disability into mainstream programmes as well as disability specific provision is recommended.
Full Text Available The cluster system offers space for raising awareness among humanitarian actors and for putting disability on the agenda, but it impairs local and cross-cutting dynamics at field level.
Balogh, Robert; McMorris, Carly A; Lunsky, Yona; Ouellette-Kuntz, Helene; Bourne, Laurie; Colantonio, Angela; Gonçalves-Bradley, Daniela C
When compared to the general population, persons with an intellectual disability have lower life expectancy, higher morbidity, and more difficulty finding and obtaining healthcare. Organisational interventions are used to reconfigure the structure or delivery of healthcare services. This is the first update of the original review. To assess the effects of organisational interventions of healthcare services for the mental and physical health problems of persons with an intellectual disability. For this update we searched CENTRAL, MEDLINE, EMBASE, CINAHL and other databases, from April 2006 to 4 September 2015. We checked reference lists of included studies and consulted experts in the field. Randomised controlled trials of organisational interventions of healthcare services aimed at improving care of mental and physical health problems of adult persons with an intellectual disability. We employed standard methodological procedures as outlined in the Cochrane Handbook of Systematic Reviews of Interventions, in addition to specific guidance from the Cochrane Effective Practice and Organisation of Care (EPOC) Group. We identified one new trial from the updated searches.Seven trials (347 participants) met the selection criteria. The interventions varied but had common components: interventions that increased the intensity and frequency of service delivery (4 trials, 200 participants), community-based specialist behaviour therapy (1 trial, 63 participants), and outreach treatment (1 trial, 50 participants). Another trial compared two active arms (traditional counselling and integrated intervention for bereavement, 34 participants).The included studies investigated interventions dealing with the mental health problems of persons with an intellectual disability; none focused on physical health problems. Four studies assessed the effect of organisational interventions on behavioural problems for persons with an intellectual disability, three assessed care giver burden, and
Full Text Available Sensors have become ubiquitous in their reach and scope of application. They are a technological cornerstone for various modes of health surveillance and participatory medicine—such as quantifying oneself; they are also employed to track people with certain as impairments perceived ability differences. This paper presents quantitative and qualitative data of an exploratory, non-generalizable study into the perceptions, attitudes and concerns of staff of a disability service organization, that mostly serve people with intellectual disabilities, towards the use of various types of sensor technologies that might be used by and with their clients. In addition, perspectives of various types of privacy issues linked to sensors, as well data regarding the concept of quantified self were obtained. Our results highlight the need to involve disabled people and their support networks in sensor and quantified-self discourses, in order to prevent undue disadvantages.
The benefits of a satellite services system and the basic needs of the Space Transportation System to have improved satellite service capability are identified. Specific required servicing equipment are discussed in terms of their technology development status and their operative functions. Concepts include maneuverable television systems, extravehicular maneuvering unit, orbiter exterior lighting, satellite holding and positioning aid, fluid transfer equipment, end effectors for the remote manipulator system, teleoperator maneuvering system, and hand and power tools.
Yell, Mitchell; Smith, Carl; Katsiyannis, Antonis; Losinski, Mickey
In the past few years, the provision of mental health services in public schools has received considerable attention. When students with disabilities are eligible for special education and related services under the Individuals With Disabilities Education Act (IDEA), mental health services are required if such services are needed to provide…
Departing from Product Development models based on physical artefacts. Moving towards integrated Product Development and System Operations models suited Product/Service-systems......Departing from Product Development models based on physical artefacts. Moving towards integrated Product Development and System Operations models suited Product/Service-systems...
Somme, D; Trouvé, H; Couturier, Y; Carrier, S; Gagnon, D; Lavallart, B; Hébert, R; Cretin, C; Saint-Jean, O
The French health and services system to maintain at home is characterized by its fragmentation, whereas the need of the people for intervention is generally total. This fragmentation have consequences: delay in services delivery, inadequate transmission of information, redundant evaluation, service conditioned by the entrance point solicited rather than by the need of the person and inappropriate use of expensive resources by ignorance or difficulty of access to the less expensive resources. The purpose of integration is to improve continuity of interventions for people in loss of autonomy. It consists in setting up a whole of organisational, managerial and clinical common tools. Organisational model "Projet et Recherches sur l'Intégration des Services pour le Maintien de l'Autonomie" (Prisma) tested in Quebec showed a strong impact on the prevention of the loss of autonomy in term of public health on a population level. This model rests on six principal elements: partnership, single entry point, case-management, a multidimensional standardized tool for evaluation, an individualized services plan and a system for information transmission. Thus, it was decided to try to implement in France this organisational model. The project is entitled Prisma France and is presented here. The analysis of the context of implementation of the innovation which represents integration in the field of health and services for frail older reveals obstacles (in particular because of diversity of professional concerned and a presentiment of complexity of the implementation of the model) and favourable conditions (in particular the great tension towards change in this field). The current conditions in France appear mainly favourable to the implementation of integration. The establishment of Prisma model in France requires a partnership work of definition of a common language as well on the diagnoses as on the solutions. The strategic and operational dialogue is thus a key element of the
Stevens, Alissa C; Courtney-Long, Elizabeth A; Okoro, Catherine A; Carroll, Dianna D
Beginning in 2013, in addition to the 2-item disability question set asked since 2001, Behavioral Risk Factor Surveillance System (BRFSS) began using 5 of the 6 items from the US Department of Health and Human Services-recommended disability question set. We assess and compare disability prevalence using the 2-question and 5-question sets and describe characteristics of respondents who identified as having a disability using each question set. We used data from the 2013 BRFSS to estimate the prevalence of disability for each question set and the 5 specific types of disability. Among respondents identified by each disability question set, we calculated the prevalence of selected demographic characteristics, health conditions, health behaviors, and health status. With the 2-question set, 21.6% of adults had a disability and with the 5-question set, 22.7% of adults had disability. A total of 51.2% of adults who identified as having a disability with either the 2-question or 5-question set reported having disabilities with both sets. Adults with different disability types differed by demographic and health characteristics. The inclusion of the 5 new disability questions in BRFSS provides a level of detail that can help develop targeted interventions and programs and can guide the adaptation of existing health promotion programs to be more inclusive of adults who experience specific types of disabilities.
Breen, Lauren; Wildy, Helen; Saggers, Sherry
Despite increasing demand for wellness approaches from disability advocates and consumer groups, they are not implemented routinely in childhood disability services. Interviews were conducted with 23 allied health therapists and managers working within four Australian childhood disability services. They described attempts to embed wellness…
... Nondiscrimination on the Basis of Disability in State and Local Government Services, Public Accommodations and in... of Disability; Accessibility of Web Information and Services of State and Local Government Entities and Public Accommodations; Nondiscrimination on the Basis of Disability in State and Local Government...
Mackey, Ellen; Dodd, Karen
Following Beacroft & Dodd's (2009) audit of pain recognition and management within learning disability services in Surrey, it was recommended that learning disability services should receive training in pain recognition and management. Two hundred and seventy-five services were invited to participate, of which 197 services in Surrey accepted…
... seeking to employ individuals with disabilities. (5) In the case of any small business enterprise operated..., including enterprises established under the Randolph-Sheppard program, management services and supervision... and improve small business enterprises operated by individuals with significant disabilities...
Goverman, Jeremy; Mathews, Katie; Holavanahalli, Radha K; Vardanian, Andrew; Herndon, David N; Meyer, Walter J; Kowalske, Karen; Fauerbach, Jim; Gibran, Nicole S; Carrougher, Gretchen J; Amtmann, Dagmar; Schneider, Jeffrey C; Ryan, Colleen M
The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) established the Burn Model System (BMS) in 1993 to improve the lives of burn survivors. The BMS program includes 1) a multicenter longitudinal database describing the functional and psychosocial recovery of burn survivors; 2) site-specific burn-related research; and 3) a knowledge dissemination component directed toward patients and providers. Output from each BMS component was analyzed. Database structure, content, and access procedures are described. Publications using the database were identified and categorized to illustrate the content area of the work. Unused areas of the database were identified for future study. Publications related to site-specific projects were cataloged. The most frequently cited articles are summarized to illustrate the scope of these projects. The effectiveness of dissemination activities was measured by quantifying website hits and information downloads. There were 25 NIDILRR-supported publications that utilized the database. These articles covered topics related to psychological outcomes, functional outcomes, community reintegration, and burn demographics. There were 172 site-specific publications; highly cited articles demonstrate a wide scope of study. For information dissemination, visits to the BMS website quadrupled between 2013 and 2014, with 124,063 downloads of educational material in 2014. The NIDILRR BMS program has played a major role in defining the course of burn recovery, and making that information accessible to the general public. The accumulating information in the database serves as a rich resource to the burn community for future study. The BMS is a model for collaborative research that is multidisciplinary and outcome focused.
benefits occurs when a service member is found unfit for duty , but the condition is determined to have occurred as a result of misconduct, negligence ...service members evaluated for disability Hospitalization records received by AMSARA include data on direct care inpatient visits among active duty ...hospitalization among active duty service members evaluated for disability .......... 58 Database Limitations
Department of Veterans Affairs — Voluntary Service System (VSS) is a national-level application which replaced the site-based Voluntary Timekeeping System (VTK). VTK was used for many years at the...
This paper discusses issues regarding the validity and reliability of psychoeducational assessments provided to Disability Services Offices at Canadian Universities. Several vignettes illustrate some current issues and the potential consequences when university students are given less than thorough disability evaluations and ascribed diagnoses.…
Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah
To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with
Beverungen, Daniel; Müller, Oliver; Matzner, Martin
Recent years have seen the emergence of physical products that are digitally networked with other products and with information systems to enable complex business scenarios in manufacturing, mobility, or healthcare. These “smart products”, which enable the co-creation of “smart service” that is b......Recent years have seen the emergence of physical products that are digitally networked with other products and with information systems to enable complex business scenarios in manufacturing, mobility, or healthcare. These “smart products”, which enable the co-creation of “smart service......” that is based on monitoring, optimization, remote control, and autonomous adaptation of products, profoundly transform service systems into what we call “smart service systems”. In a multi-method study that includes conceptual research and qualitative data from in-depth interviews, we conceptualize “smart...... service” and “smart service systems” based on using smart products as boundary objects that integrate service consumers’ and service providers’ resources and activities. Smart products allow both actors to retrieve and to analyze aggregated field evidence and to adapt service systems based on contextual...
The 3M Food Service System 2 employs a "cook/chill" concept for serving food in hospitals. The system allows staff to prepare food well in advance, maintain heat, visual appeal and nutritional value as well as reducing operating costs. The integral heating method, which keeps hot foods hot and cold foods cold, was developed by 3M for the Apollo Program. In the 1970s, the company commercialized the original system and in 1991, introduced Food Service System 2. Dishes are designed to resemble those used at home, and patient satisfaction has been high.
Matthew P. JANICKI
Full Text Available With improved general health status many adults with intellectual disabilities (ID are living to old age, much like other adults. The World Health Organization has recognized the needs of this older population and identified the challenges they pose for governmental ministries and non-governmental organizations charged with planning, advocacy, financing, and delivery of specialty lifecare services and rehabilitation programs. These challenges include a range of issues normally confronting older adults, such as pensioning and financial security, changes in lifestyles associated with retirement and adaptations to living arrangements and housing, modifications in daily activities and community inclusion, changing physical and sensory abilities, and greater demands for support for aging families and other carers. As older adults with ID may also be affected by latelife or age-related conditions and begin to experience secondary impairments, these challenges may be more pronounced when encountered by NGOs located in countries with developing market economies. In these instances, the onus on promoting healthy aging will fall upon national entities which are responsible for targeting people with disabilities from infancy and childhood, and providing lifelong supports for adolescents, adults, and families. Ideally, if such efforts are undertaken early, they will lead to actions that can be undertaken to promote better health as people with ID age and ensure that the latter part of their lives are experienced as ‘quality of life years.’
Inclusion of laboratory and diagnostic information on the medical condition or injury that precipitated the disability evaluation in each service’s...Annual Report 2015 Disability Evaluation Systems Analysis and Research Prepared by Accession Medical Standards Analysis and Research Activity...Preventive Medicine Branch Walter Reed Army Institute of Research Silver Spring, Maryland Disability Evaluation Systems Analysis and Research
Olsson, Lena M.; Elgmark Andersson, Elisabeth; Granlund, Mats; Huus, Karina
Background: Children with a mild intellectual disability (ID) and their families often require social services; however, because of the characteristics of the formal service system, these families may be at risk of not receiving necessary services. The aim of this study was to obtain knowledge regarding the types and number of services that…
Sandqvist, Gunnel; Hesselstrand, Roger; Petersson, Ingemar F
OBJECTIVE: To study work disability (WD) with reference to levels of sick leave and disability pension in early systemic sclerosis (SSc). METHODS: Patients with SSc living in the southern part of Sweden with onset of their first non-Raynaud symptom between 2003 and 2009 and with a followup of 36...... months were included in a longitudinal study. Thirty-two patients (26 women, 24 with limited SSc) with a median age of 47.5 years (interquartile range 43-53) were identified. WD was calculated in 30-day intervals from 12 months prior to disease onset until 36 months after, presented as the prevalence...... of WD per year (0-3) and as the period prevalence of mean net days per month (± SD). Comparisons were made between patients with different disease severity and sociodemographic characteristics, and between patients and a reference group (RG) from the general population. RESULTS: Seventy-eight percent...
Whittle, Erin Louise; Fisher, Karen R.; Reppermund, Simone; Lenroot, Rhoshel; Trollor, Julian
Background: It is well established that people with an intellectual disability have high rates of mental health problems, yet rates of uptake of services do not match need. Aim: To identify the current literature pertaining to the barriers and facilitators to access to mental health services for people with an intellectual disability. Method: A…
Bullock, Charles C.; Mahon, Michael J.; Killingsworth, Charles L.
Ultimately, all successful recreation programs center around its participants wants and needs. Serving people with disabilities is no exception. "Introduction to Recreation Services for People with Disabilities" is intended to be an introductory book for anyone planning or working in the parks, recreation, and leisure service industry. Through…
Peter Thomas Sandy
Conclusion: Observation is a useful practice in in-patient learning disability services, which can be used to prevent or reduce the incidence of self-harm in these settings. This approach should therefore be an integral part of nurses' daily therapeutic activities in in-patient learning disability services.
Rice, Travis A.
The main purpose of this study was to investigate the disability support service (DSS) office designs at three varying U.S. postsecondary institutions and their relationship to the experiences of students with a learning disability. The three postsecondary institutions represent a community college, a medium sized university and a large research university all-residing in a single bellwether state. Selection of the cases and postsecondary institutions was carefully done in order to investig...
Full Text Available The Brazilian education system provides a specific form of organization for the inclusive education of students with disabilities. Law No. 9394 dated December 20, 1996, “Lei de diretrizes e bases da educação nacional”, presents in Chapter V the “educação especial" as a form of organization offered to students "portadores de Necessidades especiais”. Admission of students with disabilities in the Brazilian schools was characterized by several phases: the welfarist phase, the integration phase and the inclusion phase, which is the most recent one and now being debated. The presence of a special device fosters the differences, even when everybody enters the classbecause a separation perspective damps down all the procedural and design efforts towards a true integration, holding back collaboration and action sharing among teachers. We consider however effective an action that accompanies the gradual learning evolution mediating between the student with disabilities and peers, between him and the teachers, between him and the learning tools designed.
Weatherill, Pamela; Bahn, Susanne; Cooper, Trudi
This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.
Mac Giolla Phadraig, Caoimhin
This study aimed to generate prioritised goals for oral health services for people with disabilities as a first step in meeting the need for evidence based oral health services for people with disabilities in Ireland.
Biebel, Kathleen; Mizrahi, Raphael; Ringeisen, Heather
Accessing and successfully completing postsecondary educational opportunities may be challenging for those living with psychiatric disabilities. This exploratory study highlights the experiences of individuals with psychiatric disabilities participating in postsecondary educational support initiatives. Investigators conducted case studies with 3 education support initiatives across the United States. Focus groups revealed what concrete supported education services were helpful and key ingredients in delivering education supports. Access to specialists, mindfulness techniques, help with time management and procrastination, and facilitating classroom accommodations were identified as critical. Developing authentic relationships with supported education staff, flexibility in service delivery and access to student peers living with psychiatric disabilities were noted as key ingredients in service delivery. Incorporating the voice of students with psychiatric disabilities into supported education services can increase access, involvement, and retention, therein providing more supports to students with psychiatric disabilities achieving their postsecondary education goals. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Lawson, Janelle E; Cruz, Rebecca A; Knollman, Gregory A
Providing equal-status contact between those with and without disabilities can improve attitudes and reduce discrimination toward individuals with disabilities. This study investigated community service learning as a means by which to provide college students with equal-status contact with individuals with disabilities and increase their positive attitudes toward those with disabilities. A total of 166 college students in one university in the United States enrolled in an Introduction to Disability course received content on disability in society and participated in community service involving 20h of direct contact with individuals with disabilities. Findings indicated that college students who had prior contact with individuals with disabilities had more positive attitudes toward individuals with disabilities than college students who did not have prior contact at the start of the course. For the college students who did not have any prior contact, their attitudes toward individuals with disabilities became significantly more positive at the end of the community service learning course. Implications and suggestions for future research are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Children and adolescents with chronic diseases and disabling conditions often need related services. As medical home professionals, pediatricians can assist children, adolescents, and their families with the complex federal, state, and local laws, regulations, and systems associated with these services. Expanded roles for pediatricians in Individual Family Service Plan, Individualized Education Plan, and 504 Plan development and implementation are recommended. The complex range of federal, state, and local laws, regulations, and systems for special education and related services for children and adolescents in public schools is beyond the scope of this statement. Readers are referred to the policy statement "The Pediatrician's Role in Development and Implementation of an Individual Education Plan (IEP) and/or an Individual Family Services Plan"(1) by the American Academy of Pediatrics for additional background materials.
Park, Jiyoon; Bouck, Emily
Although there are many secondary data analyses of the National Longitudinal Transition Study-2 (NLTS-2) to investigate post-school outcome for students with disabilities, there has been a lack of research with in-school service predictors and post-school outcome for students with specific disability categories. This study was a secondary data analysis of NLTS-2 to investigate the relationship between current employment status and in-school services for individuals with intellectual disability. Statistical methods such as descriptive statistics and logistic regression were used to analyze NLTS-2 data set. The main findings included that in-school services were correlated with current employment status, and that primary disability (i.e., mild intellectual disability and moderate/severe intellectual disability) was associated with current employment status. In-school services are critical in predicting current employment for individuals with intellectual disability. Also, data suggest additional research is needed to investigate various in-school services and variables that could predict employment differences between individuals with mild and moderate/severe intellectual disability. Copyright © 2018 Elsevier Ltd. All rights reserved.
Trute, B; Hiebert-Murphy, D; Wright, A
Potential service outcome measures were tested for their utility in the assessment of the quality of 'family centred' service coordination in the provincial network of children's disability services in Manitoba, Canada. This study is based on in-home survey data provided by 103 mothers at 6 and 18 months following assignment of a 'dedicated' service coordinator. Service outcome indicators included measures of parent self-esteem, parenting stress, family functioning and the need for family support resources. Hierarchical regression analyses showed no relationship between level of quality of family-centred service coordination and standardized psychosocial measures of parent and family functioning. However, family centredness of service coordination was found to predict significant reduction in level of family need for psychosocial support resources after 18 months of contact with a service coordinator. Outcome measures that are focused on specific and tangible results of service coordination appear to be of higher utility in service quality assessment than are more global, standardized measures of parent and family functioning.
Darzi, Andrea J; Officer, Alana; Abualghaib, Ola; Akl, Elie A
The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes. We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale. Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively). The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their
Demirkan, Haluk; Krishna, Vikas
This book presents a multidisciplinary and multisectoral perspective on the nature of service systems, on research and practice in service and on the future directions to advance service science. It offers theory-based research with actionable results.
Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong
Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.
Buys, L.; Aird, R.; Miller, E.
Background: Considerable attention is currently being directed towards both active ageing and the revising of standards for disability services within Australia and internationally. Yet, to date, no consideration appears to have been given to ways to promote active ageing among older adults with intellectual disabilities (IDs). Methods:…
Devereux, Jason; Hastings, Richard; Noone, Steve
Background: Staff in intellectual disability services can be at risk of stress and burnout at work. Given that staff well-being has implications for the quality of life of the staff themselves and people with intellectual disabilities themselves, this is an important research and practical topic. In this paper, we review work stress theories that…
Boland, Máirín C
There is limited background information on self-rated health in people with disability in Ireland. This paper examines self-rated health scores and dimensions of functioning in people attending disability services and compares scores to the general population in Ireland, which has not been done before.
Diodati, Melissa R.
Leisure participation is influential on the quality of life of individuals. Individuals with disabilities can face barriers in leisure participation, impacting their quality of life. IDEA (2004) recognizes recreation as a related service as one way to enhance the leisure experiences for students with disabilities. The purpose of this embedded case…
Holly, Deirdre; Sharp, John
People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…
Daudji, Anisa; Eby, Sarah; Foo, Tina; Ladak, Fahreen; Sinclair, Cameal; Landry, Michel D; Moody, Kim; Gibson, Barbara E
The objectives of this study were to describe perceptions of disability among South Asian immigrant mothers of children with disabilities in a large multicultural urban centre in Ontario, Canada, and to explore how these perceptions influence rehabilitation services. The study was built on our previous work conducted with mothers in South Asia. A descriptive qualitative research design was employed. Semi-structured interviews were conducted with five mothers who had immigrated to Canada from South Asia in the last decade, and whose children were receiving outpatient rehabilitation services. Three primary themes were identified: (1) perceptions of disability reflected a mix of traditional and western beliefs; (2) mothers experienced physical, emotional and social suffering related to socio-cultural and material barriers and (3) mothers' primary goal for their children was the achievement of independent walking, which was linked to notions of achieving a ?normal? life and the desire for more rehabilitation interventions. South Asian immigrant mothers' perceptions of their children's disabilities had important similarities and differences to mothers living in South Asia. Healthcare professionals can assist families in managing and coping with their child's disabilities by exploring their unique values and beliefs and identifying achievable outcomes together.
McAloone, Timothy Charles; Andreasen, Mogens Myrup
, company and society benefit from the service systems related to each one of these dimensions, rather than simply one of the above. There are existing examples of the enhancement of business and market share by focusing on PSS, but this is often not a result of upfront strategy and ambitious goals. We...... attempt to identify the nature of such a multiple definition of PSS, the link to proper understanding of value and utility and innovative approaches for PSS-oriented product development. This paper will expand on the phenomenon of PSS in the belief that a proper understanding of PSS will give us...
Chitty, Kate M; Evans, Elizabeth; Torr, Jennifer J; Iacono, Teresa; Brodaty, Henry; Sachdev, Perminder; Trollor, Julian N
Information on the rates and predictors of polypharmacy of central nervous system medication in older people with intellectual disability is limited, despite the increased life expectancy of this group. This study examined central nervous system medication use in an older sample of people with intellectual disability. Data regarding demographics, psychiatric diagnoses and current medications were collected as part of a larger survey completed by carers of people with intellectual disability over the age of 40 years. Recruitment occurred predominantly via disability services across different urban and rural locations in New South Wales and Victoria. Medications were coded according to the Monthly Index of Medical Specialties central nervous system medication categories, including sedatives/hypnotics, anti-anxiety agents, antipsychotics, antidepressants, central nervous system stimulants, movement disorder medications and anticonvulsants. The Developmental Behaviour Checklist for Adults was used to assess behaviour. Data were available for 114 people with intellectual disability. In all, 62.3% of the sample was prescribed a central nervous system medication, with 47.4% taking more than one. Of those who were medicated, 46.5% had a neurological diagnosis (a seizure disorder or Parkinson's disease) and 45.1% had a psychiatric diagnosis (an affective or psychotic disorder). Linear regression revealed that polypharmacy was predicted by the presence of neurological and psychiatric diagnosis, higher Developmental Behaviour Checklist for Adults scores and male gender. This study is the first to focus on central nervous system medication in an older sample with intellectual disability. The findings are in line with the wider literature in younger people, showing a high degree of prescription and polypharmacy. Within the sample, there seems to be adequate rationale for central nervous system medication prescription. Although these data do not indicate non-adherence to
Abstract Service orientation is an approach to software systems development that has become a popular way to implement distributed, loosely coupled...runtime. The later you defer binding the more flexibility service providers and service consumers have to develop their software systems independently...Enterprise Service Bus An Enterprise Service Bus (ESB) is a software pattern that can be part of a SOA infrastructure and acts as an intermediary
Olsen, Angela; Majeed-Ariss, Rabiya; Teniola, Simonette; White, Catherine
Background: People with learning disabilities are more likely to experience sexual abuse and less likely to access support than the general population, this is due to a range of variables at the individual, societal and service-delivery level. This study presents a service evaluation of St Mary's Sexual Assault Referral Centre, Manchester to…
... necessary to legally transport service animals on flights from the U.S. into the United Kingdom is found in... disability to travel with service animals? 382.117 Section 382.117 Aeronautics and Space OFFICE OF THE... disability to travel with service animals? (a) As a carrier, you must permit a service animal to accompany a...
compensation amount for each rating, and the tax advantage of each VA award (disability compensation is not subject to fed- eral income or payroll tax...17,030). Disability compensation has further advantages for veterans, because these payments are not subject to federal income and payroll tax. When...Burnham, and N. Augustin (1997). “Model Selection: An Integral Part of Inference.” Biometrics , Vol. 53, No. 2, pp. 603–618. Buddin, Richard, and Kanika
Mac Giolla Phadraig, Caoimhin; Dougall, Alison; Stapleton, Siobhan; McGeown, Danielle; Nunn, June; Guerin, Suzanne
Background: In Ireland, people with learning disabilities have poor oral health. This is in part due to inappropriate oral health services. Recognising the value of inclusive approaches to research and healthcare planning, this study sought to include a group of people with learning disabilities in priority setting for oral health services in…
Bigaj, Stephen J.; Bazinet, Gregory P.
Suggests a team approach for effectively and efficiently providing services for postsecondary students with disabilities. Reviews various teaming concepts and presents a framework for a postsecondary disability problem-solving team. (Author/JOW)
Breen, Lauren J; Wildy, Helen; Saggers, Sherry; Millsteed, Jeannine; Raghavendra, Parimala
Wellness approaches are not routine in childhood disability services, despite theoretical and empirical support and an increasing demand for them from health consumers and disability activists. We aimed to investigate how health professionals define or understand wellness and its practice in the context of childhood disability. A qualitative, interpretive approach was taken. Semi-structured interviews were conducted with 23 health professionals (allied health therapists and managers) providing early intervention and ongoing therapy within four Australian childhood health and disability services. Years of experience providing services to children with disabilities and their families ranged from 6 months to 30 years (M=9.41, SD=9.04). The data revealed a noteworthy impediment to incorporating wellness into practice - the difficulties in the allied health professionals reaching consensus in defining wellness. There appeared to be distinct differences between the four services, while there appeared to be no appreciable difference based on the individual professional's years of experience or allied health discipline. The effect of organisational culture should be considered in efforts to embed wellness in childhood health and disability services in order to address client well-being, empowerment, choice, independence and rights to meaningful and productive lives. © 2011 Informa UK, Ltd.
Hamdani, Yani; Proulx, Meghann; Kingsnorth, Shauna; Lindsay, Sally; Maxwell, Joanne; Colantonio, Angela; Macarthur, Colin; Bayley, Mark
LIFEspan is a service delivery model of continuous coordinated care developed and implemented by a cross-organization partnership between a pediatric and an adult rehabilitation hospital. Previous work explored enablers and barriers to establishing the partnership service. This paper examines healthcare professionals' (HCPs') experiences of 'real world' service delivery aimed at supporting transitional rehabilitative care for youth with disabilities. This qualitative study - part of an ongoing mixed method longitudinal study - elicited HCPs' perspectives on their experiences of LIFEspan service delivery through in-depth interviews. Data were categorized into themes of service delivery activities, then interpreted from the lens of a service integration/coordination framework. Five main service delivery themes were identified: 1) addressing youth's transition readiness and capacities; 2) shifting responsibility for healthcare management from parents to youth; 3) determining services based on organizational resources; 4) linking between pediatric and adult rehabilitation services; and, 5) linking with multi-sector services. LIFEspan contributed to service delivery activities that coordinated care for youth and families and integrated inter-hospital services. However, gaps in service integration with primary care, education, social, and community services limited coordinated care to the rehabilitation sector. Recommendations are made to enhance service delivery using a systems/sector-based approach.
Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H; Khalil, Hesham S
The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Using the Arksey O'Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet.
Barelds, Anna; van de Goor, Ien; van Heck, Guus; Schols, Jos
Care and service trajectories for people with intellectual disabilities (i.e. people with mental retardations) are routes within the healthcare delivery system that consist of all the steps that people with intellectual disabilities and their families have to take in order to realise the needed care and services. This article aims to identify the quality aspects of trajectories that are considered important by people with intellectual disabilities and their parents/relatives. In addition, it examines how these aspects are related to quality determinants mentioned in the literature on integrated care and to authoritative models for quality assessment of care and service delivery. Quality aspects were collected during eight focus group discussions with people with intellectual disabilities or their parents/relatives. In addition, quality determinants of integrated care and authoritative models for quality assessment were selected by means of a thorough review of the literature. Finally, the quality aspects identified using focus groups were compared to the determinants and models found in the literature. The quality aspects presented by people with intellectual disabilities referred particularly to the immediate situation in receiving care and services, such as 'keeping appointments' and 'time and attention', whereas parents/relatives also referred to broader 'organisational issues', such as 'access to support' and 'problems with placement'. The quality aspects, however, are minimally related to the quality determinants of integrated care, probably because clients and their parents/relatives find it difficult to have an overview of the coherence between the various actions that have to be performed, when going through the trajectories. In contrast, the quality aspects seem to fit into the domains of the authoritative models for quality assessment, probably because of the minimal focus of the models on long-term aspects in care and service delivery.
Mheta, Doreen; Mashamba-Thompson, Tivani P
The Sustainable Development Goals (SDGs) emphasises the increasing equitable coverage of quality health care and provision of integrated services as means of reducing maternal mortality. Despite so much effort being placed on improved access to maternity health care, studies show that women with disabilities are being systemically excluded from the mainstream maternal health services. The proposed scoping review aims to map literature on the barriers and facilitators of access to maternal services for women with disabilities. The search strategy for this scoping review study will involve electronic databases including Pubmed, MEDLINE via EBSCOhost, CINAHL Plus with full text via EBSCOhost, Africa-Wide Info via EBSCOhost, JSTOR and Proquest Health and Medical Complete. Articles will also be searched through the "Cited by" search as well as citations included in the reference lists of included articles. A two-stage mapping strategy would be conducted. Stage 1 would be to screen studies through examining their titles. Furthermore, we will screen abstracts of the identified studies descriptively and by focus and method as stipulated by the inclusion and exclusion criteria. In stage 2, we will extract data from the included studies. A parallel screening and data extraction will be undertaken by two reviewers. We will access the quality of the included studies using the mixed methods appraisal tool (MMAT). We will use NVIVO version 10 to extract the relevant outcomes and thematic analysis of the studies. We anticipate to find relevant studies reporting evidence on the barriers and facilitators of access to maternal health services in Sub-Saharan Africa. The evidence obtained from the included studies when summarised will help guide future research. The study findings will be disseminated electronically and in print. In addition, it will be presented at conferences related to sexual reproductive health, maternal health care and reproductive health.
Hunt, Xanthe; Carew, Mark T; Braathen, Stine Hellum; Swartz, Leslie; Chiwaula, Mussa; Rohleder, Poul
There is a body of theoretical work, and some empirical research, which suggests that non-disabled people assume people with physical disabilities are not suitable romantic partners, do not have sexual drives or desires, or are not sexually active. It has also been proposed that people with physical disabilities face barriers to sexual healthcare access which are structural as well as social. The present paper explores non-disabled South Africans' beliefs concerning the degree to which non-disabled respondents enjoy sexual and reproductive rights, and benefit from sexual and reproductive healthcare, compared to people without disability. Using a survey, we asked 1989 South Africans to estimate the degree to which people with physical disabilities and people without disability have sexual rights, and benefit from sexual and reproductive healthcare services, respectively. Respondents were more likely to support the idea that the population without disability were deserving of sexual rights compared to people with physical disabilities. Respondents were more likely to rate the degree to which people with physical disability benefit from sexual and reproductive healthcare as less than that for people without physical disabilities. These findings provide some of the first empirical support that non-disabled people perceive people with physical disabilities as having fewer sexual and reproductive rights, and deriving less benefit from sexual and reproductive health services, than the population without disability. To have diminished sexual rights, and benefit less from sexual and reproductive healthcare, we suggest, evinces a negation of the sexual and reproductive needs and capacity of people with physical disabilities.
Rutherford, Robert B., Jr.; Bullis, Michael; Anderson, Cindy Wheeler; Griller-Clark, Heather M.
This monograph, one of a series on youth with disabilities and the juvenile justice system, reviews current data on disabilities requiring special education and related supports. Statistics on the prevalence of juvenile crime are followed by statistics on the prevalence of special education disabilities in the system, specifically specific…
Carter, Erik W.; Swedeen, Beth; Moss, Colleen K.
Service learning is an effective curricular approach to increase instructional relevance and engagement for all students. For students with significant disabilities in transition, meaningful service can be an especially useful avenue for exploring career interests, gaining and practicing important life skills, and connecting to the community in…
... facility, if the veteran: (1) Is in need of nursing home care for a VA adjudicated service-connected...' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Per Diem Payments § 51.41 Per diem for certain veterans based on service-connected disabilities...
Hare, Dougal Julian; Chapman, Melanie; Fraser, Janelle; Gore, Sarah; Burton, Mark
A survey of service providers for people with learning disabilities in the Manchester (England) region identified a total of 174 people with either a confirmed or a suspected autistic spectrum disorder. Discussion of current and historical factors in estimating incidence suggests that the usual 10% of service users represents the lowest estimate…
Evans, E.; Howlett, S.; Kremser, T.; Simpson, J.; Kayess, R.; Trollor, J.
Background: People with intellectual disability (ID) experience higher rates of major mental disorders than their non-ID peers, but in many countries have difficulty accessing appropriate mental health services. The aim of this paper is to review the current state of mental health services for people with ID using Australia as a case example, and…
Browning, Ellen R.; Caro, Patricia; Shastry, Sunita P.
Providing services for children with disabilities has been a part of the culture of India for generations. However service provision has been within the context of family and community rather than in the public sector and thus has been inclusive by its very nature. This article describes current educational provisions and practices in India for…
Smith, Robin M.
When students with disabilities are isolated socially and physically, their self-confidence and engagement may be low. Encouraging leadership and service in students who are often overlooked for these roles enhances peer relations, engagement, and self-confidence. Principles and strategies for fostering leadership and service are described.…
Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin
Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…
Brady, Nancy C.; Bruce, Susan; Goldman, Amy; Erickson, Karen; Mineo, Beth; Ogletree, Bill T.; Paul, Diane; Romski, Mary Ann; Sevcik, Rose; Siegel, Ellin; Schoonover, Judith; Snell, Marti; Sylvester, Lorraine; Wilkinson, Krista
The National Joint Committee for the Communication Needs of People with Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities. PMID:26914467
People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme. This proposed initiative aimed to enhance end of life care for people with learning disabilities through the implementation of a community learning disability link nurse in the hospice setting. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
Hopf, Suzanne C; McLeod, Sharynne
The World Health Organization's World report on disability calls upon all nations to 'remove the barriers which prevent [people with disabilities] from participating in their communities; getting a quality education, finding decent work, and having their voices heard' (p. 5). People with communication disability (PWCD), as a consequence of their atypical communication, may be more likely to be excluded from society, and denied their basic human rights, than other people with disability. Fiji, a multicultural and multilingual nation in the south-western Pacific Ocean, has limited services for PWCD. Service providers in Fiji include disability care workers, special education teachers, traditional healers, and a small number of visiting volunteer speech-language pathologists. This paper outlines the historical and current barriers to, and drivers of change for, service development for PWCD in Fiji. Five barriers to service development for PWCD in Fiji were identified. (1) A major structural barrier is the small population size to develop appropriate infrastructure including professional education programs. (2) Geographical barriers include the dispersed geography across 300 islands, low population density, the rural-urban divide, and risk of disaster from cyclones and flooding. (3) Linguistic diversity, while culturally important, can present a barrier to the provision of quality services that are available in the languages spoken by PWCD. (4) Cultural barriers include historical political instability, although Fiji has become more stable due to the recent democratic elections. The social climate affects development of services that are appropriate for different dominant cultural groups. (5) Financial barriers include low gross domestic product, low financial security and low human development index; however, the financial outlook for Fiji is steadily improving due to the change in political stability. Three levels of drivers of change were identified. Macro
Fichten, Catherine Susan; Heiman, Tali; Havel, Alice; Jorgensen, Mary; Budd, Jillian; King, Laura
We have examined the sustainability of providing services for students with disabilities in higher education in Canada and Israel. The two countries differ in their approaches: Israel subscribes to the accommodations model of service delivery; Canada, to the universal design approach. Case examples of services to students with disabilities in…
Abdullah, Melissa Ng Lee Yen; Mey, See Ching; Eng, Tan Kok; Othman, Rosly; Omar, Ahmad Fairuz
Transition services are required by law for students with disabilities in many developed countries. In Malaysia, however, there is still no specific legislation mandating that school-to-work transition planning and services be provided to students with disabilities. This study investigated the state of the transition services provided by…
McDougall, Janette; Horgan, Karen; Baldwin, Patricia; Tucker, Mary Ann; Frid, Pamela
In 2001, the World Health Organization published the International Classification of Functioning, Disability and Health (ICF). The ICF is just beginning to be used in a variety of clinical and research settings in Canada and worldwide. The purpose of the present article is to describe the initial use of the ICF at an Ontario children's rehabilitation centre, and to consider further uses both within and outside the centre for enhancing services for children and youth with chronic physical health conditions and disabilities, as well as for their families. A description is provided on how the ICF has been used at the centre to guide clinical thinking and practice, and to justify and steer research directions. Plans underway to use the ICF to collect and record functional data at the centre are also described. Finally, recommendations for the use of the ICF to enhance communication among child health professionals across service settings are provided. Used in conjunction with the International Classification of Diseases - Tenth Revision, the ICF's conceptual framework and classification system shows great promise for enhancing the quality of services for children with chronic conditions and their families. This information may assist paediatric specialists, other child health professionals, researchers and administrators to use the ICF in similar settings. It may also stimulate exploration of the use of the ICF for general paediatricians and other service providers in the larger community.
