WorldWideScience

Sample records for disability functioning autonomy

  1. "It's My Life": Autonomy and People with Intellectual Disabilities

    Science.gov (United States)

    Björnsdóttir, Kristín; Stefánsdóttir, Guðrún V; Stefánsdóttir, Ástríður

    2015-01-01

    This article discusses autonomy in the lives of adults with intellectual disabilities. The article draws on inclusive research in Iceland with 25 women and 16 men and employs ideas of relational autonomy from the perspectives of the Nordic relational approach to disability. In this article, we examine autonomy in relation to private life, that is,…

  2. The relationship between perceived promotion of autonomy/dependence and pain-related disability in older adults with chronic pain: the mediating role of self-reported physical functioning.

    Science.gov (United States)

    Matos, Marta; Bernardes, Sónia F; Goubert, Liesbet

    2016-08-01

    Chronic pain is prevalent among older adults and is usually associated with high levels of functional disability. Social support for the promotion of functional autonomy and dependence has been associated with pain-related disability and self-reported physical functioning. Nevertheless, these relationships need further inquiry. Our aims were to investigate: (1) the relationship between perceived promotion of autonomy/dependence and pain-related disability and (2) the extent to which self-reported physical functioning mediated these relationships. 118 older adults (Mage = 81.0) with musculoskeletal chronic pain completed the Portuguese versions of the revised formal social support for Autonomy and Dependence in Pain Inventory, the pain severity and interference scales of the Brief Pain Inventory, and the physical functioning scale of the Medical Outcomes Study-Short-Form 36 v2. Higher levels of perceived promotion of autonomy were associated with lower pain-related disability; this relationship was partially mediated by self-reported physical functioning (B = -.767, p dependence was associated with higher pain-related disability; this effect was also partially accounted for by self-reported physical functioning (B = .889, p dependence for managing older adults' experience of chronic pain.

  3. Autonomy Support in People with Mild-to-Borderline Intellectual Disability: Testing the Health Care Climate Questionnaire-Intellectual Disability

    Science.gov (United States)

    Frielink, Noud; Schuengel, Carlo; Embregts, Petri J. C. M.

    2018-01-01

    Background: Autonomy support in people with intellectual disability (ID) is an important yet understudied topic. Psychometrically sound instruments are lacking. This study tested the factor structure and reliability of an instrument for assessing the extent people with intellectual disability perceive their support staff as autonomy supportive.…

  4. "You Have to Care." Perceptions of Promoting Autonomy in Support Settings for Adults with Intellectual Disability

    Science.gov (United States)

    Petner-Arrey, Jami; Copeland, Susan R.

    2015-01-01

    This study from the south-western United States investigated the perceptions of persons with intellectual disability receiving support and of persons providing support regarding the autonomy of people with intellectual disability. The participants included 10 people with intellectual disability and 10 support workers. Through interviews, this…

  5. Euthyroid goitre with and without functional autonomy: A comparison

    International Nuclear Information System (INIS)

    Hillenhinrichs, H.; Emrich, D.

    1998-01-01

    Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global 99m Tc thyroid uptake of ≥3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [de

  6. The Limits of Autonomy: Ideals in Care for People with Learning Disabilities

    NARCIS (Netherlands)

    Pols, Jeannette; Althoff, Brigitte; Bransen, Els

    2017-01-01

    In the Netherlands, autonomy is a key ideal in visions of care for people with learning disability. This ideal can lead to tension when clients, in the opinion of their caregivers, overuse alcohol or drugs. In this article, we analyze how professional caregivers understand the ideal of autonomy in

  7. "A Lesson in Love": The Right to Autonomy of the Disabled

    OpenAIRE

    Fernanda Holanda Fernandes

    2016-01-01

    The International Convention on the Rights of Persons with Disabilities aims to promote the autonomy of these individuals. In this context, it guarantees the right to sexuality, family pool, legal recognition, civil and political rights, etc. From this perspective, the goal is to understand autonomy as an element of human dignity and the theoretical foundations of exercise for people with disabilities. As an example, presents the movie "I Am Sam" in the history of a parent with mental retarda...

  8. Reproductive autonomy of women and girls under the Convention on the Rights of Persons with Disabilities.

    Science.gov (United States)

    Ngwena, Charles G

    2018-01-01

    Women and girls with disabilities have historically been denied the freedom to make their own choices in matters relating to their reproduction. In the healthcare sector they experience multiple discriminatory practices. Women and girls with intellectual disabilities are particularly vulnerable to coerced or forced medical interventions. The present article considers the contribution the Convention on the Rights of Persons with Disabilities makes towards affirming the rights of women and girls with disabilities to enjoy reproductive autonomy, including autonomy related to reproductive health, on an equal basis with individuals without disabilities. The Convention is paradigm-setting in its maximal approach to affirming the rights of individuals with disabilities to make autonomous choices under conditions of equality and non-discrimination. The Convention is the first human rights treaty to clearly affirm that impairment of decision-making skills is not a justification for depriving a person with cognitive or intellectual disability of legal capacity. © 2017 International Federation of Gynecology and Obstetrics.

  9. Radioiodine therapy of functional autonomy using the functional autonomous volume

    International Nuclear Information System (INIS)

    Seeger, T.; Emrich, D.; Sandrock, D.

    1995-01-01

    In order to determine the effective radiation dose to be delivered by 131 I in functional autonomy we have used the functional autonomous volume calculated from the global 99m Tc thyroid uptake under exogenous or endogenous suppression before and 3 to 7 months after treatment. The radiation dose to the autonomous volume was calculated retrospectively in 131 patients with unifocal, multifocal and disseminated autonomy (75 hyperthyroid, 56 euthyroid) who received 131 I treatment of 200-300 Gy to the total volume of the gland. It could be shown that at least 350 Gy to the autonomous volume are required to reach the desired effect of treatment which was dependent only on the radiation dose delivered to the functional autonomous volume. (orig.) [de

  10. Autonomy and social functioning of recently admitted nursing home residents.

    Science.gov (United States)

    Paque, Kristel; Goossens, Katrien; Elseviers, Monique; Van Bogaert, Peter; Dilles, Tinne

    2017-09-01

    This paper examines recently admitted nursing home residents' practical autonomy, their remaining social environment and their social functioning. In a cross-sectional design, 391 newly admitted residents of 67 nursing homes participated. All respondents were ≥65 years old, had mini-mental state examination ≥18 and were living in the nursing home for at least 1 month. Data were collected using a structured questionnaire and validated measuring tools. The mean age was 84, 64% were female, 23% had a partner, 80% children, 75% grandchildren and 59% siblings. The mean social functioning score was 3/9 (or 33%) and the autonomy and importance of autonomy score 6/9 (or 67%). More autonomy was observed when residents could perform activities of daily living more independently, and cognitive functioning, quality of life and social functioning were high. Residents with depressive feelings scored lower on autonomy and social functioning compared to those without depressive feelings. Having siblings and the frequency of visits positively correlated with social functioning. In turn, social functioning correlated positively with quality of life. Moreover, a higher score on social functioning lowered the probability of depression. Autonomy or self-determination and maintaining remaining social relationships were considered to be important by the new residents. The remaining social environment, social functioning, quality of life, autonomy and depressive feelings influenced each other, but the cause--effect relation was not clear.

  11. Autonomy and Substitute Decision-Making with People with Intellectual Disabilities. Ethical Perspective

    OpenAIRE

    Xabier ETXEBERRIA MAULEON

    2016-01-01

    The text deals with the existing ethical tension between decision-making on behalf of people with intellectual disabilities and substitute decision-making, and the duty-bound respect for the person’s autonomy. The work begins by distinguishing decision- making on behalf of someone and substitute decision-making, consequently favoring the latter, as well as relating autonomy to interdependence. This first clarification leads to the construction of a basic and general criterion for substitute d...

  12. Autonomy support in people with mild to borderline intellectual disability : Testing the Health Care Climate Questionnaire-Intellectual Disability (HCCQ-ID)

    NARCIS (Netherlands)

    Frielink, N.; Schuengel, C.; Embregts, P.J.C.M.

    2017-01-01

    Background Autonomy support in people with intellectual disability (ID) is an important yet understudied topic. Psychometrically sound instruments are lacking. This study tested the factor structure and reliability of an instrument for assessing the extent people with intellectual disability

  13. "A Lesson in Love": The Right to Autonomy of the Disabled

    Directory of Open Access Journals (Sweden)

    Fernanda Holanda Fernandes

    2016-06-01

    Full Text Available The International Convention on the Rights of Persons with Disabilities aims to promote the autonomy of these individuals. In this context, it guarantees the right to sexuality, family pool, legal recognition, civil and political rights, etc. From this perspective, the goal is to understand autonomy as an element of human dignity and the theoretical foundations of exercise for people with disabilities. As an example, presents the movie "I Am Sam" in the history of a parent with mental retardation and their legal battle for custody of their daughter.

  14. Radioiodine therapy of benign thyroid disorders: functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.

    2005-01-01

    In the last 15 years, several concepts have been developed to further improve the outcome of radioiodine therapy in functional thyroid autonomy. Results of radioiodine therapy in functional autonomy are considerably better than in Graves' disease. All of the currently-applied concepts offer healing rates of 75-100%, but they differ considerably in the hypothyreosis rates attained. The target volume can be precisely determined by sonography only in unifocal autonomy. In the case of multifocal and disseminated autonomy, the entire thyroid is taken as the target volume and the focal dose is reduced ('dosimetric compromise'). TcTUs-based dose concepts calculate the functionally autonomous volume from the TcTUs and replace the target volume by sonography, in the TcTUs-adapted dose concepts, sonographic target volume is left and the focal dose varied in dependence of the suppression uptake. The objective is to attain a high rate of success with a low rate of hypothyreosis. (orig.)

  15. Our experience with radioiodine therapy of thyroid functional autonomies

    International Nuclear Information System (INIS)

    Kraft, Otakar

    2005-01-01

    Full text: In this paper the author presents his experience with radioiodine therapy of thyroid functional autonomies. The objectives of this study were to establish the efficacy and determine the adverse effects of radioiodine therapy of patients with thyroid functional autonomies. The main pathologic attribute of thyroid functional autonomies is the loss of regulation in the axis of hypothalamus-hypophysis-thyroid. The main cause of functional autonomy of the thyroid is iodine deficiency. Over a period of 30 years (1974-2004) 799 patients (age from 33 to 86 years; average age 58.7 years; the female: male ration was 7.4:1) with unifocal functional autonomy (UFA), multifocal functional autonomy (MFA) and disseminated functional autonomy (DFA) received at least one treatment of radioiodine. For diagnostics and the evaluation of radioiodine therapeutic effect of functional autonomies a thyroid scintigraphy is the basic and necessary procedure. In some patients a common scintigraphy with special imaging modulation, in some patients a scintigraphy after suppression or stimulation by means of thyroid hormones or TSH were done. We have also performed a thyroid ultrasonography, an assessment of a serum level of a total and free thyroxine, total triiodothyronine, TSH, radioiodine accumulation test, estimation of radioiodine effective half-life, in some patients TRH-TSH test. The follow-up examinations were done in all patients after 4-6 months, another examination after one year in 545 patients and after two years in 254 patients. One therapeutic dose received 733 patients (91.74%) and it was sufficient for an elimination of functional autonomies. Some patients were retreated if there was the evidence of small or no treatment effect and no elimination of functional autonomies. Two radioiodine treatments received 62 patients (7.76%) and three treatments 4 patients (0.5%). We advocate individual pre-therapeutic dosimetry to determine the activity necessary to achieve a

  16. Respecting autonomy in the end-of-life care of people with intellectual disabilities: a qualitative multiple-case study.

    NARCIS (Netherlands)

    Bekkema, N.; Veer, A.J.E. de; Hertogh, C.M.P.M.; Francke, A.L.

    2014-01-01

    Background: The aim of this article was to describe how caregivers and relatives shape respect for autonomy in the end-of-life care for people with intellectual disabilities (ID) and to discuss to what extent this corresponds with a relational concept of autonomy, such as described in care ethics.

  17. Space autonomy as migration of functionality: the mars case

    NARCIS (Netherlands)

    Grant, T.; Bos, A.; Neerincx, M.; Soler, A.O.; Brauer, U.; Wolff, M.

    2006-01-01

    This paper develops Grandjean and Lecouat's insight that spacecraft autonomy can be seen as the migration of functionality from the ground segment to the space segment. Their insight is extended to manned planetary exploration missions and applied to an IT-based crew assistant for supporting manned

  18. Reduction of thyroid volume following radioiodine therapy for functional autonomy

    International Nuclear Information System (INIS)

    Luster, M.; Jacob, M.; Thelen, M.H.; Michalowski, U.; Deutsch, U.; Reiners, C.

    1995-01-01

    In a retrospective study we evaluated the data of 112 patients who underwent radioiodine treatment for functional autonomy of the thyroid at Essen University Hospital from 1988 to 1993. Therapeutic activities of radioiodine were administered after individual determination of activity for intended radiation doses (150-300 Gy) taking into consideration autonomously functioning volume, maximum uptake, and effective half-life. The achieved dose was calculated by means of measurement of the radioiodine kinetics during therapy. Depending on the type of autonomous function of the thyroid (solitary autonomously functioning nodule, multiple autonomously functioning nodules, autonomously functioning thyroid tissue) volume reductions between 39 and 46% were found approximately 6 months after treatment. (orig.) [de

  19. Differentiated thyroid carcinoma with functional autonomy.

    Science.gov (United States)

    Yaturu, Subhashini; Fowler, Marjorie R

    2002-01-01

    To present a case of papillary carcinoma in an autonomously hyperfunctioning thyroid nodule. We chronicle the clinical and laboratory findings in a patient with a painless neck mass, with a particular focus on the pathologic findings after surgical removal of the right thyroid lobe. A 39-year-old woman had an enlarging nodule of the right thyroid lobe. Results of thyroid function tests suggested subclinical hyperthyroidism. Two months later, the patient complained of increasing swelling in the neck (but still had no symptoms suggestive of hyperthyroidism). Thus, resection of the right thyroid lobe was performed. Pathologic analysis disclosed low-grade papillary thyroid carcinoma within the nodule, with a small rim of compressed inactive-appearing thyroid tissue surrounding the nodule. Subsequently, she underwent total thyroidectomy and follow-up care for thyroid carcinoma. Although solitary hyperfunctioning nodules of the thyroid gland are usually considered benign, the current case suggests that the diagnosis of autonomous thyroid nodules does not preclude thyroid carcinoma in a functioning nodule.

  20. Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults' chronic pain experiences.