Roadhouse, C; Shuman, C; Anstey, K; Sappleton, K; Chitayat, D; Ignagni, E
Genetic counselors adopt seemingly contradictory roles: advocating for individuals with genetic conditions while offering prenatal diagnosis and the option of selective termination to prevent the birth of a child with a disability. This duality contributes to the tension between the disability and clinical genetics communities. Varying opinions exist amongst the disability community: some value genetic services while others are opposed. However, there is limited research exploring the opinions of individuals with a disability regarding issues related to reproduction and genetic services in the context of personal experience. This exploratory qualitative study involved interviews with seven women and three men who self-identify as having a disability. We sought to gain their perspectives on experiences with disability, thoughts about reproduction and parenting, and perceptions of genetic services. Transcripts of the interviews were analyzed thematically using qualitative content analysis. Data analysis showed that societal views of disability affected the lived experience and impacted reproductive decision-making for those with a disability. It also showed differing interest in genetic services. Concerns about the perceived collective implications of genetic services were also raised. These findings contribute to the understanding of the disability perspective toward reproductive decision-making and genetic services. A further goal is to promote a meaningful dialogue between the genetics and disability communities, with the potential to enhance the genetic and reproductive care provided to individuals with disabilities.
Juneja, Monica; Jain, Rahul; Singhal, Swati; Mishra, Devendra
To identify the problems faced by parents of children with developmental disabilities in availing rehabilitative services and to find their satisfaction level. This study was carried out at a Child Development Clinic (CDC) located in Northern India. Children with developmental disabilities, who were availing services at CDC for at least last 3 mo and had at least 3 follow-up visits, were enrolled. A questionnaire pertaining to the socio-demographic profile, problems faced in availing services and satisfaction level was filled by the parents of the enrolled children. During the study period, 161 parents filled the questionnaire. 77.6% had some problems in getting the services, the major being difficulty in commuting (50%) and financial constraint (21.7%). More than 80% parents use public transport to reach CDC with 19% travelling more than 50 Km. 29.8% had difficulty in bringing their child to the clinic, either due to severe behavioral problems or physical disability. However, majority of the families were well satisfied with the services as 95% of them graded their satisfaction level at 3 or more on the scale of 0-5. Parents of children with developmental disabilities face many problems in getting rehabilitative services. They travel long distances, face hardships in carrying their child, and lose their day's earnings, apart from spending time and money for their child's therapy. However, most of the parents are well satisfied with the services.
Kronick, Richard; Dreyfus, Tony; Lee, Lora; Zhou, Zhiyuan
This article describes a system of diagnostic categories that Medicaid programs can use for adjusting capitation payments to health plans that enroll people with disability. Medicaid claims from Colorado, Michigan, Missouri, New York, and Ohio are analyzed to demonstrate that the greater predictability of costs among people with disabilities makes risk adjustment more feasible than for a general population and more critical to creating health systems for people with disability. The application of our diagnostic categories to State claims data is described, including estimated effects on subsequent-year costs of various diagnoses. The challenges of implementing adjustment by diagnosis are explored. PMID:10172665
... the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES... disabilities who reside on Federal or State reservations, consistent with their individual strengths, resources...
Devkota, Hridaya Raj; Murray, Emily; Kett, Maria; Groce, Nora
Women with disabilities are less likely to receive maternal healthcare services compared to women without disabilities. While few studies have reviewed healthcare experience of women with disabilities, no studies have been conducted to understand provider's attitude towards disability in Nepal, yet the attitude and behaviour of healthcare providers may have a significant influence on aspects of care and the use of service by women with disabilities. This study examines healthcare provider's attitudes towards disability and explores the experience of women with disabilities in maternal healthcare service utilization during pregnancy and childbirth. The study used mixed method approach. An attitude survey was conducted among 396 healthcare providers currently working in public health facilities in Rupandehi district of Nepal. For additional insight, eighteen in-depth interviews with women with disabilities who used maternal healthcare services in a healthcare facility within the study district in their last pregnancy were undertaken. The Attitude Towards Disabled Persons (ATDP) scale score was used to measure the attitudes of healthcare providers. For quantitative data, univariate and multivariate analysis using ANOVA was used to understand the association between outcome and independent variables and qualitative analysis generated and described themes. Mean ATDP score among healthcare providers (78.52; SD = 14.75), was low compared to the normative score of 100 or higher. Nurses/auxiliary nurse midwives obtained the highest mean score (85.59, SD = 13.45), followed by general clinical health workers (Mean score = 82.64, SD 15.10). The lowest score was obtained by Female Community Health Volunteers (FCHV) (Score = 73.75, SD = 13.40) (P women with disabilities. The mean score difference between those who received disability training and who did not was also found statistically insignificant (P > 0.05). This may reflect the small number of individuals
Narayan, Jayanthi; Pratapkumar, Raja; Reddy, Sudhakara P
In resource poor settings innovative and bottom-up approaches are required to provide services to people with with disabilities. In this context, the present paper explains a community-based model of manpower development and coordination of services for people with intellectual disabilities in unified state of Andhra Pradesh in India. Women with disabilities from the village were identified, and those willing to be trained to work as community resource persons (CRPs) were selected and given hands-on training in a phased manner. A total of 130 women were trained in five groups of 25-30 per group and were deployed in the community to screen, identify and refer children with intellectual disabilities. The training content included basic stimulation and interface with functionaries of other government departments of health, education and welfare to ensure comprehensive service delivery. Neighbourhood centres (NHCs) were established where the CRPs could meet with families collectively. The results indicated that the CRPs were welcomed by the families. The NHCs established primarily as recreation centres, promoted inclusion and functioned as information dissemination centre. The services provided by the CRPs were owned and monitored by the Women's self-help group and the disability groups thus ensuring sustainability of the model.
Wylie, Karen; McAllister, Lindy; Davidson, Bronwyn; Marshall, Julie; Amponsah, Clement; Bampoe, Josephine Ohenewa
In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. A qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability. One hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors - including the Western healthcare, religious, and traditional sectors. Understanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the
Nondwe B. Mlenzana
Objectives: This article aimed to review the relevant literature regarding barriers to and facilitators of rehabilitation services for people with disabilities. Method: Articles for the period 1990–2010 using descriptors related to rehabilitation services, barriers, facilitators and the physically disabled population were retrieved for this review. Results: A total of 19 article titles were identified from references of other articles but following application of the inclusion criteria selected for this review, only six articles were chosen. Five of these articles were qualitative studies and one was a quantitative study. Barriers and facilitators regarding rehabilitation services highlighted by participants in the studies included a perception that health professionals have a lack of understanding of rehabilitation for people with disabilities and there was a lack of information sharing from health professionals about the rehabilitation process. On the other hand some participants reported that health professionals demonstrated confidence in the disability and rehabilitation process during consultation and highlighted that their needs were met by the rehabilitation professionals. Conclusion: Even though there were few studies highlighting the barriers to and facilitators of rehabilitation services, they highlighted that there are gaps in the process of rehabilitation services provided. It would be advisable for health professionals to take cognisance of the issues highlighted in this study in order to make rehabilitation services more effective.
Roysdon, Christine, Ed.; White, Howard D., Ed.
Eleven articles introduce expert systems applications in library and information science, and present design and implementation issues of system development for reference services. Topics covered include knowledge based systems, prototype development, the use of artificial intelligence to remedy current system inadequacies, and an expert system to…
Theodoratos, Oreste; McPherson, Lyn; Franklin, Catherine; Tonge, Bruce; Einfeld, Stewart; Lennox, Nicholas; Ware, Robert S
Adolescents with intellectual disability have increased rates of psychopathology compared with their typically developing peers and present to hospital more frequently for ambulant conditions. The aim of this study is to describe the psychopathology and related characteristics of a sample of adolescents with intellectual disability who presented to general hospital services. We investigated a cohort of adolescents with intellectual disability in South East Queensland, Australia between January 2006 and June 2010. Demographic and clinical data were obtained via mailed questionnaires and from general practice notes. Psychopathology was measured with the Short Form of the Developmental Behaviour Checklist. Of 98 individuals presenting to hospital, 71 (72.5%) had significant levels of psychopathology. Unknown aetiology for the intellectual disability was associated with presence of problem behaviours. Adolescents with more severe intellectual disability were more likely to have major problem behaviours. Co-morbid physical health issues were not associated with psychopathology. Only 12 (12.1%) adolescents had undergone specialized mental health intervention. The general hospital environment may offer opportunities for liaison psychiatry services to screen and provide management expertise for adolescent individuals with intellectual disability presenting for physical health issues.
Nix, Mary P.
There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…
Woodruff, Elizabeth A.; Sinelnikov, Oleg A.
While many scholars agree that service learning is beneficial to both the student and the community, the research on service learning in the physical education setting is limited. However, there are courses that can be aligned with the professional preparation needs of students and the broader needs of the community. Drawing on theory which has…
Full Text Available Purpose: The article describes the development of a practical model of joint, integrated inspection of managed care services for people with learning disabilities in Scotland. The model will give a reliable measure of the impact services are making to people's lives and the quality of service that individuals are actually receiving. Context of case: At present health, social services and education services for people with learning disabilities in Scotland are inspected separately, by up to nine different agencies. The first joint, integrated inspections of all services for people with learning disabilities in Scotland will take place in 2006. This is the first inspection of its kind in the UK, and the first to involve carers and people with learning disabilities on the inspection team. Data sources: Quality Outcome Indicators were developed in 21 different areas, or domains. Evidence based best practice, and evaluative data from previous inspections were the primary sources of data. Case description: This paper reviews the background and rationale for the integrated, joint inspection process. Strengths and constraints of this approach to inspection are discussed, including the crucial importance of commitment from services and from inspectors, rather than mere compliance with demands. Some guidance on how to fully involve staff, carers and services users in the inspection process is given. Conclusions and discussion: The model will produce data to inform decision-making for managers in integrated services and give services users clear information about how well local needs are being met, what areas need development, and what capacity the organisations have to improve. The model of inspection may be of interest to practitioners in a national and international context. The model will be evaluated, following the first joint inspection.
Basit, Abdul; Altin, Müfit
Traditionally, conventional power plants have the task to support the power system, by supplying power balancing services. These services are required by the power system operators in order to secure a safe and reliable operation of the power system. However, as in the future the wind power...... is going more and more to replace conventional power plants, the sources of conventional reserve available to the system will be reduced and fewer conventional plants will be available on-line to share the regulation burden. The reliable operation of highly wind power integrated power system might...... then beat risk unless the wind power plants (WPPs) are able to support and participate in power balancing services. The objective of this PhD project is to develop and analyse control strategies which can increase the WPPs capability to provide system services, such as active power balancing control...
Tan, Seok Hong
Information on unmet health care needs reveal problems that are related to unavailability and inaccessibility of services. The study objectives were to determine the prevalence, and the reasons for unmet service needs among children with disabilities in the state of Penang, Malaysia. Caregivers of children with disabilities aged 0 to 12 years registered with the Penang Social Welfare Department in 2012 answered a self-administered mailed questionnaire. A total of 305 questionnaires were available for analysis (response rate 37.9%). Services that were very much needed and yet highly unmet were dental services (49.6% needed, 59.9% unmet), dietary advice (30.9% needed, 63.3% unmet), speech therapy (56.9% needed, 56.8% unmet), psychology services (25.5% needed, 63.3% unmet), and communication aids (33.0% needed, 79.2% unmet). Access problems were mainly due to logistic issues and caregivers not knowing where to obtain services. Findings from this study can be used to inform strategies for service delivery and advocacy for children with disabilities in Penang, Malaysia. © 2015 APJPH.
Jacobs, Myrthe; Downie, Helen; Kidd, Gill; Fitzsimmons, Lorna; Gibbs, Susie; Melville, Craig
Background: Children and young people with learning disabilities experience high rates of mental health problems. Methods: The present study reviewed the literature on mental health services for children with learning disabilities, to identify known models of service provision and what has been experienced as effective or challenging in providing…
Burges, Karsten; Freier, Karin; Vincent, Jeremy; Montigny, Marie; Engel, Bernd; Konstanciak, Wilhelm; Makdessi, Georges; Acres, Adrien; Schlaaff, Torsten; Defaix, Christophe
The French-German office for Renewable energies (OFAEnR) organised a photovoltaic conference on system services and photovoltaic facilities. In the framework of this French-German exchange of experience, about 100 participants have analysed and discussed the regulatory, technical and economical context of system services, their evolution and implementation in the framework of an accelerated development of photovoltaic conversion in both countries. This document brings together the available presentations (slides) made during this event: 1 - Technical Introduction to system services: principles, actors and perspectives (Karsten Burges); 2 - Legal guidelines of EEG (Renewable energy Sources Act) and the System Stability Ordinance as well as future measures for PV grid integration (Karin Freier); 3 - evolution of ancillary services regulation; opening the possibility for new market players to participate in maintaining the system stability (Jeremy Vincent, Marie Montigny); 4 - Paradigm shift for ancillary services: PV as a new stakeholder (Bernd Engel); 5 - Challenges of RES integration (Wilhelm Konstanciak 6 - System services supplied by PV inverters, solutions for frequency and active/reactive power control at the injection point (Georges Makdessi); 7 - Grid disturbance abatement and voltage stability control by monitoring local scale PV production (Adrien Acres); 8 - Flexibly Adaptable Power Plant Controller - The Answer to Various Grid Requirements (Torsten Schlaaff); 9 - ENR-pool project: What kind of business model for ancillary services by PV power plants? (Christophe Defaix)
... passengers with a disability for providing services and accommodations required by this rule? 382.31 Section... a disability for providing services and accommodations required by this rule? (a) Except as...) If your web site that passengers use to make reservations or purchase tickets is not accessible to a...
... to passengers with a disability are available only in a type or class of service or part of a vessel that are more expensive than the type or class of service or part of a vessel that the passenger... of the Secretary of Transportation TRANSPORTATION FOR INDIVIDUALS WITH DISABILITIES: PASSENGER...
Zinzi, Michele; Romeo, Carlo; Thomsen, Kirsten Engelund
of the description of 5 main technologies: condensing boilers, heat pumps, ventilation systems, lighting and photovoltaic systems. For each technology chapter there is the same content list: an introduction, a brief technology description, some advantages and disadvantages, market penetration and utilisation, energy...
Christensen, Lars Ballieu; Stevns, Tanja
This paper presents how SensusAccess has been adapted and is being used in higher education to create inclusive educational environments. Reflecting on challenges of providing alternate versions of educational material to students with disabilities, it also discusses how the service can benefit mainstream learners.
Fujiura, Glenn T.; Li, Henan; Magaña, Sandy
Health services and associated costs for adults with intellectual and developmental disabilities (IDD) were nationally profiled and the predictors of high expense users statistically modeled. Using linked data from the National Health Interview Survey and Medical Expenditure Panel Survey for the years 2002 through 2011, the study found a mixed…
Lambert, Matthew C.; Trout, Alexandra L.; Nelson, Timothy D.; Epstein, Michael H.; W. Thompson, Ronald
Background: Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with…
... DEPARTMENT OF EDUCATION Applications for New Awards; Technology and Media Services for Individuals With Disabilities--Stepping-Up Technology Implementation Correction In notice document 2012-12278 appearing on pages 29989 through 29995 in the issue of Monday, May 21, 2012 make the following correction...
Herman, Sandra E.; Marcenko, Maureen O.
This study examined effects of resource perceptions and respite use in a theoretical model of adaptation with 72 parents of children with developmental disabilities. Amount and quality of respite services indirectly affected parental depression. Both quality and respite use were related to helpfulness of the parent's social network. The strongest…
... Rights Division, Department of Justice. ACTION: Final rule; correction. SUMMARY: This document contains... of the rule relating to service animals. DATES: Effective Date: March 15, 2011. FOR FURTHER INFORMATION CONTACT: Barbara J. Elkin, Attorney Advisor, Disability Rights Section, Civil Rights Division, U.S...
Ng, Louisa; Talman, Paul; Khan, Fary
Motor neurone disease (MND) places considerable burden upon patients and caregivers. This is the first study, which describes the disability profile and healthcare needs for persons with MND (pwMND) in an Australian sample from the perspective of the patients and caregivers to identify current gaps in the knowledge and service provision. A…
O'Brien, Gerald V.; Ellegood, Christina
The 1990 Americans with Disabilities Act has had a profound influence on social workers and social services administrators in virtually all work settings. Because of the multiple elements of the act, however, assessing the validity of claims can be a somewhat arduous and complicated task. This article provides a "decision tree" for…
Gilham, Christopher M.; Tompkins, Joanne
In this article, two teacher educators describe and explain how they are reconceptualizing a pre-service teacher education course on inclusion using disability studies in education (DSE) scholarship. The DSE approach better connects the oft-separated field of diversity and inclusion, and builds on the program's overall focus on equity education.…
Beck, Tanja; Diaz del Castillo, Patricia; Fovet, Frederic; Mole, Heather; Noga, Brodie
This article presents out an outcome analysis of a Universal Design (UD) audit to the various professional facets of a disability service (DS) provider's office on a large North American campus. The context of the audit is a broad campus-wide drive to implement Universal Design for Learning (UDL) in teaching practices. In an effort for consistency…
Lawson, Janelle E.; Cmar, Jennifer L.
For over 25 years, students with disabilities in California received educationally related mental health services through interagency collaboration between school districts and county mental health agencies. After a major change in state policy that eliminated state-mandated interagency collaboration, school districts in California are now solely…
Al-Hilawani, Yasser A.
The purpose of this paper is to provide description, analyses, and insights with respect to the procedures and services currently available to students enrolled in the learning disability (LD) program in Oman. Traditionally, students in Oman were identified based on low academic achievement by the end of first grade without applying any…
Lin, Jin-Ding; Wu, Chia-Ling; Lin, Pei-Ying; Lin, Lan-Ping; Chu, Cordia M.
Although longevity among older adults with intellectual disabilities is increasing, there is limited information on their premature aging related health characteristics and how it may change with increasing age. The present paper provides information of the institutional manager's perception on early onset aging and service preparation for this…
Peter T. Sandy
Aim: To explore nurses' knowledge and understanding of the use of observation on patients who self-harm in a learning disability service in the United Kingdom. Design: and methods: This study adopted a qualitative approach, and utilised interpretative phenomenological analysis as a design and as a tool of analysis. The study was conducted in a secure learning disability service in the United Kingdom. Data were obtained from registered nurses using individual interviews (n = 20 and focus groups (n = 3 x 5 = 15. Data were analysed thematically using the principles of interpretative phenomenological analysis. Results: Three superordinate themes emerged from data analysis: 1 observation: its meaning, 2 observation: does it prevent self-harm? 3 Observation: making it work. Conclusion: Observation is a useful practice in in-patient learning disability services, which can be used to prevent or reduce the incidence of self-harm in these settings. This approach should therefore be an integral part of nurses' daily therapeutic activities in inpatient learning disability services.
Cook, Erin E.; Nickerson, Amanda B.; Werth, Jilynn M.; Allen, Kathleen P.
A sample of 124 service providers (e.g. mental health professionals, educators, administrators) completed a survey about bullying of individuals with disabilities and the use and perceived effectiveness of resources and strategies to address bullying. Providing support and performing an action in response to bullying were reported to be used more…
Paratransit is the transportation service that supplements larger public transportation : systems by providing individualized rides without fixed routes or timetables. In 1990, : the Americans with Disabilities Act (ADA) was passed which allows passe...
Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard
Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and
Services for older adults and younger people with disabilities are increasingly merging, as reflected in the creation of Aging and Disability Resource Centers (ADRCs). Using ADRCs to coordinate services is challenging, primarily because these fields have different service delivery philosophies. Independent Living Centers, which serve people with disabilities, have a philosophy that emphasizes consumer control and peer mentoring. However, the aging service delivery philosophy is based in a case management or medical model in which the role of consumers directing their services is less pronounced. Using institutional logics theory and a qualitative research design, this study explored whether a unified service delivery philosophy for ADRCs was emerging. Based on focus groups and questionnaires with staff from ADRCs, findings revealed that competing service delivery models continue to operate in the aging and disability fields.
Ziviani, Jenny; Darlington, Yvonne; Feeney, Rachel; Rodger, Sylvia; Watter, Pauline
To gain insight into the special issues confronting parents when accessing early intervention for children with physical disabilities where child and/or family characteristics indicate complex needs within the unique Australian context. Qualitative interviews with families receiving early intervention for their children with physical disabilities (N=10). Families with complex circumstances such as having children with high support needs, those from culturally and linguistically diverse backgrounds, and single-parent families were recruited to the study. Families where parents had mental or health issues, parents/other family members had an identified disability, and/or where families lived in regional or rural locations were also purposively sampled. Participants highlighted issues around (i) the nature of early intervention services provided; (ii) the ways in which services were structured; and (ii) managing their child's needs/planning into the future. Parents stressed the importance of having access to a variety of early intervention services aside from therapy. They also emphasised the need for greater clarity about what to expect from services, the intensity of therapy, other services they could access and how long they would be able to receive these. Despite their complex circumstances and needs, participants' experiences of accessing early intervention services were largely consistent with the broader research literature. Of the parents interviewed, those with health problems and single mothers expressed most apprehension about managing their child's needs and planning for the future. © 2013 Occupational Therapy Australia.
Full Text Available Today the ERP business information systems are an essential tool for organization management, regardless of size and field of activity. Their successful implementation and use is conditioned predominantly by IS/ICT knowledge and managerial skills required for directing their life cycle correctly. Defining and correct setting of the service level is a key requirement and skill, usually provided by a service provider based on an implementation and service contract, or an advisory organization, in particular when presale services concerning analyses and tender documentation processing are provided. The following paper discusses the characteristics of the individual service types and the particulars of their practical use. Moreover, it presents the selected significant results of the long-term research performed by the authors in the Center for inVestigations into Information Systems.
Therapy has been critiqued for personalizing the political (Kitzinger, 1993). The social-relational model (Thomas, 1999) is one theoretical resource for understanding the practices of therapy through a political lens. The social model(s) have viewed therapy with suspicion. This paper highlights – using composite case examples and the authors primary therapeutic modality, systemic therapy – some systemic practices with adults with Intellectual Disability (ID) that enact a position that it is s...
Greenstein, Caroline; Lowell, Anne; Thomas, David Piers
To compare the outcomes of two cycles of continuous quality improvement (CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. Case study based at one paediatric physiotherapy service Community-based paediatric allied health service in Northern Australia. Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. Comparison of findings from the two studies Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process. © 2015 National Rural Health Alliance Inc.
California Community Colleges, Sacramento. High-Tech Center for the Disabled.
This document provides information on the integration of assistive computer technologies and library automation systems at California Community Colleges in order to ensure access for students with disabilities. Topics covered include planning, upgrading, purchasing, implementing and using these technologies with library systems. As information…
Bashkireva, A S; Bogdanov, E A; Shestakov, V P; Svintsov, A A; Chernova, G I; Cherniakina, T S
The article presents a comparative analysis of the effectiveness of the individual rehabilitation programs among elderly citizens and disabled persons of the Astrakhan region, the part of the South Federal District of Russia. We analyzed the data of the statistical survey of the social services provided rehabilitation facilities for the elderly and disabled people in the Astrakhan region. Analytical results thus obtained shown that the network of agencies and centers of social rehabilitation in the Astrakhan region did not correspond to the needs of elderly people and disabled persons. The negative dynamics in the number of social care centers as well as in the number of people who were provided with their services revealed the need for optimization of the institutional structure and its management. These specific characteristics of the social rehabilitation services in the Astrakhan region thus identified should be taken into consideration in order to improve the rehabilitation programs among elderly citizens and disabled persons in the South Region of the Russian Federation.
Autonomy of mid-seriously and seriously intellectually disabled persons is encouraged both by legislations on human rights and the modern social care and services. The process leading to the maximum possible autonomy is illustrated by a developmental spiral in our model. Specialty of the development is that the personal educational projects are realized during everyday activities. The process requires conscious professionals with an empowering and motivating attitude, with adult relationship to the intellectually disabled persons and versatile skills and tools. In this educational relationship the social professional and the supported person are equal partners moving together along the spiral of human development. An innovative tool-battery has been developed aiding support-staff in the 'pedagogical' task embedded into everyday social services. The tool-battery and its first application in supported living services of the Hungarian Down Foundation are introduced in this paper.
Demirkan, Haluk; Spohrer, James C.; Krishna, Vikas
Services systems can range from an individual to a firm to an entire nation. They can also be nested and composed of other service systems. They are configurations of people, information, technology and organizations to co-create value between a service customer and a provider (Maglio et al. 2006; Spohrer et al. 2007). While these configurations can take many, potentially infinite, forms, they can be optimized for the subject service to eliminate unnecessary costs in the forms of redundancies, over allocation, etc. So what is an ideal configuration that a provider and a customer might strive to achieve? As much as it would be nice to have a formula for such configurations, experiences that are result of engagement, are very different for each value co-creation configurations. The variances and dynamism of customer provider engagements result in potentially infinite types and numbers of configurations in today's global economy.
Lawler, James; Iturralde, Val; Goldstein, Allan; Joseph, Anthony
College curricula of engineering and information systems do not afford frequent engagement with individuals with disabilities. The authors of this research study analyzed the benefits of disability films for a community film festival of largely engineering and information systems students and individuals with developmental and intellectual…
BACKGROUND: People with Multiple Sclerosis have a life long need for physiotherapy and exercise interventions due to the progressive nature of the disease and their greater risk of the complications of inactivity. The Multiple Sclerosis Society of Ireland run physiotherapy, yoga and exercise classes for their members, however there is little evidence to suggest which form of physical activity optimises outcome for people with the many and varied impairments associated with MS. METHODS AND DESIGN: This is a multi-centre, single blind, block randomised, controlled trial. Participants will be recruited via the ten regional offices of MS Ireland. Telephone screening will establish eligibility and stratification according to the mobility section of the Guys Neurological Disability Scale. Once a block of people of the same strand in the same geographical region have given consent, participants will be randomised. Strand A will concern individuals with MS who walk independently or use one stick to walk outside. Participants will be randomised to yoga, physiotherapy led exercise class, fitness instructor led exercise class or to a control group who don\\'t change their exercise habits.Strand B will concern individuals with MS who walk with bilateral support or a rollator, they may use a wheelchair for longer distance outdoors. Participants will be randomised to 1:1 Physiotherapist led intervention, group intervention led by Physiotherapist, group yoga intervention or a control group who don\\'t change their exercise habits. Participants will be assessed by physiotherapist who is blind to the group allocation at week 1, week 12 (following 10 weeks intervention or control), and at 12 week follow up. The primary outcome measure for both strands is the Multiple Sclerosis Impact Scale. Secondary outcomes are Modified Fatigue Impact Scale, 6 Minute Walk test, and muscle strength measured with hand held dynamometry. Strand B will also use Berg Balance Test and the Modified
Marely del Rosario Cruz Felipe
Full Text Available In the transfer of students with visual disabilities at the Technical University of Manabí (UTM accidents have been reported when going through some ramps and other obstacles, especially on rainy days. This article belongs to an investigation into the realization of an alert system for students with visual disabilities. The objective of the implementation of this system is to guide students with visual disabilities on different obstacles that exist in their transfer through the university. To carry out the implementation of this system, the alert systems and the technologies that are currently used as a result of a recording studio in the national and international scope were analyzed, the tools and technologies used in the developed solution are described. (Definition, technologies for the change of people, software, programming languages, etc. that allowed an efficient implementation in a short time of the proposed system by means of RFID (Radio Frequency Identification technology. The above is reflected in the positive orientation for the transfer of 32 students with visual disabilities through the university and by those who have contributed to improving their quality of life.
Lin, Jin-Ding; Wu, Chia-Ling; Lin, Pei-Ying; Lin, Lan-Ping; Chu, Cordia M
Although longevity among older adults with intellectual disabilities is increasing, there is limited information on their premature aging related health characteristics and how it may change with increasing age. The present paper provides information of the institutional manager's perception on early onset aging and service preparation for this population. We used purposive sampling to recruit 54 institutional managers who care for people with intellectual disabilities in Taiwan. The present study employed a cross-sectional design using a self-administrative structured questionnaire that was completed by the respondents in November 2009. The results showed that more than 90% of the respondents agreed with earlier onset aging characteristics of people with ID. However, nearly all of the respondents expressed that the government policies were inadequate and the institution is not capable of caring for aging people with ID, and more than half of them did not satisfy to their provisional care for this group of people. With regard to the service priority of government aging policy for people with ID, the respondent expressed that medical care, financial support, daily living care were the main areas in the future policy development for them. The factors of institutional type, expressed adequacy of government's service, respondent's job position, age, and working years in disability service were variables that can significantly predict the positive perceptions toward future governmental aging services for people with ID (adjusted R(2) = 0.563). We suggest that the future study strategy should underpin the aging characteristics of people with intellectual disabilities and its differences with general population to provide the useful information for the institutional caregivers. Copyright © 2010 Elsevier Ltd. All rights reserved.
Full Text Available To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54% were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction
Bartys, Serena; Frederiksen, Pernille; Bendix, Tom
Work disability due to low back pain is a significant global health concern. Current policy and practice aimed at tackling this problem is largely informed by the biopsychosocial model. Resultant interventions have demonstrated some small-scale success, but they have not created a widespread...... and disability benefits), healthcare and family systems (spouse/partner/close others) can act as obstacles to work participation for those with low back pain. Systematic searches of several scientific and grey literature sources were conducted, resulting in 1762 records. Following a systematic exclusion process...
Bolokonya, Herbert Chiwalo
In the field of radiation safety and protection there are a number of institutions that are involved in achieving different goals and strategies. These strategies and objectives are achieved based on a number of tools and systems, one of these tools and systems is the use of a management system. This study aimed at reviewing the management system concept for Technical Service Providers in the field of radiation safety and protection. The main focus was on personal monitoring services provided by personal dosimetry laboratories. A number of key issues were found to be prominent to make the management system efficient. These are laboratory accreditation, approval; having a customer driven operating criteria; and controlling of records and good reporting. (au)
This document amends the Department of Veterans Affairs (VA) Schedule for Rating Disabilities (VASRD) by revising the portion of the Schedule that addresses endocrine conditions and disorders of the endocrine system. The effect of this action is to ensure that the VASRD uses current medical terminology and to provide detailed and updated criteria for evaluation of endocrine disorders.
Full Text Available Purpose: The article summarises the process and the results of the first, integrated inspection of managed care services for people with learning disabilities in Scotland. The multi-agency model used was developed to be congruent with the existing performance inspection models, used by single agency inspection. The inspection activities and main outcomes are described, and suggestions are made for improvements. Context of case: In 2006 an inspection model was devised to assess the quality of health, social services and education services for people with learning disabilities in one geographical area of Scotland, as a precursor to a programme of inspections nationally. The first joint, integrated inspection of all services for people with learning disabilities in Scotland took place in June 2006, and the report was published in March 2007. This was the first multi-agency inspection of its kind in the UK, and the first to involve carers and people with learning disabilities on the inspection team. Data sources: A number of data sources were used to check existing practice against agreed Quality Outcome indicators. Primary sources of data were social work records, health records, education records, staff surveys, carer surveys, interviews with staff, family carers and people with learning disabilities, and self evaluations completed by the services being inspected. Eleven different domains, each with sub-indicators were investigated. Case description: This paper summarises the process of an integrated, multi-agency inspection, how the inspection activities were conducted and the main findings of this inspection. Practical improvements to the process are suggested, and these may be of use to other services and inspectorates. Conclusions and discussion: The integrated inspection was a qualified success. Most major objectives were achieved. The sharing of data amongst inspection agencies, establishing the level of commitment to integrated inspection
Du Mont, Janice; Macdonald, Sheila; White, Meghan; Turner, Linda
Little is known about the characteristics of women with disabilities who have experienced abuse and their satisfaction with care received from specialized healthcare providers working in hospital-based violence services. To address this gap, we surveyed clients presenting to 30 sexual assault/domestic violence treatment centers (SA/DVTCs) in Ontario. Of the 920 women aged 12 years or older who completed a survey, 194 (21%) reported having a disability. Bivariate analyses revealed that women with a disability who experienced abuse were more likely than those without a disability to be older, separated, widowed or divorced, and unemployed; to live alone or to be homeless or living in a shelter; and to report less support from family and friends or colleagues. Women with disabilities were less likely to have been assaulted by acquaintances known for Women with disabilities were also more likely than those without disabilities to sustain physical injuries in the assault. Despite these significant differences, almost all women with disabilities rated the care received as excellent or good (97%) and reported that they received the care needed (98%); were able to choose the preferred care (95%); felt safe during the visit (96%); and were treated sensitively (97%), respectfully (96%), and in a nonjudgmental manner (96%). Furthermore, 96% stated that they would recommend the services to others. Women with disabilities were overwhelmingly satisfied with SA/DVTC services. However, given their distinct vulnerabilities and increased risk of being injured, attending health providers should receive training relevant to working with this population.
Full Text Available Background: There is dearth of studies related to pattern of disability among persons who availed psychosocial rehabilitation services in India. We studied the pattern of disability among persons who availed half-way home-care services for psychosocial rehabilitation. Materials and Methods: Out of 130 case files of discharged patients, 50 files were randomly selected for data collection. Indian Disability Evaluation and Assessment Schedule was used to assess the pattern of disability in the sample. Results: The study revealed that only one-third (35% of the residents had disability in self-care, 41% in communication and understanding and 47% in interpersonal relationship. Overall, majority (76% of the respondents had moderate level of psychiatric disability at the time of discharge from half-way home. There was no significant relationship between gender and type of psychiatric illness with the level of disability. The overall disability correlated positively with the duration of illness (rs=0.39. Conclusion: Three-fourth of the residents who availed half-way home-care services had moderate level of disability.
Chapman, Melanie; Lacey, Huma; Jervis, Nicola
Background: Dementia prevalence rates are higher amongst people with learning disabilities than the general population. People with Down's syndrome are at even greater risk of developing dementia and of developing dementia at an earlier age. This study, conducted as part of a wider service evaluation, explored community learning disability team…
Full Text Available State-of-art systems provide comprehensive solutions almost to all users from the data pre-processing through data processing to their final presentation. Consequently, these solutions are very expensive and unavailable for some potential end users. Thus, several questions come up. Do we really need all these functions and, if not why do we have to pay for them? Is it possible to develop such a system with all these functions but without the need of end users to pay extra money for that? In the following text the authors will try to answer the above questions. Web services are a hit of the day. On many experts opinions web services represent a standard for a new information system generation. A prove of this statement could be the fact that every new software product support this form of the internet use. Also in the geoinformatics, this facility is successfully used for a long time (e.g. WMS, WFS. But as all, even web services are further developed and also native protocols, based on the XML format, are subsequently replaced by general protocols (e.g. SOAP.These protocols also use XML, but they enable the development of distributed systems with paralleled features using the Internet as a communication middleware. Thus, it is possible to develop wide information systems with a high level of modularity and integration with existing systems. The paper describes the architecture for the development of open and modular systems.
Schnitzler, A; D'Apolito, A C; Roche, N; Genêt, F; Ameille, J; Azouvi, P
Mediclen is an occupational health service in charge of following-up 36,736 workers (divided among 1770 companies) in 3 cities of an area near Paris. The employment rate of disabled people among the French population is not well known (rough estimate 4.4%), and few studies have reported on the situation of workers with a motor impairment. The recent computerization of medical records allowed us to identify 195 workers considered disabled by the French administration (i.e. 0.55% of the 36,736 workers followed up in 2002). Among these, 26 had a motor impairment. Twenty-one neurological disabilities were central and 5 were peripheral or neuromuscular. The workers were 44-years-old. Only two workers had a severe handicap. Companies had to adapt workstations for half of the workers, with the advice of neurologists (7 of 10 advice given) and once a physical medicine doctor. The integration of people with motor impairments into the world of work is rare and difficult. This practical experience showed the difficulties people with motor impairment face. Close collaboration of physical medicine services with occupational health services is necessary to improve the integration of this population into the world of work.
Zhang, Lei; Li, Wenfei; Zhu, Jieping; Huang, Tingting; Zhu, Lin; Chen, Gong; Zheng, Xiaoying
To investigate the status and associated factors of demand satisfaction (DS) of services for older adults with visual disability (OAVD). Based on the 2nd National Sample Survey on Disability in 2006, a total number of 24 017 OAVD cases were included. Associated relationships among demographic, health-related, social, economic factors and services of DS, including health demand (Type I), basic livelihood demand (Type II), and environmental support demand (Type III) were analyzed. The proportions of DS of Type I, II, III services for OAVD were 35.1% , 9.3% and 4.3% respectively. Eight factors as:having pension insurance (OR = 1.64), living in urban areas (OR = 1.54), per capita household income at ≥5 000 or over Yuan (OR = 1.46)were favorable ones on OAVD DS while at age ≥80 or above (OR = 0.90), being male (OR = 0.93)were adverse factors of Type I. Four factors as:being male (OR = 1.43), living in urban areas (OR = 1.15), subjects defined as grade II (OR = 1.36) and grade I (OR = 1.70) etc., were favorable factors on OAVD DS. Five factors as: range of age groups at 15-59 (OR = 0.57) or at ≥60 (OR = 0.45), per capita household income at 1 000-1 999 Yuan (OR = 0.77), 2 000-4 999 Yuan (OR = 0.58) and ≥5 000 Yuan (OR = 0.39) were adverse factors of Type II. Factors as: living in urban areas (OR = 1.23), defined as grade II (OR = 1.38) and grade I (OR = 1.34), having pension insurance (OR = 1.62) and per capita household income at ≥5 000 Yuan (OR = 1.42) etc., were favorable factors of Type III. The DS degree of older adults with visual disability was generally very low while factors as: per capita household income, situation on social insurance, age, degree of disability, age when disability was identified, areas of residence, gender, grade of disability, marriage status, levels of education etc., were significantly associated with the service on DS.
Houtrow, Amy J; Okumura, Megumi J; Hilton, Joan F; Rehm, Roberta S
The aims of this study were to profile and compare the health and health services characteristics for children with special health care needs (CSHCN), with and without disabilities, and to determine factors associated with unmet need. Secondary data analysis of the 2005-2006 National Survey of Children with Special Health Care Needs was conducted. The sociodemographics, health, and health services of CSHCN with and without disabilities were compared. Multivariable logistic regression was employed to examine factors associated with unmet need for health services. Children from minority racial and ethnic groups and children living in or near poverty were over-represented among CSHCN with disabilities, compared with other CSHCN. Statistically higher percentages of CSHCN with disabilities had behavioral problems (39.6% vs 25.2%), anxiety/depressed mood (46.1% vs 24.0%), and trouble making/keeping friends (38.1% vs 15.6%) compared with other CSHCN. Thirty-two percent of CSHCN with disabilities received care in a medical home compared with 51% of other CSHCN. CSHCN with disabilities had higher rates of need and unmet need than other CSHCN for specialty care, therapy services, mental health services, home health, assistive devices, medical supplies, and durable medical equipment. The adjusted odds of unmet need for CSHCN with disabilities were 71% higher than for other CSHCN. CSHCN with disabilities had more severe health conditions and more health services need, but they less commonly received care within a medical home and had more unmet need. These health care inequities should be amenable to policy and health service delivery interventions to improve outcomes for CSHCN with disabilities. Copyright Â© 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of
Worrall, Linda E; Howe, Tami; O'Callaghan, Anna; Hill, Anne J; Rose, Miranda; Wallace, Sarah J; Rose, Tanya; Brown, Kyla; Power, Emma; O'Halloran, Robyn; Rohde, Alexia
This commentary aims to extend the debate of the lead article authors (Wylie, McAllister, Davidson, and Marshall, 2013) by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.
Bekir Busatlic; Nejdet Dogru; Isaac Lera; Enes Sukic
Smart home refers to the application of various technologies to semi-unsupervised home control It refers to systems that control temperature, lighting, door locks, windows and many other appliances. The aim of this study was to design a system that will use existing technology to showcase how it can benefit people with disabilities. This work uses only off-the-shelf products (smart home devices and controllers), speech recognition technology, open-source code libraries. The Voice Activated Sm...
Hees, S. van; Cornielje, H.; Wagle, P.; Veldman, E.
Purpose: Persons with disabilities face additional barriers in accessing primary healthcare services, especially in developing countries. Consequently the prevalence of secondary health conditions is higher among this population. This study aims to explore the perceived barriers to access primary
Herrman, Helen; Evert, Helen; Harvey, Carol; Gureje, Oye; Pinzone, Tony; Gordon, Ian
The prevalence of psychosis and needs for care among homeless people were studied in inner Melbourne. This was a two-stage nested study within the Australian National Survey of People Living with Psychotic Illness. A screen for psychosis was administered to a representative sample of men and women living in marginal housing in a mental health service catchment area. A selected subsample of 82 screen-positive respondents was interviewed using the Diagnostic Interview for Psychosis (DIP), a semistructured, standardized interview with three modules: (i) demography, functioning and quality of life; (ii) diagnosis; and (iii) service use. An unexpectedly high prevalence of people living with psychotic disorders (estimated lifetime prevalence 42%, 95% CI=37-47%) may reflect a concentration of vulnerable people in the shrinking marginal housing supply in the inner city areas. Disability in everyday, occupational and social functioning is greater for this subgroup than for other people living with psychosis in Australia. Most people were single and unemployed, and many reported social isolation and feeling unsafe. Substance use disorders were common. Most people were using health services, including specialist mental health services, but few were receiving rehabilitation, vocational or housing support. Despite high levels of contact with a well-organized, sectorized mental health service in an affluent country, this pocket of several hundred people had high levels of persisting disability and needs. The literature and local experience suggest that changing this situation is likely to require co-ordinated policy and practice between the health, welfare and housing sectors.
Fleming, Padraic; McGilloway, Sinead; Barry, Sarah
Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual…
Hemmings, C. P.; Underwood, L. A.; Bouras, N.
Background: There remains a severe lack of evidence on the effectiveness of community services for adults with psychosis and intellectual disabilities (ID). There has been little consensus even of what services should provide for this service user group. Method: A consultation of multidisciplinary professionals was carried out by using a…
Full Text Available Abstract Background The PRISMA Model is an innovative coordination-type integrated-service-delivery (ISD network designed to manage and better match resources to the complex and evolving needs of elders. The goal of this study was to examine the impact of this ISD network on unmet needs among disabled older persons living in the community. Methods Using data from the PRISMA study, we compared unmet needs of elders living in the community in areas with or without an ISD network. Disabilities and unmet needs were assessed with the Functional Autonomy Measurement System (SMAF. We used growth-curve analysis to examine changes in unmet needs over time and the variables associated with initial status and change. Sociodemographic characteristics, level of disability, self-perceived health status, cognitive functioning, level of empowerment, and the hours of care received were investigated as covariates. Lastly, we report the prevalence of needs and unmet needs for 29 activities in both areas at the end of the study. Results On average, participants were 83 years old; 62% were women. They had a moderate level of disability and mild cognitive problems. On average, they received 2.07 hours/day (SD = 1.08 of disability-related care, mostly provided by family. The findings from growth-curve analysis suggest that elders living in the area where ISD was implemented and those with higher levels of disability experience better fulfillment of their needs over time. Besides the area, being a woman, living alone, having a higher level of disability, more cognitive impairments, and a lower level of empowerment were linked to initial unmet needs (r2 = 0.25; p Conclusions In spite of more than 30 years of home-care services in the province of Quebec, disabled older adults living in the community still have unmet needs. ISD networks such as the PRISMA Model, however, appear to offer an effective response to the long-term-care needs of the elderly.
Chou, Li-Der; Lai, Nien-Hwa; Chen, Yen-Wen; Chang, Yao-Jen; Yang, Jyun-Yan; Huang, Lien-Fu; Chiang, Wen-Ling; Chiu, Hung-Yi; Shin, Haw-Yun
As Internet technologies evolve, their applications have changed various aspects of human life. Here, we attempt to examine their potential impact on services for families with developmentally delayed children. Our research is thus designed to utilize wireless mobile communication technologies, location services, and search technology in an effort to match families of specific needs with potential care providers. Based on the investigation conducted by our counselors, this paper describes a platform for smooth communication between professional communities and families with children with developmental disabilities (CDD). This research also looks into the impact of management of mobile social network services and training on the operation of these services. Interaction opportunities, care, and support to families with CDD are introduced.
Suzuki, Rie; Peterson, Jana J; Weatherby, Amanda V; Buckley, David I; Walsh, Emily S; Kailes, June Isaacson; Krahn, Gloria L
This article describes the development of Promoting Access to Health Services (PATHS), an intervention to promote regular use of clinical preventive services by women with physical disabilities. The intervention was developed using intervention mapping (IM), a theory-based logical process that incorporates the six steps of assessment of need, preparation of matrices, selection of theoretical methods and strategies, program design, program implementation, and evaluation. The development process used methods and strategies aligned with the social cognitive theory and the health belief model. PATHS was adapted from the workbook Making Preventive Health Care Work for You, developed by a disability advocate, and was informed by participant input at five points: at inception through consultation by the workbook author, in conceptualization through a town hall meeting, in pilot testing with feedback, in revision of the curriculum through an advisory group, and in implementation by trainers with disabilities. The resulting PATHS program is a 90-min participatory small-group workshop, followed by structured telephone support for 6 months.
Saulo, Bryson; Walakira, Eddy; Darj, Elisabeth
Disabled people are overlooked and marginalised globally. There is a lack of information on blind people and HIV-related services and it is unclear how HIV-services target blind people in a sub-Saharan urban setting. To explore how blind people are reached by HIV-services in Kampala, Uganda. A purposeful sample of blind people and seeing healthcare workers were interviewed, and data on their opinions and experiences were collected. The data were analysed by qualitative content analysis, with a focus on manifest content. Three categories emerged from the study, reaching for HIV information and knowledge, lack of services, and experiences of discrimination. General knowledge on HIV prevention/transmission methods was good; however, there was scepticism about condom use. Blind people mainly relied on others for accessing HIV information, and a lack of special services for blind people to be able to test for HIV was expressed. The health service for blind people was considered inadequate, unequal and discriminatory, and harassment by healthcare staff was expressed, but not sexual abuse. Concerns about disclosure of personal medical information were revealed. Access to HIV services and other healthcare related services for blind people is limited and the objectives of the National Strategic Plan for HIV/AIDS 2007-2012 have not been achieved. There is a need for alternative methods for sensitisation and voluntary counselling and testing (VCT) for blind people. Copyright © 2011 Elsevier B.V. All rights reserved.
Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel
Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.
McCarthy, Michael J
As a component of a training development project for intercity air travel providers, we investigated the capacity of the airline industry to meet the needs of travelers with disabilities by exploring: (1) the level of sensitivity among personnel to travelers' needs, (2) training currently provided, (3) areas in which additional training might be beneficial, and (4) organisational/systems-level commitment to dignified assistance to all travelers. Forty-four airline/vendor employees participated in nine focus groups in four US cities. Groups were audio recorded and transcribed. A grounded-theory approach was used to develop a coding system which was then applied to transcripts to identify themes. Factors influencing capacity grouped broadly into four areas: characteristics of the job/system, characteristics of current training, characteristics of providers themselves, and characteristics of travelers. At an interpersonal level, providers were empathetic and desired to provide dignified services. They lacked training and adequate equipment in some cases, however, and organisational commitment varied between companies. Traveler characteristics were also shown to impact service delivery. Results are promising but additional regulatory and organisational policies are needed to ensure quality services. Providers and consumers of intercity air travel services may benefit from the findings and recommendations of this study.
Clark, Phillipa; Macarthur, Jude
To describe the reported experiences of the estimated 14 500 New Zealand children with a physical disability and those of their families and whanau (extended families). We have used data from the Household Disability Survey conducted in 2002 to obtain this information. These children and their carers reported a number of perceived unmet needs in all areas covered in the survey: service and assistance, transport, accommodation and education. Thus an estimated 24% reported an unmet need for equipment, and 10% an unmet need for home modification. Around 9% reported having to fund respite care themselves. Of particular note was the proportion of children who had difficulties joining in games and sport at school (59%), going on school outings or camps (28%), playing at school (47%), and or making friends (35%). In all, an estimated 67% of children had one or more problems taking part at school. More could be done to help such families and to facilitate the full participation of these children.
greater accessibility because of multiple, complex, and interrelated barriers to HIV\\/AIDS service utilisation at the service delivery level. Factors external to, as well as within, the health sector are key to understanding the access deficit in the FSU where low or concentrated HIV\\/AIDS epidemics are prevalent. Funders of HIV\\/AIDS programmes need to consider how best to tackle key structural and systemic drivers of access including prohibitionist legislation on drugs use, limited transparency and low staff salaries within the health sector.
Full Text Available Introduction: Awareness of disability issues has gained considerable interest by advocacy groups in recent years. However, it is uncertain whether attitudes and perceptions of all service providers and society have adjusted accordingly towards the health care of people with disabilities. This study sought to examine the attitudes of health providers from the perspective of people with disabilities in the Kumasi Metropolis. Methods: A cross-sectional study using semi-structured questionnaires was conducted with people with disabilities (with physical, hearing and visual impairments, in the Kumasi Metropolis. The study used a multi-stage sampling involving cluster and simple random sampling to select 255 respondents split amongst the following five clusters of communities; Oforikrom, Subin, Asewase, Tafo and Asokwa. Data were analysed using STATA 14 and presented in descriptive and inferential statistics. Results: The study found that 71% of the respondents faced some form of discrimination including the use of derogatory remarks, frustration and unavailable required services on the basis of their disability, the type of services they need and the location. Women were 3.89 times more likely to face discrimination; Adjusted odds ratio (AOR = 3.89 (95% confidence interval [CI]; 1.41, 10.76, and visually impaired was more likely to be discriminated at the facility compared with physical disability; AOR = 5.05 (95% CI; 1.44, 17.65. However, respondents with some educational qualification and those who stayed with their family members were less likely to face discrimination; AOR = 0.08 (95% CI; 0.01, 0.39. Conclusion: The study recommends the provision of in-service training for service providers to update their knowledge on disability issues and improve access to services for people with disabilities.
Gunther, Eric J M; Sliker, Levin J; Bodine, Cathy
Unemployment among the almost 5 million working-age adults with cognitive disabilities in the USA is a costly problem in both tax dollars and quality of life. Job coaching is an effective tool to overcome this, but the cost of job coaching services sums with every new employee or change of employment roles. There is a need for a cost-effective, automated alternative to job coaching that incurs a one-time cost and can be reused for multiple employees or roles. An effective automated job coach must be aware of its location and the location of destinations within the job site. This project presents a design and prototype of a cart-mounted indoor positioning and navigation system with necessary original software using Ultra High Frequency Radio Frequency Identification (UHF RFID). The system presented in this project for use within a warehouse setting is one component of an automated job coach to assist in the job of order filler. The system demonstrated accuracy to within 0.3 m under the correct conditions with strong potential to serve as the basis for an effective indoor navigation system to assist warehouse workers with disabilities. Implications for rehabilitation An automated job coach could improve employability of and job retention for people with cognitive disabilities. An indoor navigation system using ultra high frequency radio frequency identification was proposed with an average positioning accuracy of 0.3 m. The proposed system, in combination with a non-linear context-aware prompting system, could be used as an automated job coach for warehouse order fillers with cognitive disabilities.
Full Text Available This paper presents a novel wayfinding system adapted to people with cognitive disabilities. It adapts to the user in terms of route calculation, instructions delivery, and interface design. To do so, the system divides the calculated route into atomic instructions and uses street-level photographs at the decision points. To evaluate this approach, we compared it with a commercial navigation application on a field trial with a sample of users (N = 18. From the evaluation, we concluded that our system improves users’ performance in terms of the number who reached the destination and were able to identify it correctly.
Full Text Available This paper focused on the pivotal role of counseling services for parents, teachers and children with learning disabilities in primary schools with reference to Nigeria. This is with the view to educate the teachers to become more informed about what learning disabilities are and to create awareness and instill hope in the bewildered parents/guardians of children with learning disabilities to appreciate and serve as advocates for their wards. Consequently, a brief historical perspective of learning disabilities in terms of its origin, the need, characteristics and causes has been presented. It is discovered that learning disabilities is a condition with many manifestations and may be compounded by environmental factors such as the home and school. Contrary to people’s conception of the condition, individuals with learning disabilities are of above average intelligence and can be gifted and talented. The paper went further to examine specific areas of counseling services that are needed by pupils, parents and teachers of children with learning disabilities. These include but not limited to personal, social, and academic spheres. Possible challenges of providing effective guidance and counseling services in primary schools are highlighted. Among them are inadequate trained and certified counselors, poor facilities and non patronage by pupils and teachers in addition to parental ignorance. The paper then concluded with suggestions as a way forward.
Veridian's Portable Batch System (PBS) was the recipient of the 1997 NASA Space Act Award for outstanding software. A batch system is a set of processes for managing queues and jobs. Without a batch system, it is difficult to manage the workload of a computer system. By bundling the enterprise's computing resources, the PBS technology offers users a single coherent interface, resulting in efficient management of the batch services. Users choose which information to package into "containers" for system-wide use. PBS also provides detailed system usage data, a procedure not easily executed without this software. PBS operates on networked, multi-platform UNIX environments. Veridian's new version, PBS Pro,TM has additional features and enhancements, including support for additional operating systems. Veridian distributes the original version of PBS as Open Source software via the PBS website. Customers can register and download the software at no cost. PBS Pro is also available via the web and offers additional features such as increased stability, reliability, and fault tolerance.A company using PBS can expect a significant increase in the effective management of its computing resources. Tangible benefits include increased utilization of costly resources and enhanced understanding of computational requirements and user needs.
Thanh, Nguyen Xuan; Moffatt, Jessica; Jacobs, Philip; Chuck, Anderson W; Jonsson, Egon
To estimate the break-even effectiveness of the Alberta Fetal Alcohol Spectrum Disorder (FASD) Service Networks in reducing occurrences of secondary disabilities associated with FASD. The secondary disabilities addressed within this study include crime, homelessness, mental health problems, and school disruption (for children) or unemployment (for adults). We used a cost-benefit analysis approach where benefits of the service networks were the cost difference between the two approaches: having the 12 service networks and having no service network in place, across Alberta. We used a threshold analysis to estimate the break-even effectiveness (i.e. the effectiveness level at which the service networks became cost-saving). If no network was in place throughout the province, the secondary disabilities would cost $22.85 million (including $8.62 million for adults and $14.24 million for children) per year. Given the cost of network was $6.12 million per year, the break-even effectiveness was estimated at 28% (range: 25% to 32%). Although not all benefits associated with the service networks are included, such as the exclusion of the primary benefit to those experiencing FASD, the benefits to FASD caregivers, and the preventative benefits, the economic and social burden associated with secondary disabilities will "pay-off" if the effectiveness of the program in reducing secondary disabilities is 28%.
Tuffrey-Wijne, Irene; Goulding, Lucy; Giatras, Nikoletta; Abraham, Elisabeth; Gillard, Steve; White, Sarah; Edwards, Christine; Hollins, Sheila
To identify the factors that promote and compromise the implementation of reasonably adjusted healthcare services for patients with intellectual disabilities in acute National Health Service (NHS) hospitals. A mixed-methods study involving interviews, questionnaires and participant observation (July 2011-March 2013). Six acute NHS hospital trusts in England. Reasonable adjustments for people with intellectual disabilities were identified through the literature. Data were collected on implementation and staff understanding of these adjustments. Data collected included staff questionnaires (n=990), staff interviews (n=68), interviews with adults with intellectual disabilities (n=33), questionnaires (n=88) and interviews (n=37) with carers of patients with intellectual disabilities, and expert panel discussions (n=42). Hospital strategies that supported implementation of reasonable adjustments did not reliably translate into consistent provision of such adjustments. Good practice often depended on the knowledge, understanding and flexibility of individual staff and teams, leading to the delivery of reasonable adjustments being haphazard throughout the organisation. Major barriers included: lack of effective systems for identifying and flagging patients with intellectual disabilities, lack of staff understanding of the reasonable adjustments that may be needed, lack of clear lines of responsibility and accountability for implementing reasonable adjustments, and lack of allocation of additional funding and resources. Key enablers were the Intellectual Disability Liaison Nurse and the ward manager. The evidence suggests that ward culture, staff attitudes and staff knowledge are crucial in ensuring that hospital services are accessible to vulnerable patients. The authors suggest that flagging the need for specific reasonable adjustments, rather than the vulnerable condition itself, may address some of the barriers. Further research is recommended that describes and
Heyman, Bob; Swain, John; Gillman, Maureen
This paper explores the role of complexity and simplification in the delivery of health care for adults with learning disabilities, drawing upon qualitative data obtained in a study carried out in NE England. It is argued that the requirement to manage complex health needs with limited resources causes service providers to simplify, standardise and routinise care. Simplified service models may work well enough for the majority of clients, but can impede recognition of the needs of those whose characteristics are not congruent with an adopted model. The data were analysed in relation to the core category, identified through thematic analysis, of secondary complexity arising from organisational simplification. Organisational simplification generates secondary complexity when operational routines designed to make health complexity manageable cannot accommodate the needs of non-standard service users. Associated themes, namely the social context of services, power and control, communication skills, expertise and service inclusiveness and evaluation are explored in relation to the core category. The concept of secondary complexity resulting from organisational simplification may partly explain seemingly irrational health service provider behaviour.
Cardoso, Jorge; Poels, Geert
This SpringerBrief explores the internal workings of service systems. The authors propose a lightweight semantic model for an effective representation to capture the essence of service systems. Key topics include modeling frameworks, service descriptions and linked data, creating service instances, tool support, and applications in enterprises.Previous books on service system modeling and various streams of scientific developments used an external perspective to describe how systems can be integrated. This brief introduces the concept of white-box service system modeling as an approach to mo
Elliot, Timothy R.; Patnaik, Ashweeta; Naiser, Emily; Fournier, Constance J.; McMaughan, Darcy K.; Dyer, James A.; Phillips, Charles D.
We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy community.…
Prof. dr. Jean Pierre Wilken; Zsolt Bugarszki; Karin Hanga; Dagmar Narusson; Koidu Saia; Marju Medar
This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the
Dura-Vila, G.; Hodes, M.
Background: An emerging literature suggests that ethnic and cultural factors influence service utilisation among people with intellectual disability (ID), but this has not previously been reviewed. Aims: To investigate possible ethnic variation in uptake of mental health services in children, adolescents and adults with ID in high-income…
Matanga, Zephania; Freeze, Rick; Duchesne, Hermann; Nyachoti, Martin
A novel participatory workshop methodology was adopted in this qualitative study of the intersection of disability and diversity in the lives of individuals. Social service recipients, parents, educators, service providers, and policy makers in three Canadian cities were conjoined in daylong discussions designed to investigate if the realities of…
Lakhani, Ali; McDonald, Donna; Zeeman, Heidi
Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research
This research aimed to illuminate the experiences of adults with learning disabilities of the reflecting team, in the context of their systemic family therapy. Five adults with learning disabilities were recruited from one community learning disability team. A qualitative design using interpretative phenomenological analysis (IPA) was appropriate…
Berry, Ruth; Firth, Graham; Leeming, Catherine; Sharma, Vishal
Intensive Interaction was initially developed in the 1980s as an educational approach for developing social communication and engagement with people with severe or profound intellectual disabilities and/or autism. Intensive Interaction has subsequently been adopted by a range of practitioners and professionals working in learning disability services and has a broad multi-disciplinary acceptance, being recommended in a number of UK governmental guidance documents. Despite this, there has been limited work on developing a deeper psychological understanding of the approach. This study utilises a qualitative description/thematic analysis approach to explore how clinical psychologists conceptualise the approach with regard to currently accepted psychological theories, as well as looking at other factors that influence their adoption and advocacy. The sample deliberately consisted of eight NHS (National Health Service) clinical psychologists known to be using or advocating the use of Intensive Interaction with people with a learning disability. The results of this study indicate that although the participants referred to some theories that might explain the beneficial outcomes of Intensive Interaction, these theories were rarely explicitly or clearly referenced, resulting in the authors having to attribute specific theoretical positions on the basis of inductive analysis of the participants' responses. Moreover, the participants provided varying views on how Intensive Interaction might be conceptualised, highlighting the lack of a generally accepted, psychologically framed definition of the approach. In conclusion, it was felt that further research is required to develop a specifically psychological understanding of Intensive Interaction alongside the formation of a Special Interest Group, which might have this task as one of its aims. There appeared to be a limited recognition amongst the participants of the specific psychological theories that can be seen to explain
Brady, Laura Thompson; Fong, Lisa; Waninger, Kendra N; Eidelman, Steven
As leaders from the Baby Boomer generation prepare for retirement over the next decade, emerging leaders must be identified and supported in anticipation of a major organizational transition. Authentic leadership is a construct that informs the development of values-driven leaders who will bring organizations into the future, just as the previous generation of leaders oversaw the movement of services away from state institutions and into networks of community-based service delivery organizations. The purpose of this exploratory study was to examine executive and emerging leaders' opinions about the unique leadership values, skills, and challenges in organizations that serve individuals with intellectual and developmental disabilities. Themes of defining, developing, and sustaining leaders emerged from the data and are explored through an authentic leadership framework.
Holanda, Cristina Marques de Almeida; De Andrade, Fabienne Louise Juvêncio Paes; Bezerra, Maria Aparecida; Nascimento, João Paulo da Silva; Neves, Robson da Fonseca; Alves, Simone Bezerra; Ribeiro, Kátia Suely Queiroz Silva
This study seeks to identify the formation of social support networks of people with physical disabilities, and how these networks can help facilitate access to health services and promote social inclusion. It is a cross-sectional study, with data collected via a form applied to physically disabled persons over eighteen years of age registered with the Family Health Teams of the municipal district of João Pessoa in the state of Paraíba. It was observed that the support networks of these individuals predominantly consist of family members (parents, siblings, children, spouses) and people outside the family (friends and neighbors). However, 50% of the interviewees declared that they could not count on any support from outside the family. It was observed that the support network contributes to access to the services and participation in social groups. However, reduced social inclusion was detected, due to locomotion difficulties, this being the main barrier to social interaction. Among those individuals who began to interact in society, the part played by social support was fundamental.
Siegel, Ellin B; Maddox, Laura L; Ogletree, Billy T; Westling, David L
Speech-language pathologists in school settings were surveyed with an instrument created from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities' quality indicators self-assessment tool. Participants valued practice indicators of quality communication assessment and intervention to a higher degree than their actual practice. These findings appear to suggest that SLPs may not provide best practice services to individuals with severe disabilities. Suggestions for enhancing inservice training and intervention practices of SLPs and team members who work with individuals with severe disabilities are provided. The reader will be able to; (1) understand the value of using the NJC quality indicators to guide SLP practices with individuals with severe disabilities in schools; (2) recognize that research indicates that SLPs working with individuals with severe disabilities in schools may not provide best practice services to the extent that they value these practices; (3) discuss possible strategies to increase the quality of services provided to individuals with severe disabilities in schools.
Same, Anne; Lee, Elinda Ai Lim; McNamara, Beverley; Rosenwax, Lorna
Little is known about the significance of gardening services for frail elderly people. This study explored the value of a gardening service for frail older people and people with a disability living in the community. Using qualitative and quantitative data collected from pre-gardening ( n = 38) and post-gardening service delivery interviews ( n = 35) and the Housing Enabler, the value of a gardening service was examined. Findings suggest that the service had a positive impact on the independence and emotional well-being of frail aged people and younger people with a functional disability, with little impact on physical health. Results indicate that gardening services should be fundamental to planning for these populations to remain or return to living in the community.
Unwin, Gemma; Larkin, Michael; Rose, John; Kroese, Biza Stenfert; Malcolm, Stephen
(Please see www.Toolsfortalking.co.uk for an easy read summary of the project.) The Tools for Talking are a set of resources that were developed through collaboration between Black, Asian and minority ethnic people with learning disabilities and researchers at the University of Birmingham. The resources were designed to be used by people with learning disabilities and service providers to facilitate culturally-sensitive communication and information sharing, service planning and delivery. They comprise illustrative videos and exploratory activities relating to five topics, namely, culture, activities, support from staff, important people, choices and independence. These topics emerged as important to people with learning disabilities during the 'Access to Social Care-Learning Disabilities' (ASC-LD) study which involved interviews with 32 adults with learning disabilities from Black, Asian and minority ethnic communities. The results of the ASC-LD study were used to develop a set of draft resources which were then co-developed through collaboration with people with learning disabilities and service providers. A 'Partnership event' was convened to involve stakeholders in the development of the resources. This paper describes the refinement of these materials by people with learning disabilities from Black, Asian and minority ethnic backgrounds in cooperation with a range of other stakeholders. Background Black, Asian and minority ethnic people with learning disabilities face inequities in health and social care provision. Lower levels of service uptake and satisfaction with services have been reported, however, this is largely based on the views of carers. The 'Access to Social Care: Learning Disabilities (ASC-LD)' study sought to explore the views and experiences of social support services among adults with learning disabilities from Black, Asian and minority ethnic communities. Interviews with 32 Black, Asian and minority ethnic adults with learning disabilities
Sripada, Rebecca K; Hannemann, Claire M; Schnurr, Paula P; Marx, Brian P; Pollack, Stacey J; McCarthy, John F
To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership. We assessed receipt of VHA mental health encounters in each of the 52 weeks prior to and following PTSD disability rating or rating increase. The best fitting model had five groups: No Use (36.6 percent), Low Use (37.7 percent), Increasing Use (9.4 percent), Decreasing Use (11.2 percent), and High Use (5.1 percent). Adjusting for demographic characteristics and compared with the No Use group, Veterans in the other groups were more likely to reside closer to a VHA facility, receive a higher PTSD disability rating, and screen positive for military sexual trauma. Service use remained stable (80 percent) or increased (9 percent) for the vast majority of Veterans. Service utilization declined for only 11 percent. Data did not indicate substantial service discontinuation following rating. Low VHA service utilization suggests opportunities to enhance outreach for Veterans with PTSD-related disability benefits. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
King, Gillian; McPherson, Amy; Kingsnorth, Shauna; Stewart, Debra; Glencross-Eimantas, Tanya; Jones-Galley, Kimberlea; Morrison, Andrea; Isihi, Ana Maria; Gorter, Jan Willem
Residential immersive life skills (RILS) programs are designed to equip youth with physical disabilities with the foundational life skills required to assume adult roles. The objective was to determine RILS service providers' perceptions of the active ingredients of the intervention change process. Thirty-seven service providers from various disciplines completed measures to assess expertise status and participated in qualitative interviews. Qualitative themes were derived, and similarities and differences in themes were identified for blinded groups of novices, intermediates, and experts. The three main themes, reflecting change processes, were: (a) creating a supportive program atmosphere with multiple opportunities for learning, (b) using strategies to support, encourage, and engage youth, and (c) intentionally fostering youth experiences of skill development, social interaction, and pride in accomplishment. In contrast to the novices, experts displayed a more holistic perspective and paid attention to higher-order issues such as providing opportunities and enabling youth. The findings indicate how RILS service providers work to create a program atmosphere and employ strategies to intentionally foster particular youth experiences. The findings explicate service providers' theories of practice, the intentional design of RILS program environments to bring about client change, and the value of service provider expertise. Implications for Rehabilitation Service providers of youth independence-oriented life skills programs can intentionally create a learning-oriented and supportive program atmosphere by using non-directive, coaching/guiding, and engagement strategies Youth experiences of skill development, shared experience with others, and pride in accomplishment can be cultivated by providing a range of learning opportunities, including choice making, problem-solving, and skill mastery Compared to more novice service providers, experts discussed managing the
Crook, Bradley; Tomlins, Rose; Bancroft, Ann; Ogi, Laura
The importance of making research participation accessible for people with learning disabilities is emphasised in government and NHS research strategies. This evaluation explored the realities of this goal from the perceptions of people with learning disabilities and clinicians within an NHS learning disability service. People with learning…
Campens, J; Schiettecat, T; Vervliet, M; Van Heck, L; Lesseliers, J; Goethals, I; De Witte, N
Considering the increasing life expectancy of people with intellectual disabilities (ID), the importance of cooperation between services for people with ID and elderly care services has been stressed in Flanders and the Netherlands, as well as internationally. However, the prevalence, intensity and content of such a cooperation are yet unknown. In order to gain information to address this issue, an online-survey was delivered to directors of all nursing homes in Flanders (n = 781). 229 surveys were completed.In more than 75% of the nursing homes, people with ID were among the residents over the past decade. However, at the same time a lack of expertise has been identified as a barrier to provide them optimal care and support. Hence, the respondents point out that a cooperation with ID care services could be beneficial. Nevertheless, those partnerships only arose in a quarter of the nursing homes so far, primarily for the purpose of exchange of expertise. Intersectoral multidisciplinary consultations and intersectoral care team consultations have been taking place as well, be it mainly in the context of a persons' transition from an ID care service to a nursing home. Until now, radical cooperations which involve an exchange of staff, seem to be rather rare.
From fundamental concepts and theories to implementation protocols and cutting-edge applications, the Handbook of Mobile Systems Applications and Services supplies a complete examination of the evolution of mobile services technologies. It examines service-oriented architecture (SOA) and explains why SOA and Service Oriented Computing (SOC) will play key roles in the development of future mobile services. Investigating current service discovery frameworks, the book covers the basics of mobile services and applications developed in various contexts. The first section provides readers with the r
Brabrand, Claus; Møller, Anders; Sandholm, Anders
Interactive web services are increasingly replacing traditional static web pages. Producing web services seems to require a tremendous amount of laborious low-level coding due to the primitive nature of CGI programming. We present ideas for an improved runtime system for interactive web services...... built on top of CGI running on virtually every combination of browser and HTTP/CGI server. The runtime system has been implemented and used extensively in , a tool for producing interactive web services....
Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M
To examine differences in access to health care and receipt of clinical preventive services by type of disability among working-age adults with disabilities. Secondary analysis of Medical Expenditure Panel Survey (MEPS) data from 2002 to 2008. We conducted cross-sectional logistic regression analyses comparing people with different types of disabilities on health insurance status and type; presence of a usual source of health care; delayed or forgone care; and receipt of dental checkups and cancer screening. We pooled annualized MEPS data files across years. Our analytic sample consisted of adults (18-64 years) with physical, sensory, or cognitive disabilities and nonmissing data for all variables of interest. Individuals with hearing impairment had better health care access and receipt than people with other disability types. People with multiple types of limitations were especially likely to have health care access problems and unmet health care needs. There are differences in health care access and receipt of preventive care depending on what type of disability people have. More in-depth research is needed to identify specific causes of these disparities and assess interventions to address health care barriers for particular disability groups. © Health Research and Educational Trust.
Frilander, Heikki; Lallukka, Tea; Viikari-Juntura, Eira; Heliövaara, Markku; Solovieva, Svetlana
Disability retirement causes a significant burden on the society and affects the well-being of individuals. Early health problems as determinants of disability retirement have received little attention. The objective was to study, whether interrupting compulsory military service is an early indicator of disability retirement among Finnish men and whether seeking medical advice during military service increases the risk of all-cause disability retirement and disability retirement due to mental disorders and musculoskeletal diseases. We also looked at secular trends in these associations. We examined a nationally representative sample of 2069 men, who had entered military service during 1967-1996. We linked military service health records with cause-specific register data on disability retirement from 1968 to 2008. Secular trends were explored in three service time strata. We used the Cox regression model to estimate proportional hazard ratios and their 95% confidence intervals. During the follow-up time altogether 140 (6.8%) men retired due to disability, mental disorders being the most common cause. The men who interrupted service had a remarkably higher cumulative incidence of disability retirement (18.9%). The associations between seeking medical advice during military service and all-cause disability retirement were similar across the three service time cohorts (overall hazard ratio 1.40 per one standard deviation of the number of visits; 95% confidence interval 1.26-1.56). Visits due to mental problems predicted disability retirement due to mental disorders in the men who served between 1987 and 1996 and a tendency for a similar cause-specific association was seen for musculoskeletal diseases in the men who served in 1967-1976. In conclusion, health problems-in particular mental problems-during late adolescence are strong determinants of disability retirement. Call-up examinations and military service provide access to the entire age cohort of men, where
Proctor, S N; Azar, S T
There is evidence to suggest that parents with an intellectual disability (ID) constitute a higher proportion of child-protective services (CPS) cases than would be expected based on the prevalence of ID in the general population. Researchers have suggested that the stereotypic assumptions and expectations that CPS workers have about parents with an ID might influence decisions and responses made to such parents. This study examined whether parental ID (having an ID vs. not) had an effect on CPS workers' emotional reactions, attributions and decisions about risk to the child, whether to remove the child and workers' general willingness to help the parent. Two hundred and twelve CPS workers read vignettes describing parents who were labelled as either having or not having an ID. Workers responded to the vignettes by making ratings of their emotional reactions, attributions and decisions regarding risk, removal and helping. CPS workers made significantly higher ratings of pity, willingness to help and risk for parents with an ID than for parents without an ID. Lower ratings of anger and disgust were found for parents with an ID than for parents without an ID. Parents' intellectual status did not have a direct effect on workers' attributions or removal decisions. The results show evidence for the influence of stereotypes regarding parental ID due to its differential effect on CPS workers' emotional reactions and decisions about child risk and their willingness to help. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.
This paper draws upon a study completed in 2000 that focused upon health and welfare provision for people with learning disabilities in one English county. This study drew upon the theoretical insights of Michel Foucault to provide an analysis of the micro politics of care planning. This involved the analysis of text from two sources: the academic literature and interview material gained from a number of professionals working in health and welfare services for people with learning disabilities. Drawing upon this research material, the first part of this paper briefly explores the relationship between policy, professional practice and the people who are the subjects of that practice. The discussion then moves on to consider Foucault's five methodological precautions and the way power produces a localised web of activity that identifies specific targets for management. In this process power draws into the web a range of informal and formal practices that initially lie outside of the web. The discourse produced through the activity surrounding care planning provides the evidence of this flow of power. This discourse then takes on the status of science (truth), which reproduces this activity.