    Science.gov (United States)

    Matos, Marta; Bernardes, Sónia F; Goubert, Liesbet; Beyers, Wim

    2017-12-01

    This longitudinal study aimed to investigate (a) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain and (b) the mediating role of pain-related self-efficacy and pain-related fear in this moderation. One hundred and seventy older adults (Mage = 78.0; SD = 8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with 3 measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire, and the Tampa Scale of Kinesiophobia. Using structural equation modeling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator. These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults' pain-related disability. Also, they clarify the role of pain-related self-efficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain on older adults' healthy ageing process, are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Negotiated autonomy in diabetes self-management: the experiences of adults with intellectual disability and their support workers.

    Science.gov (United States)

    Whitehead, L C; Trip, H T; Hale, L A; Conder, J

    2016-02-02

    The basic human right of autonomy is underpinned by the ability to practice decision-making. The rights of people with disabilities to engage in autonomous decision-making are promoted as best practice and includes decisions around health and self-care. Little is known about autonomy in the field of long-term condition management. This paper explores how people with intellectual disabilities (ID) and their support workers experience and practice autonomy in relation to the management of diabetes. Semi-structured interviews were completed in residential and independent living settings with people living with an ID and type 1 (N = 8) or type 2 (N = 6) diabetes and their support workers (N = 17). The participant with ID's support worker was present as requested; however, the interviews were run separately with each participant rather than jointly. Thematic analysis was undertaken, and a constructivist lens informed both data collection and analysis. The analysis revealed a strong process of negotiated autonomy between people with ID and their support workers in relation to the daily management of diabetes. During times of transition, roles in relation to diabetes management were renegotiated, and the promotion of autonomy was prefaced within the context of risk and client safety. Goals to increase independence were drivers for negotiating greater autonomy. The successful negotiation of autonomy in relation to diabetes illustrates the potential for people with ID to play a key role in the management of long-term health conditions. The study highlights the primacy of developing decision-making skills among people with ID. Promoting opportunities for decision-making and an ethos of supported decision-making through person-centred planning are all vital in working towards enhancing autonomy. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  2. Perceived autonomy and activity choices among physically disabled older people in nursing home settings: a randomized trial

    DEFF Research Database (Denmark)

    Andresen, Mette; Runge, Ulla; Hoff, Morten

    2009-01-01

    OBJECTIVE. To evaluate the effect of individually tailored programs on perceived autonomy in institutionalized physically disabled older people and to describe participants' activity wishes and content of the programs. METHOD. This blinded randomized trial with follow up included a total of nine...... the correspondence between the individual wishes for activities and the concrete content of the programs was not obvious, results indicate potential for enabling the perception of autonomy among physically disabled older nursing home residents. The clinical consequences may suggest a focus on existing traditions...... nursing homes and 50 nursing home residents who were randomized into either a control group or an intervention group. Perceived autonomy was measured at baseline (T1), after 12 weeks (T2) of intervention and after 24 weeks (T3) Wishes for daily activities was identified at T1. Weekly reports of individual...

  3. Autonomy Support, Need Satisfaction, and Motivation for Support among Adults with Intellectual Disability: Testing a Self-Determination Theory Model

    Science.gov (United States)

    Frielink, Noud; Schuengel, Carlo; Embregts, Petri J. C. M.

    2018-01-01

    The tenets of self-determination theory as applied to support were tested with structural equation modelling for 186 people with ID with a mild to borderline level of functioning. The results showed that (a) perceived autonomy support was positively associated with autonomous motivation and with satisfaction of need for autonomy, relatedness, and…

  4. The Impact of Motivation and Teachers’ Autonomy Support on Children’s Executive Functions

    Directory of Open Access Journals (Sweden)

    Zrinka eSosic-Vasic

    2015-02-01

    Full Text Available The present study investigates the interplay of executive functions, motivation and teacher’s autonomy support in school context. In a cross-sectional study design 208 students from different school types completed a standardized motivation questionnaire and processed two executive function tasks. All teachers who teach these students were asked about their autonomy supporting behavior by a standardized test. Multilevel analyses assessed the effects of the student’s motivation and their teachers’ autonomy support on student’s executive functions. Our results show considerable relationships between these variables: high executive function capacities came along with teacher’s autonomy support and student’s intrinsic motivation styles, whereas low executive function capacities were related to external regulation styles. The results indicate the importance of autonomy support in school instruction and disclose the need to popularize the self-regulation approach.

  5. The impact of motivation and teachers’ autonomy support on children’s executive functions

    Science.gov (United States)

    Sosic-Vasic, Zrinka; Keis, Oliver; Lau, Maren; Spitzer, Manfred; Streb, Judith

    2015-01-01

    The present study investigates the interplay of executive functions, motivation, and teacher’s autonomy support in school context. In a cross-sectional study design 208 students from different school types completed a standardized motivation questionnaire and processed two executive function tasks. All teachers who teach these students were asked about their autonomy supporting behavior by a standardized test. Multilevel analyses assessed the effects of the student’s motivation and their teachers’ autonomy support on student’s executive functions. Our results show considerable relationships between these variables: high executive function capacities came along with teacher’s autonomy support and student’s intrinsic motivation styles, whereas low executive function capacities were related to external regulation styles. The results indicate the importance of autonomy support in school instruction and disclose the need to popularize the self-regulation approach. PMID:25762958

  6. The impact of motivation and teachers' autonomy support on children's executive functions.

    Science.gov (United States)

    Sosic-Vasic, Zrinka; Keis, Oliver; Lau, Maren; Spitzer, Manfred; Streb, Judith

    2015-01-01

    The present study investigates the interplay of executive functions, motivation, and teacher's autonomy support in school context. In a cross-sectional study design 208 students from different school types completed a standardized motivation questionnaire and processed two executive function tasks. All teachers who teach these students were asked about their autonomy supporting behavior by a standardized test. Multilevel analyses assessed the effects of the student's motivation and their teachers' autonomy support on student's executive functions. Our results show considerable relationships between these variables: high executive function capacities came along with teacher's autonomy support and student's intrinsic motivation styles, whereas low executive function capacities were related to external regulation styles. The results indicate the importance of autonomy support in school instruction and disclose the need to popularize the self-regulation approach.

  7. Who's counting? Institutional Autonomy and the Production of Activity Data for Disability Policy in France (2006-2014

    Directory of Open Access Journals (Sweden)

    Pierre-Yves Baudot

    2014-07-01

    Full Text Available This article deals with the use of figures for public action piloting in disability policy. This particular public action sector seems to lack piloting figures and comparable data for the monitoring of action in institutions in charge of granting social services for disabled persons, the Maisons départementales des personnes handicapées (MDPH. Based on fieldwork carried out since 2011 in this sector, this article reveals that the production of specific activity figures requires resource mobilisation and precise tasks on the part of organisations. The production of activity data therefore can reflect the autonomy of these administrative organisations. In limiting the capacity of these organisations specifically tasked with benefits attribution decisions, political authorities have also limited the autonomy they could in theory have claimed, and, in so doing, have limited their capacity to make these decisions independently of the political configurations and economic situations within which these benefits are recognised

  8. Conceptualizing Parental Autonomy Support: Adolescent Perceptions of Promotion of Independence versus Promotion of Volitional Functioning

    Science.gov (United States)

    Soenens, Bart; Vansteenkiste, Maarten; Lens, Willy; Luyckx, Koen; Goossens, Luc; Beyers, Wim; Ryan, Richard M.

    2007-01-01

    In current research on parenting, 2 ways of conceptualizing perceived parental autonomy support can be distinguished. Parental autonomy support can be defined in terms of promotion of independence (PI) or in terms of promotion of volitional functioning (PVF). This study aimed to establish the empirical distinctiveness of both conceptualizations…

  9. Radioiodine-treatment (RIT) of functional thyroidal autonomy

    International Nuclear Information System (INIS)

    Meller, J.; Sahlmann, C.O.; Becker, W.

    2002-01-01

    Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)

  10. Euthyroid goitre with and without functional autonomy: A comparison; Jodmangelstruma mit und ohne funktionelle Autonomie in der euthyreoten Phase: Ein Vergleich

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    Hillenhinrichs, H.; Emrich, D. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

    1998-05-01

    Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global {sup 99m}Tc thyroid uptake of {>=}3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [Deutsch] Analyse der funktionellen Autonomie in der euthyreoten Phase. Methoden: Es wurden 163 klinisch euthyreote Patienten mit Jodmangelstruma ohne und 179 mit funktioneller Autonomie anhand von Geschlechtsverhaeltnis, Lebensalter, Beschwerden, Symptomen, sonographischem Befund, qualitativer und quantitativer Szintigraphie ohne und mit Suppression, TRH-Test, Hormonkonzentrationen und Jodausscheidung im Urin verglichen. Ergebnisse: Lebensalter, Beschwerden und Symptome, Schilddruesenvolumen und Echomuster lieferten keinen ausreichend sicheren Beitrag zur Diagnose. Die quantitative Szintigraphie war dem TRH-Test ueberlegen. Erhoehte Hormonkonzentrationen ergaben sich bei 15% der Patienten mit funktioneller Autonomie. Als Grenzwert fuer ein erhoehtes spontanes Hyperthyreoserisiko wurde eine globale thyreoidale {sup 99m}Tc-Aufnahme unter Suppression von {>=}3% ermittelt, die in 20% der Patienten mit funktioneller

  11. The radio-iodine therapy of the functional autonomy. Indications, findings, risks

    International Nuclear Information System (INIS)

    Reiners, C.

    1990-01-01

    The functional autonomy of the thyroid is a disorder, which appears in connection with iodine deficit and befalls the complete organ. An absolute indication for a radio-iodine-therapy is given in case of hyperthyreoidism (these are 25 % of all at the functional autonomy). Contrary to the operation method the advantage of the I-131-therapy is, that all of the functional autonome-cells can be reached. The risk at the I-131-therapy is low. (Botek)

  12. The impact of motivation and teachers? autonomy support on children?s executive functions

    OpenAIRE

    Sosic-Vasic, Zrinka; Keis, Oliver; Lau, Maren; Spitzer, Manfred; Streb, Judith

    2015-01-01

    The present study investigates the interplay of executive functions, motivation, and teacher’s autonomy support in school context. In a cross-sectional study design 208 students from different school types completed a standardized motivation questionnaire and processed two executive function tasks. All teachers who teach these students were asked about their autonomy supporting behavior by a standardized test. Multilevel analyses assessed the effects of the student’s motivation and their teac...

  13. The Impact of Motivation and Teachers’ Autonomy Support on Children’s Executive Functions

    OpenAIRE

    Zrinka eSosic-Vasic; Oliver eKeis; Maren eLau; Manfred eSpitzer; Manfred eSpitzer; Judith eStreb

    2015-01-01

    The present study investigates the interplay of executive functions, motivation and teacher’s autonomy support in school context. In a cross-sectional study design 208 students from different school types completed a standardized motivation questionnaire and processed two executive function tasks. All teachers who teach these students were asked about their autonomy supporting behavior by a standardized test. Multilevel analyses assessed the effects of the student’s motivation and their teach...

  14. Parental Psychological Control and Autonomy Granting: Distinctions and Associations with Child and Family Functioning

    Science.gov (United States)

    Kunz, Jennifer Hauser; Grych, John H.

    2012-01-01

    Objective This study utilized an observational coding scheme to identify parenting behavior reflecting psychological control and autonomy granting and examined relations between these parenting dimensions and indices of child and family functioning. Design A community sample of 90 preadolescents (aged 10.5 to 12 years) and both of their parents engaged in a triadic interaction that was coded for parental psychological control and autonomy granting. Participants also completed measures of child adjustment, interparental conflict, and triangulation. Results Factor analyses indicated that a two-factor model better fit the data than a one-factor model, suggesting that psychological control and autonomy granting are best conceptualized as independent but related constructs. Parental psychological control and autonomy granting exhibited some shared and some unique correlates with indices of child and family functioning. Hierarchical regressions revealed significant interactions between these dimensions, suggesting that the strength of some associations between parents’ use of psychological control and youth adjustment problems depends on the level of autonomy granting exhibited by the parent. Conclusions By examining psychological control and autonomy granting simultaneously as unique constructs, this study identifies patterns of psychological control and autonomy granting that undermine youth adjustment. Findings inform targeted intervention efforts for families of preadolescent youth. PMID:23418403

  15. The role of sex, attachment and autonomy-connectedness in personality functioning.

    Science.gov (United States)

    Bachrach, Nathan; Croon, Marcel A; Bekker, Marrie H J

    2015-11-01

    Previous studies have found significant relationships among sex, attachment and autonomy-connectedness and DSM-IV personality characteristics. In the present study, we aimed to add to the current knowledge about attachment-related aspects of personality pathology, by examining the relationships of these same variables with dimensions of pathological personality structure as conceptualized by Kernberg. The study was performed among 106 ambulatory patients from a Dutch mental healthcare institute. A path model based upon neo-analytical object relation theory and attachment theory was tested. We expected significant associations among sex, attachment, autonomy and aspects of personality functioning. Both insecure attachment styles as well as the autonomy-connectedness components of sensitivity to others (SO) and capacity of managing new situations predicted general personality dysfunctioning significantly. More specifically, reality testing was negatively predicted by the autonomy component of capacity of managing new situations, and aggression was significantly predicted by sex as well as both insecure attachment styles. We advise scientists as well as clinicians to be alert on sex differences in autonomy-connectedness and aspects of personality dysfunctioning. Taking sex-specific variations in attachment and autonomy into account next to a more explicit focus on insecure attachment styles and autonomy problems may enhance, the current relatively low, treatment effectiveness for personality pathology. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Autonomy support, need satisfaction, and motivation for support among adults with intellectual disability : Testing a self-determination theory model

    NARCIS (Netherlands)

    Frielink, N.; Schuengel, C.; Embregts, P.J.C.M.

    2018-01-01

    The tenets of self-determination theory as applied to support were tested with structural equation modelling for 186 people with ID with a mild to borderline level of functioning. The results showed that (a) perceived autonomy support was positively associated with autonomous motivation and with

  17. Functional disability in elderly with dementia

    Directory of Open Access Journals (Sweden)

    Tainã Alves Fagundes

    2017-03-01

    Full Text Available Introduction: Dementia represents one of the major causes of disability and dependence in old age and can affect functional capacity in all areas of occupational performance, including basic and instrumental activities of daily living (BADL and IADL, respectively, leisure, social participation and others. Objectives: To characterize the functional disability level in elderly people with dementia and verify the existence of correlation between functionality and the stage or type of dementia. Method: Quantitative, exploratory, cross-sectional study, with a sample of 25 caregivers of elderly with dementia. For the characterization of the participants were used structured questionnaires and to assess functional disability, the Disability Assessment Scale for Dementia - DAD was applied. Results: Greater incapacity was observed in the IADL sub item. This finding is compatible with the literature on the hierarchy in functional decline in the elderly: decline begins in IADL, while BADL remain unaffected for a longer period. There was no significant correlation between the type of dementia, age or gender and disability. It was verified through the Spearman coefficient (rho = 0.87, a significant correlation of high magnitude between functional disability and stage of dementia (p = 0.0001. Conclusion: Such findings reiterate the importance of giving priority to early detection and prevention of the functional decline, which is the manifestation of vulnerability among the elderly.

  18. Perceived participation and autonomy: aspects of functioning and contextual factors predicting participation after stroke.

    Science.gov (United States)

    Fallahpour, Mandana; Tham, Kerstin; Joghataei, Mohammad Taghi; Jonsson, Hans

    2011-04-01

    To describe perceived participation and autonomy among a sample of persons with stroke in Iran and to identify different aspects of functioning and contextual factors predicting participation after stroke. A cross-sectional study. A total of 102 persons, between 27 and 75 years of age, diagnosed with first-ever stroke. Participants were assessed for different aspects of functioning, contextual factors and health conditions. Participation was assessed using the Persian version of the Impact on Participation and Autonomy questionnaire. This study demonstrated that the majority of the study population perceived their participation and autonomy to be good to fair in the different domains of their participation, but not with respect to the autonomy outdoors domain. In addition, physical function was found to be the most important variable predicting performance-based participation, whereas mood state was the most important variable predicting social-based participation. The results emphasize the importance of physical function, mood state and access to caregiving services as predictors of participation in everyday life after stroke. Whilst there are two dimensions of participation in this Persian sample of persons with stroke, the factors explaining participation seem to be the same across the cultures.

  19. Evaluation of Functional Disability in ALS

    Directory of Open Access Journals (Sweden)

    Akbar Soltan-Zadeh

    2002-06-01

    Full Text Available Objective: Amyotrophic Lateral Sclerosis (ALS is a progressive degenerative fatal disorder of motor neuron. In this research course of functional disability and possible underlying factors affecting disability were studied. Materials & Methods: First 59 patients with definite ALS were selected and for each patient ALSFRS (ALS Functional Rating Scale was determined at Initial and the end of a six month period. Results: During this period 9 patients expired. Bulbar onset localization showed a more rapid course than non-bulbar onset group. Conclusion: There was no significant relationship between the age group or gender with progression of disability. In expired group, mean survival in bulbar onset and older patients were significantly less than those with non-bulbar onset and younger ones. There was no significant relationship between survival and gender.

  20. Impact of anxiety, apathy and reduced functional autonomy on perceived quality of life in Parkinson's disease.

    Science.gov (United States)

    D'Iorio, Alfonsina; Vitale, Carmine; Piscopo, Fausta; Baiano, Chiara; Falanga, Anna Paola; Longo, Katia; Amboni, Marianna; Barone, Paolo; Santangelo, Gabriella

    2017-10-01

    Parkinson's disease (PD) is characterized by a wide spectrum of non-motor symptoms that may impact negatively on the activities of the patient's daily life and reduce Health-related quality of life (HRQoL). The present study explored the impact of specific non-motor symptoms on the HRQoL in PD. Eighty-four outpatients underwent the Montreal Cognitive Assessment (MoCA) assessing global functioning and several questionnaires to assess depression, apathy, impulse control disorders (ICD), anxiety, anhedonia and functional impact of cognitive impairment. The perceived QoL was assessed by Parkinson's Disease Questionnaire (PDQ-8). The PD sample was divided into patients with high and low HRQoL around the median of PDQ-8 and compared on clinical features, cognitive and neuropsychiatric variables. A linear regression analysis, in which the global functioning, apathy, depression, anxiety, anhedonia, ICD and the functional autonomy scores were entered as independent variables and PDQ-8 score as dependent variable, was applied. Patients with lower HRQoL were more depressed, apathetic, anxious and showed more severe reduction of functional autonomy and global functioning than patients with high HRQoL. The regression analysis revealed that higher level of anxiety, executive apathy and more reduced functional autonomy were significantly associated with higher score on PDQ-8. The finding indicated that anxiety, apathy associated with impaired planning, attention and organization (i.e., executive apathy evaluated by the Dimensional Apathy Scale) and reduced functional autonomy contribute significantly to reduce the HRQoL in PD. Therefore, early identification and management of these neuropsychiatric symptoms should be relevant to preserve HRQoL in PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Executive functions in adolescents with spina bifida: relations with autonomy development and parental intrusiveness.

    Science.gov (United States)

    Tuminello, Elizabeth R; Holmbeck, Grayson N; Olson, Rick

    2012-01-01

    The current study was part of a larger longitudinal investigation and examined the relation of parent-report and performance measures of executive functioning (EF) with measures of behavioral and emotional autonomy and parental intrusiveness in adolescents with and without spina bifida (SB; n=65 in a comparison sample and 61 in an SB sample; M age=14.55, SD=0.63). For both groups, higher levels of parent-reported EF problems predicted higher levels of observed child dependency and lower levels of teacher-reported intrinsic motivation. Higher scores on performance EF measures predicted lower levels of observed child dependency and observed maternal intrusiveness for both groups. In adolescents with SB only, higher performance EF scores predicted higher intrinsic motivation and emotional autonomy from both mother and father and predicted lower levels of observed paternal intrusiveness. While causal conclusions cannot be drawn, EFs appear to be closely related to autonomy development and parental intrusiveness, particularly for adolescents with SB. These results suggest that the inclusion of EF training in interventions targeting adolescents with SB may be beneficial for autonomy development.

  2. Effects of eight weeks of functional training in the functional autonomy of elderly women: a pilot study.

    Science.gov (United States)

    DE Matos, Dihogo G; Mazini Filho, Mauro L; Moreira, Osvaldo C; DE Oliveira, Cláudia E; DE Oliveira Venturini, Gabriela R; DA Silva-Grigoletto, Marzo E; Aidar, Felipe J

    2017-03-01

    This study aimed to evaluate the effects of eight weeks of practical training on the functional autonomy of the elderly. The study included 52 elderly women, 65.42±10.31 years, 65.29±11.30 kg body mass, 1.58±0.07 height, 26.30±4.52 body mass index, 86.48±10.96 cm waist circumference. These elderly women received a specific functional training protocol where their functional autonomy was assessed at three specific times (0, 10 and 20 sessions). The evaluation consisted of a set of five tests defined by the Latin-American Development Group for the Elderly (GDLAM) to determine the functional autonomy of the elderly: walk 10 meters (C10m); stand up from a chair and walk straightaway (SUCWA); dress and undress a T-shirt (DUT); stand up from a sitting position (SUSP); stand up from a lying position (SULP). In each test, the time taken to complete the task was measured. There were statistically significant differences in all functional autonomy tests after 20 training sessions: C10m (pre: 8.10±1.27; post: 7.55±1.10); SUCWA (pre: 40.98±2.77; post: 38.44±2.57); DUT (pre: 13.25±0.88; post: 11.85±0.82); SUSP (pre: 10.74±0.52; post: 8.98±056) and SULP (pre: 3.86±0.37; post: 2.82±0.37). It was determined that 20 functional training sessions were enough to improve the functional autonomy of elderly women. However, we believe that higher volume and intensity of training could be interesting alternatives for even stronger results in future interventions.

  3. Executive Functioning and Figurative Language Comprehension in Learning Disabilities

    Science.gov (United States)

    Bishara, Saied; Kaplan, Shani

    2016-01-01

    The goal of the research was to examine executive functioning and figurative language comprehension among students with learning disabilities as compared to students without learning disabilities. As part of the research, we examined 20 students with learning disabilities and 21 students with no learning disabilities, both groups of students…

  4. Regional resources buffer the impact of functional limitations on perceived autonomy in older adults with multiple illnesses.

    Science.gov (United States)

    Schüz, Benjamin; Westland, Josh N; Wurm, Susanne; Tesch-Römer, Clemens; Wolff, Julia K; Warner, Lisa M; Schwarzer, Ralf

    2016-03-01

    Retaining perceptions of autonomy is a key component of successful aging. Perceived autonomy refers to the capacity to make and enact self-directed decisions. These perceptions are often threatened in older adults with multiple illnesses, when functional limitations resulting from these illnesses impede the enactment of self-directed decisions. Regional resources (in Germany specifically at the level of administrative districts) might counteract these impediments of autonomy. Economically stronger districts can provide more-concrete support resources for older adults, buffering the negative effect of functional limitations on self-perceived autonomy. This study assessed participants aged over 65 with 2 or more chronic conditions. In total, N = 287 provided data (Mage = 73.3, SD = 5.07), and n = 97 were women. Gross domestic product (GDP) per capita was used as a proxy measure of administrative district wealth in Germany. Hierarchical multilevel regression analyses with cross-level interactions were conducted. Results suggest that the detrimental effect of functional limitations on perceived autonomy is less pronounced for participants residing in higher GDP districts. Conversely, for participants in lower GDP districts, the effect is exacerbated. This finding suggests that districts with greater financial resources might be better able to invest in supports that promote and facilitate autonomy and, thus, provide a buffer against threats to individual perceived autonomy. (c) 2016 APA, all rights reserved).

  5. Exploring Functional Disability in Older Adults with Low Vision

    Science.gov (United States)

    Travis, Linda A.; Boerner, Kathrin; Reinhardt, Joann P.; Horowitz, Amy

    2004-01-01

    This article reports on a study that explored the prevalence and predictors of functional disability that are due to visual problems as opposed to functional disability that is due to other health problems. It also discusses the implications for psychosocial and rehabilitative interventions that target different types of disability. (Contains 5…

  6. The eSMAF: a software for the assessment and follow-up of functional autonomy in geriatrics

    Directory of Open Access Journals (Sweden)

    Tousignant Michel

    2007-02-01

    Full Text Available Abstract Background Functional status or disability forms the core of most assessment instruments used to identify mix and level of resources and services needed by older adults who possess common characteristics. The Functional Autonomy Measurement System (SMAF is a 29-item scale measuring functional ability in five different areas. It has been recommended for use for home care, for allocation of chronic beds, for developing care plans in institutional settings and for epidemiological and evaluative studies. The SMAF can also be used with a case-mix classification system (Iso-SMAF to allocate resources based on patients' functional autonomy characteristics. The objective of this project was to develop a software version of the SMAF to facilitate the evaluation of the functional status of older adults in health services research and to optimize the clinical decision-making process. Results The eSMAF was developed over an 24-month period using a modified waterfall software engineering process. Requirements and functional specifications were determined using focus groups of stakeholders. Different versions of the software were iteratively field-tested in clinical and research environments and software adaptations made accordingly. User documentation and online help were created to assist the deployment of the software. The software is available in French or English versions under a 30-day unregistered demonstration license or a free restricted registered academic license. It can be used locally on a Windows-based PC or over a network to input SMAF data into a database, search and aggregate client data according to clinical and/or administrative criteria, and generate summary or detailed reports of selected data sets for print or export to another database. Conclusion In the last year, the software has been successfully deployed in the clinical workflow of different institutions in research and clinical applications. The software performed

  7. Professional autonomy.

    Science.gov (United States)

    Aprile, A E

    1998-02-01

    Professional autonomy may represent the first step to implementing measures that will allow CRNAs to attain a level of independent practice consistent with their clinical and educational training. Autonomy is regarded as an essential ingredient of professionalism and confers independent function at the individual practitioner level. The principle of autonomy refers to the individual's capacity to make independent decisions based on the assumption that he or she possesses the cognitive, psychological, and emotional faculties to make rational decisions. Nursing practice meets the first two criteria of professionalism--competence and dedication to an important social good. The third criterion of professionalism, autonomy, has been a focal point for controversy since the late nineteenth century, in which obedience to supervisors and physicians remained a central focus of nursing ethics teaching until the advent of feminism in the 1970s. This article presents a thorough analysis of these concepts with some thoughts on how understanding the fundamental precepts and further research may not only help maintain the current level of CRNA professional autonomy but serve to guide us to become more autonomous in the future.

  8. Effect of resistive training on the maximum strenght,flexibility and functional autonomy of elderly woman

    Directory of Open Access Journals (Sweden)

    Estélio Henrique Martin Dantas

    2006-12-01

    Full Text Available The objective of this study was to investigate the effects of resistive training on maximum strength, flexibility and functional autonomy, as well as the correlation between maximum strength and functional autonomy of the elderly women (strength group, GF, n=11, = 66.3 ± 7.84 years/control group, GC, n=11, =65.1 ± 3.33 years. They participated of a resistive training (75-85% 1RM during 16 weeks, 2 days/week. Statistical procedures were Pearson’s correlation and Student t-test, using the SPSS package, version 12.0. Data showed signifi cant results for GF on the strength, fl exibility and functional autonomy, and signifi cant correlation between strength and functional autonomy (r=-0.67. The data suggested that training program enhances performance in activities of daily living with a training protocol of only 2 days/week. RESUMO O objetivo desse estudo foi verifi car os efeitos do treinamento resistido na força máxima, na fl exibilidade e na autonomia funcional, bem como a correlação existente entre a força máxima e a autonomia funcional de idosas (grupo de força - GF n=11, = 66,3±7,84 anos e um grupo controle - GC n=11, =65,1±3,33 anos. O GF foi submetido a um treinamento contra resistência de força (75-85% 1RM, por 16 semanas, 2 dias/semana. O tratamento estatístico utilizado foi correlação de Pearson e o teste “t” de Student. Os dados mostraram resultados signifi cativos do GF no ganho da força máxima, fl exibilidade e autonomia funcional, e correlação signifi cativa entre a força máxima medida no exercício supino reto (SR e o teste de autonomia funcional levantar da posição de decúbito ventral (LPDV (r=-0,67. Os dados sugerem que o programa de treinamento melhorou o desempenho das atividades da vida diária da amostra, com um treinamento de apenas 2 dias/semana.

  9. Sleep and Cognitive Functioning in Children with Disabilities

    Science.gov (United States)

    Buckhalt, Joseph A.

    2013-01-01

    Sleep disorders and sleep of insufficient duration and quality have been associated with impaired cognitive functioning in typically developing children and in children with a wide array of disabilities and medical conditions. Among children with disabilities, those with intellectual disability, attention deficit hyperactivity disorder, and autism…

  10. Functioning and disability in recent research from Cameroon: a ...

    African Journals Online (AJOL)

    Introduction: People living with disabilities in Cameroon face many barriers to daily functioning and social participation. However, there is limited research on disabilities and their impact. We sought to examine the research related to disability from Cameroon. Methods: We conducted a systematic review, bibliometric ...