Bertoli, A M; Fernández, M; Alarcón, G S; Vilá, L M; Reveille, J D
To examine the risk factors for self-reported work disability in patients from the LUpus in MInorities: NAture vs. Nurture cohort with systemic lupus erythematosus (SLE). Patients with SLE of Hispanic (Texas and Puerto Rico), African American and Caucasian ethnicity were studied. Work disability was defined by patients' self-report. Only patients known to be employed at the baseline visit were included. The probabilities of self-reporting work disability over time were examined by the Kaplan-Meier method; differences between ethnic groups were examined by the log-rank test. The relationship of baseline socioeconomic-demographic, clinical, behavioural and psychological features with work disability was examined by standard statistical tests. Variables with p
Bertoli, A M; Fernández, M; Alarcón, G S; Vilá, L M; Reveille, J D
Objective To examine the risk factors for self‐reported work disability in patients from the LUpus in MInorities: NAture vs. Nurture cohort with systemic lupus erythematosus (SLE). Methods Patients with SLE of Hispanic (Texas and Puerto Rico), African American and Caucasian ethnicity were studied. Work disability was defined by patients' self‐report. Only patients known to be employed at the baseline visit were included. The probabilities of self‐reporting work disability over time were examined by the Kaplan–Meier method; differences between ethnic groups were examined by the log‐rank test. The relationship of baseline socioeconomic–demographic, clinical, behavioural and psychological features with work disability was examined by standard statistical tests. Variables with p⩽0.10 in these analyses were examined by logistic regression. Results The rate of self‐reported work disability among the 273 patients studied was 19% at 5 years; it was numerically higher for the African Americans (25%) than for the Hispanics from Texas (19%) and the Caucasians (18%). The rate for the Hispanics from Puerto Rico was 7% at 2 years; 5‐year rates could not be estimated for this ethnic subgroup (shorter follow‐up in the cohort). In the regression analysis, age, male sex, poverty, total disease duration, disease activity and damage accrual were predictors of work disability. Conclusions The rate of work disability was 19% at 5 years. Patients with SLE with more severe disease and with lower socioeconomic status are at high risk of becoming disabled. The toll SLE imposes could possibly be reduced in patients at risk if, in addition to medical treatment, services needed to overcome their disadvantageous socioeconomic status are provided. PMID:16815862
Full Text Available Hidehiro Sugisawa,1 Toshio Shinoda,2 Yumiko Shimizu,3 Tamaki Kumagai,4 Hiroaki Sugisaki,5 Seiji Ohira6,† 1Department of Gerontology, Graduate School of Gerontology, J. F. Oberlin University, Tokyo, 2Department of Medical Care Technology, Faculty of Medical and Health Science, Tsukuba International University, Tsuchiura, 3Department of Community Health Nursing, The Jikei University School of Nursing, Chofu, 4Department of Fundamental Nursing, Graduate School of Nursing, Osaka City University, Osaka, 5Hachioji Azumacho Clinic, Hachioji, Tokyo, 6Sapporo Kita Clinic, Sapporo, Hokkai-do, Japan †Professor Dr. Seiji Ohira passed away on September 5, 2017 Background: This study aimed to investigate the levels of unmet needs for home and community-based services (HCBS evaluated by case managers (CMs among disabled patients on hemodialysis (DPHD and to examine factors related to unmet needs. Unmet needs for HCBS were defined as situations in which patients do not use or underuse HCBS despite needing them. Candidates for the factors relating to unmet needs for HCBS included three dimensions: predisposing, enabling, and need factors.Methods: Self-administrated questionnaires were collected from 391 CMs of DPHD certified with long-term care insurance. These were introduced by the dialysis facilities that a member of the Japanese Association of Dialysis Physicians belonged to. CMs were asked questions about their management of each individual case. HCBS included home help, visiting nursing, daycare, and short stay.Results: The prevalence of unmet needs for each HCBS ranged from 32% for home help to 48% for short stay. Barriers to service usage in the patients were associated with unmet needs for all four services. The patients with more severe cognitive malfunction were more likely to have unmet needs for visiting nursing and short stay. Heavier burden with caregiving was associated with more likelihood of unmet needs for home help and short stay
Full Text Available Smart home refers to the application of various technologies to semi-unsupervised home control It refers to systems that control temperature, lighting, door locks, windows and many other appliances. The aim of this study was to design a system that will use existing technology to showcase how it can benefit people with disabilities. This work uses only off-the-shelf products (smart home devices and controllers, speech recognition technology, open-source code libraries. The Voice Activated Smart Home application was developed to demonstrate online grocery shopping and home control using voice comments and tested by measuring its effectiveness in performing tasks as well as its efficiency in recognizing user speech input.
Andersen, Helle Elisabeth
This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person with disabilities...... (PWDs) coming for HIV/AIDS testing or treatment. However, problems with discriminatory attitudes towards PWDs could not be confirmed from my fieldwork observations at five different HIV/AIDS clinics in Uganda. That observation was confirmed in my interviews with PWDs and health workers. Health workers...... said that PWDs were entitled to the same care and treatment as everybody else. However, I observed that only few PWDs seem to attend those HIV/AIDS services, and the question arose why that is so. Problems with access and confidence (for example lack of sign language interpreters) are often reported...
Objectives: This study aimed to use an explanatory model of illness framework to document experiences of illness, disability and recovery amongst service users with schizophrenia and their caregivers in a poorly resourced area in the North West Province. Data were used to provide recommendations for a contextually appropriate non-specialist facilitated group psychosocial rehabilitation intervention. Method: Eighteen in-depth individual interviews were conducted: nine with schizophrenia service users and nine with caregivers. Interviews were conducted by two trained field researchers; both clinical psychologists fluent in the first language of participants. All interviews were recorded, translated and transcribed. Data were thematically analysed using NVivo 9. Results: Participants linked the illness to witchcraft, poverty and stress. Family conflict was recognised in the course of the illness, causing stress and challenges for emotional well-being. Knowledge of diagnosis and biomedical treatment was minimal. Key factors recognised by service users as promoting recovery were the ability to work, and the support of traditional healers and religious structures. Conclusion: Based on the findings of this study, a group psychosocial rehabilitation intervention emerged as a recommendation, with the incorporation of psycho-education, adherence support, coping skills, and opportunities for income generation and productive activity. The importance of also enlisting the support of religious leaders and traditional healers in supporting recovery is emphasised.
Clare, I C H; Madden, E M; Holland, A J; Farrington, C J T; Whitson, S; Broughton, S; Lillywhite, A; Jones, E; Wade, K A; Redley, M; Wagner, A P
In the UK, the closure of 'long-stay' hospitals was accompanied by the development of community teams (CTs) to support people with intellectual disabilities (IDs) to live in community settings. The self-reported experiences of staff working in such teams have been neglected. Focusing on a single county-wide service, comprising five multi-disciplinary and inter-agency CTs, we measured perceptions among the health care and care management Team members of (1) their personal well-being; (2) the functioning of their team; and (3) the organisation's commitment to quality, and culture. Almost three-quarters of the questionnaires were returned (73/101; 72%). The scores of health care practitioners and care managers were very similar: (1) the MBI scores of more than half the respondents were 'of concern'; (2) similarly, almost four in ten respondents' scores on the Vision scale of the TCI were 'of concern'; (3) the perceived commitment to quality (QIIS-II Part 2) was uncertain; and (4) the organisational culture (QIIS-II, Part 1) was viewed as primarily hierarchical. The perceived absence of a vision for the service, combined with a dominant culture viewed by its members as strongly focussed on bureaucracy and process, potentially compromises the ability of these CTs to respond proactively to the needs of people with IDs. Given the changes in legislation, policy and practice that have taken place since CTs were established, it would be timely to revisit their role and purpose. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
This presentation was prepared at the invitation of Professor Yukio Ohsawa, Department of Systems Innovation, School of Engineering, The University of Tokyo, for delivery at the International Workshop on Innovating Service Systems, sponsored by the Japanese Society of Artificial Intelligence (JSAI) as part of the JSAI Internation Symposium on AI, 2010. It offers several challenges for Service Science and Service Innovation. the goal of the presentation is to stimulate thinking about how service systems viII evolve in the future, as human society advances from its terrestrial base toward a permanent presence in space. First we will consider the complexity of the International Space Station (ISS) as it is today, with particular emphasis of its research facilities, and focus on a current challenge - to maximize the utilization of ISS research facilities for the benefit of society. After briefly reviewing the basic principles of Service Science, we will discuss the potential application of Service Innovation methodology to this challenge. Then we viII consider how game-changing technologies - in particular Synthetic Biology - could accelerate the pace of sociocultural evolution and consequently, the progression of human society into space. We will use this provocative vision to advance thinking about how the emerging field of Service Science, Management, and Engineering (SSME) might help us anticipate and better handle the challenges of this inevitable evolutionary process.
Skempes, Dimitrios; Bickenbach, Jerome
Rehabilitation care is fundamental to health and human dignity and a human right enshrined in the United Nations Convention on the Rights of Persons with Disabilities. The provision of rehabilitation is important for reducing the need for formal support and enabling persons with disabilities to lead an independent life. Increasingly scholars and advocacy groups voice concerns over the significant barriers facing people with disabilities in accessing appropriate and quality rehabilitation. A growing body of research highlights a "respond-need" gap in the provision of rehabilitation and assistive technologies and underscore the lack of indicators for assessing performance of rehabilitation systems and monitoring States compliance with human rights standards in rehabilitation service planning and programming. While research on human rights and health monitoring has increased exponentially over the last decade far too little attention has been paid to rehabilitation services. The proposed research aims to reduce this knowledge gap by developing a human rights based monitoring framework with indicators to support human rights accountability and performance assessment in rehabilitation. Concept mapping, a stakeholder-driven approach will be used as the core method to identify rights based indicators and develop the rehabilitation services monitoring framework. Concept mapping requires participants from various stakeholders groups to generate a list of the potential indicators through on line brainstorming, sort the indicators for conceptual similarity into clusters and rate them against predefined criteria. Multidimensional scaling and hierarchical cluster data analysis will be performed to develop the monitoring framework while bridging analysis will provide useful insights about patterns of agreement or disagreement among participants views on indicators. This study has the potential to influence future practices on data collection and measurement of compliance with
Hazarika, Panna; Galligan, Stephen
Controlling warehousing operations and food inventory, administering school cafeteria activity, and measuring the profitability of food service operations are identified as food service administrative problems. A comprehensive school food services information system developed to address these problems is described. (Author/MLF)
Muenke, Raychel C.
The purpose of this exploratory study was to analyze the perceptions (through survey data) of Disability Support Services (DSS) personnel regarding the transition process for students with Autism Spectrum Disorder (ASD) from secondary to postsecondary institutions. Participants from 408 postsecondary institutions completed the survey with 60.4%…
... SMALL BUSINESS ADMINISTRATION 13 CFR Parts 121, 124, 125, 126, and 134 RIN 3245-AF65 Small Business, Small Disadvantaged Business, HUBZone, and Service-Disabled Veteran-Owned Protest and Appeal Regulations AGENCY: U.S. Small Business Administration. ACTION: Proposed rule. SUMMARY: The U.S. Small...
Beyer, Stephen; Brown, Tony; Akandi, Rachel; Rapley, Mark
Background: Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for…
Participant direction allows people with intellectual and developmental disabilities (IDD) and/or their families to direct services; in doing so, participant direction shifts participants from passive recipients to active consumers. Medicaid encourages, but does not require, states to allow participant direction. The aim of this study was to…
Brown, Kirsten R.
Students with Autism Spectrum Disorder (ASD) are participating in postsecondary education at an increasing rate. Yet, we know little about what types of accommodations or services disability resource providers employ to support students with ASD. The purpose of this study was to examine how postsecondary institutions are fostering the academic…
Alexander, R. T.; Green, F. N.; O'Mahony, B.; Gunaratna, I. J.; Gangadharan, S. K.; Hoare, S.
Aim: To establish any differences between patients with and without a diagnosis of personality disorders, being treated in a secure inpatient service for offenders with intellectual disability (ID) in the UK. Method: A cohort study involving a selected population of people with ID and offending behaviours. Results: The study included a total of…
Esan, Fola; Chester, Verity; Gunaratna, Ignatius J.; Hoare, Sudeep; Alexander, Regi T.
Background: To describe the characteristics of those with autism spectrum disorder (ASD) treated within a forensic intellectual disability hospital and to compare them with those without ASD. Method: Service evaluation of a cohort of 138 patients treated over a 6-year period. Results: Of the 138, 42 had an ASD. Personality disorders and harmful…
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What definitions are important in... Business Credit and Assistance SMALL BUSINESS ADMINISTRATION GOVERNMENT CONTRACTING PROGRAMS Definitions for the Service-Disabled Veteran-Owned Small Business Concern Program § 125.8 What definitions are...
Luiselli, James K.; St. Amand, CarrieAnne; MaGee, Christine; Sperry, James M.
We describe a training program to teach applied behavior analysis (ABA) knowledge competencies to paraprofessional staff (N = 47) at a habilitation services agency for adults with developmental disabilities. Before and following training, staff completed assessment of knowledge tests for three content areas: basic learning principles,…
Peters-Scheffer, N.C.; Didden, H.C.M.; Mulders, M.; Korzilius, H.P.L.M.
This study evaluated the effectiveness of low intensity behavioral treatment (on average 6.5 h per week) supplementing preschool services in 3-6-year-old children with autism spectrum disorder and severe to mild intellectual disability. Treatment was implemented in preschools (i.e., daycare centers)
Brabrand, Claus; Møller, Anders; Sandholm, Anders
Interactive web services are increasingly replacing traditional static web pages. Producing web services seems to require a tremendous amount of laborious low-level coding due to the primitive nature of CGI programming. We present ideas for an improved runtime system for interactive web services ...... built on top of CGI running on virtually every combination of browser and HTTP/CGI server. The runtime system has been implemented and used extensively in , a tool for producing interactive web services.......Interactive web services are increasingly replacing traditional static web pages. Producing web services seems to require a tremendous amount of laborious low-level coding due to the primitive nature of CGI programming. We present ideas for an improved runtime system for interactive web services...
...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... appointment of people with mental retardation, severe physical disabilities, and psychiatric disabilities. As... a particular work environment. Persons with disabilities today, however, often have work...
With the passing of disability legislation, more individuals with disabilities are attending postsecondary institutions (Hall & Belch, 2000). Across the postsecondary landscape, Minority Serving Institutions (MSIs) enroll 14% of all students enrolled in postsecondary institutions (Harmon, 2012). As more students with disabilities enroll in…
McLaughlin, Dorry; Barr, Owen; McIlfatrick, Sonja; McConkey, Roy
Evidence from European and American studies indicates limited referrals of people with learning (intellectual) disabilities to palliative care services. Although professionals' perceptions of their training needs in this area have been studied, the perceptions of people with learning disabilities and family carers are not known. This study aimed to elicit the views of people with learning disabilities, and their family carers concerning palliative care, to inform healthcare professional education and training. A qualitative, exploratory design was used. A total of 17 people with learning disabilities were recruited to two focus groups which took place within an advocacy network. Additionally, three family carers of someone with a learning disability, requiring palliative care, and two family carers who had been bereaved recently were also interviewed. Combined data identified the perceived learning needs for healthcare professionals. Three subthemes emerged: 'information and preparation', 'provision of care' and 'family-centred care'. This study shows that people with learning disabilities can have conversations about death and dying, and their preferred end-of-life care, but require information that they can understand. They also need to have people around familiar to them and with them. Healthcare professionals require skills and knowledge to effectively provide palliative care for people with learning disabilities and should also work in partnership with their family carers who have expertise from their long-term caring role. These findings have implications for educators and clinicians. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Tan, Adrian; McAloone, Timothy Charles; Gall, Catherine
‘Product/service-systems’ (PSS) are innovation strategies where instead of focusing on the value of selling physical products, one focuses on the value of the utility of products and services throughout the product’s life period. This approach enables companies to provide customers with offerings...... that continuously deliver value and create a strong competitive advantage. PSS attempts to transcend the old industrial credo that value is embedded in products and the consideration of ‘cost-quality-time’ relates to the physical artefact. While there is increasing interest in PSS, limited research has been done...
Full Text Available The Service Engineering (SE is understood as a framework to create innovative services in application development of information technology approach to Service Oriented Architecture (SOA. Implementing SOA is required methodology to identify services that can be used again in the application and organization of a company. in this research, software development model used is object-oriented methodologies, SOA itself is a collection consisting of tools, technologies, frameworks, and best practices that facilitate the implementation of a service quickly. in a study this uses the tools of Business Process Management System (BPMS to support the implementation of service-oriented software. the purpose of this study is to produce a model of activities and artifacts of the application software development models of the SE with a case study Rate Loans. Validation to the design of the model is done through testing of the software produced. The results showed that the application of the SE in the development of service-oriented software can use the object-oriented methodology by providing additional value-added analysis and redesign of business processes to be implemented on a BPMS. BPMS usage of the application of the SE on the SOA has the advantage of visualization in the management of business processes.
Diabetes is an increasingly prevalent chronic illness that places a huge burden on the individual, the health system and society. Patients with active foot disease and lower limb amputations due to diabetes have a significant amount of interaction with the health care services. The purpose of this study was to explore the attitudes and experiences of foot care services in Ireland among people with diabetes and active foot disease or lower limb amputations.
Hsuan, Juliana; McAloone, Tim C.; Neugebauer, Line
We apply a management tool to classify different integrated PSS within the context of Danish maritime industry. We investigate how a firm should organize its operations to manage the transition from being a manufacturing to a servitizing company, and to provide a guideline for strategic positioni...... and planning of the balance between product sales and service activities....
Crockett, Jennifer; Finlayson, Janet; Skelton, Dawn A.; Miller, Gillian
Background: People with intellectual disabilities experience high rates of falls. Balance and gait problems are common in people with intellectual disabilities, increasing the likelihood of falls; thus, tailored exercise interventions to improve gait and balance are recommended. The present authors set up a physiotherapy-led falls pathway service…
Moorman, Bridget A
These scenarios reflect where the future is heading for remote health monitoring technology and service expectations. Being able to manage a "system of systems" with timely service hand-off over seams of responsibility and system interfaces will become very important for a BMET or clinical engineer. These interfaces will include patient homes, clinician homes, commercial/civilian infrastructure, public utilities, vendor infrastructure as well as internal departmental domains. Concurrently, technology is changing rapidly resulting in newer software delivery modes and hardware appliances as well as infrastructure changes. Those who are able to de-construct the complex systems and identify infrastructure assumptions and seams of servicing responsibility will be able to better understand and communicate the expectations for service of these systems. Moreover, as identified in Case 1, prodigious use of underlying system monitoring tools (managing the "meta-data") could move servicing of these remote systems from a reactive approach to a proactive approach. A prepared healthcare organization will identify their current and proposed future service combination use cases and design service philosophies and expectations for those use cases, while understanding the infrastructure assumptions and seams of responsibility. This is the future of technical service to the healthcare clinicians and patients.
Khrichenkov, A.; Shaufler, V.; Bannikova, L.
Under market conditions, the trade services system in post-Soviet Russia, being one of the most important city infrastructures, loses its systematic and hierarchic consistency hence provoking the degradation of communicating transport systems and urban planning framework. This article describes the results of the research carried out to identify objects and object parameters that influence functioning of a locally significant trade services system. Based on the revealed consumer behaviour patterns, we propose methods to determine the optimal parameters of objects inside a locally significant trade services system.
Francis, Linda E; Colson, Paul W; Mizzi, Pamela
Involvement of mental health service consumers in the provision of mental health services is a growing model in community mental health. It is, however, a complicated issue, made ever more so by the passage of the Americans with Disabilities Act. In this ethnographic case study, we seek to explore the changes one social services agency has made to adjust to the requirements of the ADA and the impact of these changes on their consumer employees. Our results indicate potential for positive progress as a result of the ADA, but also unexpected pitfalls as organizational cultures change as well.
Ozer, D; Nalbant, S; Aǧlamıș, E; Baran, F; Kaya Samut, P; Aktop, A; Hutzler, Y
This study investigated attitudes towards teaching students with intellectual disability (ID) within a representative sample of secondary school physical education (PE) teachers, and to determine the effects of age, gender, teaching experience, and having acquaintance with ID and students with ID on their attitudes. Participants were 729 secondary school PE teachers who worked in 81 major cities of Turkey. The Teachers Attitudes towards Children with Intellectual Disability Scale was administered. The statistical analysis revealed that there was no significant effect on factors and total attitudes scores of gender and having students with ID. Significant effects on factors and total attitudes score were found in teaching experiences and having acquaintance with ID. It is encouraged to maintain and further develop in-service education programmes of adapted physical activity for PE teachers. © 2012 The Authors. Journal of Intellectual Disability Research © John Wiley & Sons Ltd, MENCAP & IASSID.
The equitable provision of home enteral nutrition (HEN) in the community can have a transformative effect on patient experience and family life for adults and children alike. While optimising quality of life in HEN patients can be challenging, the initiation of HEN positively impacts this measure of healthcare provision.1 Quality of life scores have been shown to improve in the weeks after hospital discharge, and HEN is physically well tolerated. However, it may be associated with psychological distress, and sometimes reluctance among HEN patients to leave their homes.2 Globally, HEN can attenuate cumulative projected patient care costs through a reduction in hospital admission and complications including hospital acquired infections.3 In an era where the cost of disease related malnutrition and associated prolonged hospital stay is being tackled in our healthcare systems, the role of HEN is set to expand. This is a treatment which has clear clinical and social benefits, and may restore some independence to patients and their families. Rather than the indications for HEN being focused on specific diagnoses, the provision of months of quality life at home for patients is adequate justification for its prescription.4 Previously, a review of HEN service provision in 39 cases demonstrated that patients want structured follow-up after hospital discharge, and in particular, would like one point of contact for HEN education and discharge.5 Management structures, funding challenges and the need for further education, particularly within the primary care setting may limit optimal use of HEN. The Irish Society for Clinical Nutrition and Metabolism (IrSPEN) aims to develop a national guideline document, drawing on international best practice, forming a template and standards for local policy development in the area of HEN service provision, training and follow-up. The first step in guideline development was to investigate patient experience for adults and children alike. Care
This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\
Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Green, Vanessa A.; Oliva, Doretta; Alberti, Gloria; Carrella, Luigina
This study extended the research on a special text messaging system, which allows persons with multiple disabilities to (a) write and send messages to distant partners and (b) have messages from those partners read out to them. The study involved two women with multiple disabilities (including blindness or minimal residual vision). The system…
Van Dort, Sandra; Coyle, Julia; Wilson, Linda; Ibrahim, Hasherah Mohd
The lead article by Wylie, McAllister, Davidson, and Marshall (2013) puts forward pertinent issues facing the speech-language pathology profession raised by the World Report on Disability. This paper continues the discussion by reporting on a capacity building action research study on the development, implementation, and evaluation of a new approach to early intervention speech-language pathology through clinical education in Malaysia. This research evaluated a student-led service in community-based rehabilitation that supplemented existing and more typical institution-based services. A Malaysian community-based rehabilitation project was chosen due to its emphasis on increasing the equitability and accessibility of services for people with disabilities which was a catalyst for this research. Also, expanding awareness-building, education, and training activities about communication disability was important. The intention was to provide students with experience of working in such settings, and facilitate their development as advocates for broadening the scope of practice of speech-language pathology services in Malaysia. This article focuses on the findings pertaining to the collaborative process and the learning experiences of the adult participants. Through reflection on the positive achievements, as well as some failures, it aims to provide deeper understanding of the use of such a model.
Parsons, Mike; Scutt, Simon
Within Logica UK, over 30 IT service projects are considered safetyrelated. These include operational IT services for airports, railway infrastructure asset management, nationwide radiation monitoring and hospital medical records services. A recent internal audit examined the processes and documents used to manage system safety on these services and made a series of recommendations for improvement. This paper looks at the changes and the challenges to introducing them, especially where the service is provided by multiple units supporting both safety and non-safety related services from multiple locations around the world. The recommendations include improvements to service agreements, improved process definitions, routine safety assessment of changes, enhanced call logging, improved staff competency and training, and increased safety awareness. Progress is reported as of today, together with a road map for implementation of the improvements to the service safety management system. A proposal for service assurance levels (SALs) is discussed as a way forward to cover the wide variety of services and associated safety risks.
Full Text Available New trends in multi-agent systems call for self-adaptation and high dynamics, hence the new model of open MAS or virtual organization of agents. However, as existing agent platforms are not yet equipped to support this behavior, it is necessary to create new systems and mechanisms to facilitate the development of these new architectures. This article presents PANGEA, an agent platform to develop open multi-agent systems, specifically those including organizational aspects such as virtual agent organizations. The platform allows the integral management of organizations and offers tools to the end user. Additionally, it includes a communication protocol based on the IRC standard, which facilitates implementation and remains robust even with a large number of connections. The introduction of a CommunicationAgent and a Sniffer make it possible to offer Web Services for the distributed control of interaction. In order to test PANGEA, an integral system was developed to help the disabled, gathering a set of easily deployable and integrated services under a single architecture.
Andersen, Helle Elisabeth
Abstract This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person with dis......Abstract This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person...... with disabilities (PWDs) coming for HIV/AIDS testing or treatment. However, problems with discriminatory attitudes towards PWDs could not be confirmed from my fieldwork observations at five different HIV/AIDS clinics in Uganda. That observation was confirmed in my interviews with PWDs and health workers. Health...... workers said that PWDs were entitled to the same care and treatment as everybody else. However, I observed that only few PWDs seem to attend those HIV/AIDS services, and the question arose why that is so. Problems with access and confidence (for example lack of sign language interpreters) are often...
Full Text Available The paper discusses the potential of assistive service robots to support disabled and elderly people. It shows that they have considerable untapped potential in this area, but also that inappropriate implementations could increase isolation, reduce independence and lead to users feeling as though they are under surveillance. The main body of the paper presents an overview of existing applications and discusses their benefits and potential problems. This is organized by an extension of the common classification into socially and physically assistive robots by the two categories of sensory assistive and mixed assistance robots. Another more detailed classification is also presented. This discussion is introduced by an overview of many of the technological components of smart mobile robots. It is followed by a discussion of user acceptance. The problems of existing models based on either solely positive or solely negative factors are noted and a model containing both types of factors is proposed. The need for continuing research is noted and various proposals are made.
Pedace, Claudio; Rosa, Antonella; Francesconi, Paolo; Acampora, Anna; Ricciardi, Walter; Damiani, Gianfranco
Population aging and the concurrent increase of age-related chronic degenerative diseases and disability are associated with an increased proportion of elderly persons who are dependent in activities of daily living (ADL). ADL-dependent persons need continuous and long-term health and social care according to the "taking charge" rationale, in order to warrant access and continuity of care. A healthcare system needs to respond to the long-term and complex needs, such as those of disabled elderly people, by providing appropriate health and social care services in Primary Care. A Primary Health Care system is organized according to two governance levels have distinct aims but are closely inter-dependent in their operational mechanisms. The system governance is accountable for the community and individual health protection while the delivery governance is accountable for the provision of services in accordance with appropriateness, safety and economic criteria. Delivery governance can be considered "integrated governance" as a synergy exists between two decision-making systems guiding provider choices, which are corporate governance and clinical governance. The aim of this study was to analyse the abovementioned governance levels within the healthcare system in Tuscany (Italy) referring to long-term residential care for disabled elderly people. The case of excessive accesses to emergency departments from different types of Nursing Homes (NH) is used as an example to analyse different levels of responsibility involved in the management of a critical phenomenon. Suggestions for improvement in the different levels of governance for disabled elderly people are provided, in order to support institutional programming activities.
Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex
The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as...
Maddison, Jane; Beresford, Bryony
Satisfaction with service-related choices has not received much research attention, especially beyond medical/health-related decisions. This paper reports findings from an analysis of parents' accounts of making service-related choices with, or on behalf of, a disabled son or daughter with a degenerative condition. It focuses particularly on factors and processes, which contribute to parents' satisfaction. This is particularly interesting given that sub-optimal outcomes or negative consequences are often experienced following a service-related choice being implemented. The data reported here were collected as part of a larger, longitudinal study (the Choice and Change project) of service users' experiences of choice-making, including the outcomes and consequences of those choices. Parents of disabled young people with degenerative conditions formed part of this sample. The accounts of 14 of these parents, collected over three interviews during a two and a half-year period, all of whom expressed satisfaction with the medium- to long-term outcomes of a service-related choice, were selected for specific analyses to understand what underlies satisfaction with service-related choices. Clarity of the desired outcome for the young person supported effective decision-making and led parents to feel confident that the best possible choice was being made. Evidence of desired outcomes being attained were used by parents to 'trade off' the negative consequences of a choice. These included the considerable demands placed on parents' personal, financial and practical resources to operationalise a choice, and the emotional impact incurred by significant changes such as the loss of the carer role. The passage of time was important in allowing evidence of positive outcomes to emerge, psychological or emotional adjustments to be made, and for parents to develop trust in new service providers. The findings suggest that practitioners can have an important role in both practical and
Pimdee, Atipong; Nualnetr, Nomjit
Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members. Patients and their caregivers were also satisfied with the services. In conclusion, the ICF is an effective means of guiding home health care.
Russell, Andrew T.; Hahn, Joan Earle; Hayward, Katharine
The purpose of this study was to describe the medication management and treatment provided in a specialty outpatient psychiatry clinic for 198 community-residing children and adults with intellectual disability and other developmental disabilities (IDD) referred to the clinic and discharged between 1999 and 2008. Using a descriptive design, data…
Full Text Available The problems of consumer services at domestic enterprises are showed. The shortcomings in the service of enterprise operation are analyzed. The basic features of the functioning of the service system forming medium are determined. The authors develop the measures to improve the quality of services which can contribute to their development, expansion of the customer base, increase in sales volume (goods and services as well as improving efficiency and profitability. Taking into account the current environment of enterprises the proposed measures are formed. The article proves the expediency of the use of the client-oriented approach to a customer, the use of software programs and the improvement of the CRM-system at enterprises, the introduction of «7P» concept.
Beadle-Brown, Julie; Murphy, Bev; Positive Behaviour Support Academy; Mencap
This resource provides an overview of what good support looks like in services for people with learning disabilities and/or autism. The definition of “good” is based on both research and good practice and emphasises the nature and quality of the support needed to ensure good quality of life outcomes for people with learning disabilities and/or autism.
Datta, Poulomee; Talukdar, Joy
This study investigated the influence of the support services on the test anxiety of students and/or their ability to submit assignments in each of the two disability groups, those with vision impairment and those with intellectual disability, who were placed in specialist and mainstream educational settings in South Australia. Interviews were…
Van Riper, Cynthia L; Wallace, Lee Shelly
It is the position of the American Dietetic Association that nutrition services provided by registered dietitians (RDs) and dietetic technicians, registered (DTRs), are essential components of comprehensive care for all people with developmental disabilities and special health care needs. Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community-based, and culturally competent. People with developmental disabilities and special health care needs frequently have nutrition concerns, including growth alterations (failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, medication-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Individuals with special needs are also more likely to develop comorbid conditions such as obesity or endocrine disorders that require nutrition interventions. Poor health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Health maintenance and avoidance of complications can be promoted by timely and cost-effective nutrition interventions. Public policy for individuals with special needs has evolved over time, resulting in a transition from institutional facilities and programs to community living. The expansion of public access to technology and health information on the Internet challenges RDs and DTRs to provide accurate scientific information for those with developmental disabilities and special health care needs. Nationally credentialed RDs and DTRs are best prepared to provide appropriate nutrition information for wellness and quality of life.
Francescutti, Carlo; Frattura, Lucilla; Troiano, Raffaella; Gongolo, Francesco; Martinuzzi, Andrea; Sala, Marina; Meucci, Paolo; Raggi, Alberto; Russo, Emanuela; Buffoni, Mara; Gorini, Giovanna; Conclave, Mario; Petrangeli, Agostino; Solipaca, Alessandro; Leonardi, Matilde
To report on the preliminary results of an Italian project on the implementation of an ICF-based protocol for providing public services and benefits for persons with disabilities. The UN Convention on the Rights of persons with disabilities (UNC) was mapped to the ICF, and core elements were implemented in an ICF-based evaluation protocol. A person-environment interaction classification (PEIC) tree was also developed for defining evaluation outputs. The PEIC and the ICF-based protocol are the guideline and the data interpretation source, respectively, for providing public services and benefits. They enable to assign persons to different services, from surveillance and monitoring to facilitator provision or sustain over time, to barrier removal or to the reorganisation of environmental factors provision. A detailed description of the target intervention is made available through the implementation of a protocol, which points out the effect of personal support and other environmental factors. The detailed description of functioning and disability provided by our methodology can help policy makers and administrators in decision making, on the basis of a description of real needs, and in targeting person-tailored interventions.
... Genitourinary System, Digestive System, Dental Conditions, and Infectious Diseases, Immune Disorders and... Disability Criteria for the Genitourinary System, Digestive System, Dental Conditions, and Infectious... 4.88-4.89), (2) the Digestive System (38 CFR 4.110-4.114), (3) the Genitourinary System (38 CFR 4...
Holland, Deirdre M
Medication reconciliation is a basic principle of good medicines management. With the establishment of the National Acute Medicines Programme in Ireland, medication reconciliation has been mandated for all patients at all transitions of care. The clinical pharmacist is widely credited as the healthcare professional that plays the most critical role in the provision of medication reconciliation services.
Alzate, Elvis Siprián Castro; Martínez, Alejandro Castillo
According to the World Health Organization (WHO), the aftermaths of suicide attempts are the sixth leading cause of poor health and disability in the world. Establish the level of disability and related factors in terms of restrictions regarding participation and activity limitations in cases of suicidal attempts attended by the Public Service Network Health of Santiago de Cali, from September 2009 to June 2010. A cross-section, observational study was applied to 126 people between 15 and 65 who had attempted suicide and were treated at the Public Health Service in Santiago de Cali. A Spanish version of the Disability Assessment Scale of the World Health Organization 30 disability-adjusted life years (DALYs) were calculated together with a disability prevalence of 95.3%. 4.6% of the sample did not show disability while 41.27% had mild disability, 38.1%, moderate disability, and 15.87%, severe disability. Factors related with disability were: Age, occupation, presence of mental illness, current depressive symptoms, lethal methods, use of psychiatric drugs, activity limitations, participation restrictions and lack of religious practice. The prevalence of disability in people who have committed suicidal attempts treated at the public health services in Santiago de Cali, was 95.3%. The results are consistent with the study of global burden of disease that establishes a high score for mental disorders in suicidal attempts. The presence of a deficiency after the suicide attempt increases the burden of disability. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Harvey, Carol; Brophy, Lisa; Parsons, Samuel; Moeller-Saxone, Kristen; Grigg, Margaret; Siskind, Dan
People with psychosocial disability are an important, although often neglected, subgroup of those living with severe and persistent mental illness. Rehabilitation, provided through clinical and non-government organisations in Australia, may contribute to their personal recovery goals. We hypothesised that people with psychoses with the greatest disability and complex needs would receive services from both sectors, reflecting treatment and rehabilitation needs. Participants in the 2010 Australian national survey of psychosis (n = 1825) were interviewed to assess demographic, functional, mental and physical health characteristics and service use in the previous year. Two subgroups were created and compared: those using services from community mental health with, and without, non-governmental organisation involvement. Group membership was predicted by hierarchical logistic regression using variables selected on a priori grounds. Usefulness of the final model was examined by calculating improvement over the rate of accuracy achievable by chance alone. The model was statistically significant but fell just short of useful (criterion 71.6%, model achieved 70.6%). Four independent variables contributed uniquely to predicting whether participants received both services (never married, childhood trauma, group accommodation, poor global functioning) consistent with the hypothesis. However, severe dysfunction in socialising was less likely to predict membership of the combined services group when compared with no dysfunction (p = 0.001, odds ratio = 0.384, confidence interval = [0.218, 0.677]), as was current smoking compared with none (p = 0.001, odds ratio = 0.606, confidence interval = [0.445, 0.824]). Findings suggest services provided by non-governmental organisations are targeted to those with the greatest disability although targeting could be improved. A subgroup of people with psychosis and severe disability in community mental health
Stein, A.A.; Felder, C.M.; Martin, R.L.
The availability and reliability of the service water system is critical for safe operation of a nuclear power plant. Degradation of the system piping and components has forced utilities to re-evaluate the corrosion behavior of current and alternative system materials, to support assessments of the remaining service life of the service water system, selection of replacement materials, implementation of corrosion protection methods and corrosion monitoring programs, and identification of maintenance and operational constraints consistent with the materials used. TU Electric and Stone and Webster developed a service water materials evaluation program for the Comanche Peak Steam Electric Station. Because of the length of exposure and the generic interest in this program by the nuclear power industry, EPRI joined TU to co-sponsor the test program. The program was designed to evaluate the corrosion behavior of current system materials and candidate replacement materials and to determine the operational and design changes which could improve the corrosion performance of the system. Although the test program was designed to be representative of service water system materials and environments targeted to conditions at Comanche Peak, these conditions are typical of and relevant to other fresh water cooled nuclear service water systems. Testing was performed in raw water and water treated with biocide under typical service water operating conditions including continuous flow, intermittent flow, and stagnant conditions. The test program evaluated the 300 Series and 6% molybdenum stainless steels, copper-nickel, titanium, carbon steel, and a formed-in-place nonmetallic pipe lining to determine susceptibility to general, crevice, and microbiologically influenced corrosion and pitting attack. This report presents the results of the test program after 4 years of exposure
Maynard, Charles; Trivedi, Ranak; Nelson, Karin; Fihn, Stephan D
The association between disability and cause of death in Veterans with service-connected disabilities has not been studied. The objective of this study was to compare age at death, military service and disability characteristics, including disability rating, and cause of death by year of birth. We also examined cause of death for specific service-connected conditions. This study used information from the VETSNET file, which is a snapshot of selected items from the Veterans Benefits Administration corporate database. We also used the National Death Index (NDI) for Veterans which is part of the VA Suicide Data Repository. In VETSNET, there were 758,324 Veterans who had a service-connected condition and died between the years 2004 and 2014. Using the scrambled social security number to link the two files resulted in 605,493 (80%) deceased Veterans. Age at death, sex, and underlying cause of death were obtained from the NDI for Veterans and military service characteristics and types of disability were acquired from VETSNET. We constructed age categories corresponding to period of service; birth years 1938 and earlier corresponded to Korea and World War II ("oldest"), birth years 1939-1957 to the Vietnam era ("middle"), and birth years 1958 and later to post Vietnam, Gulf War, and the more recent conflicts in Iraq and Afghanistan ("youngest"). Sixty-two percent were in the oldest age category, 34% in the middle group, and 4% in the youngest one. The overall age at death was 75 ± 13 yr. Only 1.6% of decedents were women; among women 25% were in the youngest age group, while among men only 4% were in the youngest group. Most decedents were enlisted personnel, and 60% served in the U.S. Army. Nearly 61% had a disability rating of >50% and for the middle age group 54% had a disability rating of 100%. The most common service-connected conditions were tinnitus, hearing loss, and post-traumatic stress disorder (PTSD). In the oldest group, nearly half of deaths were due to
Full Text Available Locating occupational therapy within gendered and racialized systems of power, the authors consider the intersectional nature of critical disability studies discourse and the need for occupational therapy to incorporate such values into practice. This article discusses ways in which occupational therapy as a profession and individual therapists can align with or resist the economic determination which has come to dominate medical systems. It considers some of the political background to the history of the profession and its relationship with power. This positioning of the profession is explored against the impact of neoliberal economic policy on health, rights, service delivery and disability, and against some key issues, the pressure of ageing populations and the positon of occupational therapists as women professionals. Current policies present a critical challenge to central occupational therapy tenets. Occupational therapists may find themselves working both in alliance with disabled people and disability activists, and against them.
.... In the Veterans Entrepreneurship and Small Business Development Act of 1999 (P.L. 106-50), Congress stated that too little had been done to help veterans particularly service-disabled veterans, in starting small businesses...