  11. Parental Autonomy Granting and School Functioning among Chinese Adolescents: The Moderating Role of Adolescents’ Cultural Values

    Science.gov (United States)

    Wang, Cixin; Do, Kieu Anh; Bao, Leiping; Xia, Yan R.; Wu, Chaorong

    2017-01-01

    School adjustment and achievement are important indicators of adolescents’ well-being; however, few studies have examined the risk and protective factors predicting students’ school adjustment and achievement at the individual, familial, and cultural level. The present study examined the influences of individual and familial factors and cultural values on Chinese adolescents’ school functioning (e.g., school adjustment and grades). It also tested whether cultural values moderated the relationship between parenting and adolescents’ school functioning. Self-report data were collected from a stratified random sample of 2,864 adolescents (51.5% female, mean age = 15.52 years, grade 6th – 12th) from 55 classrooms, in 13 schools in Shanghai, China. Results showed that self-esteem (bse→adj = 0.05, SE = 0.01, p autonomy granting and adolescents’ grades (bindepxautom = 0.06, SE = 0.02, p cultural values may influence adolescents’ appraisal of parental autonomy granting, which then impacts their school functioning. PMID:29326622

  12. Parental Autonomy Granting and School Functioning among Chinese Adolescents: The Moderating Role of Adolescents' Cultural Values.

    Science.gov (United States)

    Wang, Cixin; Do, Kieu Anh; Bao, Leiping; Xia, Yan R; Wu, Chaorong

    2017-01-01

    School adjustment and achievement are important indicators of adolescents' well-being; however, few studies have examined the risk and protective factors predicting students' school adjustment and achievement at the individual, familial, and cultural level. The present study examined the influences of individual and familial factors and cultural values on Chinese adolescents' school functioning (e.g., school adjustment and grades). It also tested whether cultural values moderated the relationship between parenting and adolescents' school functioning. Self-report data were collected from a stratified random sample of 2,864 adolescents (51.5% female, mean age = 15.52 years, grade 6th - 12th) from 55 classrooms, in 13 schools in Shanghai, China. Results showed that self-esteem ( b se→adj = 0.05, SE = 0.01, p school adjustment and grades, respectively. More importantly, results showed that independent self-construal moderated the relationship between parental autonomy granting and adolescents' grades ( b indepxautom = 0.06, SE = 0.02, p autonomy granting, which then impacts their school functioning.

  13. Reproduction, functional autonomy and changing experiences of intimate partner violence within marriage in rural India.

    Science.gov (United States)

    Bourey, Christine; Stephenson, Rob; Hindin, Michelle J

    2013-12-01

    The literature on intimate partner violence in resource-poor contexts relies primarily on cross-sectional studies. Because changes in women's status and empowerment are hypothesized to influence violence vulnerability, longitudinal studies are needed to determine the potential benefits and harms associated with such changes. Data were collected prospectively from a representative cohort of 4,749 married women in rural areas of four socially and demographically diverse states in India in 1998-1999 and 2002-2003. A multinomial regression model including social and demographic characteristics and intersurvey changes and events related to functional autonomy and reproduction was fitted to a categorical outcome measuring the absence (reference), initiation, cessation and continuation of intimate partner violence. Continued freedom of movement, increased freedom of movement and continued financial autonomy between baseline and follow-up were associated with a lower risk of violence initiation rather than no violence (relative risk ratio, 0.7 for each). Having a first child was associated with lower risk of violence initiation and continuation rather than no violence (0.6 and 0.2, respectively). Women who reported that their relative economic contribution to the household decreased or increased and women who experienced an unwanted pregnancy had a higher risk of violence continuation rather than no violence (1.8, 1.8 and 1.5, respectively). The death of a child was associated with higher risk of violence initiation rather than no violence (1.4). Future research to inform interventions to reduce intimate partner violence should consider how changes in women's reproductive experiences and functional autonomy may be linked to changes in intimate partner violence.

  14. Functional diversity in Spain. Towards the equal inclusion of persons with disabilities

    Directory of Open Access Journals (Sweden)

    Colectivo Ioé

    2013-07-01

    Full Text Available This text brings together some of the conclusions of the study Disabilities and social inclusion, edited in 2012 by La Caixa Foundation, which in its turn in based on the last survey on Disability, Personal Autonomy and Frailty conducted by the Spanish Statistical Office (INE in 2008. In particular, it focuses on some of the aspects of major interest for understanding the ways of social inclusion and labor insertion of the persons with functional diversity, a group of 3.8 million people, of which 1.5 million people are in their working age. Some analyses and proposals to address the problems of chronification and marginalization of this large sector of the population are highlighted from a socio-preventative approach.

  15. [Functioning and disability: the International Classification of Functioning, Disability and Health (ICF)].

    Science.gov (United States)

    Fernández-López, Juan Antonio; Fernández-Fidalgo, María; Geoffrey, Reed; Stucki, Gerold; Cieza, Alarcos

    2009-01-01

    The World Health Organization's International Classification of Functioning, Disability and Health (ICF) has provided a new foundation for our understanding of health, functioning, and disability. It covers most of the health and health-related domains that make up the human experience, and the most environmental factors that influence that experience of functioning and disability. With the exhaustive ICF, patients' functioning -including its components body functions and structures and activities and participation-, becomes a central perspective in medicine. To implement the ICF in medicine and other fields, practical tools (= ICF Core Sets) have been developed. They are selected sets of categories out of the whole classification which serve as minimal standards for the assessment and reporting of functioning and health for clinical studies and clinical encounters (Brief ICF Core Set) or as standards for multiprofessional comprehensive assessment (Comprehensive ICF Core Set). Different from generic and condition-specific health-status measures, the ICF Core Sets include important body functions and structures and contextual factors. The use of the ICF Core Sets provides an important step towards improved communications between healthcare providers and professionals, and will enable patients and their families to understand and communicate with health professionals about their functioning and treatment goals. Specific applications include multi- and interdisciplinary assessment in clinical settings and in legal expert evaluations and use in disease or functioning-management programs. The ICF has also a potential as a conceptual framework to clarify an interrelated universe of health-related concepts which can be elucidated based on the ICF and therefore will be an ideal tool for teaching students in all medical fields and may open doors to multi-professional learning.

  16. Do Children's Executive Functions Account for Associations Between Early Autonomy-Supportive Parenting and Achievement Through High School?

    Science.gov (United States)

    Bindman, Samantha W; Pomerantz, Eva M; Roisman, Glenn I

    2015-08-01

    This study evaluated whether the positive association between early autonomy-supportive parenting and children's subsequent achievement is mediated by children's executive functions. Using observations of mothers' parenting from the NICHD Study of Early Child Care and Youth Development ( N = 1,306), analyses revealed that mothers' autonomy support over the first 3 years of life predicted enhanced executive functions (i.e., inhibition, delay of gratification, and sustained attention) during the year prior to kindergarten and academic achievement in elementary and high school even when mothers' warmth and cognitive stimulation, as well as other factors (e.g., children's early general cognitive skills and mothers' educational attainment) were covaried. Mediation analyses demonstrated that over and above other attributes (e.g., temperament), children's executive functions partially accounted for the association between early autonomy-supportive parenting and children's subsequent achievement.

  17. Global functioning and disability in dissociative disorders.

    Science.gov (United States)

    Mueller-Pfeiffer, Christoph; Rufibach, Kaspar; Perron, Noelle; Wyss, Daniela; Kuenzler, Cornelia; Prezewowsky, Cornelia; Pitman, Roger K; Rufer, Michael

    2012-12-30

    Dissociative disorders are frequent comorbid conditions of other mental disorders. Yet, there is controversy about their clinical relevance, and little systematic research has been done on how they influence global functioning. Outpatients and day care patients (N=160) of several psychiatric units in Switzerland were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV Axis I Disorders, Structured Clinical Interview for DSM-IV Dissociative Disorders, Global Assessment of Functioning Scale, and World Health Organization Disability Assessment Schedule-II. The association between subjects with a dissociative disorder (N=30) and functional impairment after accounting for non-dissociative axis I disorders was evaluated by linear regression models. We found a proportion of 18.8% dissociative disorders (dissociative amnesia=0%, dissociative fugue=0.6%, depersonalization disorder=4.4%, dissociative identity disorder=7.5%, dissociative disorder-not-otherwise-specified=6.3%) across treatment settings. Adjusted for other axis I disorders, subjects with a comorbid dissociative identity disorder or dissociative disorder-not-otherwise-specified had a median global assessment of functioning score that was 0.86 and 0.88 times, respectively, the score of subjects without a comorbid dissociative disorder. These findings support the hypothesis that complex dissociative disorders, i.e., dissociative identity disorder and dissociative disorder-not-otherwise-specified, contribute to functional impairment above and beyond the impact of co-existing non-dissociative axis I disorders, and that they qualify as "serious mental illness". Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Parental Autonomy Granting and School Functioning among Chinese Adolescents: The Moderating Role of Adolescents’ Cultural Values

    Directory of Open Access Journals (Sweden)

    Cixin Wang

    2017-12-01

    Full Text Available School adjustment and achievement are important indicators of adolescents’ well-being; however, few studies have examined the risk and protective factors predicting students’ school adjustment and achievement at the individual, familial, and cultural level. The present study examined the influences of individual and familial factors and cultural values on Chinese adolescents’ school functioning (e.g., school adjustment and grades. It also tested whether cultural values moderated the relationship between parenting and adolescents’ school functioning. Self-report data were collected from a stratified random sample of 2,864 adolescents (51.5% female, mean age = 15.52 years, grade 6th – 12th from 55 classrooms, in 13 schools in Shanghai, China. Results showed that self-esteem (bse→adj = 0.05, SE = 0.01, p < 0.001; bse→grades = 0.08, SE = 0.02, p < 0.001, parent–adolescent conflict (bconflict→adj = -0.03, SE = 0.00, p < 0.001; bconflict→grades = -0.04, SE = 0.01, p < 0.001, and conformity to parental expectations (bconform→adj = -0.03, SE = 0.02, p < 0.05; bconform→grades = 0.10, SE = 0.04, p < 0.05 all had significant effects on both school adjustment and grades, respectively. More importantly, results showed that independent self-construal moderated the relationship between parental autonomy granting and adolescents’ grades (bindepxautom = 0.06, SE = 0.02, p < 0.01. The findings suggest that cultural values may influence adolescents’ appraisal of parental autonomy granting, which then impacts their school functioning.

  19. THE FUNCTIONS OF CATALAN EDUCATIONAL INSPECTION FROM THE CATALAN EDUCATIONAL LAW (LEC AND THE CENTERS AUTONOMY PROCESS

    Directory of Open Access Journals (Sweden)

    Joan Segura Torres

    2017-06-01

    Full Text Available Catalonia is one of the most developed community in relation to the centers autonomy. A step forward was made with of the LEC (2009 and the Centers Autonomy Decree. The role of the Educational Inspection has not been explained or revised to adapt to those new changes and how to contribute from its position. This article presents a review of all the current legislative documentation in Autonomy of Centers and Educational Inspection in Catalonia with the aim of contributing some conclusions which show us how the inspection function is positioned in developing its functions facing this situation change and suggestions about where it should lead to contribute to the improvement of educational quality. It has been carried out within the framework of the PhD Program of the Autonomous University of Barcelona.

  20. Fathers Matter: The Role of Father Autonomy Support and Control in Preschoolers' Executive Function Development

    Science.gov (United States)

    Meuwissen, Alyssa S.; Carlson, Stephanie M.

    2015-01-01

    Although previous work has shown that mothers' parenting influences the development of child executive function (important self-control skills developed in the preschool years) the role of fathers' parenting has not been thoroughly investigated. We observed fathers' autonomy support and control in dyadic play with their 3-year-old children (N pairs = 110), and measured father and child EF independently with laboratory tasks. We found that fathers' controlling parenting was significantly inversely related to the child EF composite, above and beyond family income and child verbal ability. These results are consistent with the hypothesis that fathers are important for the development of EF in their children, and suggest fathers should be included in both research and parenting interventions. PMID:26209884

  1. [Implementation of functional autonomy measurement system: barriers and facilitators in PISE-Dordogne project].

    Science.gov (United States)

    Gervais, Pauline; Hébert, Réjean; Lamontagne, Julie; Tousignant, Michel

    2011-12-01

    The objectives of the study were to identify the adjustments made during the implantation and the conditions favouring or limiting the SMAF utilisation. A multiqualitative quote was developed. The Functional autonomy measurement system (SMAF) was implanted in 11 French medico-social establishments. Analyses were made with the mixed type thematic method from Miles and Huberman. Principal adjustments that have been made during implantation concern the informatics assistance and clinical support. Strategic, organizational and individual factors explained adhesion level of actors and the subsequent flow of implantation. Establishment of SMAF and of the software eSMAF® in the medico-social establishments rests on a certain number of conditions which could be identified during the study. These conditions made it possible to work out structured recommendations for future implementations.

  2. Do Children's Executive Functions Account for Associations between Early Autonomy-Supportive Parenting and Achievement through High School?

    Science.gov (United States)

    Bindman, Samantha W.; Pomerantz, Eva M.; Roisman, Glenn I.

    2015-01-01

    This study evaluated whether the positive association between early autonomy-supportive parenting and children's subsequent achievement is mediated by children's executive functions. Using observations of mothers' parenting from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (N…

  3. Thyroid autonomy: sensitive detection in vivo and estimation of its functional relevance using quantified high-resolution scintigraphy

    International Nuclear Information System (INIS)

    Baehre, M.; Lindemann, C.; Emrich, D.; Hilgers, R.

    1988-01-01

    This study is concerned with 236 euthyroid individuals living in an area of iodine deficiency, 227 of whom had endemic goitres. In these subjects, autonomy could be suspected owing to an inhomogeneous activity distribution on the thyroid scintigram or a subnormal TSH response to TRH. They complete a total number of 426 investigated individuals. Previously, in 190 separated controls without evidence of autonomy, the reference ranges for the thyroid 99m Tc pertechnetate uptake under suppression (TcU s ), a measure for the non-suppressible thyroid iodide clearance, and for suppressibility of circumscribed thyroid regions, had been determined. These two parameters obtained by highresolution quantified scintigraphy were used for an accurate detection of thyroid autonomy among the 236 individuals. Suppression scintigraphy revealed autonomy in 171 patients. ΔTSH after TRH was subnormal in 40% of the subjects with abnormal thyroid suppressibility. Prevalence of abnormal suppression was dependent on three factors: patient age, goitre type and estimated thyroid weight. In the total investigated collective, the prevalence of autonomy was 77% in patients with a goitre weight above 50 g. The individuals with abnormal suppression were grouped into four classes of TcU s . I these classes, free thyroxie index (FT 4 I) and total triiodothyronine (TT 3 ) icreased with increasing TcU s , whereas ΔTSH decreased. This finding indicates a continuum of different extents of autonomous thyroid function, whereas in the individual patient, the extent can be determined using the pertechnetate uptake under suppression. In addition, FT 4 I, TT 3 and ΔTSH in each of the TcU s classes depended on the individual iodine supply. It is concluded that, in patients with thyroid autonomy, actual thyroid hormone concentrations and TSH stimulation are determined by two major factors: the extent of autonomy and the individual iodine supply. Therefore, in iodine deficiency, the TRH test may be normal

  4. A comparison of the International Classification of Functioning, Disability, and Health to the disability tax credit.

    Science.gov (United States)

    Conti-Becker, Angela; Doralp, Samantha; Fayed, Nora; Kean, Crystal; Lencucha, Raphael; Leyshon, Rhysa; Mersich, Jackie; Robbins, Shawn; Doyle, Phillip C

    2007-01-01

    The Disability Tax Credit (DTC) Certification is an assessment tool used to provide Canadians with disability tax relief The International Classification of Functioning, Disability and Health (ICF) provides a universal framework for defining disability. The purpose of this study was to evaluate the DTC and familiarize occupational therapists with the process of mapping measures to the ICF classification system. Concepts within the DTC were identified and mapped to appropriate ICF codes (Cieza et al., 2005). The DTC was linked to 45 unique ICF codes (16 Body Functions, 19 Activities and Participation, and 8 Environmental Factors). The DTC encompasses various domains of the ICF; however, there is no consideration of Personal Factors, Body Structures, and key aspects of Activities and Participation. Refining the DTC to address these aspects will provide an opportunity for fair and just determinations for those who experience disability.

  5. Comparison of Functional Disability with Physical Activity in Patients ...

    African Journals Online (AJOL)

    The objectives of this study were to evaluate the effects of functional disabilities and physical activity in patients with low back pain (LBP) and apparently healthy individuals (AHI).Oswestry Low back Pain disability questionnaire was administered to thirty five (35) subjects drawn from 3 various health facilities in Lagos State.

  6. The Role of Autonomy, Self-Realization, and Psychological Empowerment in Predicting Outcomes for Youth with Disabilities

    Science.gov (United States)

    Shogren, Karrie A.; Shaw, Leslie A.

    2016-01-01

    This study examined the degree to which the three of the four essential characteristics of self-determination (autonomy, self-realization, and psychological empowerment) predicted quality of life-related adult outcome constructs using secondary analysis of data from the National Longitudinal Transition Study-2. The pattern of predictive…

  7. CIFKAS A Measurer of Functional Disability Status in Knee ...

    African Journals Online (AJOL)

    CIFKAS A Measurer of Functional Disability Status in Knee Osteoarthritis. Vijay Batra, Vijai Prakash Sharma, Meenakshi Batra, Vineet Sharma, Girdhar Gopal Agarwal, Vijay K Singh, Ravindra Mohan Pandey ...

  8. Whether antithyroid drugs influence on the outcome of radioiodine therapy of thyroid functional autonomy?

    International Nuclear Information System (INIS)

    Valuyevich, Viktar V.; Danilova, Larisa I.; Kaiser, Klaus P.; Ostwald-Lenz, Elisabeth; Wieler, Helmut

    2005-01-01

    Full text: The purpose of research was an estimation of the influence of antithyroid medication on efficiency of radioiodine therapy (RIT) in patients with thyroid functional autonomy (FA). 100 patients with various clinical variants of FA were included in research and received treatment with radioiodine. From them uni-focal autonomy (UFA) was diagnosed in 65 person, multifocal (MFA) in 14 and disseminated (DA) in 21. Among the patients included in research 8 had relapse of hyperthyroidism after initial operative treatment and 1 after RIT. The data in work are submitted as a median (1-st and 3-rd quartiles). The age of surveyed was 65.5 (54; 72.5), from them 63 persons were a female, 37 were a male. From surveyed 2 groups of patients were formed. The first group consisted from 50 person, initially accepting during 4 months (2.5; 6) antithyroid drugs (ATD) which cancellation had been made as a rule 2 day prior to RIT, and the second one included 50 person, not accepting ATD neither up to nor after RIT. 9 elderly and multi morbid patients from the first group continued to accept ATD within several months after RIT. Carbimazole (n=45) or methimazole (n=5) in a dose of 10 mg (5; 10) were used as ATD. Therapeutic activity of 131 I was calculated by means of Marinelli's formula. The target dose for UFA has made 400 Gy, for MFA and DA - 150 Gy. For calculation of thyroid uptake 24-hour radioiodine test was carried 2-3 day prior to RIT. Used activity of I-131 have made from 4.08 up to 58.89 mCi. Duration of inpatient stay has made 3 days (2; 5). In 4 months (4; 5) after RIT the successful result (euthyroidism or hypothyroidism) has been achieved in 48 (96 %) patients accepting ATD, and in 47 (94 %) patients who were not accepting last. Conclusion: The conclusion that antithyroid medication does not influence on the efficiency of RIT of FA was made. It was revealed that frequency of hypothyroidism after RIT in patients of the first group was higher (36 %) than in patients

  9. The influence of antithyroid drugs on the results of radioiodine therapy of thyroid functional autonomy

    International Nuclear Information System (INIS)

    Valuevich, V.V.

    2005-01-01

    The purpose of the given research was the estimation of the influence of antithyroid medication on efficiency of radioiodine therapy (RIT) of nonimmune hyperthyroidism in patients with thyroid functional autonomy (FA). 100 patients with various clinical variants of thyroid FA were included in research and received treatment with radioactive iodine. From surveyed 2 groups of patients were formed. The first group consisted from 50 persons initially accepting during 4 months (2.5; 6) antithyroid drugs (ATD) which cancellation had been made, as a rule, 2 day prior to RIT, and the second included 50 persons not accepting ATD neither up to nor after RIT. 9 elderly and multimorbid patients from the first group continued to accept ATD within several months after RIT. Carbimazole (n=45) or methimazole (n=5) in a doze of 10 mg (5; 10) were used as antithyroid drugs. In 4 months (4; 5) after RIT the successful result (euthyrosis or hypothyroidism) was achieved in 48 (96%) patients accepting ATD, and in 47 (94%) patients who were not accepting last. The conclusion that antithyroid medication does not influence on efficiency of RIT of thyroid FA is made. It is revealed that frequency of hypothyroidism after RIT in patients of the first group was higher (36%), than in patients of the second group (20%). (authors)

  10. Results of a TcTUs-optimized radioiodine therapy of multifocal and disseminated functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.; Endlicher, D.; Prillwitz, A.; Rudolph, F.; Groth, P.; Schuemichen, C.

    1999-01-01

    Aim: The presented study prospectively evaluates the efficacy of optimized radioiodine therapy in patients (pts) with multifocal (MFA) and disseminated (DISA) autonomy. The target dose was related to the total thyroid volume and was increased in moderate and nonlinear increments for 150 to 300 Gy dependent on the pretherapeutic Tc-99m pertechnetate thyroid uptake under suppression (TcTUs). Patients with focal autonomy were treated with a target dose independent of TcTUs and were used as control group. Methods: The data of 641 pts (518 women, 123 men) were evaluated, 466 pts with MFA or DISA and 175 pts with focal autonomy. In pts with MFA and DISA the target dose was increased in four steps: TcTUs 3-6%: 200 Gy, >6-12%: 250 Gy and >12%: 300 Gy. In pts with focal autonomy a fixed target dose of 300 or 400 Gy was applied. The radioactivity to be administered was calculated using a modified Marinelli formula. The follow-up examination was performed at the earliest after four, on average after eight months. Normalization of TSH was the only criterion for successful therapy. Results: The success rate in pts with latent or manifest hyperthyroidism in focal autonomy was 91.5%, thereby was not successful in 5.1% and hypothyroidism occurred in 3.4%. The average success rate in pts with MFA and DISA was 91.5%, therapy failed in 7.5% and a very low rate of 1% with hypothyroidism was seen. Conclusion: The presented optimized therapy concept with calculated, nonlinear increase of the target dose according to the TcTUs-level guaranteed even in MFA and DISA a high success rate comparable to that in focal autonomy along with a very low rate of hypothyroidism. (orig.) [de

  11. Assessing functional impairment in siblings living with children with disability.

    Science.gov (United States)

    Goudie, Anthony; Havercamp, Susan; Jamieson, Barry; Sahr, Timothy

    2013-08-01

    The purpose of this study was to empirically test if siblings of children with disability had higher levels of parent-reported behavioral and emotional functional impairment compared with a peer group of siblings residing with only typically developing children. This was a retrospective secondary analysis of data from the Medical Expenditure Panel Survey. We included only households with at least 2 children to ensure sibling relationships. Two groups of siblings were formed: 245 siblings resided in households with a child with disability and 6564 siblings resided in households with typically developing children. Parents responded to questions from the Columbia Impairment Scale to identify functional impairment in their children. On the basis of parent reports and after adjusting for sibling demographic characteristics and household background, siblings of children with disability were more likely than siblings residing with typically developing children to have problems with interpersonal relationships, psychopathological functioning, functioning at school, and use of leisure time (P siblings of children with disability classified with significant functional impairment was 16.0% at the first measurement period and 24.2% at the second (P siblings of typically developing children there was a smaller percentage increase from 9.5% to 10.3% (P mental health services and, as such, early assessment and interventions to limit increasing severity and short- to long-term consequences need to be addressed. Health care professionals need to consider a family-based health care approach for families raising children with disability.

  12. Vitamin B12 Deficiency in Relation to Functional Disabilities

    Directory of Open Access Journals (Sweden)

    Heather E. Rasmussen

    2013-11-01

    Full Text Available This study was designed to assess whether symptoms, functional measures, and reported disabilities were associated with vitamin B12 (B12 deficiency when defined in three ways. Participants, aged 60 or more years of age, in 1999–2002 National Health and Nutrition Examination Surveys (NHANES were categorized in relation to three previously used definitions of B12 deficiency: (1 serum B12 20 μmol/L; and (3 serum B12 0.21 μmol/L. Functional measures of peripheral neuropathy, balance, cognitive function, gait speed, along with self-reported disability (including activities of daily living were examined with standardized instruments by trained NHANES interviewers and technicians. Individuals identified as B12 deficient by definition 2 were more likely to manifest peripheral neuropathy OR (odds (95% confidence intervals, p value: 9.70 (2.24, 42.07, 0.004 and report greater total disability, 19.61 (6.22, 61.86 0.0001 after adjustments for age, sex, race, serum creatinine, and ferritin concentrations, smoking, diabetes, and peripheral artery disease. Smaller, but significantly increased, odds of peripheral neuropathy and total disability were also observed when definition 3 was applied. Functional measures and reported disabilities were associated with B12 deficiency definitions that include B12 biomarkers (homocysteine or methylmalonic acid. Further study of these definitions is needed to alert clinicians of possible subclinical B12 deficiency because functional decline amongst older adults may be correctable if the individual is B12 replete.

  13. Radioiodine therapy of thyroid functional autonomies: Experience at a single university referral hospital centre in Czech Republic

    International Nuclear Information System (INIS)

    Kraft, O.

    2006-01-01

    This paper presents the results of I-131 therapy in patients suffering from various types of functional autonomies of the thyroid gland. The efficacy and adverse effects of radioiodine therapy are presented. Seven hundred ninety-nine patients (age range= 33 to 86 years; average age= 58.7 years; Male: Female = 7.4:1) with unifocal, multifocal and disseminated functional autonomies of thyroid gland were treated with at least one therapeutic dose of I-131. Baseline Tc-99m pertechnetate thyroid scans, radioactive iodine uptake studies and ultrasonography were performed in all cases prior to radio iodine therapy. Baseline serum total and free thyroxine (T-T4 and F-T4), total triiodothyronine (T-T3) and TSH levels were estimated in all cases. Effective half life of radio iodine in the thyroids was also determined in all patients prior to therapy and a few patients were subjected to TRH stimulation tests. Following treatment all patients were evaluated after a period of 4-6 months. Further follow up evaluations were done at one year in 545 patients and at two years in 254 patients. Complete elimination of functional autonomy was achieved in 733 (91.74%) patients with a single therapeutic dose of I-131, while 62 (7.76%) patients required two doses of I-131 and only 4 (0.5%) patients required three therapeutic doses of I-131. Following I-131 therapy, the suppression of TSH levels in serum disappeared in 607 (76%) of treated patients. An average volume reduction of 38% was noted in the thyroid gland following I-131. Side effects were minimal and only a few patients complained of transient neck pressure, pain and neck swelling. Postradiation hypothyroidism was diagnosed in 36 patients (4.5%). We conclude that radio iodine treatment is the most comfortable and economical approach to the treatment of the thyroid functional autonomies. The results of our approach show that the radioiodine therapy of the thyroid functional autonomies is safe, with low incidence of adverse effects

  14. Functional Evaluation of Asibot: A New Approach on Portable Robotic System for Disabled People

    Directory of Open Access Journals (Sweden)

    Alberto Jardón

    2012-01-01

    Full Text Available In this work, an innovative robotic solution for human care and assistance is presented. Our main objective is to develop a new concept of portable robot able to support the elderly and those people with different levels of disability during the execution of daily tasks, such as washing their face or hands, brushing their teeth, combing their hair, eating, drinking, and bringing objects closer, among others. Our prototype, ASIBOT, is a five degrees of freedom (DOF self-contained manipulator that includes the control system and electronic equipment on board. The main advantages of the robot are its light weight, about 11 kg for a 1.3 m reach, its autonomy, and its ability to move between different points (docking stations of the room or from the environment to a wheelchair and vice versa, which facilitates its supportive functions. The functional evaluation of ASIBOT is addressed in this paper. For this purpose the robotic arm is tested in different experiments with disabled people, gathering and discussing the results according to a methodology that allows us to assess users' satisfaction.

  15. Are gains in decision-making autonomy during early adolescence beneficial for emotional functioning? The case of the United States and china.

    Science.gov (United States)

    Qin, Lili; Pomerantz, Eva M; Wang, Qian

    2009-01-01

    This research examined the role of children's decision-making autonomy in their emotional functioning during early adolescence in the United States and China. Four times over the 7th and 8th grades, 825 American and Chinese children (M = 12.73 years) reported on the extent to which they versus their parents make decisions about issues children often deem as under their authority. Children also reported on their emotional functioning. American children made greater gains over time in decision-making autonomy than did Chinese children. Initial decision-making autonomy predicted enhanced emotional functioning similarly among American and Chinese children. However, gains over time in decision-making autonomy predicted enhanced emotional functioning more in the United States (vs. China) where such gains were normative.