Mukherjee, Mina; Westphal, Alexander
The case of Hall vs. Florida tested Florida's so called "bright line rule" in determining intellectual disability in capital cases. The Supreme Court Decision reflects a more general trend from categorical to dimensional approaches in psychiatric diagnostic systems.
Full Text Available Purpose: This action research aimed at developing an action plan to improve the accessibility to home health care and assistive devices for persons with disabilities in a rural community, and to evaluate changes in the numbers of such persons who received appropriate home health care and assistive devices after a three-month implementation of the action plan.Method: The study was conducted at a sub-district of Maha Sarakham Province, Thailand. The main beneficiaries were 99 persons with disabilities (mean age55.4±18.7 years. Group meetings were organised for persons with disabilities, caregivers, and various community members. An action plan for improving the accessibility of persons with disabilities to home health care and assistive devices was collaboratively formulated and implemented for three months.Results: The main strategy for improving accessibility was to increase the competency of village health volunteers in providing home health care and assistive devices to persons with disabilities. After the three-month action plan implementation, the number of persons with disabilities who received appropriate home health care, i.e. at least once a month, significantly increased from 33.3% to 72.2% (Chi-square test, PConclusions: Under the supervision of physical therapists and/or other allied health professionals, the village health volunteer is likely to be a key person for improving the accessibility to home health care and assistive devices for persons with disabilities in a rural community.Limitations: The study was limited to only one sub-district. No comparable areas were studied. Further, since the study recruited persons with disabilities from a rural community, applicability of the findings to persons with disabilities in an urban community should be considered judiciously.
Michielsen, Adriana J
Inflammatory mediators in the tumour microenvironment promote tumour growth, vascular development and enable evasion of anti-tumour immune responses, by disabling infiltrating dendritic cells. However, the constituents of the tumour microenvironment that directly influence dendritic cell maturation and function are not well characterised. Our aim was to identify tumour-associated inflammatory mediators which influence the function of dendritic cells. Tumour conditioned media obtained from cultured colorectal tumour explant tissue contained high levels of the chemokines CCL2, CXCL1, CXCL5 in addition to VEGF. Pre-treatment of monocyte derived dendritic cells with this tumour conditioned media inhibited the up-regulation of CD86, CD83, CD54 and HLA-DR in response to LPS, enhancing IL-10 while reducing IL-12p70 secretion. We examined if specific individual components of the tumour conditioned media (CCL2, CXCL1, CXCL5) could modulate dendritic cell maturation or cytokine secretion in response to LPS. VEGF was also assessed as it has a suppressive effect on dendritic cell maturation. Pre-treatment of immature dendritic cells with VEGF inhibited LPS induced upregulation of CD80 and CD54, while CXCL1 inhibited HLA-DR. Interestingly, treatment of dendritic cells with CCL2, CXCL1, CXCL5 or VEGF significantly suppressed their ability to secrete IL-12p70 in response to LPS. In addition, dendritic cells treated with a combination of CXCL1 and VEGF secreted less IL-12p70 in response to LPS compared to pre-treatment with either cytokine alone. In conclusion, tumour conditioned media strongly influences dendritic cell maturation and function.
Zhang, J. H.; Yang, J.; Sun, Y. S.
This system combines the Mapworld platform and informationization of disabled person affairs, uses the basic information of disabled person as center frame. Based on the disabled person population database, the affairs management system and the statistical account system, the data were effectively integrated and the united information resource database was built. Though the data analysis and mining, the system provides powerful data support to the decision making, the affairs managing and the public serving. It finally realizes the rationalization, normalization and scientization of disabled person affairs management. It also makes significant contributions to the great-leap-forward development of the informationization of China Disabled Person's Federation.
Giangreco, Michael F
When speech-language pathologists provide educationally related services for students with lowincidence disabilities who are placed in inclusive classrooms, they are asked to work with a variety of other adults. The ways in which these adults make decisions about individualizing a student's educational program, determine related services, and coordinate their activities have an impact on educational outcomes for students as well as on interprofessional interactions. This article summarizes a team process for making related services decisions called VISTA (Vermont Interdependent Services Team Approach) and a series of nine research studies pertaining to the use and impact of VISTA. It also addresses related topics, such as team size, consumer perspectives, and paraprofessional supports. Five major implications from these studies are offered concerning (a) developing a disposition of being an ongoing learner, (b) developing a shared framework among team members, (c) having a research-based process to build consensus, (d) clarifying roles, and (e) increasing involvement of families and general education teachers.
Masood , Tehreem; Cherifi , Chantal; Moalla , Néjib
International audience; Service oriented systems are highly dynamic systems composed of several web services. One of the most important challenges in service oriented systems is to deliver acceptable quality of service. For this purpose, it is required to monitor quality of service along different activities of service oriented system. Existing research focuses on specific activities but do not take into account all the activities of service oriented system together at the infrastructure leve...
Borsci, Simone; Federici, Stefano; Mele, Maria Laura
This book provides the necessary tools for the evaluation of the interaction between the user who is disabled and the computer system that was designed to assist that person. The book creates an evaluation process that is able to assess the user's satisfaction with a developed system. Presenting a new theoretical perspective in the human computer interaction evaluation of disabled persons, it takes into account all of the individuals involved in the evaluation process.
Apdullah Yayık; Yakup Kutlu
This paper aims to develop brain-computer interface system based on electroencephalography that can aid disabled people in daily life. The system relies on one of the most effective event-related potential wave, P300, which can be elicited by oddball paradigm. Developed application has a basic interaction tool that enables disabled people to convey their needs to other people selecting related objects. These objects pseudo-randomly flash in a visual interface on computer screen. The user must...
Full Text Available In what ways might systems thinking be helpful to designers? In the 21st century, the types of project with which designers have become engaged has expanded to include service systems. Service systems are typically composites of mechanisms, organisms, human beings and ecologies. Systems thinking is a perspective with theories, methods and practices that enables transcending disciplinary boundaries. Application of systems thinking in designing a service system can aid in surfacing potential flaws and/or anticipating future breakdowns in functions, structures and/or processes. Designers and systems thinkers should work together to improve the nature of service systems. As a starter set into these conversations, seven conditions are proposed as a starting context. These conditions are presented neither as rigourously defined nor as exhaustive, but as an entry point into future joint engagement.
Manton, K G; Woodbury, M A; Vertrees, J C; Stallard, E
The case mix-adjusted pattern of use of health care services, especially posthospital care, is compared before and after the introduction of Medicare's Prospective Payment System (PPS). The 1982 and 1984 National Long Term Care Surveys (NLTCS) linked to Medicare administrative records 1982-1986 provide health and health service use data for 12-month periods before and after the introduction of PPS. Case-mix differences between pre- and post-periods are controlled by using the Grade of Membership model to identify health groups from the NLTCS data. Differences in timing (e.g., hospital length of stay) were controlled using life table models estimated for each health group, that is, service use patterns pre- and post-PPS are compared within groups. Hospital LOS and admission rates declined post-PPS. Changes in the timing and location of death occurred but, overall, mortality did not increase. Changes in post-acute care service use by elderly, chronically disabled Medicare beneficiaries were observed: home health service use increased overall and among the unmarried disabled population. PPS did not adversely affect quality of care as reflected in mortality or in hospital readmissions. Moreover, the differential use of post-acute care, and changes in hospital LOS by health group, indicate that the system responded, specific to marital status and age, to the severity of needs of chronically disabled persons.
Electricity cannot be stored in significant quantities and requires generation and demand be balanced instantly in order to control the frequency. This means that the electric system must be equipped with specific devices in order to ensure this dynamic balance. Of the services required by the electric system, some are mandatory for the generators, while others are voluntary, these last ones being those supplied under market schemes. On the other hand, the commitment of the Spanish electric system to incorporate a significant volume of renewable energy, due to its intermittent properties, demands that these adjustment services use a greater volume of this energy in order to ensure the reliability of the system at all times. Finally, securing the Iberian electric market implies that there might be variations in these services - not only in the volume but also in their characteristics. (Author)
Hansen, Anca Daniela; Altin, Müfit
The objective of this report is to illustrate and analyse, by means of simulation test cases, the impact of wind power advanced ancillary services, like inertial response (IR), power oscillation damping (POD) and synchronising power (SP) on the power system. Generic models for wind turbine, wind...... power plant and power system are used in the investigation....
Koromilas, A.; Miller, K.; Lamb, T.
Software system permits onsite direct control of logistics operations, which include spare parts, initial installation, tool control, and repairable parts status and control, through all facets of operations. System integrates logistics actions and controls receipts, issues, loans, repairs, fabrications, and modifications and assets in predicting and allocating logistics parts and services effectively.
Williamson, Heather J.; Perkins, Elizabeth A.
Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver…
Zhang, Jiang; Rossello Busquet, Ana; Soler, José
This paper makes three contributions to assist households to control their home devices in an easy way and to simplify the software installation and configuration processes across multi-vendor environments. First, a Home Environment Service Knowledge Management System is proposed, which is based...... on the knowledge implemented by ontology and uses the inference function of reasoner to find out available software services according to household requests. Second, this paper provides a concrete methodology to exploit and acquire conflict-free information from ontology knowledge by using a reasoner. At last......, a strategy of calculating the sequence of service dependency hierarchy is proposed by this paper....
Raynor, Olivia; Hayward, Katharine; Francis, Wilbert; Campisi, Catherine
For several decades, institutions of higher education (IHE) have been addressing the need for postsecondary education (PSE) for students with intellectual disabilities (ID). These efforts have increased significantly since 2008 with passage of the Higher Education Opportunity Act (HEOA). The law includes a defined set of services and activities…
This publication contains self-esteem exercises and a learning disabilities (LD) curriculum for students with LD in adult basic education programs. The 37 student exercises are designed to build the self-esteem of students with LD. They include self-evaluations, profiles, and checklists. Topics covered are success, decision making, problem…
Nixon, Stephanie A; Cameron, Cathy; Hanass-Hancock, Jill; Simwaba, Phillimon; Solomon, Patricia E; Bond, Virginia A; Menon, Anitha; Richardson, Emma; Stevens, Marianne; Zack, Elisse
Introduction Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs), there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. Methods This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Results Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1) disability-related discrimination heightened when seeking HIV services, (2) communication barriers and related concerns with confidentiality, and (3) movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants’ profound concerns about poverty and unmet basic needs. Discussion This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Conclusions Despite the growing body of literature on increased
Nixon, Stephanie A; Cameron, Cathy; Hanass-Hancock, Jill; Simwaba, Phillimon; Solomon, Patricia E; Bond, Virginia A; Menon, Anitha; Richardson, Emma; Stevens, Marianne; Zack, Elisse
Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs), there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1) disability-related discrimination heightened when seeking HIV services, (2) communication barriers and related concerns with confidentiality, and (3) movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants' profound concerns about poverty and unmet basic needs. This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Despite the growing body of literature on increased risk of exposure to HIV among HIV-negative PWDs, this is
AJ Cronin (1896-1981) was a Scottish-born doctor-turned-novelist whose most famous novel is The Citadel, published in 1937. The book describes the struggles of an idealistic young doctor working in Wales and London in the 1920s and 30s. The novel was a global bestseller and its portrayal of a largely ineffective, corruption-ridden system of healthcare is thought to have directly influenced the foundation of the National Health Service in 1948. The Citadel anticipates such phenomena as evidence-based medicine and continuing medical education. This paper argues that the novel was never intended as propaganda for a state-controlled national health service. On the contrary, Cronin was against state control. Analysis of the novel is informed by recent biographical revelations about Cronin and the blurring of the margin between fact and fiction in Cronin\\'s life and work is examined.
AJ Cronin (1896-1981) was a Scottish-born doctor-turned-novelist whose most famous novel is The Citadel, published in 1937. The book describes the struggles of an idealistic young doctor working in Wales and London in the 1920s and 30s. The novel was a global bestseller and its portrayal of a largely ineffective, corruption-ridden system of healthcare is thought to have directly influenced the foundation of the National Health Service in 1948. The Citadel anticipates such phenomena as evidence-based medicine and continuing medical education. This paper argues that the novel was never intended as propaganda for a state-controlled national health service. On the contrary, Cronin was against state control. Analysis of the novel is informed by recent biographical revelations about Cronin and the blurring of the margin between fact and fiction in Cronin\\'s life and work is examined.
Bauer, Sarah E; Schumacher, Jessica R; Hall, Allyson; Marlow, Nicole M; Friedel, Claudia; Scheer, Danielle; Redmon, Susan
Research has not fully characterized barriers to health care faced by persons with disabilities (PWD) which constitutes a critical gap given the increased risk of chronic illness faced by PWD. To understand the current barriers to seeking health care-related services for PWD in Florida. The study was based on a random-digit-dial telephone interview survey of respondents aged 18 and over (n = 1429). Multivariable logistic regression assessed the relationship between disability and physical and communication barriers. One thousand four hundred and twenty-nine Florida residents participated in the survey. Thirty-three percent of respondents (n = 471) reported having a disability. PWD were significantly older (mean age 68 vs. 61) and had lower levels of income and education than persons without disabilities (PWOD) (p barrier (Odds Ratio [OR] = 16.6 95% CI: 7.9, 34.9), a clinical experience barrier (OR = 13.9 95% CI: 6.9, 27.9) a communication and knowledge barrier (OR = 6.7 95% CI: 4.0, 11.3) and a barrier coordinating care (OR = 5.7 95% CI: 3.4, 9.6) compared to persons without disabilities (PWOD). PWD disproportionately face health care access difficulties that can impede the receipt of high quality care within and between provider visits. Efforts to reduce physical barriers and improve communication between providers and PWD may improve functional status and quality of life for these patients. Copyright © 2016 Elsevier Inc. All rights reserved.
Jarrell, D.B.; Zimmerman, P.W.; Gore, M.L.
The Service Water System (SWS) represents the final heat transfer loop between decay heat generated in the nuclear core and the safe dispersal of that heat energy in the environment. It is the objective of this investigation to demonstrate that aging phenomena can be identified and quantified such that aging degradation of system components can be detected and mitigated prior to the reduction of system availability to below an acceptable threshold. The approach used during the Phase I task was to (1) perform a literature search of government and private sector reports which relate to service water, aging related degradation, and potential methodologies for analysis; (2) assemble a data base which contains all the commercial power plants in the US, their Service Water System configuration, characteristics, and water source; (3) obtain and examine the available service water data from large generic data bases, i.e. NPRDS, LER, NPE, inspection reports, and other relevant plant reference data; (4) perform a fault tree analysis of a typical plant service water systems to examine failure propagation and understand specific input requirements of probabilistic risk analyses; (5) develop an in-depth questionnaire protocol for examining the information resource at a power plant which is not available through data base query and visit a central station power plant and solicit the required information; (6) analyze the information obtained from the in-depth plant interrogation and draw contrasts and conclusions with the data base information; (7) utilize the plant information to perform an interim assessment of service water system degradation mechanisms and focus future investigations. This paper addresses the elements of this task plan numbered 1, 3, 6, and 7. The remaining items are detailed in the phase-I report
We have over the past three years been working on the feasibility of Opportunistic Cloud Services (OCS) for enterprises. OCS is about enterprises strategically contributing and utilizing spare IT resources as cloud services. One of the major challenges that such a platform faces is data security...... and trust management issues. This paper presents a trust management system for OCS platforms. It models the concept of trust and applies it to OCS platforms. The trust model and the trust management system are verified through the simulation of the computation of the trust values with Infrastructure...
Gulley, Stephen P; Altman, Barbara M
An overarching question in health policy concerns whether the current mix of public and private health coverage in the United States can be, in one way or another, expanded to include all persons as it does in Canada. As typically high-end consumers of health care services, people with disabilities are key stakeholders to consider in this debate. The risk is that ways to cover more persons may be found only by sacrificing the quantity or quality of care on which people with disabilities so frequently depend. Yet, despite the many comparisons made of Canadian and U.S. health care, few focus directly on the needs of people with disabilities or the uninsured among them in the United States. This research is intended to address these gaps. Given this background, we compare the health care experiences of working-age uninsured and insured Americans with Canadian individuals (all of whom, insured) with a special focus on disability. Two questions for research guide our inquiry: (1) On the basis of disability severity level and health insurance status, are there differences in self-reported measures of access, utilization, satisfaction with, or quality of health care services within or between the United States and Canada? (2) After controlling covariates, when examining each level of disability severity, are there any significant differences in these measures of access, utilization, satisfaction, or quality between U.S. insured and Canadian persons? Cross-sectional data from the Joint Canada/United States Survey of Health (JCUSH) are analyzed with particular attention to disability severity level (none, nonsevere, or severe) among three analytic groups of working age residents (insured Americans, uninsured Americans, and Canadians). Differences in three measures of access, one measure of satisfaction with care, one quality of care measure, and two varieties of physician contacts are compared. Multivariate methods are then used to compare the healthcare experiences of
Harrington, Amanda L; Hirsch, Mark A; Hammond, Flora M; Norton, H James; Bockenek, William L
To determine what percentage of persons with disabilities have a primary care provider, participate in routine screening and health maintenance examinations, and identify perceived physical or physician barriers to receiving care. A total of 344 surveys, consisting of 66 questions, were collected from adults with disabilities receiving care at an outpatient rehabilitation clinic. A total of 89.5% (95% CI 86.3%-92.8%) of participants reported having a primary care physician. Younger persons (P brain injury (P use, and safety with relationships at home ranged from 26.6% to 37.5% compared with screening for depression, diet, exercise, and smoking (64.5%-70%). Completion rates of age- and gender-appropriate health maintenance examinations ranged from 42.4% to 90%. A total of 2.67% of participants reported problems with physical access at their physician's office, and 36.4% (95% CI 30.8%-42.1%) of participants reported having to teach their primary care physician about their disability. Most persons with disabilities have a primary care physician. In general, completion rates for routine screening and health maintenance examinations were high. Perceived deficits in primary care physicians' knowledge of disability issues seem more prevalent than physical barriers to care.
Bye, Amanda; Aston, Megan
Children with intellectual disabilities spend more time in the health-care system than mainstream children. Parents have to learn how to navigate the system by coordinating appointments, understanding the referral process, knowing what services are available, and advocating for those services. This places an incredible amount of responsibility on families. This article is one mother's personal story and reflection about her journey through the Canadian health-care system in Nova Scotia, with her daughter who has an intellectual disability. The reflection identifies moments of tension experienced by a mother and how she was expected to be a medical system navigator, doctor-educator, time manager, and care coordinator and the roles that led to feelings of repression, extreme frustration, and fear. A final discussion offers an analysis of her experience, using concepts from feminist post-structuralism. © The Author(s) 2015.
Kleinberg, I; Scior, K
The impact of staff and service user gender on responses of staff in intellectual disability (ID) services is poorly understood. The present study set out to assess the role of gender in influencing staff emotions, attributions and behavioural intentions in response to aggression displayed by adults with ID. A new scale measuring staff behavioural intentions was developed. A two × two (staff gender × service user gender) between subjects design was used to compare the responses of day and residential support staff to physical aggression by a hypothetical service user. In response to a vignette depicting a service user with ID assaulting a member of staff, 160 respondents completed measures of affective responses, causal attributions and behavioural intentions while imagining themselves as the target of the service user's assault. Female participants reported feeling more fear/anxiety, more depression/anger and less confident/relaxed than male participants. The longer staff had worked with people with ID, the more likely they were to favour safety-focused behaviours. More confident female participants were less likely to favour safety-focused behaviours, but confidence had no effect on male participants' endorsement of these behaviours. Increased confidence in both was associated with lower agreement of safety-focused behaviours in relation to the female vignette, regardless of participant gender. The more control women believed the service user had over their behaviour, the more likely they were to choose safety-focused behaviours. Punitive behaviours were favoured more in response to the male rather than the female service user. Punitive behaviours were also favoured more by more junior staff and by participants who expected feeling more depressed/angry in response to the vignettes. Both staff and service user gender influenced staff responses to aggression, yet the latter played a smaller role than expected. The role of gender in staff-service user
Gutenbrunner, Christoph; Nugraha, Boya
Strengthening of health-related rehabilitation services must start from the needs of persons with health conditions experiencing disability and should be implemented within health systems. The implementation of rehabilitation services in health systems should be planned and realized according to the World Health Organization's 6 constituents of health systems (i.e. health service delivery; health workforce; health information systems; essential medicines; financing; and leadership and governance). The development of recommendations based on situation analysis and best-available data is crucial. In order to facilitate such data collection at a national level, a checklist and a related questionnaire (Rehabilitation Service Assessment Tool (RSAT)) were developed and implemented. The following steps were followed to develop a checklist for implementation of rehabilitation services: a literature search, drafting, checking and testing the list, and development of the RSAT. The RSAT comprises 8 sections derived from 5 main domains of the most important areas of information (i.e. country profile; health system; disability and rehabilitation; national policies, laws, and responsibilities; and relevant non-governmental stakeholders). The implementation of RSAT in different missions has shown that the principles are working well and that RSAT is feasible and helpful. Further field testing is important and the development of an internationally agreed tool should be promoted.
Full Text Available Objective: Strengthening of health-related rehabilitation services must start from the needs of persons with health conditions experiencing disability and should be implemented within health systems. The implementation of rehabilitation services in health systems should be planned and realized according to the World Health Organization’s 6 constituents of health systems (i.e. health service delivery; health workforce; health information systems; essential medicines; financing; and leadership and governance. The development of recommendations based on situation analysis and best-available data is crucial. Methods: In order to facilitate such data collection at a national level, a checklist and a related questionnaire (Rehabilitation Service Assessment Tool (RSAT were developed and implemented. The following steps were followed to develop a checklist for implementation of rehabilitation services: a literature search, drafting, checking and testing the list, and development of the RSAT. Results: The RSAT comprises 8 sections derived from 5 main domains of the most important areas of information (i.e. country profile; health system; disability and rehabilitation; national policies, laws, and responsibilities; and relevant non-governmental stakeholders. Conclusion: The implementation of RSAT in different missions has shown that the principles are working well and that RSAT is feasible and helpful. Further field testing is important and the development of an internationally agreed tool should be promoted.
Whitford, David L
BACKGROUND: There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. METHODS\\/DESIGN: In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. DISCUSSION: The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more
Katz, Gregorio; Márquez-Caraveo, Maria E; Lazcano-Ponce, Eduardo
Intellectual disability is a public health issue, which has largely been overlooked in Mexico. The magnitude of this problem is unknown; few programs exist for adults and mental health professionals focus mainly on identifying treatable comorbidities. In Mexico, there is an example of a best practice in social integration. This program has benefited hundreds of adults with intellectual disability by teaching four basic abilities: practical academic skills; vocational skills; independent living skills; and skills for community integration. In a sociocultural and economic context such as Mexico's, social integration programs are feasible and necessary in order to provide an organized social response to the health, social, and vocational needs of people with intellectual disability and should become part of public policy.
Lee, S.; Pan, L.; Zhai, C.; Tang, B.; Kubar, T. L.; Li, J.; Zhang, J.; Wang, W.
Both the National Research Council Decadal Survey and the latest Intergovernmental Panel on Climate Change Assessment Report stressed the need for the comprehensive and innovative evaluation of climate models with the synergistic use of global satellite observations in order to improve our weather and climate simulation and prediction capabilities. The abundance of satellite observations for fundamental climate parameters and the availability of coordinated model outputs from CMIP5 for the same parameters offer a great opportunity to understand and diagnose model biases in climate models. In addition, the Obs4MIPs efforts have created several key global observational datasets that are readily usable for model evaluations. However, a model diagnostic evaluation process requires physics-based multi-variable comparisons that typically involve large-volume and heterogeneous datasets, making them both computationally- and data-intensive. In response, we have developed a novel methodology to diagnose model biases in contemporary climate models and implementing the methodology as a web-service based, cloud-enabled, provenance-supported climate-model evaluation system. The evaluation system is named Climate Model Diagnostic Analyzer (CMDA), which is the product of the research and technology development investments of several current and past NASA ROSES programs. The current technologies and infrastructure of CMDA are designed and selected to address several technical challenges that the Earth science modeling and model analysis community faces in evaluating and diagnosing climate models. In particular, we have three key technology components: (1) diagnostic analysis methodology; (2) web-service based, cloud-enabled technology; (3) provenance-supported technology. The diagnostic analysis methodology includes random forest feature importance ranking, conditional probability distribution function, conditional sampling, and time-lagged correlation map. We have implemented the
Murphy, A P
Facial trauma is a commonly encountered presentation to emergency departments. When associated airway compromise occurs, co-existing head and neck injuries serve to produce a challenging clinical situation. We describe two patients who suffered multi-system trauma, with severe maxillofacial injuries that necessitated prompt definitive airway management and mid-face stabilisation in the pre-hospital and emergency department phases of resuscitation. The McKesson prop is a simple yet highly effective tool for use in these injuries.
Frasincar, F.; Houben, G.J.P.M.; Barna, P.; Vasilecas, O.; Eder, J.; Caplinskas, A.
Hera is a model-driven methodology for designing Web information systems. In the past a CASE tool for the Hera methodology was implemented. This software had different components that together form one centralized application. In this paper, we present a distributed Web service-oriented architecture
Sampson, Demetrios G.
The need for designing the next generation of web service-based educational systems with the ability of integrating components from different tools and platforms is now recognised as the major challenge in advanced learning technologies. In this paper, we discuss this issue and we present the conceptual design of such environment, referred to as…
Romanenko, A.G.; Todeschini, C.
Development of the bibliographic data base covering the world-wide nuclear science literature is described along with the network arrangements by which the data base and associated services are made available. The consequences of the system's decentralized operating philosophy are also addressed. (U.K.)
Fisch, Clifford B.; Fisch, Martin L.
The Stanley S. Lamm Institute for Developmental Disabilities of The Long Island College Hospital, in conjunction with Micro-Med Systems has developed a low cost micro-computer based information system (ADDOP TRS) which monitors quality of care in outpatient settings rendering services to the developmentally disabled population. The process of conversion from paper record keeping systems to direct key-to-disk data capture at the point of service delivery is described. Data elements of the information system including identifying patient information, coded and English-grammar entry procedures for tracking elements of service as well as their delivery status are described. Project evaluation criteria are defined including improved quality of care, improved productivity for clerical and professional staff and enhanced decision making capability. These criteria are achieved in a cost effective manner as a function of more efficient information flow. Administrative applications including staff/budgeting procedures, submissions for third party reimbursement and case reporting to utilization review committees are considered.
A smart electric power distribution system (FREEDM system) that incorporates DERs (Distributed Energy Resources), SSTs (Solid State Transformers - that can limit the fault current to two times of the rated current) & RSC (Reliable & Secure Communication) capabilities has been studied in this work in order to develop its appropriate protection & service restoration techniques. First, a solution is proposed that can make conventional protective devices be able to provide effective protection for FREEDM systems. Results show that although this scheme can provide required protection but it can be quite slow. Using the FREEDM system's communication capabilities, a communication assisted Overcurrent (O/C) protection scheme is proposed & results show that by using communication (blocking signals) very fast operating times are achieved thereby, mitigating the problem of conventional O/C scheme. Using the FREEDM System's DGI (Distributed Grid Intelligence) capability, an automated FLISR (Fault Location, Isolation & Service Restoration) scheme is proposed that is based on the concept of 'software agents' & uses lesser data (than conventional centralized approaches). Test results illustrated that this scheme is able to provide a global optimal system reconfiguration for service restoration.
Abstract Background In this paper, we give an overview of methadone treatment in Ireland and outline the rationale for designing an electronic health record (EHR) with extensibility, interoperability and decision support functionality. Incorporating several international standards, a conceptual model applying a problem orientated approach in a hierarchical structure has been proposed for building the EHR. Methods A set of archetypes has been designed in line with the current best practice and clinical guidelines which guide the information-gathering process. A web-based data entry system has been implemented, incorporating elements of the paper-based prescription form, while at the same time facilitating the decision support function. Results The use of archetypes was found to capture the ever changing requirements in the healthcare domain and externalises them in constrained data structures. The solution is extensible enabling the EHR to cover medicine management in general as per the programme of the HRB Centre for Primary Care Research. Conclusions The data collected via this Irish system can be aggregated into a larger dataset, if necessary, for analysis and evidence-gathering, since we adopted the openEHR standard. It will be later extended to include the functionalities of prescribing drugs other than methadone along with the research agenda at the HRB Centre for Primary Care Research in Ireland.
Maria Dorina PASCA
Full Text Available For people with disabilities, to find a way to improve life quality by having a job and by developing independent living skills is a “sine qua non” condition for their social integration. The social mediator working within a disability employment support system facilitates the logistic implementation of a viable and plausible program, which can identify, and maintain a workplace for people with disabilities, and acts as a motivational guarantee of these persons’ chance for a better life while also providing life lessons to all of us. Hence, the major role of the social mediator is to develop a new cognitive structure of communication for disabled people so that they can act as our equals and not as marginalized human beings.
Lin, Sue C; Gold, Robert S
Assistive technology (AT) enhances the ability of individuals with disabilities to be fully engaged in activities at home, at school, and within their communities-especially for children with developmental disabilities (DD) with physical, sensory, learning, and/or communication impairments. The prevalence of children with DD in the United States has risen from 12.84% in 1997 to 15.04% in 2008. Thus, it is important to monitor the status of their AT needs, functional difficulties, services utilization, and coordination. Using data from the 2009-2010 National Survey on Children with Special Health Care Needs (NS-CSHCN), we conducted bivariate and multivariate statistical analysis, which found that 90% or more of parents of both children with DD and other CSHCN reported that their child's AT needs were met for vision, hearing, mobility, communication, and durable medical equipment; furthermore, children with DD had lower odds of AT needs met for vision and hearing and increased odds for meeting AT needs in mobility and communication. Our findings outline the current AT needs of children with DD nationally. Fulfilling these needs has the potential to engender positive lifelong effects on the child's disabilities, sense of independence, self-confidence, and productivity.
Full Text Available The author analyzes the current Croatian regulation of movement within the local and regional civil service system. This includes the institutes of transfer, promotion, appointment and removal of the heads of administrative bodies, as well as changes in the workplace that may occur in the process of reorganization of the administrative bodies, with additional references to the particularities related to the position of heads of administrative bodies and employees. The procedural context of these issues, related to the implementation of administrative procedure and administrative dispute, is also discussed. The author offers legal interpretation to resolve doubts arising in the practice of implementation of the mentioned civil service institutes.
Fesko, Sheila Lynch; Hall, Allison Cohen; Quinlan, Jerrilyn; Jockell, Catherine
As individuals with intellectual and developmental disabilities become more engaged in community employment, it will be critical to consider how their employment experience changes as they age. Similar to other seniors, individuals will need to consider whether they want to maintain their employment, reduce their work commitment, or retire…
Mallik, Kalisankar; Yuspeh, Sheldon
A 1-year demonstration project involving 24 developmentally disabled students (9- to 20-years-old) with severe physical limitations was conducted to increase their educational and vocational possibilities by using cost-effective bio-engineering techniques to modify their physical environment and develop improved adaptive devices. Phase I of the…
McMorris, Carly A.; Weiss, Jonathan A.; Cappelletti, Gabriella; Lunsky, Yona
Carers of individuals with an intellectual disability are often responsible for managing their children's psychiatric crises when they arise. The purpose of this study was to examine the experiences of families using crisis and short-term transitional supports from the perspectives of families and of crisis and transitional support staff. Three…
Hatton, Chris; Wigham, Sarah; Craig, Jaime
Background: There is an absence of research concerning the assessment of housing support worker job performance, particularly in the development of job performance measures that reflect the priorities of people with intellectual disabilities and their families. Method: A worker-oriented job analysis method was used to develop four short job…
Miller, Maury; Gresham, Pamela
The search for "markers", or indicators of learning disabilities, has shown that teachers can be good indicators, but literature has not shown which markers or indicators are most noticed or receiving most of teachers' attention. This investigation asked preservice teachers to describe their own first memories of students with learning…
Swift, Charlotte; Waites, Erin; Goodman, Wendy
Background: Domestic violence abuse (DVA) has been identified by the UK Government as a priority to address. Whilst there is a growing body of research into perpetrators of DVA from the mainstream population, there is scant research into perpetrators of DVA who have an intellectual disability. This lack of an evidence base suggests there may be a…
McCarron, Mary; O'Dwyer, Marie; Burke, Eilish; McGlinchey, Eimear; McCallion, Philip
There are limited studies on the prevalence of epilepsy and co-morbid conditions in older adults with an ID. To begin to address this prevalence of epilepsy was estimated for participants in the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing. Associations with demographic variables and co morbid health conditions were…
Merineau-Cote, J.; Morin, D.
Background: Some individuals with intellectual disabilities (IDs) exhibit aggressive behaviour directed towards themselves, others or the environment. Displaying aggressive behaviour is associated with a number of negative consequences such as the exposure to restrictive interventions. This study aims to identify personal and environmental factors…
Hilton, Alan; Gerlach, Kent
Presents a position statement of the Board of Directors of the Division on Mental Retardation and Developmental Disabilities that reviews the employment, preparation, and management of paraeducators. The statement addresses role definition, employment and management, legal and ethical responsibilities, job descriptions, paraeducator training, and…
Ingham, Barry; Riley, Jenny; Nevin, Helen; Evans, Gemma; Gair, Elodie
The emotional responses to challenging behaviour of direct care staff who support people with intellectual disabilities is thought to be an important mediating factor within the stress experienced by staff and a potential maintaining factor in challenging behaviour. A brief workshop to improve direct care staff resilience was developed and…
Yamaki, Kiyoshi; Wing, Coady; Mitchell, Dale; Owen, Randall; Heller, Tamar
States have increasingly transitioned Medicaid enrollees with disabilities from fee-for-service (FFS) to Medicaid Managed Care (MMC), intending to reduce state Medicaid spending and to provide better access to health services. Yet, previous studies on the impact of MMC are limited and findings are inconsistent. We analyzed the impact of MMC on…
Butterly, Felicity; Percy, Carol; Ward, Gillian
The aim of this study was to identify the outcomes expected and assessed by those providing service dogs to children with developmental disabilities. Seventeen registered service dog providers were invited to complete a mixed methods online survey. Five providers, who prepared dogs to work with a wide range of conditions and behaviours, mainly…
Wilhelm, Gretchen Marie
This study examined the perceived value of academic support service types for post-secondary students with learning disabilities in the Christian higher education milieu. Grounded in a model of service utilization (Pescosolido, 1992), the research methodology applied in this study addressed the following research question: What is the perceived…
Lin, Jin-Ding; Hsu, Shang-Wei; Yen, Chia-Feng; Chou, Ying-Ting; Wu, Chia-Ling; Chu, Cordia M.; Loh, Ching-Hui
Aims: The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan. Methods: The study employed a cross-sectional design and was…
Flanagan, J M
Classical or transferase-deficient galactosaemia is an inherited metabolic disorder caused by mutation in the human Galactose-1-phosphate uridyl transferase (GALT) gene. Of some 170 causative mutations reported, fewer than 10% are observed in more than one geographic region or ethnic group. To better understand the population history of the common GALT mutations, we have established a haplotyping system for the GALT locus incorporating eight single nucleotide polymorphisms and three short tandem repeat markers. We analysed haplotypes associated with the three most frequent GALT gene mutations, Q188R, K285N and Duarte-2 (D2), and estimated their age. Haplotype diversity, in conjunction with measures of genetic diversity and of linkage disequilibrium, indicated that Q188R and K285N are European mutations. The Q188R mutation arose in central Europe within the last 20 000 years, with its observed east-west cline of increasing relative allele frequency possibly being due to population expansion during the re-colonization of Europe by Homo sapiens in the Mesolithic age. K285N was found to be a younger mutation that originated in Eastern Europe and is probably more geographically restricted as it arose after all major European population expansions. The D2 variant was found to be an ancient mutation that originated before the expansion of Homo sapiens out of Africa.
Abstract Service providers and service users often have different perspectives on health and social care services. We have undertaken a systematic review of empirical data between 1988 and March 2011 relating to ALS service users\\' perspectives on health and social care services. Forty-seven texts were extracted and a narrative synthesis conducted. Few studies have explored ALS patients\\' experiences in relation to their satisfaction with services. Our review showed that ALS patients expect dignified care but they are often dissatisfied with health care services and have unmet expectations of their care. Most studies of decision-making and preferences for care have focused on end-of-life intervention. Various factors influence preferences for care from the service user perspective and people with ALS may adjust their use of services as they negotiate change. In conclusion, further research on the timeliness of services to meet changing needs of service users is required. The service user experience of allied health care services prior to end-of-life care also warrants investigation. Service providers need to support people with ALS as they negotiate feelings of acceptance and independence. Research to identify the key parameters of the ALS patient experience of services is required.
Touzet, Rodolfo; Pittaluga, Roberto R.
The implementation of a Quality system is an indispensable requirement to assure the protection and the radiological safety, especially in those facilities where the potential risks are important. One of the 'general conclusions' of the Conference of Malaga (to achieve the RPP) is also the implementation of quality systems. Lamentably the great majority of the Services of Health in the world, more than 95 %, has not nowadays any formal quality system but only any elements what can be named a 'natural quality system' that includes protocols of work, records of several processes, certified of training of the personnel and diverse practices that are realized in systematic form but that not always are documented. Most health services do not have the necessary means available to adhere quickly to international standards. At the same time the health services do not have either qualified or trained personnel to lead a certification or accreditation project and most of them do not have the resources available to hire external consultants, especially the public hospitals. The scenario described represents a challenge for the Regulatory Authorities who must determine 'how to ensure that installations comply with an acceptable standard of quality without it placing an impossible strain on their budget?' Due to these circumstances a 'Basic Guide' has developed for the implementation of a quality system in every Health Service that takes the elements as a foundation of the standard ISO - 9000:2000 and the standard for systems management GSR-3 of the IAEA. The criteria and the methodologies are showed in the presentation. (author)
Maruyama, Yukio; Mizuno, Hiromi; Shoda, Kohei; Sekine, Yasuhiro.
For the purpose of improving the intelligent productivity in offices, the introduction of PC-LAN system by the initiative of users has been advanced. In this example, by connecting many personal computers, the information service system that possesses the information on the business of power stations in common was constructed, and intelligent productivity was improved. This information service system is that in which all users are the sponsor as the users and the offerer of information are united, therefore, high conscience level is required for individual users, and the attentive device for the easiness of use was exercised so as to always maintain newest information. The background of introducing this system is explained. The information systems in power stations are the system related to operation control, preventive maintenance and so on and the system for helping the routine works of personnel. The main functions are the offer of the operational data of power stations, the offer of the information on the expected visitors to the PR hall of nuclear power stations, electronic information exchange and so on. The constitution and the features of the system are reported. (K.I.)
Del Val, Lara; Jiménez, María I.; Alonso, Alonso; de La Rosa, Ramón; Izquierdo, Alberto; Carrera, Albano
Disabled people already profit from a lot of technical assistance that improves their quality of life. This article presents a system which will allow interaction between a physically disabled person and his environment. This system is controlled by voluntary muscular movements, particularly those of face muscles. These movements will be translated into machine-understandable instructions, and they will be sent by means of a wireless link to a mobile robot that will execute them. Robot includes a video camera, in order to show the user the environment of the route that the robot follows. This system gives a greater personal autonomy to people with reduced mobility.
Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott
The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to
Ikeda, Kazunari; Hashimoto, Souichi; Hayashi, Akiko; Kanno, Atsushi
Auditory sensory memory stage can be functionally divided into two subsystems; transient-detector system and permanent feature-detector system (Naatanen, 1992). We assessed these systems in persons with intellectual disability by measuring event-related potentials (ERPs) N1 and mismatch negativity (MMN), which reflect the two auditory subsystems, respectively. Added to these, P3a (an ERP reflecting stage after sensory memory) was evaluated. Either synthesized vowels or simple tones were delivered during a passive oddball paradigm to adults with and without intellectual disability. ERPs were recorded from midline scalp sites (Fz, Cz, and Pz). Relative to control group, participants with the disability exhibited greater N1 latency and less MMN amplitude. The results for N1 amplitude and MMN latency were basically comparable between both groups. IQ scores in participants with the disability revealed no significant relation with N1 and MMN measures, whereas the IQ scores tended to increase significantly as P3a latency reduced. These outcomes suggest that persons with intellectual disability might own discrete malfunctions for the two detector systems in auditory sensory-memory stage. Moreover, the processes following sensory memory might be partly related to a determinant of mental development.
Smith, Diane L
In 2011, about 1.8 million or 8 percent of the 22.2 million veterans were women in the US. The unemployment rate for female veterans of the wars in Iraq and Afghanistan rose to 13.5%, above the 8.4% for non-veteran adult women. To examine data from the Behavioral Risk Factor Surveillance System (BRFSS), from 2004-2011 to determine the relationship between employment and veteran status, disability and gender. Chi square analysis was used to determine if significant differences existed between the employment rate of female veterans with disabilities and female veterans without disabilities, female non-veterans with disabilities and male veterans with disabilities. Binomial logistic regression analysis was used to determine how veteran status, disability and gender affected the likelihood of not being employed. Significant differences were found in employment rate between female veterans with disabilities and female veterans without disabilities, but not when compared to female non-veterans with disabilities or male veterans with disabilities. Disability was the strongest factor increasing the likelihood of not being employed, though veteran status and female gender were also predictive. Female veterans with disabilities experience low levels of employment. Policies and programs are needed to address the unique needs of these veterans.
Full Text Available Disability is a complex phenomenon. It reflects an interaction between features of a person’s body and features of the society in which he or she lives. International Classification of Functioning, Disability and Health (ICF, lays stress on the functional as well as the structural problem of a person. All the definitions of disability also include the disorders of the reproductive and endocrine system. So infertility and impotency should also be included in the category of disability. It affects the participation in areas of life and can have a disabling affect on an individual. Like any other disability the couple has to adapt and integrate infertility in their sense of self thus infertility comes as a major life crisis. Medically, infertility, in most cases, is considered to be the result of a physical impairment or a genetic abnormality. Socially, couples are incapable of their reproductive or parental roles. On social level, infertility in most cultures remains associated with social stigma and taboo just like the social model of disability. Couples who are unable to reproduce may be looked down upon due to social stigmatisation. Infertility can lead to divorces and separation leading to a broken family life. Without labelling infertility as a disability, it is difficult for the people to access services and welfare benefits offered by the government. Infertility treatments are highly sophisticated so they are very expensive and are even not covered by insurance and government aid.In the light of all this it becomes imperative to categorise infertility as disability.
Eklund, Mona; Eklund, Lisa
Day centres can prepare for open-market employment, and attendees' work motivation is key in this. Adopting a gender perspective, this study investigated (1) motivation for day centre attendance, satisfaction with the day centre services, number of hours spent there, and number and type of occupations performed; and (2) whether those factors were related with motivation for open-market employment. Women (n = 164) and men (n = 160) with psychiatric disabilities completed self-report questionnaires. There were no gender differences regarding satisfaction with the day centre services or number of hours spent there, but women engaged in more occupations. More women than men performed externally-oriented services and textile work, while men were in the majority in workshops. Externally oriented services, working in workshops, and low satisfaction with the day centre services were associated with higher motivation for employment. Women and men were equally motivated for employment. Women scored higher on motivation for attending the day centre, something that may deter transition into open-market employment. For men, less motivation for attending day centres may reduce their possibilities of gaining skills that can facilitate transitioning to open-market employment. Thus, the possibility for transitioning from day centre activities to open-market employment may be gendered.
Tomasone, Jennifer R; Arbour-Nicitopoulos, Kelly P; Pila, Eva; Lamontagne, Marie-Eve; Cummings, Isabelle; Latimer-Cheung, Amy E; Routhier, François
In Canada, two counseling services are offered to facilitate physical activity participation among persons with physical disabilities, yet both have encountered concerns related to the recruitment and retainment of clients. The purpose of this paper is to explore factors related to service adoption among nonusers, and the barriers and facilitators to maintaining service participation among adopters. Individuals who had never enrolled in the services (nonusers, n = 13) as well as current/previous service clients (adopters, n = 26) participated in interviews based on the Theoretical Domains Framework. Transcripts were subjected to deductive thematic analysis according to participant group. Fifteen themes relating to service adoption within 10 of the 12 theoretical domains were identified for nonusers, while 23 themes relating to maintenence of service participation were identified across all 12 theoretical domains for adopters. The findings provide strategies to improve recruitment, adoption, and retention of clients in counseling services and to enhance the experiences of targeted service users. Implications for Rehabiliation Peer support and education for equipment use should be built into physical activity programs to encourage participation among persons with physical disabilities. Programs that encourage physical activity among individuals with disabilities should be designed by practitioners to be responsive to a variety of needs, which are addressed in the program's advertisements and offerings. The Theoretical Domains Framework is a useful framework for providing valuable insight about clients' experiences of adoption and maintenance of a behavior change service, suggesting merit in other rehabilitation settings.
... there is a need for special education and related services for a child, as early as the child's third... special education and these related services: (1) Audiology services, including identification of children... supervised students in such fields as child development, special education, child psychology, various...
Malik, Kulsoom Jawaid; Unwin, Gemma; Larkin, Michael; Kroese, Biza Stenfert; Rose, John
Carers and service users with intellectual disabilities from minority ethnic groups have typically been reported to be dissatisfied with the social care services they receive. However, service users themselves have rarely been asked directly about their experiences of social care. This paper aims to understand the meaning of social care services in the lives of South Asian women with intellectual disabilities, in the United Kingdom. 10 British South Asian women with mild-moderate intellectual disabilities were interviewed about their experiences of social care services. The transcripts were analysed using interpretative phenomenological analysis. The analysis produced three super-ordinate themes, which focus on how services facilitate the development of complex identities, how the participants explored their sense of being 'stuck' between cultures as they negotiated their journeys towards independence, and the triple disadvantage which they experienced as a consequence of the intersection between gender, ethnicity and disability. The participants were broadly satisfied with the role which services played in these domains, and appeared to find them valuable and helpful. The results suggest that the participants successfully managed complex identity issues, such as acculturation processes, with the support of services. It may be helpful to give more explicit consideration to the positive role which good services can play in supporting people with intellectual disabilities in the development of their identities and goals, alongside the more traditionally 'concrete' objectives of such social care. Engagement with families in 'positive risk-taking' is likely to be an important component of success. Copyright © 2017 Elsevier Ltd. All rights reserved.
Reppermund, Simone; Srasuebkul, Preeyaporn; Heintze, Theresa; Reeve, Rebecca; Dean, Kimberlie; Emerson, Eric; Coyne, David; Snoyman, Phillip; Baldry, Eileen; Dowse, Leanne; Szanto, Tracey; Sara, Grant; Florio, Tony; Trollor, Julian N
People with intellectual disability are a minority group who experience poorer physical and mental health than the general population and have difficulty accessing healthcare services. There is lack of knowledge about healthcare service needs and gaps experienced by people with intellectual disability. This study aims to interrogate a large linked administrative data set containing hospital admissions, presentations to emergency departments (ED) and mortality data to provide evidence to inform the development of improved health and mental health services for this population. A retrospective cohort of people with intellectual disability (n=51 452) from New South Wales (NSW), Australia, to explore health and mental health profiles, mortality, pattern of health service use and associated costs between 2005 and 2013. The cohort is drawn from: the Disability Services Minimum Data Set; Admitted Patients Data Collection; Emergency Department Data Collection, Australian Bureau of Statistics Death Registry and Registry of Births, Deaths and Marriages. Mental health service usage among those with intellectual disability will be compared to a cohort of people who used mental health services (n=1 073 139) and service usage other than for mental health will be compared with published data from the general population. The median age of the cohort was 24 at the time of the last hospital admission and 21 at the last ED presentation. The cohort has a higher proportion of men than women and accounts for 0.6% of the NSW population in 2011. Over 70% had up to 5 ED presentations and hospitalisations between 2005 and 2012. A high proportion of people with intellectual disability live in the most disadvantaged neighbourhoods. Results will be used to inform the development of more responsive healthcare, including improved interactions between health, social and disability supports. More generally, the results will assist the development of more inclusive policy frameworks for people
Tailoring the delivery of disability services to the preferences and requirements of service users allows for more effective partnerships. The aim of this research was to explore parents' perceptions and the expectations of their child's speech-language pathology (SLP) within an intellectual disability service. Parents of school-aged children with intellectual disability who received a SLP service in Ireland participated in the research: 17 parents participated in focus groups and 103 parents answered questionnaires. The core themes from the focus groups, which subsequently informed the questionnaire design, were: experience of the SLP service, communication difficulties, expectations of the SLP service, and future developments. The key questionnaire results indicated that parents viewed their SLP as the "expert" and viewed school-based and clinic-based services differently. Parents were more likely to believe that their child would always need therapy if they received a school-based service. Whereas, parents were more likely to think that their child's speech was improving as they got older and were more likely to be aware of therapy activities if therapy was clinic-based. The findings have implications for the delivery of SLP services suggesting that clarification of parents' roles and expectations are required.
Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire
This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with Special Health Care Needs was utilized to examine the association between child's special needs condition and three outcomes (N = 18,136): access to services (difficulty using services, difficulty getting referrals, lack of source of care, and inadequate insurance coverage), quality of care (lack of care coordination, lack of shared decision making, and no routine screening), and family impact (financial, employment, and time-related burden). Multivariate logistic regressions were performed to compare caregivers of children with autism spectrum disorders to caregivers of children with developmental disabilities (cerebral palsy, Down syndrome, developmental delay, or intellectual disability), mental health conditions (attention deficit hyperactivity disorder, anxiety, behavioral/conduct problems, or depression), or both developmental disabilities and mental health conditions. Caregivers of children with autism spectrum disorders were significantly more likely to report difficulty using services, lack of source of care, inadequate insurance coverage, lack of shared decision making and care coordination, and adverse family impact as compared to caregivers of children with developmental disabilities, mental health conditions, or both. © The Author(s) 2013.
Full Text Available Abstract Background Patient reported outcome measures (PROMs are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated stakeholder views on the accessibility and use of PROMs to develop suggestions for more inclusive practice. Methods Taking PROMs recommended for chronic obstructive pulmonary disease (COPD as an example, we conducted 8 interviews with people with low literacy skills and/or learning disabilities, and 4 focus groups with 20 health professionals and people with COPD. Discussions covered the format and delivery of PROMs using the EQ-5D and St George Respiratory Questionnaire as prompts. Thematic framework analysis focused on three main themes: Accessibility, Ease of Use, and Contextual factors. Results Accessibility included issues concerning the questionnaire format, and suggestions for improvement included larger font sizes and more white space. Ease of Use included discussion about PROMs’ administration. While health professionals suggested PROMs could be completed in waiting rooms, patients preferred settings with more privacy and where they could access help from people they know. Contextual Factors included other challenges and wider issues associated with completing PROMs. While health professionals highlighted difficulties created by the system in managing patients with low literacy/learning disabilities, patient participants stressed that understanding the purpose of PROMs was important to reduce intimidation. Conclusions Adjusting PROMs’ format, giving an explicit choice of where patients can complete them, and clearly conveying PROMs’ purpose and benefit to patients may help to prevent inequality when using PROMs in health services.
Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl
This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. Population based-survey with a nested case-control study. Morropon, a semiurban district located in Piura, northern Peru. For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case-control study, only one participant, case or control, per household was included in the study. Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a
Jetha, Arif; Pransky, Glenn; Fish, Jon; Hettinger, Lawrence J.
Background Return-to-work (RTW) within a complex organizational system can be associated with suboptimal outcomes. Purpose To apply a sociotechnical systems perspective to investigate complexity in RTW; to utilize system dynamics modeling (SDM) to examine how feedback relationships between individual, psychosocial, and organizational factors make up the work disability system and influence RTW. Methods SDMs were developed within two companies. Thirty stakeholders including senior managers, an...
Full Text Available This article focusses on the borderland between "work" and "not work" in UK disability benefit systems. People who claim disability benefits often have to prove that they are "incapable of work" in order to qualify. The idea of incapacity for work requires an understanding of the meaning of the term "work," a concept which has a common sense simplicity but which is much more difficult to define in practice. UK disability benefit systems have developed the notion of "permitted work" to allow people to do small amounts of paid work while retaining entitlement to benefit. This concept of "permitted work" has its roots in the early twentieth century when claimants were sometimes entitled to disability benefits if any work that they did was considered to be sufficiently trivial to not count as "work." Policy on this changed over time, with particular developments after the Second World War, as rehabilitation and therapy became the key focus of permitted work rules. Current developments in UK social security policy treat almost everyone as a potential worker, changing the way in which permitted work operates. This article uses archive material on appeals against refusals of benefit, policy documents and case law to consider the social meanings of these moving boundaries of permitted work. Disability benefits are not value neutral: they are measures of social control which divide benefit claimants into those who are required to participate in the labour market and those who are exempted from this requirement.
Hummel, W.; Beck, H.J.
AREVA NP Fuel Services have many years of experience in visual examination and measurements on fuel assemblies and associated core components by using state of the art cameras and measuring technologies. The used techniques allow the surface and dimensional characterization of materials and shapes by visual examination. New enhanced and sophisticated technologies for fuel services f. e. are two shielded color camera systems for use under water and close inspection of a fuel assembly. Nowadays the market requirements for detecting and characterization of small defects (lower than the 10th of one mm) or cracks and analyzing surface appearances on an irradiated fuel rod cladding or fuel assembly structure parts have increased. Therefore it is common practice to use movie cameras with higher resolution. The radiation resistance of high resolution CCD cameras is in general very low and it is not possible to use them unshielded close to a fuel assembly. By extending the camera with a mirror system and shielding around the sensitive parts, the movie camera can be utilized for fuel assembly inspection. AREVA NP Fuel Services is now equipped with such kind of movie cameras. (orig.)
Full Text Available Question: What are the experiences of Indigenous children with physical disability and their carers of their community-based physiotherapy service? What factors influence their experiences of the physiotherapy service and how could the service be improved? Design: A qualitative study using in-depth, semi-structured open-ended interviews consistent with the researchers’ interpretivist perspectives and ethical principles of Indigenous health research. Interviews were audio recorded, transcribed and coded for themes with qualitative research software using inductive analysis. The interviews were then checked for transcription accuracy and the themes were confirmed with the participants. Participants: Nine parents and foster carers of children with physical disability aged 0 to 21 years, five children and youth with physical disability aged 8 to 21 years. Results: The data generated three themes, which informed practice recommendations: carers of children with physical disability experience increased demands and complexity in their lives; relationships involving caring, consistency and communication are important to consumers using the physiotherapy service; and being Indigenous influences consumers’ experiences in ways that may not be obvious to non-Indigenous service providers. The issue of communication underpinned the participants’ experiences throughout these themes. Conclusion: The research highlighted the importance of effective communication, developing relationships, viewing the child wholistically and recognising the influence of being Indigenous on clients’ healthcare needs and experiences. The results suggested that community-based physiotherapists adopt a family/person-centred, context-specific approach when working with Indigenous children with a physical disability and their carers. [Greenstein C, Lowell A, Thomas D (2016 Communication and context are important to Indigenous children with physical disability and their carers
Hollederer, A; Wildner, M
There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.
Services are becoming a key focus in the current era. Organizations globally are facing rapid changes in providing services. Despite this alarming growth, the advancement in Information and Communications Technology (ICT) has created so many opportunities but considerable challenges for the service industry. Information and Communication Technologies (ICT) have become part of everyday life in recent years. ICT can provide dignity and well-being to people through self-facilitation. ICT lik...
... About CDC.gov . Disability & Health Home Disability Overview Disability Inclusion Barriers to Inclusion Inclusion Strategies Inclusion in Programs & Activities Resources Healthy Living Disability & Physical Activity Disability & Obesity Disability & Smoking Disability & Breast ...
Hirpara, Kieran Michael
Cervical spondylosis is a common and disabling condition. It is generally felt that the initial management should be nonoperative, and these modalities include physiotherapy, analgesia and selective nerve root injections. Surgery should be reserved for moderate to severe myelopathy patients who have failed a period of conservative treatment and patients whose symptoms are not adequately controlled by nonoperative means. A review of the literature supporting various modalities of conservative management is presented, and it is concluded that although effective, nonoperative treatment is labour intensive, requiring regular review and careful selection of medications and physical therapy on a case by case basis.
Smith, Madison; Wilder, David A
The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to identify the variables responsible for performance problems. To date, the PDC-HS has not been examined with individuals with intellectual disabilities. In the current study, two supervisors with intellectual disabilities completed the PDC-HS to assess the productivity of two supervisees with disabilities who performed a pricing task in a thrift store. The PDC-HS suggested that performance deficits were due to a lack of training; a PDC-HS-indicated intervention was effective to increase accurate pricing. • The PDC-HS is an informant-based tool designed to identify the variables responsible for employee performance problems in human service settings. • The PDC-HS can be completed by some individuals with intellectual disabilities in a supervisory position to identify the variables responsible for problematic job performance among their supervisees. • A PDC-HS indicated intervention was demonstrated to be effective to improve the job performance of individuals with disabilities. • The PDC-HS may be a useful tool to support performance improvement and job maintenance among individuals with intellectual disabilities.
Claes, Claudia; Ferket, Neelke; Vandevelde, Stijn; Verlet, Dries; De Maeyer, Jessica
Policy evaluation focuses on the assessment of policy-related personal, family, and societal changes or benefits that follow as a result of the interventions, services, and supports provided to those persons to whom the policy is directed. This article describes a systematic approach to policy evaluation based on an evaluation framework and an…
Sundramoorthy, V.; Hartel, Pieter H.; Scholten, Johan
We analyze the fundamental concepts and issues in service discovery. This analysis places service discovery in the context of distributed systems by describing service discovery as a third generation naming system. We also describe the essential architectures and the functionalities in service
... EDUCATION VOCATIONAL REHABILITATION SERVICE PROJECTS What Conditions Must Be Met by a Grantee? § 369.42 What... rehabilitation services provided in projects assisted under these programs must be provided in the same manner as... under its project, or as appropriate, the parents, family members, guardians, advocates, or authorized...
Zhang, Shaochen; Li, Yun
Individual owned forests have boomed in the last decade in China. Hundreds of millions of private forest owners have emerged since years of afforestation practice and collective forest ownership reform. Most of those private forest owners are former peasants living in afforestation areas. They thirst for forestry information, such as technique knowledge, forestry policies, finance, marketing, etc. Unfortunately the ways they could get certain information are very limit. Before internet time, Local governments are the main channel they search helps for useful information and technique supports. State and local governments have paid much attention to provide necessary forestry technique supports to those small forest owners and provided varies training projects, issued official forestry information through their websites. While, as state government expands household contract system in the management of collective forestry land, the number of individual forest owners is bumping up in future 5 years. There is still a gap between supplying ability and requirement of forestry information. To construct an effective forestry information service system in next 3-5 year can bridge the gap. This paper discusses the framework of such an information service system.
Noblet, Andrew; Graffam, Joseph; McWilliams, John
This study examined the role of working conditions in predicting the psychological health, job satisfaction and organisational commitment of personnel responsible for helping people with disabilities gain employment in the mainstream Australian labour market. The working conditions were assessed using two theories: the Job Strain Model (job demand, social support and job control) and Psychological Contract Theory (unwritten reciprocal obligations between employers and employees). In the case of the Job Strain Model, the generic dimensions had been augmented by industry-specific sources of stress. A cross-sectional survey was undertaken in June and July 2005 with 514 staff returning completed questionnaires (representing a response rate of 30%). Comparisons between respondents and non-respondents revealed that on the basis of age, gender and tenure, the sample was broadly representative of employees working in the Australian disability employment sector at that time. The results of regression analyses indicate that social support was predictive of all of the outcome measures. Job control and the honouring of psychological contracts were both predictive of job satisfaction and commitment, while the more situation-specific stressors--treatment and workload stressors--were inversely related to psychological health (i.e. as concern regarding the treatment and workload stressors increased, psychological health decreased). Collectively, these findings suggest that strategies aimed at combating the negative effects of large-scale organisational change could be enhanced by addressing several variables represented in the models--particularly social support, job control, psychological contracts and sector-specific stressors.
Oliver, P C; Piachaud, J; Done, J; Regan, A; Cooray, S; Tyrer, P
In an era of evidence-based medicine, practice is constantly monitored for quality in accordance with the needs of clinical governance (Oyebode et al. 1999). This is likely to lead to a dramatic change in the treatment of those with intellectual disability (ID), in which evidence for effective intervention is limited for much that happens in ordinary practice. As Fraser (2000, p. 10) has commented, the word that best explains "the transformation of learning disability practice in the past 30 years is 'enlightenment'." This is not enough to satisfy the demands of evidence, and Fraser exhorted us to embrace more research-based practice in a subject that has previously escaped randomized controlled trials (RCTs) of treatment because of ethical concerns over capacity and consent, which constitute a denial of opportunity which "is now at last regarded as disenfranchising". The present paper describes the difficulties encountered in setting up a RCT of a common intervention, i.e. assertive community treatment, and concludes that a fundamental change in attitudes to health service research in ID is needed if proper evaluation is to prosper.
Schwartz, Ilene S.; Garfinkle, Ann N.; Bauer, Janet
Presents two studies documenting the use of the Picture Exchange Communication System (PECS) for 31 preschool children with severe disabilities. Initial findings indicated the children could learn to use PECS quickly and efficiently. The second study, which included 18 participants, found that PECS use generalized to untrained settings. (Author/CR)
Deliberato, Débora; Nunes, Leila Regina d'Oliveira Paula
The school environment adapted to the diversity of students is an important goal, but it is a challenge when it comes to the diversity of students with disabilities. The aim of this study was to describe the use of graphic systems in the routine of a preschool classroom through a collaborative program. The study included a teacher, 22 children of…
Mazzocco, Michele M. M.; Feigenson, Lisa; Halberda, Justin
Many children have significant mathematical learning disabilities (MLD, or dyscalculia) despite adequate schooling. The current study hypothesizes that MLD partly results from a deficiency in the Approximate Number System (ANS) that supports nonverbal numerical representations across species and throughout development. In this study of 71 ninth…
Centeno, C A; Gonzalez, E A; Cagnolo, F J; Olmos, C E
When a Hospital Engineering Service (HES) is implemented within a health care environment, the idea is to improve service conditions and costs as well as to provide timely responses to equipment preventive maintenance and infrastructure requirements. An HES must, within the shortest possible period of time, meet the above requirements at the cost necessary to provide the service quality sought. In many cases there is a lack of minimal materials and staff who are qualified to attain the objectives that have been set. Therefore, external assistance becomes necessary. In this context, actions are often taken which, because they are not recorded, cannot be assessed in order to evaluate the HES. Since all action taken is appraised from the purely economic point of view, in the final analysis the contributions from staff remain invisible. This situation works against the possibility of quantifying the convenience of possessing an internal HES. The software support system we have developed here is oriented toward providing all the necessary data to address this issue
Malcolm, Matthew P; Roll, Marla C
The outcomes of assistive technology (AT) support services for post-secondary education students with disabilities are under-reported, and little is known about use-profiles and user experiences when AT interventions are applied to this rapidly growing population. We examined AT service outcomes related to performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure [COPM]), as well as how students with disabilities use and experience AT and AT services (employing an AT-use survey). Three-hundred fifty-three students with disabilities completed the AT-use survey, with a subset of these (n = 216) also participating with pre-post AT intervention COPM assessment. COPM performance and satisfaction ratings significantly increased from pre- to post-AT intervention in all academic task categories (reading, writing, note-taking, test-taking, and studying; p impacted their academic success, and believed they would continue using AT post-graduation. The study findings contribute to evidence-base for AT services with a hope we may improve AT services to best meet the changing needs of the growing number of college students with disabilities.
Ekblom-Kullberg, S; Kautiainen, H; Alha, P; Leirisalo-Repo, M; Julkunen, H
To study education, employment, absenteeism, and work disability (WD) in women with systemic lupus erythematosus (SLE) compared to population controls. The study included 181 women of working age with SLE (mean age 44.0 years, disease duration 12.7 years) and 549 female population controls matched for age living in the same metropolitan area of Helsinki. Data regarding education, employment, absenteeism, and WD in patients and controls were obtained by questionnaire and personal interview. Basic education, vocational, or academic degrees and occupational categories in patients with SLE were similar to those in controls. In total, 62% of the patients were employed, compared to 77% of the controls (p Absenteeism and work disability are, however, 2-3 times more common than in controls. Less than half of the patients were on permanent disability pension due to SLE 20 years after diagnosis of the disease.
Prabhu, Neeta T
The goal of this study was to elicit the views of patients or parents\\/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients\\/parents\\/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent\\/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.
Lee, S.; Pan, L.; Zhai, C.; Tang, B.; Jiang, J. H.
We have developed a cloud-enabled web-service system that empowers physics-based, multi-variable model performance evaluations and diagnoses through the comprehensive and synergistic use of multiple observational data, reanalysis data, and model outputs. We have developed a methodology to transform an existing science application code into a web service using a Python wrapper interface and Python web service frameworks. The web-service system, called Climate Model Diagnostic Analyzer (CMDA), currently supports (1) all the observational datasets from Obs4MIPs and a few ocean datasets from NOAA and Argo, which can serve as observation-based reference data for model evaluation, (2) many of CMIP5 model outputs covering a broad range of atmosphere, ocean, and land variables from the CMIP5 specific historical runs and AMIP runs, and (3) ECMWF reanalysis outputs for several environmental variables in order to supplement observational datasets. Analysis capabilities currently supported by CMDA are (1) the calculation of annual and seasonal means of physical variables, (2) the calculation of time evolution of the means in any specified geographical region, (3) the calculation of correlation between two variables, (4) the calculation of difference between two variables, and (5) the conditional sampling of one physical variable with respect to another variable. A web user interface is chosen for CMDA because it not only lowers the learning curve and removes the adoption barrier of the tool but also enables instantaneous use, avoiding the hassle of local software installation and environment incompatibility. CMDA will be used as an educational tool for the summer school organized by JPL's Center for Climate Science in 2014. In order to support 30+ simultaneous users during the school, we have deployed CMDA to the Amazon cloud environment. The cloud-enabled CMDA will provide each student with a virtual machine while the user interaction with the system will remain the same
National Oceanic and Atmospheric Administration, Department of Commerce — Service Records and Retention System (SRRS) is historical digital data set DSI-9949, a collection of products created by the U.S. National Weather Service (NWS) and...
This study explored registered psychiatric nurses\\' (RPNs\\') interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD). A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the "staff-patient interaction response scale" (SPIRS). Four themes emerged following data analysis: "challenging and difficult," "manipulative, destructive and threatening behaviour," "preying on the vulnerable resulting in splitting staff and other service users," and "boundaries and structure." Additionally, low levels of empathy were evident in the majority of participants\\' responses to the SPIRS. The findings provide further insight on nurses\\' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.
Beadle-Brown, J; Mansell, J; Ashman, B; Ockenden, J; Iles, R; Whelton, B
We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Siljee, J; Bosloper, [No Value; Nijhuis, J; Hammer, D; Benatallah, B; Casati, F; Traverso, P
Service-centric systems exist in a very dynamic environment. This requires these systems to adapt at runtime in order to keep fulfilling their QoS. In order to create self-adaptive service systems, developers should not only design the service architecture, but also need to design the
condition among Army and Marine Corps service members; paralysis and epilepsy were the most common type of neurological conditions in the Navy; migraines...Force in 2013 and in the previous five year period. Epilepsy and paralysis were the most common neurological conditions in the Navy. IN T R O D U...States at the Beginning of the Twenty-first Century. Annual Review of Clinical Psychology , 2007. 3(1): p. 137-158. 10. Lapierre, C.B., A.F. Schwegler
Hansen, Henrik; Hansen, Lars Henrik; Jóhannsson, Hjörtur
This paper addresses a challenge associated with large scale deployment of distributed energy resources (DER) to provide system services in future sustainable power systems; namely how to prioritize conflicting interests in a service provided by a DER. For that purpose, different services utilizing...... the DER in a future system are identified as well as potentially conflicting interests between services. A scheme is suggested for how conflicting interests should be prioritized based on considerations regarding the nature of the service and the system operating state at the time of the service request....... Examples are provided for illustrating the functionality of the scheme....
Ogunduyile, O.O.; Olugbara, O.O.; Lall, M.
This paper reports on the development of a wearable system using wireless biomedical sensors for ubiquitous healthcare service provisioning. The prototype system is developed to address current healthcare challenges such as increasing cost of services, inability to access diverse services, low quality services and increasing population of elderly as experienced globally. The biomedical sensors proactively collect physiological data of remote patients to recommend diagnostic services. The prot...
... inclusion of individuals with disabilities on the teams that develop the cloud and Web technologies... Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects... Rehabilitative Services announces a priority under the Disability Rehabilitation Research Projects and Centers...
Full Text Available This paper aims to develop brain-computer interface system based on electroencephalography that can aid disabled people in daily life. The system relies on one of the most effective event-related potential wave, P300, which can be elicited by oddball paradigm. Developed application has a basic interaction tool that enables disabled people to convey their needs to other people selecting related objects. These objects pseudo-randomly flash in a visual interface on computer screen. The user must focus on related object to convey desired needs. The system can convey desired needs correctly by detecting P300 wave in acquired 14-channel EEG signal and classifying using linear discriminant analysis classifier just in 15 seconds. Experiments have been carried out on 19 volunteers to validate developed BCI system. As a result, accuracy rate of 90.83% is achieved in online performance.
Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire
This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with…
Shooshtari, Shahin; Brownell, Marni; Mills, Rosemary S. L.; Dik, Natalia; Yu, Dickie C. T.; Chateau, Dan; Burchill, Charles A.; Wetzel, Monika
Background: Little information exists on health of children with developmental disabilities (DDs) in the Canadian province of Manitoba. Method: The present authors linked 12 years of administrative data and compared health status, changes in health and access to health and social services between children with (n = 1877) and without (n = 5661) DDs…
Strnadová, Iva; Bernoldová, Jana; Adamcíková, Zdenka; Klusácek, Jan
Background: This study examined the attitudes, knowledge and experiences of practitioners in social services and child welfare working with mothers with intellectual disability. Method: The authors used a national survey, which was completed by 329 participants. Descriptive statistics and frequency tables were generated, and the associations…
Smith, Penny; Ooms, Ann; Marks-Maran, Di
A teaching session about service users' experiences of accessing and receiving health and social care was designed and delivered by service users to first year BSc Nursing students. The aim was to enhance students' knowledge, skills and confidence in caring for people with a learning disability. An evaluation research study was undertaking at one university in London into the perceived effectiveness of the teaching session, including students' perceptions of the extent to which the service users' teaching session was useful, the impact of the session, its benefits and challenges and the sustainability of teaching sessions delivered by service users. Data were collected through an online questionnaire. Quantitative analysis was undertaken of Likert-style questions and qualitative analysis was undertaken using the Framework Method. The session impacted on students' knowledge and understanding of people with a learning disability. Students reported that they felt more comfortable and confident interacting with people with a learning disability. In addition, they reflected on their feelings about caring for people with a learning disability. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gyimah, Emmanuel Kofi; Amoako, R.
The study aimed at exploring the perceptions tutors in Colleges of Education have on how the Colleges of Education Curriculum adequately prepare pre-service teachers to enable them to identify and assess children with special educational needs and disabilities for effective inclusive education in Ghana. A descriptive survey design was adopted and…
Okiyama, Naoko; Asano, Yoshihide; Hamaguchi, Yasuhito; Jinnin, Masatoshi; Motegi, Sei-Ichiro; Koizumi, Haruka; Hasegawa, Minoru; Ishikawa, Osamu; Sato, Shinichi; Takehara, Kazuhiko; Yamamoto, Toshiyuki; Fujimoto, Manabu; Ihn, Hironobu
Localized scleroderma (LoS) involves dermal but not internal inflammation and fibrosis. Cosmetic changes often impact quality of life (QOL), however, impairment of activities of daily living (ADL) in LoS patients has not been investigated. To determine what factor(s) are associated with ADL in adult patients with LoS, we performed a retrospective observational study in 177 Japanese adult LoS patients using a novel LoS disability score based on Barthel's indices of ADL: feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfers, mobility and stairs. LoS disability scores increased in proportion to the number of affected body parts but were not correlated to age and duration of illness. The presence of leg lesions significantly impaired ADL of LoS patients compared with lesions on other body parts. Patients treated with systemic medications, who tended to have multiple lesions, presented higher LoS disability scores than those without systemic treatments. Our study proposes that physicians evaluate ADL, not only QOL, in LoS patients. Our findings using LoS disability scoring indicate that multiple affected body parts and leg lesions are risk factors for ADL impairment. © 2018 Japanese Dermatological Association.
Integration of product design into service design, or vice versa, is considered to bring more efficient and effective value addition. Besides EcoDesign tools and methods, a methodology to design such an integration of products and services from a systemic perspective, or product-service systems
Hempe, Eva-Maria; Morrison, Cecily; Holland, Anthony
There are arguments that a specialist service for adults with intellectual disabilities is needed to address the health inequalities that this group experiences. The boundary of such a specialist service however is unclear, and definition is difficult, given the varying experiences of the multiple stakeholder groups. The study reported here quantitatively investigates divergence in stakeholders' views of what constitutes a good specialist service for people with intellectual disabilities. It is the first step of a larger project that aims to investigate the purpose, function and design of such a specialist service. The results are intended to support policy and service development. A Delphi study was carried out to elicit the requirements of this new specialist service from stakeholder groups. It consisted of three panels (carers, frontline health professionals, researchers and policymakers) and had three rounds. The quantification of stakeholder participation covers the number of unique ideas per panel, the value of these ideas as determined by the other panels and the level of agreement within and between panels. There is some overlap of ideas about of what should constitute this specialist service, but both carers and frontline health professionals contributed unique ideas. Many of these were valued by the researchers and policymakers. Interestingly, carers generated more ideas regarding how to deliver services than what services to deliver. Regarding whether ideas are considered appropriate, the variation both within and between groups is small. On the other hand, the feasibility of solutions is much more contested, with large variations among carers. This study provides a quantified representation of the diversity of ideas among stakeholder groups regarding where the boundary of a specialist service for adults with learning disabilities should sit. The results can be used as a starting point for the design process. The study also offers one way to measure the
Food allergies are common in preschool children. This study’s aims are to establish prevalence, to clarify management practices, levels of preparedness and the perceived role of General Practitioners amongst Early Years Services providers. This study is an anonymous, quantitative, cross sectional study. An online questionnaire was distributed to 282 Early Years Service providers. Data were analysed using SPSS. Response rate was 35% (n=98). Prevalence of food allergy was 3% (n=119). Allergic reactions to food had occurred on site in 16% (n=15). Written emergency action plans were available in 47% of facilities (n=46). Medications were not kept on site in 63% (n=62) of facilities. General practitioners were felt to have an important role in the management of food allergies by 76% of respondents (n=61). This study identifies significant areas for improvement in the management of food allergic child in Early Years Services
To inform the strategic and operational development of a community based service model at the Crann Centre, Cork, Ireland for SB children, adults, their families and providers. A needs assessment was conducted by gathering the views of multiple stakeholder perspectives within the SB community in the geographical region the Centre will serve. The intention is to create project deliverables that are responsive to the needs highlighted through this research. The study used a multi method design with a participatory research approach to explore the needs of SB individuals, families and providers. This involved in depth interviews, focus groups and online surveys. One hundred and fifty-nine respondents contributed to this qualitative needs assessment. The research established a range of psychosocial, clinical, vocational and educational issues causing ongoing difficulties for SB individuals and families. Providers highlighted supports that would benefit the social and clinical wellbeing of persons with SB. Collectively participants in the study reported that there was an absence of coordinated, continuous and comprehensive service delivery for the SB community in the region. This was amplified by geographical location of services and access to relevant supports. Consensus across stakeholders in this research pointed to the necessity for an innovative model of community based provision at the Crann Centre. This was described as offering a service with family at the core of an assets based model of practice. A key finding was the lack of importance placed on the social and emotional development of SB individuals. Traditionally participants described a singular focus on physical health through clinically defined treatment models. The desire for a social model of disability that informed health and wellbeing of SB individuals and families emerged as a prominent recommendation from the research.
Recent policy and service provision recommends a woman-centred approach to maternity care. Midwife-led models of care are seen as one important strategy for enhancing women\\'s choice; a core element of woman-centred care. In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians. This study considers women\\'s and clinicians\\' views, experiences and perspectives of woman-centred maternity care in Ireland.