  16. View of Mexican family members on the autonomy of adolescents and adults with intellectual disability Puntos de vista de familiares de adolescentes y adultos mexicanos con discapacidad intelectual acerca de su autonomía

    Directory of Open Access Journals (Sweden)

    Betania Allen-Leigh

    2008-01-01

    Full Text Available This study aims to describe the ways in which Mexican adolescents and adults with intellectual disability exercise autonomy. Two focus groups were carried out with family members who are the legal guardians of people with intellectual disability who have received independent living training at the Center for Integral Training and Development (CADI, per its abbreviation in Spansh. Focus group transcripts were analyzed with codes defined a priori, based on an existing theoretical framework on autonomy and quality of life among intellectually disabled persons. Autonomy is exercised by the intellectually disabled in the personal, social, sexual and economic spheres of life. Empowered autonomy implies that the person is taught the necessary skills and then allowed to act upon his or her own interests. Negotiated autonomy includes guidance, explanation and negotiation; it constitutes a learning process. Interpreted autonomy is the most limited type described, and implies protection, interpretation and may involve decision-making by others. These types of autonomy constitute a complex phenomenon and the divisions between them are indistinct.Este estudio busca describir las maneras en que jóvenes y adultos mexicanos con discapacidad intelectual ejercen la autonomía. Dos grupos focales se llevaron a cabo con familiares de personas con discapacidad intelectual quienes han recibido capacitación para la vida independiente en el Centro de Capacitación y Desarrollo Integral, CADI. Se analizaron las transcripciones con códigos definidos a priori, basados en un marco teórico preexistente sobre autonomía y calidad de vida entre personas con discapacidad intelectual. Las personas con discapacidad intelectual ejercen autonomía en diversos ámbitos: personal, social, sexual y económico. La autonomía empoderada se da cuando se le enseña a la persona las habilidades necesarias y luego se le permite actuar con base en sus propios intereses. La autonom

  17. Visual functions and disability in diabetic retinopathy patients.

    Science.gov (United States)

    Shrestha, Gauri Shankar; Kaiti, Raju

    2014-01-01

    This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. A cross-sectional study was carried out among 38 visually impaired diabetic retinopathy subjects at the Low Vision Clinic of B.P. Koirala Lions Centre for Ophthalmic Studies, Kathmandu. The subjects underwent assessment of distance and near visual acuity, objective and subjective refraction, contrast sensitivity, color vision, and central and peripheral visual fields. The visual disabilities of each subject in their daily lives were evaluated using a standard questionnaire. Multiple regression analysis between visual functions and visual disabilities index was assessed. The majority of subjects (42.1%) were of the age group 60-70 years. Best corrected visual acuity was found to be 0.73±0.2 in the better eye and 0.93±0.27 in the worse eye, which was significantly different at p=0.002. Visual disability scores were significantly higher for legibility of letters (1.2±0.3) and sentences (1.4±0.4), and least for clothing (0.7±0.3). Visual disability index for legibility of letters and sentences was significantly correlated with near visual acuity and peripheral visual field. Contrast sensitivity was also significantly correlated with the visual disability index, and total scores. Impairment of near visual acuity, contrast sensitivity, and peripheral visual field correlated significantly with different types of visual disability. Hence, these clinical tests should be an integral part of the visual assessment of diabetic eyes. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  18. Reproductive autonomy: A case study

    Directory of Open Access Journals (Sweden)

    David R Hall

    2016-11-01

    Full Text Available Reproductive autonomy (RA has been challenged by the availability of genetic information, disability and the ethics of selective reproduction. Utilitarian and rights-based approaches, as well as procreative beneficence (PB fail to provide compelling reasons for infringing RA, and may even be likened to dangerous eugenics. Parents are not morally obliged to prevent the birth of a disabled child. Society should rather adopt inclusivity, recognising and providing persons with disabilities opportunities for capability and worthwhile lives.

  19. Lodge Programs Serving Family Functions for People with Psychiatric Disabilities.

    Science.gov (United States)

    Onaga, Esther E.; McKinney, Kathleen G.; Pfaff, Judy

    2000-01-01

    Interviews were conducted with people affiliated with lodges, a community program for people with psychiatric disabilities, about their perceptions of promising practices. Responses validated the notion that the lodge serves many of the functions of a family. Provides excerpts from interviews to supplement this theme. Discusses implications for…

  20. Comparison of measures of functional disability in patients with gout

    NARCIS (Netherlands)

    ten Klooster, Peter M.; Oude Voshaar, Antonius H.; Taal, Erik; van de Laar, Mart A F J

    2011-01-01

    Objective. To compare the measurement properties of the HAQ disability index (HAQ-DI), HAQ-II and short form 36 physical functioning scale (PF-10) in patients with gout. Methods. A cross-sectional sample of 97 patients with gout completed all three measures. Reliability was assessed by examining the

  1. Sensory and Motor Peripheral Nerve Function and Incident Mobility Disability

    DEFF Research Database (Denmark)

    Ward, R. E.; Boudreau, R. M.; Caserotti, P.

    2014-01-01

    ObjectivesTo assess the relationship between sensorimotor nerve function and incident mobility disability over 10years. DesignProspective cohort study with longitudinal analysis. SettingTwo U.S. clinical sites. ParticipantsPopulation-based sample of community-dwelling older adults with no mobility...

  2. Autonomia funcional de idosas praticantes de Pilates Functional autonomy of elderly women practicing Pilates

    Directory of Open Access Journals (Sweden)

    Brena Guedes de Siqueira Rodrigues

    2010-12-01

    Full Text Available O objetivo foi avaliar o efeito do método Pilates na autonomia funcional de idosas. Foram selecionadas 52 voluntárias, submetidas à avaliação geral e ao protocolo de avaliação da autonomia funcional do Grupo Latino-Americano de Desenvolvimento para Maturidade (GDLAM, que consiste em cinco testes (caminhada de 10 m, levantar-se da posição sentada, levantar-se da cadeira e locomover-se pela casa, levantar-se da posição de decúbito ventral e vestire tirar uma camiseta; em seguida, foram divididas em dois grupos: grupo Pilates (GP, n=27; idade 66,9±5,3 anos e grupo controle (GC, n=25; idade 65,2±3,9 anos. O GP foi submetido a uma série de dez exercícios de Pilates, por oito semanas, duas vezes por semana. Os dois grupos foram reavaliados após esse período. O nível de significância considerado foi de p?0,05. O GP obteve resultados significativamente melhores em todos os testes e no índice geral do GDLAM (p=0,035 após a intervenção. O GC obteve escore significativamente melhor (p=0,042 apenas no teste de caminhada de 10 m, tendo mantido sua classificação inicial de funcionalidade regular. Comparando-se os escores dos grupos após a intervenção, encontraram-se diferenças significativas em favor do GP, inclusive no índice GDLAM (pThe purpose of the study was to assess the effect of the Pilates method on elderly women's functional autonomy. Fifty-two volunteers were submitted to the evaluation protocol of the Latin-American Group for Maturity Development (GDLAM, which consists of five tests: a 10-meter walk, get up from the sitting and lying down positions, get up and walk around at home, and to put on and take off a t-shirt. They were then divided into Pilates group (PG, n=27, mean age 66.9±5.3 years and control group (CG, n=25, mean age 65.2±3.9 years old. PG underwent a series of 10 Pilates exercises twice-weekly for eight weeks, both groups being reassessed thereafter. The level of significance was set at p?0

  3. Functional autonomy, bone mineral density (BMD) and serum osteocalcin levels in older female participants of an aquatic exercise program (AAG).

    Science.gov (United States)

    Pernambuco, Carlos Soares; Borba-Pinheiro, Claudio Joaquim; Vale, Rodrigo Gomes de Souza; Di Masi, Fabrizio; Monteiro, Paola Karynne Pinheiro; Dantas, Estelio H M

    2013-01-01

    The aim of the present study was to evaluate the effects of an AAG on BMD, osteocalcin and functional autonomy in older women. The sample consisted of eighty-two post-menopausal women with low BMD, randomly divided into two groups: the Aquatic Aerobics Group [AAG; n=42; age: 66.8±4.2years], submitted to two weekly sessions over eight months, and the Control Group (GC; n=42; age: 66.9±3.2years), which did not participate in regular exercise. BMD was measured by Dual Energy X-ray Absorptiometry [DXA] of the lumbar and femur, and serum osteocalcin was measured using electrochemiluminescence. A functional autonomy assessment protocol (GDLAM, 2004) was also applied. Statistical analyses used were repeated measures ANOVA and Tukey's post hoc tests. The results showed a significant improvement in tests following the GDLAM protocol: 10 meters walk (10mw) -p=0.003; rising from a ventral decubitus position (RVDP) - Δ%=0.78, pAAG when compared to the CG. The AAG achieved the best results for BMD; however, no inter or intragroup statistical differences were recorded for total femur -p=0.975 and lumbar L(2)-L(4)p=0.597. For serum osteocalcin, intra and intergroup statistical differences of p=0.042 and p=0.027 were observed in the AAG, respectively. This demonstrates that an eight-month aquatic aerobic exercise program can improve functional autonomy and osteocalcin levels, although training did not improve lumbar and total femur BMD in the older women. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. CIFKAS A Measurer of Functional Disability Status in Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Vijay K Singh

    2012-01-01

    Full Text Available Knee osteoarthritis (OA results in structural and functional abnormalities and reduced functional performance abilities. In developing countries majority of population lives in rural areas having limited resources and socio-cultural biodiversity. Their personal, socio-cultural and occupational habits vary and need to be addressed. So a culturally relevant and contextually appropriate, Composite Indian Functional Knee Assessment Scale (CIFKAS for measuring the functional status in knee osteoarthritis was formulated. 128 participants from various geographical regions of India of age range 40 to 60 years using convenient sampling were included and informed consent signed by the participants. Each participant was assigned to one of the two groups. 39 participants in group A reported no episode of knee pain while 89 participants in group B reported at least one episode of knee pain in the last two months. Each participant was assessed on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC and CIFKAS and statistical analysis was done. The Pearson correlation coefficient calculated for all 128 subjects for pain, physical functional abilities and total functional disability score were 0.878, 0.925 and 0.945 respectively. Between group analysis was done using Independent t test and p value was found to be not significant for pain (<.178, highly significant for physical functional abilities (p<.0001 and very significant for total functional disability status score (p<.004. The results indicate that both WOMAC and CIFKAS are highly correlated and there is no difference between the two for measuring pain, but for functional ability and overall functional disability status within their functional context, CIFKAS is a better tool than WOMAC.

  5. Sibling Relationship Quality and Social Functioning of Children and Adolescents with Intellectual Disability

    Science.gov (United States)

    Floyd, Frank J.; Purcell, Susan E.; Richardson, Shana S.; Kupersmidt, Janis B.

    2009-01-01

    We examined sibling relationships for children and adolescents with intellectual disability and assessed implications for their social functioning. Targets (total N = 212) had either intellectual disability, a chronic illness/physical disability, or no disability. Nontarget siblings reported on relationship quality, sibling interactions were…

  6. Autonomy @ Ames

    Science.gov (United States)

    Van Dalsem, William; Krishnakumar, Kalmanje Srinivas

    2016-01-01

    This is a powerpoint presentation that highlights autonomy across the 15 NASA technology roadmaps, including specific examples of projects (past and present) at NASA Ames Research Center. The NASA technology roadmaps are located here: http:www.nasa.govofficesocthomeroadmapsindex.html

  7. Syntactic autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, L.M.

    1998-12-01

    The study of adapting and evolving autonomous agents should be based on a complex systems-theoretic framework which requires both self-organizing and symbolic dimensions. An inclusive framework based on the notions of semiotics and situated action is advanced to build models capable of representing, as well as evolving in their environments.Such undertaking is pursued by discussing the ways in which symbol and self-organization are irreducibly intertwined in evolutionary systems. With this semiotic view of self-organization and symbols, the authors re-think the notion of autonomy of evolving systems, and show that evolutionary systems are characterized by a particular type of syntactic autonomy. Recent developments in emergent computation in cellular automata are discussed as examples of the emergence of syntactic autonomy in computational environments. New experiments emphasizing this syntactic autonomy in cellular automata are presented.

  8. Visual functions and disability in diabetic retinopathy patients

    OpenAIRE

    Shrestha, Gauri Shankar; Kaiti, Raju

    2013-01-01

    Purpose: This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. Method: A cross-sectional study was carried out among 38 visually impaired diabetic retinopathy subjects at the Low Vision Clinic of B.P. Koirala Lions Centre for Ophthalmic Studies, Kathmandu. The subjects underwent assessment of distance and near visual acuity, objective and subjective refraction, contrast sensitivity, color vision, and central a...

  9. Autonomy and hyperthyroidism

    International Nuclear Information System (INIS)

    Emrich, D.; Schicha, H.; Baehre, M.

    1986-01-01

    The significance of autonomy in iodine-deficiency goiter for the development of hyperthyroidism was investigated. (1) In 171 of 426 consecutive patients high-resolution quantitative scintiscans showed signs suggestive of autonomy. With increasing 99mTc uptake by the thyroid their TT3 levels were found to rise progressively during suppression, while their pre-suppression TSH levels dropped progressively. This suggests global sup(99m)Tc uptake by the thyroid during suppression to be a useful indicator of the functional significance of autonomy. (2) Based on 326 patients with hyperthyroidism a system for differentiating between autonomy-related and immunogenic disease was developed and validated prospectively in another 162 patients with hyperthyroidism by assaying for thyroid stimulating antibodies (TSAb). TSAb was found to be present in 82% of the 77 patients diagnosed as having immunogenic hyperthyroidism and in only 8% of the 85 patients with autonomy-related hyperthyroidism. Our results support the assumption that autonomy in iodine-deficiency goiter plays a major role in the development of hyperthyroidism, while autoimmune processes appear to be of secondary importance. (Author)

  10. Models, controls, and levels of semiotic autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Joslyn, C.

    1998-12-01

    In this paper the authors consider forms of autonomy, forms of semiotic systems, and any necessary relations among them. Levels of autonomy are identified as levels of system identity, from adiabatic closure to disintegration. Forms of autonomy or closure in systems are also recognized, including physical, dynamical, functional, and semiotic. Models and controls are canonical linear and circular (closed) semiotic relations respectively. They conclude that only at higher levels of autonomy do semiotic properties become necessary. In particular, all control systems display at least a minimal degree of semiotic autonomy; and all systems with sufficiently interesting functional autonomy are semiotically related to their environments.