Jetha, Arif; Pransky, Glenn; Fish, Jon; Hettinger, Lawrence J
Background Return-to-work (RTW) within a complex organizational system can be associated with suboptimal outcomes. Purpose To apply a sociotechnical systems perspective to investigate complexity in RTW; to utilize system dynamics modeling (SDM) to examine how feedback relationships between individual, psychosocial, and organizational factors make up the work disability system and influence RTW. Methods SDMs were developed within two companies. Thirty stakeholders including senior managers, and frontline supervisors and workers participated in model building sessions. Participants were asked questions that elicited information about the structure of the work disability system and were translated into feedback loops. To parameterize the model, participants were asked to estimate the shape and magnitude of the relationship between key model components. Data from published literature were also accessed to supplement participant estimates. Data were entered into a model created in the software program Vensim. Simulations were conducted to examine how financial incentives and light duty work disability-related policies, utilized by the participating companies, influenced RTW likelihood and preparedness. Results The SDMs were multidimensional, including individual attitudinal characteristics, health factors, and organizational components. Among the causal pathways uncovered, psychosocial components including workplace social support, supervisor and co-worker pressure, and supervisor-frontline worker communication impacted RTW likelihood and preparedness. Interestingly, SDM simulations showed that work disability-related policies in both companies resulted in a diminishing or opposing impact on RTW preparedness and likelihood. Conclusion SDM provides a novel systems view of RTW. Policy and psychosocial component relationships within the system have important implications for RTW, and may contribute to unanticipated outcomes.
Costa, Nina; Patrício, Lia; Morelli, Nicola
Manufacturing firms are increasingly evolving towards the design of integrated product-service solutions but servitization literature does not provide specific guidance on how to design these integrated solutions. Building upon ProductService System (PSS) and Service Design (SD) approaches...... how it brings new insights to manufacturing companies moving to a service, value cocreation perspective....
Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex
The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as their previously limited insurance options. However, most published research on this population does not systematically look at effects before and after full implementation of the ACA. As the US Congress considers new health policy reforms, current and accurate data on this vulnerable population are essential. Weighted estimates, trend analyses and analytic models were conducted using the 1998-2016 National Health Interview Surveys (NHIS) and the 2014 Medical Expenditure Panel Survey. Compared with working-age adults without disabilities, those with disabilities are less likely to work, more likely to earn below the federal poverty level, and more likely to use public insurance. Average health costs for this population are 3 to 7 times higher, and access problems are far more common. Repeal of key features of the ACA, like Medicaid expansion and marketplace subsidies, would likely diminish health care access for working-age adults with disabilities.
Fellin, Melissa; Desmarais, Chantal; Lindsay, Sally
Although collaborative, culturally competent care has been shown to increase positive health outcomes and client satisfaction with services, little is known about the ways that clinicians implement service delivery models with immigrant families having a child with a disability. The purpose of this study is to examine the experiences of clinicians working with immigrant families raising a child with a physical disability and to examine the views and experiences of clinicians providing collaborative, culturally competent care to immigrant families raising a child with a physical disability. This study draws on in-depth interviews with 43 clinicians within two pediatric centers in Toronto and Quebec. Our findings show that clinicians remove or create barriers for immigrant families in different ways, which affect their ability to provide culturally competent care for immigrant families raising a child with a physical disability. Our findings suggest that there is a need for more institutional support for collaborative, culturally competent care to immigrant families raising a child with a physical disability. There is a lack of formal processes in place to develop collaborative treatment plans and approaches that would benefit immigrant families. Implications for Rehabilitation Clinicians need greater institutional support and resources to spend more time with families and to provide more rehabilitative care in families' homes. Building rapport with families includes listening to and respecting families' views and experiences. Facilitate collaboration and culturally competent care by having team meetings with parents to formulate treatment plans.
Mérida R. Rodríguez
Full Text Available Objective: this study’s goal was to determine the most prevalent mental disorders and the impact on the perception of disability and suicidal ideation among the population from a primary health care center in the city of Cali. Methodology: a cross sectional study was conducted on 254 patients who were screened with the prime-md instrument. Descriptive statistics was used in the analysis to determine the most frequent disorders. Similarly, a multiple analysis with logistic and Poisson regressions using robust variance was conducted to determine the influence of mental disorders on disability and suicidal ideation. Results: most patients were female, young, and mature adults. Depression was present in 66.8% of all cases, followed by somatization disorder and anxiety. Half of the patients had had suicidal ideations at some point in their lives, and three out of four patients claimed to suffer from some kind of disability. Upon adjusting for the covariables, depression and anxiety disorders had a strong association with suicidal ideation and perceived disability that was overestimated by the logistic regression. Conclusion: depression and anxiety were the most common disorders and showed a strong association with suicidal ideation and disability. This is why it is necessary to screen for those disorders among adults using primary health care services. Likewise, we suggest considering Poisson regression with robust variance in cross-sectional studies in health services.
Development has been made on the element technologies for a multimedia system for the disabled. In developing the non-visual graphical user interface (GUI) access system, a non-visual access system to enable the visually disabled to access a GUI system by utilizing sound and tactile devices was developed. In developing the three-dimensional sound utilizing information providing system, a system was developed, in which information on screen arrangement of the GUI in a personal computer is presented as spatial sound positions by using the three-dimensional sound control technology. The system can be operated non-visually using a mouse by controlling movements of a cursor. The current fiscal year has improved three-dimensional sound producing devices, three-dimensional sound interface, and how to handle their applications. User evaluations were also performed. Functions were expanded and improved in a system and an optical media reader that enable the visually disabled person to read printed papers by himself. Development was made also on a function to link the system with a total system. (NEDO)
In the UK mental health and associated NHS services face considerable challenges. This paper aims to form an understanding both of the complexity of context in which services operate and the means by which services have sought to meet these challenges. Systemic principles as have been applied to public service organisations with reference to interpersonal relations, the wider social culture and its manifestation in service provision. The analysis suggests that the wider culture has shaped service demand and the approaches adopted by services resulting in a number of unintended consequences, reinforcing loops, increased workload demands and the limited value of services. The systemic modelling of this situation provides a necessary overview prior to future policy development. The paper concludes that mental health and attendant services requires a systemic understanding and a whole system approach to reform. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Greenstein, Caroline; Lowell, Anne; Thomas, David
What are the experiences of Indigenous children with physical disability and their carers of their community-based physiotherapy service? What factors influence their experiences of the physiotherapy service and how could the service be improved? A qualitative study using in-depth, semi-structured open-ended interviews consistent with the researchers' interpretivist perspectives and ethical principles of Indigenous health research. Interviews were audio recorded, transcribed and coded for themes with qualitative research software using inductive analysis. The interviews were then checked for transcription accuracy and the themes were confirmed with the participants. Nine parents and foster carers of children with physical disability aged 0 to 21 years, five children and youth with physical disability aged 8 to 21 years. The data generated three themes, which informed practice recommendations: carers of children with physical disability experience increased demands and complexity in their lives; relationships involving caring, consistency and communication are important to consumers using the physiotherapy service; and being Indigenous influences consumers' experiences in ways that may not be obvious to non-Indigenous service providers. The issue of communication underpinned the participants' experiences throughout these themes. The research highlighted the importance of effective communication, developing relationships, viewing the child wholistically and recognising the influence of being Indigenous on clients' healthcare needs and experiences. The results suggested that community-based physiotherapists adopt a family/person-centred, context-specific approach when working with Indigenous children with a physical disability and their carers. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.
.... Content may be delivered on a desktop computer, laptop computer, or a mobile device like a smart phone or... Education and Rehabilitative Services may change the maximum amount through a notice published in the... is the document published in the Federal Register. Free Internet access to the official edition of...
Yoon, Hee-Yoon; Kim, Sin-Young
One of the most important issues for world libraries at the present time is to extend copyright limitations and exceptions for reproduction, for library preservation and distribution services including lending and ILL/DDS, the printout and transmission of Internet information resources, copying of library materials which are rarely available…
Young, John; Morgan, Robert L.; Callow-Heusser, Catherine A.; Lindstrom, Lauren
This study examined effects of two parent-training approaches to increase knowledge of transition resources by (a) giving parents a brochure describing local transition services or (b) providing the same brochure plus 60 min of small-group training. We randomly assigned parents to groups who completed pre- and posttests on knowledge of transition…
Background: Supported decision-making and personal budgets for services are the new paradigms. Method: Supported decision-making proposals from the Australian State of Victoria are analysed against international trends to determine the viability of laws reflecting new international norms of the United Nations Convention on the Rights of Persons…
Instead of non-cash benefits, disabled people are to receive personal payments to help them to better manage their own support. This "tailor made support" has become a legal basis for a claim in 2008. It is aimed to pave the way for a new design of assistance: more ambulant services and a stronger position for the recipient of support. Initial results within the scope of pilot projects, evaluations from various perspectives and the discernible effects of personal budgets are reported in national and international perspectives.
Zhukovskiy, Y.; Koteleva, N.
Electromechanical equipment is widely used. It is used in industrial enterprises, in the spheres of public services, in everyday life, etc. Maintenance servicing of electromechanical equipment is an important part of its life cycle. High-quality and timely service can extend the life of the electromechanical equipment. The creation of special systems that simplify the process of servicing electromechanical equipment is an urgent task. Such systems can shorten the time for maintenance of electrical equipment, and, therefore, reduce the cost of maintenance in general. This article presents an analysis of information on the operation of service services for maintenance and repair of electromechanical equipment, identifies the list of services, and estimates the time required to perform basic service operations. The structure of the augmented reality system is presented, the ways of interaction of the augmented reality system with the automated control systems working at the enterprise are presented.
Ramos, João Ricardo Martins; Ricardo, Anacleto; Novais, Paulo; Figueiredo, Lino; Almeida, Ana; Neves, José
Technology is present in almost every simple aspect of the people’s daily life. As an instance, let us refer to the smartphone. This device is usually equipped with a GPS module which may be used as an orientation system, if it carries the right functionalities. The problem is that these applications may be complex to operate and may not be within the bounds of everybody. Therefore, the main goal here is to develop an orientation system that may help people with cognitive di...
Nishigaki, Kaori; Yoneyama, Akira; Ishii, Mitsuko; Kamibeppu, Kiyoko
Limited time away from the child is cited as the main factor that increases the burden for the primary caregiver of severely disabled children. The aim of this study was to quantitatively elucidate the factors related to the desire to use social services and the actual use of respite care services by the primary caregivers of severely disabled children in Japan. In this study, we investigated the use of respite care services in accordance with the primary caregivers' wishes by examining inhibiting or promoting factors associated with respite care service use only among those who wished to use social services. A total of 169 Japanese mothers participated and answered the questionnaires. We conducted a logistic regression analysis and a multiple regression analysis to investigate the factors related to respite care service use. The most important factors affecting a primary caregiver's desire to use social services were the belief that the child would enjoy using social services and the family's approval of the social service use. The most important factors affecting respite care service use were the family's approval of the use and a large care burden on the primary caregiver. Respite care services should be sought out before the care burden becomes too great to enable the primary caregiver to more easily contribute to the continuation of home care. A background of mother-child separation anxiety disrupted the use of respite care. However, believing that the child enjoys using social services may reduce primary caregivers' psychological resistance to being separated from their child, which is supported by tradition. Thus, it is also important for respite care service providers to provide information about the children to their primary caregivers and families while they are using respite care services. © 2016 John Wiley & Sons Ltd.
Brandl, Kristin; Mol, Michael J.; Petersen, Bent
Service production systems can be seen as a structure consisting of task execution, resources executing tasks and the service output received by the client. Offshoring acts as an exogenous shock to such a service production system. Drawing on practice theory and applying a multiple case methodology...... of the impact of offshoring and to practice theory....
Lin, Yi-Jiun; Huang, I-Chun; Wang, Yun-Tung
The aim of this exploratory study is to gain an understanding of the outcomes of home-based employment service programs for people with disabilities and their related factors in Taiwan. This study used survey method to collect 132 questionnaires. Descriptive and two-variable statistics including chi-square (χ(2)), independent sample t-test and analysis of variance were employed. The results found that 36.5% of the subjects improved their employment status and 75.8% of them improved in employability. Educational level and and vocational categories including "web page production", "e-commerce", "internet marketing", "on-line store" and "website set-up and management" were significantly "positively" associated with either of the two outcome indicators - change of employment status and employability. This study is the first evidence-based study about the outcomes of home-based employment service programs and their related factors for people with disabilities in Taiwan. The outcomes of the home-based employment service programs for people with disabilities were presented. Implications for Rehabilitation Home-based rehabilitation for people with disabilities can be effective. A programme of this kind supports participants in improving or gaining employment status as well as developing employability skills. Further consideration should be given to developing cost-effective home-based programmes and evaluating their effectiveness.
Which factors most influence referral for restorative dental treatment under sedation and general anaesthesia in children with complex disabilities: caries severity, child functioning, or dental service organisation?
Norderyd, Johanna; Faulks, Denise; Molina, Gustavo; Granlund, Mats; Klingberg, Gunilla
The UN Convention on the Rights of the Child gives all children right to the highest standard of services for treatment and rehabilitation. For children with disabilities, sedation and general anaesthesia (GA) are often indicated for dental treatment; however, accessibility to this varies. The International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) enables a biopsychosocial description of children undergoing dental treatment. To investigate conscious sedation and GA in children with complex disabilities and manifest caries and analyse how caries, child functioning, and dental service organisation relate to dental GA (DGA), comparing Argentina, France, and Sweden using the ICF-CY. Quantitative, cross-sectional; data collected through structured interviews, observation, and dental records. Sedation and DGA were common. Children with limitations in interpersonal interactions and relationships were more likely to have had DGA (OR: 5.3, P = 0.015). Level of caries experience was strongly correlated with experience of DGA. There were significant differences between countries regarding caries prevalence, sedation, DGA, and functional and environmental factors. Although caries experience and child functioning are important, dental health service organisation had the most impact on the incidence of DGA, and for the use of conscious sedation, for children with complex disabilities. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
The principal aim was to assess the utility of three needs assessment\\/dependency tools for use in community-based palliative care services. Specific objectives were to assess a sample of patients receiving specialist palliative care community nursing using these tools, to assess the predictive ability of each tool, and to explore the utility of prioritizing and measuring patient dependency from a clinical nurse specialist (CNS) perspective.
Brabazon, E D
The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner(GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation.In five out of six influenza seasons investigated,peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.
Full Text Available Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an (Q,r inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.
Pan, An; Hui, Chi-Leung
Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an ( Q , r ) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.
Clifford Simplican, Stacy; Shivers, Carolyn; Chen, June; Leader, Geraldine
People with intellectual disabilities continue to underutilize technology, in part due to insufficient training. Because support staff professionals provide instructional support, how they perceive integrating new technologies is important for people with intellectual disabilities. The authors conducted a sequential mixed-methods exploratory study (quan→QUAL) including quantitative data from online surveys completed by 46 staff members and qualitative data from five focus groups attended by 39 staff members. Quantitative results show strong support for diverse technologies. In contrast, qualitative results suggest that staff members' support of technology decreases when they perceive that technology may jeopardize service users' safety or independence. Although staff members identified increasing independence as the main reason to use new technologies with service users, they also worried that technologies used to increase the social inclusion of service users may pose undue risk and thus may limit their embrace of technology. © 2017 John Wiley & Sons Ltd.
... 10,000 Pounds § 570.59 Service brake system. (a) Service brake performance. Compliance with any one of the following performance criteria will satisfy the requirements of this section. Verify that tire...
The Dublin Eye and Ear Hospital Act, 1897 came in to force on 15th July 1897. The Act provided for the amalgamation of the National Eye and Ear Hospital in Molesworth Street (founded in 1814) and St Mark\\'s Ophthalmic Hospital in Lincoln Place founded in 1844 by Sir William R. Wilde) and established this Hospital. We are therefore celebrating this year the completion of one hundred year of service by the Hospital to the citizens of Dublin and indeed to people from all parts of Ireland.
Day, Mary Rose
Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.
Mc Manus, Vicki
BACKGROUND: Cerebral palsy (CP) is the most common cause of physical disability in children but its impact on quality of life is not well understood. This study examined participation in everyday activities among children without CP and children with mild, moderate and severe impairment due to CP. We then examined ten domains of quality of life in children with CP and investigated whether participation in everyday activities was associated with improved quality of life independent of gender, age and level of impairment. METHODS: This was a cross-sectional study of children aged 8-12 years based on two questionnaires, frequency of participation (FPQ) and KIDSCREEN, completed by parents of 98 children on the South of Ireland Cerebral Palsy Register (response rate = 82%) and parents of 448 children attending two Cork city schools (response rate = 69%) who completed one questionnaire (FPQ). Multiple linear regression was used: firstly to estimate the effect of severity of CP on participation in everyday activities independent of age and gender and secondly we estimated the effect of participation on quality of life independent of age gender and level of impairment. RESULTS: Participation in 11 of the 14 everyday activities examined varied across the children without CP and the children with varying severity of CP. In general, increased impairment decreased participation. Independent of age and gender, there was a highly significant decrease in overall participation with a fall of -6.0 (95% CI = -6.9 to -5.2) with each increasing level of impairment. The children with CP generally had high quality of life. Increased impairment was associated with diminished quality of life in just two domains - Physical well-being and Social support and peers. Overall participation in everyday activities was significantly associated with quality of life in 3 of the 10 domains (Physical well-being, Social support and peers & Moods and emotions) in analysis adjusted for gender age and
Brandl, Kristin; Mol, Michael J.; Petersen, Bent
Purpose: A service production system has a structure composed of task execution, agents performing tasks and a resulting service output. The purpose of this paper is to understand how such a service production system changes as a consequence of offshoring.Design/methodology/approach: Drawing...... of a service production system in response to change ignited by offshoring. The authors find recurring effects between structures that enable and constrain agents and agents who shape the structure of the production system. Research limitations/implications: The paper offers a novel contribution to the service...... operations management literature by applying practice theory. Moreover, the authors propose a detailed, activity-driven view of service production systems and service offshoring. The authors contribute to practice theory by extending its domain to operations management.Practical implications...
Full Text Available In 2002-2007 public employment services enlarged the range of service offers within the frames of active policy of labour market for handicapped persons living in the city of Poznań and the poviat (commune. The attempt was successful despite permanent and not very high expenditure on solving the handicapped persons’ problems. Simultaneously there was an observable increase of expenditure on the whole active policy of Poznań agglomeration labour market. Owing to the law changes a lot of positive progress was achieved which introduced professional activation of handicapped people in the forms inaccessible to this group of citizens so far. It should be mentioned here that it came about also thanks to undertakings cofinanced with European funds, alongside with the assistance of private and non-governmental institutions. A constant ratio of the handicapped persons’ employment as well as slightly changeable number of handicapped persons registered at Poznań District Work Office, prove that the present situation does not develop in handicapped youth the necessary skills to actively search work, and it strengthens attitudes of professional passivity.
Jordan, L; Bryan, K
The potential value of a framework enabling practitioners to conceptualise speech and language therapy from a range of perspectives engendered by different theories about disability is explored. Four disability research paradigms are used to categorise professional activities, whilst the 'individual' and 'social' models of disability are considered as alternative value systems. Challenges facing speech and language therapists in developing roles and services to embrace different perspectives are outlined.
Neille, Joanne; Penn, Claire
Persons with disabilities make up approximately 15% of the world's population, with vulnerable communities disproportionately affected by the incidence of disability. Research reflects that persons with disabilities are vulnerable to stigma and discrimination, social isolation, and have physical barriers to accessing support services, all of which serve to perpetuate a sense of uncertainty and vulnerability within their lives. Recently a number of policies and models of intervention have been introduced intended to protect the rights of those affected by disability, yet limited research has been conducted into the lived experiences of persons with disabilities, particularly in rural contexts. This implies that little is known about the impact of the rural context on the lived experience of disability and the ways in which context impacts on the implementation of policies and practices. The current study employed a qualitative design underpinned by the principles of narrative inquiry and participant observation. Thirty adults with a variety of congenital and acquired disabilities (15 men and 15 women, ranging in age from 19 to 83 years) living in 12 rural communities in the Mpumalanga Province of South Africa were recruited through snowball sampling. Data collection comprised a combination of narrative inquiry and participant observation. Narratives were collected in SiSwati with the assistance of a SiSwati-speaking research mediator and were transcribed and translated into English. Data were analysed inductively according to the principles of thematic analysis. Findings confirmed that the experience of living with a disability in a rural area is associated with discrimination, social exclusion, and isolation and barriers to accessing services, underpinned by numerous context-specific experiences, including mortality rates, exposure to numerous and repeated forms of violence across the lifespan, and corruption and lack of transparency in the implementation of
...: communication, security, and services. In the area of communication, we developed a new computing infrastructure for partitioning protocols between the primary processor and an embedded co processor...
Kralev, Velin; Kraleva, Radoslava
This article deals with a three-layer architectural model of a distributed information system based on Web services, which will be used for automatic generation of sets of input data. The information system will be constructed of a client layer, a service layer and of a data layer. The web services as a tool of developing distributed software systems will be presented briefly. A web service and the implementation of its web methods will be described. A way to use the developed web methods in real application will be proposed. Keywords: web services
A local host computing system, a remote host computing system as connected by a network, and service functionalities: a human interface service functionality, a starter service functionality, and a desired utility service functionality, and a Client-Server-Service (CSS) model is imposed on each service functionality. In one embodiment, this results in nine logical components and three physical components (a local host, a remote host, and an intervening network), where two of the logical components are integrated into one Remote Object Client component, and that Remote Object Client component and the other seven logical components are deployed among the local host and remote host in a manner which eases compatibility and upgrade problems, and provides an illusion to a user that a desired utility service supported on a remote host resides locally on the user`s local host, thereby providing ease of use and minimal software maintenance for users of that remote service. 16 figs.
Full Text Available Recently, there have been many attempts to cope with increasingly-diversified and ever-changing customer needs by combining products and services that are critical components of innovation models. Although not only manufacturers, but also service providers, try to integrate products and services, most of the previous studies on Product Service System (PSS development deal with how to effectively integrate services into products from the product-centric point of view. Services provided by manufacturers’ PSSes, such as delivery services, training services, disposal services, and so on, offer customers ancillary value, whereas products of service providers’ PSSes enrich core value by enhancing the functionality and quality of the service. Thus, designing an effective PSS development process from the service-centric point of view is an important research topic. Accordingly, the purpose of this paper is to propose a service-oriented PSS development process, which consists of four stages: (1 strategic planning; (2 idea generation and selection; (3 service design; and (4 product development. In the proposed approach, the PSS development project is initiated and led by a service provider from a service-centric point of view. From the perspective of methodology, customer needs are converted into product functions according to Quality Function Deployment (QFD, while Analytic Hierarchy Process (AHP is employed to prioritize the functions. Additionally, this paper illustrates a service-oriented PSS development that demonstrates the application of the proposed process. The proposed process and illustration are expected to serve as a foundation for research on service-oriented PSS development and as a useful guideline for service providers who are considering the development of a service-oriented PSS.
Mieke van der Bijl-Brouwer
Full Text Available Service design is one of the keys to improving how we target today’s complex societal problems. The predominant view of service systems is mechanistic and linear. A service infrastructure—which includes solutions like service blueprints, scripts, and protocols—is, in some ways, designed to control the behavior of service professionals at the service interface. This view undermines the intrinsic motivation, expertise, and creativity of service professionals. This article presents a different perspective on service design. Using theories of social systems and complex responsive processes, I define service organizations as ongoing iterated patterns of relationships between people, and identify them as complex social service systems. I go on to show how the human-centeredness of design practices contributes to designing for such service systems. In particular, I show how a deep understanding of the needs and aspirations of service professionals through phenomenological themes contributes to designing for social infrastructures that support continuous improvement and adaptation of the practices executed by service professionals at the service interface.
Markström, Urban; Lindqvist, Rafael
This article analyzes the state of community mental health services for people with psychiatric disabilities and the interplay between different organizational levels. The study is based on document analysis and interviews with stakeholders in 10 Swedish municipalities. The results show how systems are slow to change and are linked to local traditions. The services are often delivered in closed settings, and the organizations struggle to meet the needs of a new generation of users. There is a gap between local systems and national policies because the latter pays attention to the attributes of a recovery approach.
A persistent feature of international health policy debate is whether a single-payer or multiple-payer system can offer superior performance. In Ireland, a major reform proposal is the introduction of \\'managed competition\\' based on the recent reforms in the Netherlands, which would replace many functions of Ireland\\'s public payer with a system of competing health insurers from 2016. This article debates whether Ireland meets the preconditions for effective managed competition, and whether the government should implement the reform according to its stated timeline. We support our arguments by discussing the functioning of the Dutch and Irish systems.
Ma, He; Liu, Jianbo; Zhang, Yuan; Wu, Xiaoyu
In order to achieve a more convenient and accurate digital museum navigation, we have developed a real-time and online-to-offline museum exhibits recognition system using image recognition method based on deep learning. In this paper, the client and server of the system are separated and connected through the HTTP. Firstly, by using the client app in the Android mobile phone, the user can take pictures and upload them to the server. Secondly, the features of the picture are extracted using the deep learning network in the server. With the help of the features, the pictures user uploaded are classified with a well-trained SVM. Finally, the classification results are sent to the client and the detailed exhibition’s introduction corresponding to the classification results are shown in the client app. Experimental results demonstrate that the recognition accuracy is close to 100% and the computing time from the image uploading to the exhibit information show is less than 1S. By means of exhibition image recognition algorithm, our implemented exhibits recognition system can combine online detailed exhibition information to the user in the offline exhibition hall so as to achieve better digital navigation.
Full Text Available This paper describes the design of an innovative and low cost self-assistive technology that is used to facilitate the control of a wheelchair and home appliances by using advanced voice commands of the disabled people. This proposed system will provide an alternative to the physically challenged people with quadriplegics who is permanently unable to move their limbs (but who is able to speak and hear and elderly people in controlling the motion of the wheelchair and home appliances using their voices to lead an independent, confident and enjoyable life. The performance of this microcontroller based and voice integrated design is evaluated in terms of accuracy and velocity in various environments. The results show that it could be part of an assistive technology for the disabled persons without any third person’s assistance.
Naruse, Takashi; Matsumoto, Hiroshige; Fujisaki-Sakai, Mahiro; Nagata, Satoko
Home care service demands are increasing in Japan; this necessitates improved service allocation. This study examined the relationship between home visit nursing (HVN) service use and the proportion of elderly people living within 10 min' travel of HVN agencies. The population of elderly people living within reach of HVN agencies for each of 17 municipalities in one low-density prefecture was calculated using public data and geographic information systems. Multilevel logistic analysis for 2641 elderly people was conducted using medical and long-term care insurance claims data from October 2010 to examine the association between the proportion of elderly people reachable by HVNs and service usage in 13 municipalities. Municipality variables included HVN agency allocation appropriateness. Individual variables included HVN usage and demographic variables. The reachable proportion of the elderly population ranged from 0.0 to 90.2% in the examined municipalities. The reachable proportion of the elderly population was significantly positively correlated with HVN use (odds ratio: 1.938; confidence interval: 1.265-2.967). Residents living in municipalities with a lower reachable proportion of the elderly population are less likely to use HVN services. Public health interventions should increase the reachable proportion of the elderly population in order to improve HVN service use.
Department of Veterans Affairs — The Environmental Agent Service (EAS) Registries is the information system encompassing the Ionizing Radiation Registry (IRR), the Agent Orange Registry (AOR), and...
Espinha, T.; Zaidman, A.; Gross, H.G.
When trying to understand a system that is based on the principles of Service-Oriented Architecture (SOA), it is typically not enough to understand the individual services in the architecture, but also the interactions between the services. In this paper, we present a technique based on dynamic
For most people, home is the preferred place of care and death. Despite the development of specialist palliative care and primary care models of community based service delivery, people who are dying, and their families\\/carers, can experience isolation, feel excluded from social circles and distanced from their communities. Loneliness and social isolation can have a detrimental impact on both health and quality of life. Internationally, models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement. These models have not yet been subjected to rigorous evaluation. The aims of the study described in this protocol are: (1) to evaluate the feasibility, acceptability and potential effectiveness of The Good Neighbour Partnership (GNP), a new volunteer-led model of social and practical care\\/support for community dwelling adults in Ireland who are living with advanced life-limiting illness; and (2) to pilot the method for a Phase III Randomised Controlled Trial (RCT).
The provision of high quality healthcare information about pregnancy is important to women and to healthcare professionals and it is 1 driven, in part, by a desire to improve clinical outcomes,. The objective of this study was to examine the use of digital media by women\\' to access pregnancy information. A questionnaire was distributed to women attending a large maternity hospital. Of the 522 respondents, the mean age was 31.8 years, 45% (235\\/522) were nulliparous, 62% (324\\/522) lived in the capital city and 29% (150\\/522) attended the hospital as private patients. Overall 95% (498\\/522) used the internet for pregnancy information, 76% (399\\/522) had a smartphone and 59% (235\\/399) of smartphone owners had used a pregnancy smartapp. The nature of internet usage for pregnancy information included discussion forums (70%), social networks (67%), video media (48%), e-books (15%), blogs (13%), microblogs (9%) and podcasts (4%). Even women who were socially disadvantaged reported high levels of digital media usage. In contemporary maternity care women use digital media extensively for pregnancy information. All maternity services should have a digital media strategy.
Bachani, Abdulgafoor M; Bentley, Jacob A; Zia, Nukhba; Galiwango, Edward; Lum, Jeremiah; Tuli, Gulnar; Ho, Shuen-En
Disability is highly prevalent in low-and-middle-income countries (LMICs), but there is a relative dearth of disability and caregiving research from LMICs. To examine type and severity of disability experienced by individuals 60 years and older, caregivers and type of caregiving assistance, and the interrelationships between sociodemographic factors involved in Uganda. Data was collected from two Eastern Ugandan districts using the WHO Disability Assessment Schedule 2.0. Data on availability of caregiver was analyzed for 816 participants with disability. Group comparisons and regression analyses examined differences based on caregiver availability. Approximately 66% of individuals with disability had a caregiver. The mean age of those with a caregiver (74.7 ± 8.9 years) was statistically significantly (p = .0004) higher than that of individuals without caregiver (72.4 ± 8.2 years). Significant differences based on caregiver availability were found relative to sex (p = .009), age (p≤.001), education level (p≤.001), occupation (p≤.001) and head of household status (p≤.001). The most frequent types of disability were related to vision (78.4%) and ambulation (71.7%). Caregiving most often fell to family members. Logistic regression results showed that individuals over the age of 80 years were 2.51 times more likely to have a caregiver compared to those 60-69 years (p≤.001). Those in the highest wealth quintile were 1.77 times more likely to have a caregiver. Findings demonstrate gaps in caring for aging individuals with disabilities in LMICs and highlight the importance of understanding caregiver access in generating effective healthy aging initiatives and long-term care systems. Copyright © 2018 Elsevier Inc. All rights reserved.
Abstract Background In order to reduce fatal self-poisoning legislation was introduced in the UK in 1998 to restrict pack sizes of paracetamol sold in pharmacies (maximum 32 tablets) and non-pharmacy outlets (maximum 16 tablets), and in Ireland in 2001, but with smaller maximum pack sizes (24 and 12 tablets). Our aim was to determine whether this resulted in smaller overdoses of paracetamol in Ireland compared with the UK. Methods We used data on general hospital presentations for non-fatal self-harm for 2002 - 2007 from the Multicentre Study of Self-harm in England (six hospitals), and from the National Registry of Deliberate Self-harm in Ireland. We compared sizes of overdoses of paracetamol in the two settings. Results There were clear peaks in numbers of non-fatal overdoses, associated with maximum pack sizes of paracetamol in pharmacy and non-pharmacy outlets in both England and Ireland. Significantly more pack equivalents (based on maximum non-pharmacy pack sizes) were used in overdoses in Ireland (mean 2.63, 95% CI 2.57-2.69) compared with England (2.07, 95% CI 2.03-2.10). The overall size of overdoses did not differ significantly between England (median 22, interquartile range (IQR) 15-32) and Ireland (median 24, IQR 12-36). Conclusions The difference in paracetamol pack size legislation between England and Ireland does not appear to have resulted in a major difference in sizes of overdoses. This is because more pack equivalents are taken in overdoses in Ireland, possibly reflecting differing enforcement of sales advice. Differences in access to clinical services may also be relevant.
Deerkoski, L. F.
The TDRSS and tracking services define the telecommunication performance of the TDRSS between the RF interface with user spacecraft and the data interface with NASCOM at the ground terminal. Attention is given to system constraints, forward link services, multiple-access signal design parameters, S-band single access signal design parameters, multiple-access return link services, and single-access return link services.
Filgueiras, Ernesto; Vilar, Elisângela; Rebelo, Francisco
Successful cases of professional reintegration were achieved when adequate conditions were created for the adaptation of the worker with disability to the working environment and to the professional activity, allowing them to carry out all their functions without any restriction. In this sense, this paper presents a methodology for professional integration of people with disability in service companies and industry. It has as results a matrix of analysis of a set of observables for the reintegration of people with disability into the labour market, as well as an auxiliary tool for those who work in recruitment of personnel. The main objective was to develop a tool (i.e., a software) based on the crossing of data obtained from the analysis of the individual capacities and the requirements of the job to optimise the relationship between worker and the workplace. There was also considered a series of strategies which can be adopted by the individuals and the possible adaptations in the workplace, as a way to reduce the handicap in the accomplishment of different activities. The methodology for the development of this study is divided in two phases: Phase I, destined to the assessment criteria and classification of the indispensable functional characteristics of the individuals; Phase II, related to the assessment criteria of the jobs and the functions that have to be performed. As a result it was developed an evaluation tool to match the individuals' capabilities and the job requirements. A software was created to support the evaluation and to help professionals during the assessment. This methodology together with the support tool demonstrated to be a quite inclusive tool, as it considers, as a matter of priority, the capacities of the individuals and the real necessities of the workplaces.
Roed, Casper; Sørensen, Henrik Toft; Rothman, Kenneth J; Skinhøj, Peter; Obel, Niels
In this nationwide population-based cohort study using national Danish registries, in the period 1980-2008, our aim was to study employment and receipt of disability pension after central nervous system infections. All patients diagnosed between 20 and 55 years of age with meningococcal (n = 451), pneumococcal (n = 553), or viral (n = 1,433) meningitis or with herpes simplex encephalitis (n = 115), who were alive 1 year after diagnosis, were identified. Comparison cohorts were drawn from the general population, and their members were individually matched on age and sex to patients. Five years after diagnosis, the differences in probability of being employed as a former patient with pneumococcal meningitis or herpes simplex encephalitis versus being a member of the comparison cohorts were -19.9% (95% confidence interval (CI): -24.7, -15.1) and -21.1% (95% CI: -33.0, -9.3), respectively, and the corresponding differences in probability of receiving disability pension were 20.2% (95% CI: 13.7, 26.7) and 16.2% (95% CI: 6.2, 26.3). The differences in probability of being employed or receiving disability pension in former meningococcal or viral meningitis patients versus members of the comparison cohorts were small. In conclusion, pneumococcal meningitis and herpes simplex encephalitis were associated with substantially decreased employment and increased need for disability pension. These associations did not seem to apply to meningococcal meningitis or viral meningitis. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: email@example.com.
Barchitta, M; Fragapane, S; Consoli, M T; Pennisi, C; Agodi, A
The growing needs of people with disabilities require to integrate this issue into public health in order to improve political feasibility and to ensure that disability will not be left off from any strategic table. The main aim of the "Care for Work" project was to provide training contents to help workers and unemployed people to adapt their knowledge, skills and competencies to the care services sector in order to facilitate their insertion in a new employment source. The partners participating in the project are Organizations from 5 European countries. The project has been divided into seven Work Packages (WPs): three transversal WPs and four specific WPs, each addressing specific activities necessary to achieve the final objectives of the project. The "Care for Work" learning environment contains specific information and training on the techniques for caring people with acquired physical disabilities, as text documents and short training films. The project combines e-learning (Web 2.0) and mobile learning providing a flexible training platform for workers of care services sector. The "Care for Work" project offers specific training addressed to meet the new existing needs of workers of the care services sector and/or unemployed people. All the information and results of the project are available on the web page: www.careforwork.eu, and the present article is part of the WP "Valorization".
The aim of this study is to explore whether/which job coach factors were significantly associated with the community-based employment service (CBES) programme outcome measures in Taiwan. This study used the 2003-2005 CBES programme for People with Disabilities Database in Taipei City in Taiwan (n = 3924) to do a secondary data analysis using hierarchical multiple linear regression. This study found that 'occurrences of the services provided by the job coaches' variable was definitely the dominant predictor and explained additional 19.6% and 27.8% of the variances of annual salary and annual working month outcome measures, respectively. In addition, among six composition variables of 'occurrences of the services provided by the job coaches', 'occurrences of follow-up guidance', 'occurrences of intensive guidance', and 'occurrences of consultation before interviews with employer/director of human resources' were more powerful than the other three in predicting outcomes. Job coach factors in this study were significantly correlated with CBES programme outcome measures for people with disabilities in Taiwan after controlling for the socio-demographic variables. It indicates that the more inputs in the people with disabilities made by job coaches equates to better outcomes in this Taiwan case study.
Abstract Background In this paper, we give an overview of methadone treatment in Ireland and outline the rationale for designing an electronic health record (EHR) with extensibility, interoperability and decision support functionality. Incorporating several international standards, a conceptual model applying a problem orientated approach in a hierarchical structure has been proposed for building the EHR. Methods A set of archetypes has been designed in line with the current best practice and clinical guidelines which guide the information-gathering process. A web-based data entry system has been implemented, incorporating elements of the paper-based prescription form, while at the same time facilitating the decision support function. Results The use of archetypes was found to capture the ever changing requirements in the healthcare domain and externalises them in constrained data structures. The solution is extensible enabling the EHR to cover medicine management in general as per the programme of the HRB Centre for Primary Care Research. Conclusions The data collected via this Irish system can be aggregated into a larger dataset, if necessary, for analysis and evidence-gathering, since we adopted the openEHR standard. It will be later extended to include the functionalities of prescribing drugs other than methadone along with the research agenda at the HRB Centre for Primary Care Research in Ireland.
Comuzzi, M.; Spanoudakis, G.
Runtime monitoring of Service Based Systems (SBSs) usually relies on information derived from I/O messages exchanged within business processes implementing services. When service provisioning is regulated by complex Service Level Agreements (SLAs) between service requesters, (composed) services, and
Nancy Carter RN, PhD
Full Text Available Systems navigation services provided by a designated provider or team have the potential to address health and social disparities. We conducted an environmental scan of navigation activities in a large urban Canadian community to identify and describe: service providers who engage in systems navigation; the clients who require systems navigation support and the issues they face; activities involved; and barriers and facilitators in providing systems navigation support to clients. Using an online survey and convenience sampling, we recruited individuals who self-identified as community navigators or practiced systems navigation activities as part of their role. The majority of respondents ( n = 145 were social workers, social services workers, or nurses. Clients of navigators struggled with mental health or addictions issues, disabilities, chronic diseases, and history of trauma or abuse. The most frequently reported activities of navigators were building professional relationships, managing paperwork, and communicating with relevant agencies or organizations. Barriers to navigation were time available in the work day, difficulty partnering due to bureaucratic structures, differing philosophies and ways of working, and a lack of central information repository in the community. Facilitators were a client-centered organization, the availability of multiple community resources in the region, and organizational support. Participants struggled with client waitlists, system issues such as lack of resources and interagency collaboration, and role clarity.
Full Text Available Uganda is among the first to use the Washington Group Short Set of Questions on Disability to identify persons with disabilities in its Demographic and Health Survey. In this paper, we review the HIV Knowledge, Attitudes and Behaviour component of the 2011 Ugandan Demographic and Health Survey, analysing a series of questions comparing those with and without disabilities in relation to HIV/AIDS knowledge, attitudes and practices. We found comparable levels of knowledge on HIV/AIDS for those with and those without disabilities in relation to HIV transmission during delivery (93.89%, 93.26% and through breastfeeding (89.91%, 90.63%, which may reflect increased attention to reaching the community of persons with disabilities. However, several gaps in the knowledge base of persons with disabilities stood out, including misconceptions of risk of HIV infection through mosquito bites and caring for a relative with HIV in own household (34.39%, 29.86%; p<0.001; 91.53%, 89.00%; p = 0.001, respectively. The issue is not just access to appropriate information but also equitable access to HIV/AIDS services and support. Here we found that persons with multiple disabilities were less likely than individuals without disabilities to return to receive results from their most recent HIV test (0.60[0.41-0.87], p<0.05. HIV testing means little if people do not return for follow-up to know their HIV status and, if necessary, to be connected to available services and supports. Additional findings of note were that persons with disabilities reported having a first sexual encounter at a slightly younger age than peers without disabilities; and persons with disabilities also reported having a sexually transmitted disease (STD within the last 12 months at significantly higher rates than peers without disabilities (1.38[1.18-1.63], p<0.01, despite reporting comparable knowledge of the need for safer sex practices. This analysis is among the first to use HIV
Klara J. Winkler
Full Text Available Vineyards shape important economic, cultural, and ecological systems in many temperate biomes. Like other agricultural systems, they can be multifunctional landscapes that not only produce grapes, but also for example serve as wildlife habitat, sequester carbon, and are places of rich traditions. However, research and management practices often focus mostly on individual, specific ecosystem services, without considering multifunctionality. Therefore, we set out to meet four research objectives: (1 evaluate how frequently the ecosystem services approach has been applied in vineyard systems; (2 identify which individual ecosystem services have been most frequently studied in vineyard systems, (3 summarize knowledge on the key ecosystem services identified in (2, and (4 illustrate approaches to multifunctionality in vineyards to inform more holistic land management. For research objective (1, we identified 45 publications that used the term “ecosystem services” in relation to vineyards, but found that only seven fully apply the ecosystem service concept to their research. For research objective (2, we operationalized the Common International Classification of Ecosystem Services (CICES for 27 ecosystem services in vineyards, in order to consider provisioning, regulating, and cultural services through an analysis of more than 4,000 scientific papers that mentioned individual services. We found the six most frequently studied ecosystem services included (1 cultivated crops, (2 filtration, sequestration, storage and accumulation by the vineyards, (3 pest control and (4 disease control, (5 heritage, cultural and (6 scientific services. For research objective (3, we found that research on these six single ecosystem services is highly developed, but relationships between single ecosystem services are less studied. Therefore, we suggest that greater adoption of the ecosystem services approach could help scientists and practitioners to acknowledge the
Zunilka Limonta Favier
Full Text Available We present a service that enables the design, management, innovation and implementation of information systems in academic, service, economic etc. which is intended as advice to entities that require attending to their needs whether external or internal. They offer some recommendations to improve the work in information systems and management. This paper shows how to provide differentiated services according to the characteristics of each institution.
Babai , Mohamed Zied; Jouini , Oualid
International audience; The service sector is the largest sector of the economy in most industrialized nations, and is fast becoming the largest sector in developing nations as well. Driven by today's new business environment, including advanced telecommunications, accelerated business globalization, increased automation and highly on-demand and competitive innovations, the complexity of the operations management of service systems is continuously increasing. Managers of service systems are w...
Moriarty, D D
There is significant opportunity for health service providers to gain competitive advantage through the innovative use of strategic information systems. This analysis presents some key strategic information systems issues that will enable managers to identify opportunities within their organizations.
Diks, E.B.; Kok, de A.G.; Lagodimos, A.G.
This paper reviews the most important results on divergent multi-echelon systems. In particular, we concentrate on the interactions between the elements that constitute such a multi-echelon system, in order to determine several service measures (e.g. external customer service level and inventory
Abstract Background There is a lack of international research on suicide by drug overdose as a preventable suicide method. Sex- and age-specific rates of suicide by drug self-poisoning (ICD-10, X60-64) and the distribution of drug types used in 16 European countries were studied, and compared with other self-poisoning methods (X65-69) and intentional self-injury (X70-84). Methods Data for 2000-04\\/05 were collected from national statistical offices. Age-adjusted suicide rates, and age and sex distributions, were calculated. Results No pronounced sex differences in drug self-poisoning rates were found, either in the aggregate data (males 1.6 and females 1.5 per 100,000) or within individual countries. Among the 16 countries, the range (from some 0.3 in Portugal to 5.0 in Finland) was wide. \\'Other and unspecified drugs\\' (X64) were recorded most frequently, with a range of 0.2-1.9, and accounted for more than 70% of deaths by drug overdose in France, Luxembourg, Portugal and Spain. Psychotropic drugs (X61) ranked second. The X63 category (\\'other drugs acting on the autonomic nervous system\\') was least frequently used. Finland showed low X64 and high X61 figures, Scotland had high levels of X62 (\\'narcotics and hallucinogens, not elsewhere classified\\') for both sexes, while England exceeded other countries in category X60. Risk was highest among the middle-aged everywhere except in Switzerland, where the elderly were most at risk. Conclusions Suicide by drug overdose is preventable. Intentional self-poisoning with drugs kills as many males as females. The considerable differences in patterns of self-poisoning found in the various European countries are relevant to national efforts to improve diagnostics of suicide and appropriate specific prevention. The fact that vast majority of drug-overdose suicides came under the category X64 refers to the need of more detailed ICD coding system for overdose suicides is needed to permit better design of suicide
Abstract Background A recent survey has shown that data management in clinical trials performed by academic trial units still faces many difficulties (e.g. heterogeneity of software products, deficits in quality management, limited human and financial resources and the complexity of running a local computer centre). Unfortunately, no specific, practical and open standard for both GCP-compliant data management and the underlying IT-infrastructure is available to improve the situation. For that reason the "Working Group on Data Centres" of the European Clinical Research Infrastructures Network (ECRIN) has developed a standard specifying the requirements for high quality GCP-compliant data management in multinational clinical trials. Methods International, European and national regulations and guidelines relevant to GCP, data security and IT infrastructures, as well as ECRIN documents produced previously, were evaluated to provide a starting point for the development of standard requirements. The requirements were produced by expert consensus of the ECRIN Working group on Data Centres, using a structured and standardised process. The requirements were divided into two main parts: an IT part covering standards for the underlying IT infrastructure and computer systems in general, and a Data Management (DM) part covering requirements for data management applications in clinical trials. Results The standard developed includes 115 IT requirements, split into 15 separate sections, 107 DM requirements (in 12 sections) and 13 other requirements (2 sections). Sections IT01 to IT05 deal with the basic IT infrastructure while IT06 and IT07 cover validation and local software development. IT08 to IT015 concern the aspects of IT systems that directly support clinical trial management. Sections DM01 to DM03 cover the implementation of a specific clinical data management application, i.e. for a specific trial, whilst DM04 to DM12 address the data management of trials across the unit
Verma, Navin Kumar
AbstractBackgroundAerosolized therapeutics hold great potential for effective treatment of various diseases including lung cancer. In this context, there is an urgent need to develop novel nanocarriers suitable for drug delivery by nebulization. To address this need, we synthesized and characterized a biocompatible drug delivery vehicle following surface coating of Fe3O4 magnetic nanoparticles (MNPs) with a polymer poly(lactic-co-glycolic acid) (PLGA). The polymeric shell of these engineered nanoparticles was loaded with a potential anti-cancer drug quercetin and their suitability for targeting lung cancer cells via nebulization was evaluated.ResultsAverage particle size of the developed MNPs and PLGA-MNPs as measured by electron microscopy was 9.6 and 53.2 nm, whereas their hydrodynamic swelling as determined using dynamic light scattering was 54.3 nm and 293.4 nm respectively. Utilizing a series of standardized biological tests incorporating a cell-based automated image acquisition and analysis procedure in combination with real-time impedance sensing, we confirmed that the developed MNP-based nanocarrier system was biocompatible, as no cytotoxicity was observed when up to 100 mug\\/ml PLGA-MNP was applied to the cultured human lung epithelial cells. Moreover, the PLGA-MNP preparation was well-tolerated in vivo in mice when applied intranasally as measured by glutathione and IL-6 secretion assays after 1, 4, or 7 days post-treatment. To imitate aerosol formation for drug delivery to the lungs, we applied quercitin loaded PLGA-MNPs to the human lung carcinoma cell line A549 following a single round of nebulization. The drug-loaded PLGA-MNPs significantly reduced the number of viable A549 cells, which was comparable when applied either by nebulization or by direct pipetting.ConclusionWe have developed a magnetic core-shell nanoparticle-based nanocarrier system and evaluated the feasibility of its drug delivery capability via aerosol administration. This study has
ABSTRACT: BACKGROUND: Immunological therapies enhance the ability of the immune system to recognise and destroy cancer cells via selective killing mechanisms. DNA vaccines have potential to activate the immune system against specific antigens, with accompanying potent immunological adjuvant effects from unmethylated CpG motifs as on prokaryotic DNA. We investigated an electroporation driven plasmid DNA vaccination strategy in animal models for treatment of prostate cancer. METHODS: Plasmid expressing human PSA gene (phPSA) was delivered in vivo by intra-muscular electroporation, to induce effective anti-tumour immune responses against prostate antigen expressing tumours. Groups of male C57 BL\\/6 mice received intra-muscular injections of phPSA plasmid. For phPSA delivery, quadriceps muscle was injected with 50 mug plasmid. After 80 seconds, square-wave pulses were administered in sequence using a custom designed pulse generator and acustom-designed applicator with 2 needles placed through the skin central to the muscle. To determine an optimum treatment regimen, three different vaccination schedules were investigated. In a separate experiment, the immune potential of the phPSA vaccine was further enhanced with co- administration of synthetic CpG rich oligonucleotides. One week after last vaccination, the mice were challenged subcutaneously with TRAMPC1\\/hPSA (prostate cancer cell line stably expressing human PSA) and tumour growth was monitored. Serum from animals was examined by ELISA for anti-hPSA antibodies and for IFNgamma. Histological assessment of the tumours was also carried out. In vivo and in vitro cytotoxicity assays were performed with splenocytes from treated mice. RESULTS: The phPSA vaccine therapy significantly delayed the appearance of tumours and resulted in prolonged survival of the animals. Four-dose vaccination regimen provided optimal immunological effects. Co - administration of the synthetic CpG with phPSA increased anti-tumour responses
McHugh, Seamus M
AIMS: We will examine the latest advances in genomic and proteomic laboratory technology. Through an extensive literature review we aim to critically appraise those studies which have utilized these latest technologies and ascertain their potential to identify clinically useful biomarkers. METHODS: An extensive review of the literature was carried out in both online medical journals and through the Royal College of Surgeons in Ireland library. RESULTS: Laboratory technology has advanced in the fields of genomics and oncoproteomics. Gene expression profiling with DNA microarray technology has allowed us to begin genetic profiling of colorectal cancer tissue. The response to chemotherapy can differ amongst individual tumors. For the first time researchers have begun to isolate and identify the genes responsible. New laboratory techniques allow us to isolate proteins preferentially expressed in colorectal cancer tissue. This could potentially lead to identification of a clinically useful protein biomarker in colorectal cancer screening and treatment. CONCLUSION: If a set of discriminating genes could be used for characterization and prediction of chemotherapeutic response, an individualized tailored therapeutic regime could become the standard of care for those undergoing systemic treatment for colorectal cancer. New laboratory techniques of protein identification may eventually allow identification of a clinically useful biomarker that could be used for screening and treatment. At present however, both expression of different gene signatures and isolation of various protein peaks has been limited by study size. Independent multi-centre correlation of results with larger sample sizes is needed to allow translation into clinical practice.
Amengual, Julià L
AbstractBackgroundWe report the case of a chronic stroke patient (62 months after injury) showing total absence of motor activity evoked by transcranial magnetic stimulation (TMS) of spared regions of the left motor cortex, but near-to-complete recovery of motor abilities in the affected hand.Case presentationMultimodal investigations included detailed TMS based motor mapping, motor evoked potentials (MEP), and Cortical Silent period (CSP) as well as functional magnetic resonance imaging (fMRI) of motor activity, MRI based lesion analysis and Diffusion Tensor Imaging (DTI) Tractography of corticospinal tract (CST). Anatomical analysis revealed a left hemisphere subinsular lesion interrupting the descending left CST at the level of the internal capsule. The absence of MEPs after intense TMS pulses to the ipsilesional M1, and the reversible suppression of ongoing electromyographic (EMG) activity (indexed by CSP) demonstrate a weak modulation of subcortical systems by the ipsilesional left frontal cortex, but an inability to induce efficient descending volleys from those cortical locations to right hand and forearm muscles. Functional MRI recordings under grasping and finger tapping patterns involving the affected hand showed slight signs of subcortical recruitment, as compared to the unaffected hand and hemisphere, as well as the expected cortical activations.ConclusionsThe potential sources of motor voluntary activity for the affected hand in absence of MEPs are discussed. We conclude that multimodal analysis may contribute to a more accurate prognosis of stroke patients.
Liliya D. Kiyanova
Full Text Available Of significant importance for the Russian economic system is the generalization and application of best practices in the area of vocational guidance and employment of young people with special educational needs. In Russia, a special attention is being paid to the development and creation of a vocational guidance system as one of the priorities in the sphere of training students with special educational needs. Despite the fact that in recent years much has been accomplished in this area, yet there remain a number of both conceptual and practical problems. The authors of this study have conducted a critical analysis regarding the main aspects of the problems related to vocational guidance for persons with disabilities and regarding the current trends in the creation of a professional self-determination system for persons with disabilities. The authors have also defined prospects of the concept of a vocational guidance system for school children/students with special educational needs, as well as examined existing strategies for the vocational guidance of learners with special educational needs.
Butterly, Felicity; Percy, Carol; Ward, Gillian
The aim of this study was to identify the outcomes expected and assessed by those providing service dogs to children with developmental disabilities. Seventeen registered service dog providers were invited to complete a mixed methods online survey. Five providers, who prepared dogs to work with a wide range of conditions and behaviours, mainly Asperger's syndrome, autism and communication disorders, completed the survey. All five participants reported that they expected to see positive changes as a consequence of the service dog placement, in both the recipient child and their family, including improvements in attention span and language skills, as well as increased familial cohesion. Survey responses indicated that not all desired outcomes were routinely assessed. The range of assessments used were interviews, intake conversations, pre-placement questionnaires, child social diaries filled in by parents, follow up surveys after placement, and child observation by parents. No specifically named valid and reliable clinical or research measures were referred to, showing an emphasis on assessments from parents and service dog providers. It is not clear whether pre-intervention assessments are repeated systematically at follow-up, which could show robust intervention effects. There is scope for professionals in developmental disability to work with service dog providers to improve the evidence base in this field.
Abstract Helicobacter pylori is a highly successful pathogen uniquely adapted to colonize humans. Gastric infections with this bacterium can induce pathology ranging from chronic gastritis and peptic ulcers to gastric cancer. More virulent H. pylori isolates harbour numerous well-known adhesins (BabA\\/B, SabA, AlpA\\/B, OipA and HopZ) and the cag (cytotoxin-associated genes) pathogenicity island encoding a type IV secretion system (T4SS). The adhesins establish tight bacterial contact with host target cells and the T4SS represents a needle-like pilus device for the delivery of effector proteins into host target cells such as CagA. BabA and SabA bind to blood group antigen and sialylated proteins respectively, and a series of T4SS components including CagI, CagL, CagY and CagA have been shown to target the integrin β1 receptor followed by injection of CagA across the host cell membrane. The interaction of CagA with membrane-anchored phosphatidylserine may also play a role in the delivery process. While substantial progress has been made in our current understanding of many of the above factors, the host cell receptors for OipA, HopZ and AlpA\\/B during infection are still unknown. Here we review the recent progress in characterizing the interactions of the various adhesins and structural T4SS proteins with host cell factors. The contribution of these interactions to H. pylori colonization and pathogenesis is discussed.
MiRNAs regulate gene expression at a post-transcriptional level and their dysregulation can play major roles in the pathogenesis of many different forms of cancer, including neuroblastoma, an often fatal paediatric cancer originating from precursor cells of the sympathetic nervous system. We have analyzed a set of neuroblastoma (n = 145) that is broadly representative of the genetic subtypes of this disease for miRNA expression (430 loci by stem-loop RT qPCR) and for DNA copy number alterations (array CGH) to assess miRNA involvement in disease pathogenesis. The tumors were stratified and then randomly split into a training set (n = 96) and a validation set (n = 49) for data analysis. Thirty-seven miRNAs were significantly over- or under-expressed in MYCN amplified tumors relative to MYCN single copy tumors, indicating a potential role for the MYCN transcription factor in either the direct or indirect dysregulation of these loci. In addition, we also determined that there was a highly significant correlation between miRNA expression levels and DNA copy number, indicating a role for large-scale genomic imbalances in the dysregulation of miRNA expression. In order to directly assess whether miRNA expression was predictive of clinical outcome, we used the Random Forest classifier to identify miRNAs that were most significantly associated with poor overall patient survival and developed a 15 miRNA signature that was predictive of overall survival with 72.7% sensitivity and 86.5% specificity in the validation set of tumors. We conclude that there is widespread dysregulation of miRNA expression in neuroblastoma tumors caused by both over-expression of the MYCN transcription factor and by large-scale chromosomal imbalances. MiRNA expression patterns are also predicative of clinical outcome, highlighting the potential for miRNA mediated diagnostics and therapeutics.
Henderson, Marie; Page, Howard Philip
Often the hardest job is to get business representatives to look at security as something that makes managing their risks and achieving their objectives easier, with security compliance as just part of that journey. This paper addresses that by making planning for security services a 'business tool'.
Acampora, G.; Loia, V.; Ma, Z.
Ambient intelligence (AmI)  provides a wide-ranging vision on how the Information Society will evolve, since the goal is to conceive platforms for seamless delivery of services and applications making them effectively invisible to the user. This is possible by gathering best practices from
Phang, Chee Wei; Kankanhalli, Atreyi
There have been increasing efforts by governments worldwide to innovate public service delivery, one of the means being through e-government. However, the mixed success of e-government initiatives highlights the need to better understand citizens' requirements and engage them in the development of e-government service offerings. In response to this need, we propose a service systems perspective to analyze a participatory e-government service system based on the key resources of people, organizations, shared information, and technologies. By doing so, this study bridges the gap in existing research that has separately examined the different resources without considering their inter-relationships in a systematic manner. For practitioners, the resulting framework provides a tool to understand how the key resources as well as stakeholders of the e-government service system inter-relate, which allows more comprehensive strategies to be formulated for improving e-government service offerings.
Pietras, John; Theis, Gerhard
The widespread adoption of standard packet-based data communication protocols and services for spaceflight missions provides the foundation for other standard space data handling services. These space data handling services can be defined as increasingly sophisticated processing of data or information received from lower-level services, using a layering approach made famous in the International Organization for Standardization (ISO) Open System Interconnection Reference Model (OSI-RM). The Space Data System Interconnection Reference Model (SDSI-RM) incorporates the conventions of the OSIRM to provide a framework within which a complete set of space data handling services can be defined. The use of the SDSI-RM is illustrated through its application to data handling services and protocols that have been defined by, or are under consideration by, the Consultative Committee for Space Data Systems (CCSDS).
Full Text Available Service Oriented Architecture is a design paradigm in software engineering with which a distributed system is built for an enterprise. This paradigm aims at providing the system as a service through a protocol in web service technology, namely Simple Object Access Protocol (SOAP. However, SOA is service level agreements of webservice. For this reason, this reasearch aims at combining SOA with Resource Oriented Architecture in order to expand scalability of services. This combination creates Sevice Resource Oriented Architecture (SROA with which a distributed system is developed that integrates services within project management software. Following this design, the software is developed according to a framework of Agile Model Driven Development which can reduce complexities of the whole process of software development.
Murphy, Andrew W
BACKGROUND: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland. CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines. METHODS: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and two-year follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. The SPHERE intervention involves the implementation of a structured systematic programme of care for patients with CHD attending general practice. It is a multi-faceted intervention that has been developed to respond to barriers and solutions to
Choi, Kup-Sze; Chan, Tak-Yin
To investigate the feasibility of using tablet device as user interface for students with upper extremity disabilities to input mathematics efficiently into computer. A touch-input system using tablet device as user interface was proposed to assist these students to write mathematics. User-switchable and context-specific keyboard layouts were designed to streamline the input process. The system could be integrated with conventional computer systems only with minor software setup. A two-week pre-post test study involving five participants was conducted to evaluate the performance of the system and collect user feedback. The mathematics input efficiency of the participants was found to improve during the experiment sessions. In particular, their performance in entering trigonometric expressions by using the touch-input system was significantly better than that by using conventional mathematics editing software with keyboard and mouse. The participants rated the touch-input system positively and were confident that they could operate at ease with more practice. The proposed touch-input system provides a convenient way for the students with hand impairment to write mathematics and has the potential to facilitate their mathematics learning. Implications for Rehabilitation Students with upper extremity disabilities often face barriers to learning mathematics which is largely based on handwriting. Conventional computer user interfaces are inefficient for them to input mathematics into computer. A touch-input system with context-specific and user-switchable keyboard layouts was designed to improve the efficiency of mathematics input. Experimental results and user feedback suggested that the system has the potential to facilitate mathematics learning for the students.
Wu, Zhao; Xiong, Naixue; Huang, Yannong; Gu, Qiong
Services composition technology provides a flexible approach to building Wireless Sensor Network (WSN) Service Applications (WSA) in a service oriented tasking system for WSN. Maintaining the data security of WSA is one of the most important goals in sensor network research. In this paper, we consider a WSN service oriented tasking system in which the WSN Services Broker (WSB), as the resource management center, can map the service request from user into a set of atom-services (AS) and send them to some independent sensor nodes (SN) for parallel execution. The distribution of ASs among these SNs affects the data security as well as the reliability and performance of WSA because these SNs can be of different and independent specifications. By the optimal service partition into the ASs and their distribution among SNs, the WSB can provide the maximum possible service reliability and/or expected performance subject to data security constraints. This paper proposes an algorithm of optimal service partition and distribution based on the universal generating function (UGF) and the genetic algorithm (GA) approach. The experimental analysis is presented to demonstrate the feasibility of the suggested algorithm. PMID:25093346
Orlowski, Simone; Lawn, Sharon; Matthews, Ben; Venning, Anthony; Jones, Gabrielle; Winsall, Megan; Antezana, Gaston; Bidargaddi, Niranjan; Musiat, Peter
The merits of technology-based mental health service reform have been widely debated among academics, practitioners, and policy makers. The design of new technologies must first be predicated on a detailed appreciation of how the mental health system works before it can be improved or changed through the introduction of new products and services. Further work is required to better understand the nature of face-to-face mental health work and to translate this knowledge to computer scientists and system designers responsible for creating technology-based solutions. Intensive observation of day-to-day work within two rural youth mental health services in South Australia, Australia, was undertaken to understand how technology could be designed and implemented to enhance young people's engagement with services and improve their experience of help seeking. Data were analysed through a lens of complexity theory. Results highlight the variety of professional roles and services that can comprise the mental health system. The level of interconnectedness evident in the system contrasted with high levels of service self-organization and disjointed information flow. A mental health professional's work was guided by two main constructs: risk and engagement. Most clients presented with a profile of disability, disadvantage, and isolation, so complex client presentations and decision-making were core practices. Clients (and frequently, their families) engaged with services in a crisis-dependent manner, characterized by multiple disengagements and re-engagements over time. While significant opportunities exist to integrate technology into existing youth mental health services, technologies for this space must be usable for a broad range of medical, psychological and cognitive disability, social disadvantage, and accommodate repeat cycles of engagement/disengagement over time. © 2016 Australian College of Mental Health Nurses Inc.
Jetha, Arif; Pransky, Glenn; Hettinger, Lawrence J
Work disability (WD) is characterized by variable and occasionally undesirable outcomes. The underlying determinants of WD outcomes include patterns of dynamic relationships among health, personal, organizational and regulatory factors that have been challenging to characterize, and inadequately represented by contemporary WD models. System dynamics modeling (SDM) methodology applies a sociotechnical systems thinking lens to view WD systems as comprising a range of influential factors linked by feedback relationships. SDM can potentially overcome limitations in contemporary WD models by uncovering causal feedback relationships, and conceptualizing dynamic system behaviors. It employs a collaborative and stakeholder-based model building methodology to create a visual depiction of the system as a whole. SDM can also enable researchers to run dynamic simulations to provide evidence of anticipated or unanticipated outcomes that could result from policy and programmatic intervention. SDM may advance rehabilitation research by providing greater insights into the structure and dynamics of WD systems while helping to understand inherent complexity. Challenges related to data availability, determining validity, and the extensive time and technical skill requirements for model building may limit SDM's use in the field and should be considered. Contemporary work disability (WD) models provide limited insight into complexity associated with WD processes. System dynamics modeling (SDM) has the potential to capture complexity through a stakeholder-based approach that generates a simulation model consisting of multiple feedback loops. SDM may enable WD researchers and practitioners to understand the structure and behavior of the WD system as a whole, and inform development of improved strategies to manage straightforward and complex WD cases.
Rafat Rezapour Nasrabad
Full Text Available Health care organizations are required to implement modern management practices and approaches due to the importance of improving quality and increasing efficiency of health care services. Service line management of healthcare services is one of the new approaches that managers of health sectors are interested in. The “service line” approach will organize the management of inpatient and outpatient in clinical services focusing on patient diagnostic clusters. Services specific in each patient diagnostic cluster will be offered by a multidisciplinary team including nurses, physicians, and so no. Accordingly, the present study aims to evaluate the features, process and benefits of service line management approach in the provision of health services. In this descriptive study, internal and external scientific database have been reviewed and the necessary data have been extracted from the latest research projects and related scientific documents. The results showed that the new management approach is based on a paradigm shift from traditional health care system management to healthcare service line management with a focus on managers’ competencies. Four specific manager’s competencies in this new management model are: conceptual, collaborative, interpersonal, and leadership competencies. Theses competencies should be developed in health system managers so as to lead to organizational excellency and improvement of health service quality. The health sector managers should strengthen these four key competencies and act on them. Then they will become effective leaders and managers in the health system.
Dubyna Maksym V
Full Text Available The article analyzes the nature of the financial services market by using the system approach methodology. In particular, the attention is focused on the already existing conceptual approaches to defining the nature of this market, their basic aspects are analyzed. The use of the system approach allowed to identify the essence of the financial services market as a single, complex system, which is proposed to be considered as an aggregate number of consumers and providers of financial services operating within a single economic space, their relationships emerging to meet different in their nature demands for financial services, with their interrelation being associated with movement of financial resources within this space and partially accompanied by processes of transformation of temporary free funds of economic entities into credit and investment resources. In the article the system components and the relationships between them are determined, the elements of the environment are identified and their relationship with the market for financial services described.
Kishore, M Thomas
Understanding the disability impact on parenting and caregiving is important for intervention. The present study was designed to understand the differences in perceived disability impact and related coping in mothers having children with intellectual disabilities alone compared to those having children with intellectual disabilities and additional disabilities. Accordingly, 30 mothers of children with intellectual disabilities and 30 mothers of children with intellectual and additional disabilities were assessed for disability impact and coping. Group differences for disability impact were present in specific domains but not overall. Despite variations in coping pattern, both positive and negative coping strategies were observed in both groups. The results may imply that the impact of intellectual disability is so pervasive that except in certain domains mothers may not perceive the further impact of additional disabilities. Positive coping does not rule out negative coping strategies. These findings have specific relevance to service delivery in a cultural context.
Full Text Available Objective: In 2013, the Democratic People’s Republic of Korea (DPRK signed the United Nations Convention on the Rights of Persons with Disabilities (UN-CRPD. Since the concept of rehabilitation services in the DPRK did not meet international standards, the government, through the Korean Federation for Protection of the Disabled (KFPD and Munsu Rehabilitation Hospital (MRH, set up a technical consultation with external experts. Methods: Two rounds of consultations were performed, in August 2016 and March 2017, with available methodology, as used in previous consultation processes, but excluding site visits. The consultations started by collecting available data and holding workshops with representatives from the KFPD and the MRH. The results are listed as recommendations for the improvement of health-related rehabilitation services in the DPRK. The results were further developed by KFPD into a draft National Strategy and Action Plan on Comprehensive Rehabilitation (NSAPCR 2017–2020. The draft was discussed with external experts for further improvement prior to discussion with the government. Results and discussion: Overall, the consultation processes was successful, despite the limitation of not making site visits. Recent developments in the DPRK include ratification of the UN-CRPD in December 2016. The authors hope that the NSAPCR can be implemented successfully, leading to improved quality of life for people with disabilities in the DPRK.
Andersen, S. Ry
ophthalmology, formalizid welfare for blind and partially sighted people, laws and help towards welfare, obligations to visually disabled people......ophthalmology, formalizid welfare for blind and partially sighted people, laws and help towards welfare, obligations to visually disabled people...
Full Text Available In this work we introduce a simple client-server system architecture and algorithms for ubiquitous live video and VOD service support. The main features of the system are: efficient usage of network resources, emphasis on user personalization, and ease of implementation. The system supports many continuous service requirements such as QoS provision, user mobility between networks and between different communication devices, and simultaneous usage of a device by a number of users.
Horak, J.; Orlik, A.; Stromsky, J.
Web services support the integration and interoperability of Web-based applications and enable machine-to-machine interaction. The concepts of web services and open distributed architecture were applied to the development of T-DSS, the prototype customised for web based hydro-information systems. T-DSS provides mapping services, database related services and access to remote components, with special emphasis placed on the output flexibility (e.g. multilingualism), where SOAP web services are mainly used for communication. The remote components are represented above all by remote data and mapping services (e.g. meteorological predictions), modelling and analytical systems (currently HEC-HMS, MODFLOW and additional utilities), which support decision making in water management.
WHAT IS KNOWN ON THE SUBJECT?: People with mental health problems and learning disabilities often do not receive the care they require. The Care Programme Approach (CPA) is meant to help with this. However, there have been many problems in the past with the introduction of the CPA into mental health services. There is no literature which explores what factors help or hinder the introduction of the CPA for service users with a mental health and learning disability, especially from the perspective of those responsible for overseeing this process. WHAT DOES THIS ARTICLE ADD TO EXISTING KNOWLEDGE?: The implementation of the CPA for this service user group is fragmented, and services are not working together in partnership. The CPA is being effectively implemented for people who are deemed to present with a risk to themselves or others. If a service user does not present with a high risk, they are not provided care through the CPA. Service users were not involved in the development or introduction of the policy in practice. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Services need to work better at engaging service users when they are developing and introducing new policies. Rather than applying the CPA for all service users, across all services, it should only be considered for those deemed to present with a high risk. It is effectively implemented for these people. For those not deemed to present with a high risk, services should consider using alternative service user led care planning frameworks. Introduction The Care Programme Approach was introduced in England to ensure services met the needs of people with mental health problems and a concurrent learning disability (dual diagnosis). The CPA implementation was patchy and services failed to work in partnership. Aim This study aimed to explore the factors shaping the recent implementation of the CPA for service users with a dual diagnosis. Method A single case study approach was undertaken. Data were collected through
National Oceanic and Atmospheric Administration, Department of Commerce — The Service Records Retention System (SRRS) was developed to store weather observations, summaries, forecasts, warnings, and advisories provided by the U.S. National...
Cegep Graduates with Disabilities: College Exit (CRC) Scores of Graduates Registered for Disability Related Services Compared to Non-Registered Graduates and Graduates without Disabilities. Final Report Presented to PAREA, Spring 2007
Jorgensen, Shirley; Fichten, Catherine; Havel, Alice
The goal of the study was to determine the relative competitiveness in gaining access to university of graduates with and without disabilities, and to determine whether the ease with which graduates experienced aspects of their college environment was related to their college exit scores. We found that graduates who responded to surveys, whether…
Garmann-Johnsen, Niels Frederik; Mettler, Tobias; Sprenger, Michaela
Recent advances in electronics and telecommunication have paved the way for service robots to enter the clinical world. While service robotics has long been a core research theme in computer science and other engineering-related fields, it has attracted little interest of Information Systems (IS) researchers so far. We argue that service robotics represents an interesting area of investigation, especially for healthcare, since current research lacks a thorough examination of socio-technical p...
Suzuki, Koji; Fujita, Motohiro; Matsuura, Kazuma; Fukuzono, Kazuyuki
This paper evaluates the adjustment process for crossing support system for visually disabled at signalized intersections with the use of pedestrian traffic signals in concert with visible light communication (VLC) technology through outdoor experiments. As for the experiments, we put a blindfold on sighted people by eye mask in order to analyze the behavior of acquired visually disabled. And we used a full-scale crosswalk which is taking into consideration the crossing slope, the bumps at the edge of a crosswalk between the roadway and the sidewalkand crosswalk line. From the results of the survey, it is found that repetitive use of the VLC system decreased the number of lost their bearings completely and ended up standing immobile and reduced the crossing time for each person. On the other hand, it is shown that the performance of our VLC system is nearly equal to the existing support system from the view point of crossing time and the number of standing immobile and we clarified the effect factor for guidance accuracy by the regression analyses. Then we broke test subjects down into patterns by cluster analysis, and explained the walking characteristics for each group as they used the VLC system. In addition, we conducted the additional surveys for the quasi-blind subjects who had difficulty walking by using VLC system and visually impaired users. As a result, it is revealed that guidance accuracy was improved by providing the information about their receiving movement at several points on crosswalk and the habit of their walks for each user.
Demydov, Ivan; Klymash, Mykhailo; Kharkhalis, Zenoviy; Strykhaliuk, Bohdan; Komada, Paweł; Shedreyeva, Indira; Targeusizova, Aliya; Iskakova, Aigul
This paper is devoted to the numerical investigation of the availability at cloud service systems. In this paper criteria and constraints calculations were performed and obtained results were analyzed for synthesis purposes of distributed service platforms based on the cloud service-oriented architecture such as availability and system performance index variations by defined set of the main parameters. The method of synthesis has been numerically generalized considering the type of service workload in statistical form by Hurst parameter application for each integrated service that requires implementation within the service delivery platform, which is synthesized by structural matching of virtual machines using combination of elementary servicing components up to functionality into a best-of-breed solution. As a result of restrictions from Amdahl's Law the necessity of cloud-networks clustering was shown, which makes it possible to break the complex dynamic network into separate segments that simplifies access to the resources of virtual machines and, in general, to the "clouds" and respectively simplifies complex topological structure, enhancing the overall system performance. In overall, proposed approaches and obtained results numerically justifying and algorithmically describing the process of structural and functional synthesis of efficient distributed service platforms, which under process of their configuring and exploitation provides an opportunity to act on the dynamic environment in terms of comprehensive services range and nomadic users' workload pulsing.
Mousaid, Sarah; Huegaerts, Kelly; Bosmans, Kim; Julià, Mireia; Benach, Joan; Vanroelen, Christophe
Several European countries implemented initiatives to boost the growth of the domestic cleaning sector. Few studies investigated the quality of work in these initiatives, although effects on workers' health and on social health inequalities can be expected. This study contributes to the scant research on this subject, by investigating the quality of work in the Belgian service voucher system - a subsidized system for domestic work. The applied research methodology includes a qualitative content analysis of parliamentary debates, legislation and previous research about the service voucher system and of 40 in-depth interviews with service voucher workers. The study shows that the legal framework that regulates the system must be further enhanced in order to improve the quality of work in the service voucher system. In addition, the actors involved must be better controlled, and sanctioned in case of non-compliance with legislation. © The Author(s) 2016.
Brewer, Jeffrey L; Taber-Doughty, Teresa; Kubik, Sara
We investigated the perceptions of people about the safety, security and privacy of a telecare monitoring system for adults with developmental disabilities living in residential settings. The telecare system was used by remote caregivers overnight, when staff were not present in the homes. We surveyed 127 people from different stakeholder groups in the state of Indiana. The people surveyed included those with knowledge or experience of telecare, and those without. The stakeholders were clients, their advocates, service provider administrators and independent case coordinators. The responses in each category for every group were positive except one: only 4 of the 11 telecare case coordinators agreed that the telecare system provided a secure environment. Overall, the telecare system was perceived to be as safe, secure and private as the conventional alternative of having staff in the home.
Purpose: The paper aims to provide an overall methodology and case study for the innovation and extension of a digital library, especially the service system. Design/methodology/approach: Based on the three-dimensional structure theory of the information service industry, this paper combines a comprehensive analysis with the practical experiences…