  11. Female disability disadvantage: a global perspective on sex differences in physical function and disability.

    Science.gov (United States)

    Wheaton, Felicia V; Crimmins, Eileen M

    2016-07-01

    The objectives were to determine whether women always fare more poorly in terms of physical function and disability across countries that vary widely in terms of their level of development, epidemiologic context and level of gender equality. Sex differences in self-reported and objective measures of disability and physical function were compared among older adults aged 55-85 in the United States of America, Taiwan, Korea, Mexico, China, Indonesia and among the Tsimane of Bolivia using population-based studies collected between 2001 and 2011. Data were analysed using logistic and ordinary least-squares regression. Confidence intervals were examined to see whether the effect of being female differed significantly between countries. In all countries, women had consistently worse physical functioning (both self-reported and objectively measured). Women also tended to report more difficulty with activities of daily living (ADL), although differences were not always significant. In general, sex differences across measures were less pronounced in China. In Korea, women had significantly lower grip strength, but sex differences in ADL difficulty were non-significant or even reversed. Education and marital status helped explain sex differences. Overall, there was striking similarity in the magnitude and direction of sex differences across countries despite considerable differences in context, although modest variations in the effect of sex were observed.

  12. A Comparative Analysis of Institutional Capacities for Implementing Disability Policies in East African Countries: Functions of National Councils for Disability

    Directory of Open Access Journals (Sweden)

    Akiko Yokoyama

    2012-08-01

    Full Text Available During the “African Decade of Persons with Disabilities (2000-2009”, East African countries witnessed significant achievements, especially in the development of law, collection of statistics and in funding. However, many persons with disability are still marginalised from opportunities in education, healthcare and employment.Purpose: With the pre-supposition that the lack of institutional capacities for implementing disability policies is the one major stumbling-block which hinders widespread delivery of social services to persons with disabilities in low-income countries, this study makes a comparative analysis of institutional capacities in the disability sectors of Uganda, Kenya and Tanzania.Method: The research methods adopted were a literature survey and a field survey. The framework for analysis consists of: 1 capacities and functions of disability units in central governments, 2 relationships between central and local governments in the disability sector, and 3 relationships between governments and organisations of persons with disability (DPOs. Special attention is paid to the status, roles and functions of national councils for disability (NCDs, the independent statutory bodies recently established in each of the three countries, with clear authority and duties for the implementation of disability policies. The NCDs enable multi-sectoral stakeholders to be involved in the implementation of disability policies; therefore, positive relationships between the governments and DPOs are essential for the smooth functioning of the NCDs.Results: While the result of the field survey in Tanzania reveals several effective approaches for the smooth operation of the NCD, further study is needed to verify whether these approaches would be applicable to other East African countries such as Kenya and Uganda.doi 10.5463/DCID.v23i2.106

  13. Nonverbal Learning Disabilities and Socioemotional Functioning: A Review of Recent Literature.

    Science.gov (United States)

    Little, Sara S.

    1993-01-01

    This article presents an overview of literature relating to a nonverbal learning disabilities subtype. The article addresses the relationship between nonverbal learning disabilities and socioemotional functioning, generalizability of research outcomes, individual differences, and treatment validity. (Author/JDD)

  14. Gender differences in functional disability and self-care among seniors in Bangladesh.

    Science.gov (United States)

    Tareque, Md Ismail; Tiedt, Andrew D; Islam, Towfiqua Mahfuza; Begum, Sharifa; Saito, Yasuhiko

    2017-08-08

    Disability among older adults is a public health concern. To date there are no in-depth and comprehensive analyses on older adults' disabilities in Bangladesh. This study investigated gender differences in the prevalence of disability and the socio-demographic factors associated with disability among older adults in Bangladesh. This research used a sample of 4176 elderly males and females aged 60 years and over from a nationally representative data set- Bangladesh's 2010 Household Income and Expenditure Survey. The study used both household level and individual level data and applied a wealth index, which was constructed based on household assets using principal component analysis. The Washington Group's short set of questions on disability were used to measure disability. Chi-square tests and ordinal logistic regression models were fit. Forty-two percent of older had some form of functional disability, including 5% of elderly with severe/extreme functional disability. Seven percent of older adults had a self-care disability, including 3% of elderly with a severe/extreme form of self-care disability. Elderly females suffered from all the studied disabilities, including functional and self-care disabilities in higher percentages, and had higher odds ratios of having both functional disability and self-care disability compared to elderly males. The study also identified some significant factors affecting functional disability and self-care disability, namely age, having a chronic condition, wealth status and place of residence, including divisional differences. Programs aimed at reducing functional disability among seniors, particularly elderly females, should be granted the highest priority in Bangladesh.

  15. Are Gains in Decision-Making Autonomy during Early Adolescence Beneficial for Emotional Functioning? The Case of the United States and China

    Science.gov (United States)

    Qin, Lili; Pomerantz, Eva M.; Wang, Qian

    2009-01-01

    This research examined the role of children's decision-making autonomy in their emotional functioning during early adolescence in the United States and China. Four times over the 7th and 8th grades, 825 American and Chinese children (M = 12.73 years) reported on the extent to which they versus their parents make decisions about issues children…

  16. Observed and perceived parental overprotection in relation to psychosocial adjustment in preadolescents with a physical disability: the mediational role of behavioral autonomy.

    Science.gov (United States)

    Holmbeck, Grayson N; Johnson, Sharon Z; Wills, Karen E; McKernon, Wendy; Rose, Brigid; Erklin, Shannon; Kemper, Therese

    2002-02-01

    The purpose of this study was to tes a mediational model of associations between parental overprotectiveness (OP), behavioral autonomy. and psychosocial adjustment in 68 families with 8- and 9-year-old preadolescents with spipa bifida and a demographically matched sample of 68 families with able-bodied children. Measures included questionnaire and observational assessments of parental OP; parent and child reports of behavioral autonomy; and parent, child, and teacher reports of preadolescent adjustment. On the basis of both questionnaire and observational measures of OP, mothers and fathers of children with spina bifida were significantly more overprotective than their counterparts in the able-bodied sample, although this group difference was partially mediated by children's cognitive ability. Across samples, mothers were more likely to be overprotective than fathers. Both questionnaire and observational measures of parental OP were associated with lower levels of preadolescent decision-making autonomy as well as with parents being less willing to grant autonomy to their offspring in the future. For the questionnaire measure of OP, and only for the spina bifida sample. the mediational model was supported such that parental OP was associated with less behavioral autonomy, which was, in turn, associated with more externalizing problems. Findings are discussed in relation to the literature on parenting, autonomy development, and pediatric psychology.

  17. Executive Function in Children with Intellectual Disability--The Effects of Sex, Level and Aetiology of Intellectual Disability

    Science.gov (United States)

    Memisevic, H.; Sinanovic, O.

    2014-01-01

    Background: Executive function is very important in the children's overall development. The goal of this study was to assess the executive function in children with intellectual disability (ID) through the use of the Behavior Rating Inventory of Executive Function (BRIEF) teacher version. An additional goal was to examine the differences in…

  18. Functioning and disability analysis by using WHO Disability Assessment Schedule 2.0 in older adults Taiwanese patients with dementia.

    Science.gov (United States)

    Huang, Shih-Wei; Chang, Kwang-Hwa; Escorpizo, Reuben; Chi, Wen-Chou; Yen, Chia-Feng; Liao, Hua-Fang; Chang, Feng-Hang; Chiu, Wen-Ta; Lin, Jia-Wei; Liou, Tsan-Hon

    2016-08-01

    To analyse the disability status of elderly Taiwanese dementia patients by using the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). We enrolled 12 126 disabled elderly (>65 years) patients with dementia during July 2012-January 2014 from the Taiwan Data Bank of Persons with Disability. Trained interviewers evaluated the standardised scores in the six WHODAS 2.0 domains. Student's t test was used for comparing WHODAS 2.0 scores of male and female dementia patients with different age groups. The study population comprised 12 126 patients; 7612 were women and 4514 were men. The WHODAS 2.0 scores showed that the dementia patients had global activity limitation and participation restriction in all domains. Dementia-induced disability was prominent in male patients in all of the domains of the WHODAS 2.0. The domains of life activities, getting along with people and cognition were more strongly affected than the other domains. However, women experienced more rapid functional decline than men did as they aged. The data analysed in this large-scale, population-based study revealed crucial information on dementia-induced disability in elderly patients on the basis of the WHODAS 2.0 framework. Implications for rehabilitation Dementia patients have global functional disability in all domains of WHODAS 2.0 and multidisciplinary team is needed for rehabilitation programme intervention for these patients. When considering the rehabilitation resource and strategy, the domains of cognition, activities of daily living and life activities should be focussed. When dementia patients aged 65-75 years old, male patients got more restriction of function than female and more medical resource allocation for disabled male patients is recommended. With ageing, female dementia patients exhibited more rapid functional decline than male patients did and more budget about rehabilitation for maintain functional and dementia progression is crucial for female patients.

  19. Human Intellectual Disability Genes Form Conserved Functional Modules in Drosophila

    Science.gov (United States)

    Oortveld, Merel A. W.; Keerthikumar, Shivakumar; Oti, Martin; Nijhof, Bonnie; Fernandes, Ana Clara; Kochinke, Korinna; Castells-Nobau, Anna; van Engelen, Eva; Ellenkamp, Thijs; Eshuis, Lilian; Galy, Anne; van Bokhoven, Hans; Habermann, Bianca; Brunner, Han G.; Zweier, Christiane; Verstreken, Patrik; Huynen, Martijn A.; Schenck, Annette

    2013-01-01

    Intellectual Disability (ID) disorders, defined by an IQ below 70, are genetically and phenotypically highly heterogeneous. Identification of common molecular pathways underlying these disorders is crucial for understanding the molecular basis of cognition and for the development of therapeutic intervention strategies. To systematically establish their functional connectivity, we used transgenic RNAi to target 270 ID gene orthologs in the Drosophila eye. Assessment of neuronal function in behavioral and electrophysiological assays and multiparametric morphological analysis identified phenotypes associated with knockdown of 180 ID gene orthologs. Most of these genotype-phenotype associations were novel. For example, we uncovered 16 genes that are required for basal neurotransmission and have not previously been implicated in this process in any system or organism. ID gene orthologs with morphological eye phenotypes, in contrast to genes without phenotypes, are relatively highly expressed in the human nervous system and are enriched for neuronal functions, suggesting that eye phenotyping can distinguish different classes of ID genes. Indeed, grouping genes by Drosophila phenotype uncovered 26 connected functional modules. Novel links between ID genes successfully predicted that MYCN, PIGV and UPF3B regulate synapse development. Drosophila phenotype groups show, in addition to ID, significant phenotypic similarity also in humans, indicating that functional modules are conserved. The combined data indicate that ID disorders, despite their extreme genetic diversity, are caused by disruption of a limited number of highly connected functional modules. PMID:24204314

  20. A Functional Genomic Analysis of NF1-Associated Learning Disabilities

    National Research Council Canada - National Science Library

    Tang, Shao-Jun

    2008-01-01

    Learning disabilities severely deteriorate the life of many NF1 patients. However, the pathogenic process for NF1-associated learning disabilities has not been fully understood and an effective therapy is not available...

  1. A Functional Genomic Analysis of NF1-Associated Learning Disabilities

    National Research Council Canada - National Science Library

    Tang, Shao-Jun

    2007-01-01

    Learning disabilities severely deteriorate the life of many NF1 patients. However, the pathogenic process for NF1-associated learning disabilities has not been fully understood and an effective therapy is not available...

  2. A Functional Genomic Analysis of NF1-Associated Learning Disabilities

    National Research Council Canada - National Science Library

    Tang, Shao-Jun

    2006-01-01

    Learning disabilities severely deteriorate the life of many NFI patients. However, the pathogenic process for NFI-associated learning disabilities has not been fully understood and an effective therapy is not available...

  3. Intrinsic and Extrinsic School Motivation as a Function of Age: The Mediating Role of Autonomy Support

    Science.gov (United States)

    Gillet, Nicolas; Vallerand, Robert J.; Lafreniere, Marc-Andre K.

    2012-01-01

    The main purpose of the present research was to investigate school intrinsic and extrinsic motivation, and amotivation as a function of age in a sample of 1,600 elementary and high school students aged 9-17 years. First, results revealed a systematic decrease in intrinsic motivation and self-determined extrinsic motivation from age 9 to 12 years,…

  4. Aligning Physical Activity Measures with the International Classification of Functioning, Disability and Health Framework for Childhood Disability

    Science.gov (United States)

    Ross, Samantha Mae; Case, Layne; Leung, Willie

    2016-01-01

    The introduction of the International Classification of Functioning, Disability and Health has placed emphasis on framing health behavior as a multidimensional construct. In relation to childhood physical activity, this encompasses dimensions of functional performance, activity attendance, and subjective perceptions of involvement and enjoyment…

  5. Identifying classes of persons with mild intellectual disability or borderline intellectual functioning: a latent class analysis.

    Science.gov (United States)

    Nouwens, Peter J G; Lucas, Rosanne; Smulders, Nienke B M; Embregts, Petri J C M; van Nieuwenhuizen, Chijs

    2017-07-17

    Persons with mild intellectual disability or borderline intellectual functioning are often studied as a single group with similar characteristics. However, there are indications that differences exist within this population. Therefore, the aim of this study was to identify classes of persons with mild intellectual disability or borderline intellectual functioning and to examine whether these classes are related to individual and/or environmental characteristics. Latent class analysis was performed using file data of 250 eligible participants with a mean age of 26.1 (SD 13.8, range 3-70) years. Five distinct classes of persons with mild intellectual disability or borderline intellectual functioning were found. These classes significantly differed in individual and environmental characteristics. For example, persons with a mild intellectual disability experienced fewer problems than those with borderline intellectual disability. The identification of five classes implies that a differentiated approach is required towards persons with mild intellectual disability or borderline intellectual functioning.

  6. Association of pain intensity with quality of life and functional disability in university students with lumbago

    International Nuclear Information System (INIS)

    Fatima, A.; Tanveer, F.; Ahmed, A.; Gillani, S.A.

    2017-01-01

    To determine an association of pain intensity with quality of life and functional disability in university students with lumbago. Methodology: In this cross sectional study 213 students participated. Standard questionnaire Numeric pain rating scale, Utian quality of life scale Oswestry Low Back Pain Disability Questionnaire were used for the data collection. Results: Mean age of students was 21.0 +- 1.970 years (range 18-24). Out of 213 students, 143 had lower quality of life. There was an association between pain intensity and quality of life (p=0.006). Out of 213 students, 120 had minimal disability with lower quality of life. There was strong association (p=0.015) between quality of life and functional disability. Conclusion: There was a strong association between pain intensity and quality of life, pain intensity and functional disability, quality of life and functional disability in university students with low back ache. (author)

  7. Functioning and disability in adults with myotonic dystrophy type 1.

    Science.gov (United States)

    Kierkegaard, Marie; Harms-Ringdahl, Karin; Holmqvist, Lotta Widén; Tollbäck, Anna

    2011-01-01

     To provide a comprehensive description of functioning and disability with regard to stages of disease progression in adults with myotonic dystrophy type 1 (DM1). Further to explore associations of measures of manual dexterity and of walking capacity with measures of activities of daily living (ADL) and participation in social and lifestyle activities. Seventy persons with DM1 underwent examinations, tests and answered questionnaires. Stages of disease progression were based on the muscular impairment rating scale.  Overweight, cardiac dysfunctions, respiratory restrictions, fatigue and/or low physical activity levels were found in approximately 40% of those with DM1. Over 75% had muscle impairments, and activity limitations in manual dexterity and walking. Dependence in personal and instrumental ADL was found in 16% and 39%, respectively, and participation restrictions in social and lifestyle activities in 52%. The presence of concurrent body-function impairments, activity limitations and participation restrictions was high. Significant differences were found in muscle impairment, manual dexterity, mobility, ADL and social and lifestyle activities with regard to disease progression. Cut-off values in measures of manual dexterity and walking capacity associated to functioning are proposed.  This information can be used for developing clinical practise and for health promotion for persons with DM1.

  8. High-frequency, low-intensity vibrations increase bone mass and muscle strength in upper limbs, improving autonomy in disabled children.

    Science.gov (United States)

    Reyes, M Loreto; Hernández, Marta; Holmgren, Luz J; Sanhueza, Enrique; Escobar, Raúl G

    2011-08-01

    Disuse osteoporosis in children is a progressive disease that can affect quality of life. High-frequency, low-magnitude vibration (HFLMV) acts as an anabolic signal for bone and muscle. We undertook a prospective, randomized, double-blind, placebo-controlled clinical trial to assess the efficacy and safety of regional HFLMV in disabled children. Sixty-five children 6 to 9 year of age were randomized into three groups: placebo, 60 Hz, and 90 Hz. In the two active groups, a 0.3-g mechanical vibration was delivered to the radii and femurs for 5 minutes each day. After 6 months, the main endpoint was bone mineral density (BMD) at the ultradistal radius (UDR), 33% radii (33%R), and femoral necks (FN). Secondary endpoints were area and bone mineral content (BMC) at the UDR, 33%R, and FN; grip force of the upper and lower limbs; motor function; and PedsQL evaluation. An intention-to-treat analysis was used. Fifty-seven children (88%) completed the protocol. A significant increase was observed in the 60-Hz group relative to the other groups in BMD at the UDR (p = .011), in grip force of the upper limbs (p = .035), and in the "daily activities item" (p = .035). A mixed model to evaluate the response to intervention showed a stronger effect of 60 Hz on patients with cerebral palsy on the UDR and that between-subject variability significantly affected the response. There were no reported side effects of the intervention. This work provides evidence that regional HFLMV is an effective and safe strategy to improve bone mass, muscle strength, and possibly independence in children with motor disabilities. Copyright © 2011 American Society for Bone and Mineral Research.

  9. Evolution of disability in traffic accident victims in rehabilitation, characterized by the International Classification of Functioning, Disability and Health (ICF

    Directory of Open Access Journals (Sweden)

    Ligia Regina de Oliveira

    Full Text Available Abstract Introduction: The International Classification of Functioning, Disability and Health (ICF enables monitoring of the clinical evolution of a patient. Objective: This study aimed to characterize the evolution of disabilities in patients undergoing physical therapy following traffic accidents, using the ICF. Methods: A longitudinal study of 53 accident victims was conducted between April and October 2010, in a rehabilitation unit in the capital of Mato Grosso State, Brazil. Data from physical therapy evaluation were collected in 2 stages and coded by the ICF. Results: The average time between evaluation and reevaluation was 73.4 days. The evolution of functional impairment demonstrated a reduction in the number of patients with deficits, except for muscle tone functions. On initial evaluation, 90.6% had difficulty with sensory functions and pain, varying from mild to complete, decreasing to 67.9% on reevaluation, with pain still mostly present. Almost all patients (96.2% had a disability of neuromusculoskeletal and movement related functions on initial assessment, with a decrease to 15.7% of patients on reevaluation. The greatest improvements were observed in the categories of muscle strength (36.7% and gait pattern (30.6%. On reevaluation, improvement was also observed regarding perceived impairment of body structures, especially for those with severe and complete disability. Conclusion: The study confirmed a reduction in the percentage of patients with some form of disability, and positive development in functional capacity. The use of ICF enabled evaluation of physical disabilities and monitoring of the evolution of patients undergoing physical therapy.

  10. Paradoxical effects of radioiodine therapy in functional thyroid autonomy and mild immunothyropathy

    International Nuclear Information System (INIS)

    Dunkelmann, S.; Rudolph, F.; Prillwitz, A.; Groth, P.; Schuemichen, C.

    1998-01-01

    Aim: To examine all cases with Graves' disease after radioiodine therapy of autonomously functioning thyroid tissue (AFFT) in order to find the cause. Methods: We retrospectively studied 1428 pts who were treated between 11/93 and 3/97 with radioiodine for AFTT and who underwent at least one control examination. Results: 15 (1.1%) of all pts developed Graves' disease 8.4 (4-13) months after radioiodine therapy. There was no direct suggestion of Graves' disease (TRAK negative, no endocrine ophthalmopathy) in any pt at the time of radioiodine therapy. More detailed analysis of anamnestic data, however, revealed evidence that immunothyropathy predated radioiodine therapy in 11 of the 15 pts. Paradoxical effects of radioiodine therapy manifested as an increase in immunothyropathy 14 pts, a deterioration in metabolism in 11 pts and a first occurrence of endocrine ophthalmopathy in 5 pts. Conclusion: Exacerbation of preexisting, functional primarily insignificant immunothyropathia is held responsible in most cases for the observed paradoxical effects after radioiodine therapy, resulting in radiation-induced manifest Graves' disease; however no therapeutical consequences are recommended. (orig.) [de

  11. Radioiodine therapy of thyroid autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, Christoph; Schneider, Peter [Clinic and Policlinic for Nuclear Medicine, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany)

    2002-08-01

    Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. {sup 131}I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

  12. Radioiodine therapy of thyroid autonomy

    International Nuclear Information System (INIS)

    Reiners, Christoph; Schneider, Peter

    2002-01-01

    Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. 131 I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

  13. A Functional Analysis of Gestural Behaviors Emitted by Young Children with Severe Developmental Disabilities

    Science.gov (United States)

    Ferreri, Summer J.; Plavnick, Joshua B.

    2011-01-01

    Many children with severe developmental disabilities emit idiosyncratic gestures that may function as verbal operants (Sigafoos et al., 2000). This study examined the effectiveness of a functional analysis methodology to identify the variables responsible for gestures emitted by 2 young children with severe developmental disabilities. Potential…

  14. Using a multidisciplinary classification in nursing : The international classification of functioning disability and health

    NARCIS (Netherlands)

    Van Achterberg, T; Holleman, G; Heijnen-Kaales, Y; Van der Brug, Y; Roodbol, G; Stallinga, HA; Hellema, F; Frederiks, CMA

    This paper reports a study to explore systematically the usefulness of the International Classification of Functioning, Disability and Health to nurses giving patient care. The International Classification of Functioning, Disability and Health has a history of more than 20 years. Although this World

  15. Using a multidisciplinary classification in nursing: the International Classification of Functioning Disability and Health

    NARCIS (Netherlands)

    van Achterberg, Theo; Holleman, Gerda; Heijnen-Kaales, Yvonne; van der Brug, Ype; Roodbol, Gabriël; Stallinga, Hillegonda A.; Hellema, Fokje; Frederiks, Carla M. A.

    2005-01-01

    This paper reports a study to explore systematically the usefulness of the International Classification of Functioning, Disability and Health to nurses giving patient care. The International Classification of Functioning, Disability and Health has a history of more than 20 years. Although this World

  16. Prevalence of functioning difficulties and disability in Mexican adolescent women and their populational characteristics

    Directory of Open Access Journals (Sweden)

    Betania Allen-Leigh

    2017-07-01

    Full Text Available Objective. Report prevalence of functioning difficulties and disabilities among Mexican adolescent women 15-17 years old and identify differences in characteristics of those with and without a functioning difficulty or disability Materials and methods. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used chi square tests for independence and logistic regression to explore associations between this condition and various characteristics. Results. Of Mexican adolescent women 15-17 years old, 11.1% had a functioning difficulty or disability. The group of domains of functioning difficulty and disability with by far the highest prevalence was socio-emotional and behavioral functioning difficulties or disability with 8.6%. Being employed, rural residence and self-reported depression symptoms were associated with having functioning difficulties or disability. Conclusions. This survey constitutes an important initial step in collecting data on functioning difficulty and disability in Mexico although larger samples should be studied.

  17. The International Classification of Functioning, Disability and Health (ICF) and nursing.

    Science.gov (United States)

    Kearney, Penelope M; Pryor, Julie

    2004-04-01

    Nursing conceptualizes disability from largely medical and individual perspectives that do not consider its social dimensions. Disabled people are critical of this paradigm and its impact on their health care. The aims of this paper are to review the International Classification of Functioning, Disability and Health (ICF), including its history and the theoretical models upon which it is based and to discuss its relevance as a conceptual framework for nursing. The paper presents a critical overview of concepts of disability and their implications for nursing and argues that a broader view is necessary. It examines ICF and its relationship to changing paradigms of disability and presents some applications for nursing. The ICF, with its acknowledgement of the interaction between people and their environments in health and disability, is a useful conceptual framework for nursing education, practice and research. It has the potential to expand nurses' thinking and practice by increasing awareness of the social, political and cultural dimensions of disability.

  18. Sense of life worth living (ikigai) and incident functional disability in elderly Japanese: The Tsurugaya Project.

    Science.gov (United States)

    Mori, Kentaro; Kaiho, Yu; Tomata, Yasutake; Narita, Mamoru; Tanji, Fumiya; Sugiyama, Kemmyo; Sugawara, Yumi; Tsuji, Ichiro

    2017-04-01

    To test the hypothesis that elderly persons who feel ikigai (a sense of life worth living) have a lower risk of incident functional disability than those who do not. Recent studies have suggested that ikigai impacts on mortality. However, its impact upon disability is unknown. The aim of the present study was to investigate the association between ikigai and incident functional disability among elderly persons. We conducted a prospective cohort study of 830 Japanese elderly persons aged ≥70 years as a comprehensive geriatric assessment in 2003. Information on ikigai was collected by self-reported questionnaire. Data on functional disability were retrieved from the public Long-term Care Insurance database in which participants were followed up for 11 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incidence of functional disability were calculated for three groups delineated according to the presence of ikigai (“no”, “uncertain” or “yes”) using the Cox proportional hazards regression model. The 11-year incidence of functional disability was 53.3% (442 cases). As compared with the “no” group, the multiple-adjusted HR (95% CI) of incident functional disability was 0.61 (0.36–1.02) for the “uncertain” group and 0.50 (0.30–0.84) for the “yes” group. A stronger degree of ikigai is significantly associated with a lower risk of incident functional disability. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Comparing the functional performance of children and youths with autism, developmental disabilities, and no disability using the revised pediatric evaluation of disability inventory item banks.

    Science.gov (United States)

    Kao, Ying-Chia; Kramer, Jessica M; Liljenquist, Kendra; Tian, Feng; Coster, Wendy J

    2012-01-01

    OBJECTIVE. We compared the functional performance of children with autism spectrum disorders (ASD), intellectual and developmental disabilities (IDD), and without disabilities using the revised Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) Social/Cognitive, Daily Activities, and Responsibility domains. METHOD. A nationally representative sample of parents of children ages 0-21 without disabilities (n = 2,205), with ASD (n = 108), or with IDD (n = 150) completed an online survey. We obtained predicted PEDI-CAT scaled scores for three reference ages (5, 10, 15) from a modified analysis of covariance model and compared each group's scores using contrasts of the regression parameters. RESULTS. We found no significant differences between the ASD and IDD groups. The group with ASD demonstrated significantly lower performance than the group without disabilities across the three domains at ages 10 and 15. CONCLUSION. Scores on the PEDI-CAT differentiated the group with ASD from the group without disabilities. Children with ASD and IDD did not demonstrate different performance profiles. Copyright © 2012 by the American Occupational Therapy Association, Inc.

  20. Individual autonomy in work teams : the role of team autonomy, self-efficacy, and social support

    NARCIS (Netherlands)

    Mierlo, van H.; Rutte, C.G.; Vermunt, J.K.; Kompier, M.A.J.; Doorewaard, J.A.C.M.

    2006-01-01

    Task autonomy is long recognized as a means to improve functioning of individuals and teams. Taking a multilevel approach, we unravelled the constructs of team and individual autonomy and studied the interplay between team autonomy, self-efficacy, and social support in determining individual

  1. Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults.

    Science.gov (United States)

    Zhong, Yaqin; Wang, Jian; Nicholas, Stephen

    2017-09-02

    Gender difference and life-course socioeconomic inequalities in functional disability may exist among older adults. However, the association is less well understood among Chinese older population. The objective is to provide empirical evidences on this issue by exploring the association between gender, childhood and adult socioeconomic inequalities in functional disability. Data from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS) was utilized. Functional disability was assessed by the activities of daily living (ADL) and instrumental activities of daily living (IADL). Childhood socioeconomic status (SES) was measured by birthplace, father's education and occupation. Adult SES was measured in terms of education and household income. Multivariate logistic regressions were conducted to assess the association between gender, childhood and adult SES and functional disability. Based on a sample of 18,448 older adults aged 45 years old and above, our results showed that the prevalence of ADL and IADL disability was higher among women than men, but gender difference disappeared after adult SES and adult health were controlled. Harsh conditions during childhood were associated with functional disability but in multivariate analyses only father's education was associated with IADL disability (OR for no education = 1.198; 95% CI = 1.062-1.353). Current SES such as higher education and good economic situation are protective factors of functional disability. Childhood and adult SES were both related to functional disability among older adults. Our findings highlight the need for policies and programs aimed at decreasing social inequalities during childhood and early adulthood, which could reduce socioeconomic inequalities in functional disability in later life.

  2. Functional autonomy of elderly women enrolled in a physical activity program - doi 10.4025/actascihealthsci.v34i2.8387

    Directory of Open Access Journals (Sweden)

    Estélio Herinque Martin Dantas

    2012-09-01

    Full Text Available The present study aimed to determine the effects of a physical activity program on the functional autonomy of elderly women. The sample was divided into an experimental group (EG; n = 20; 68.51 ± 5.02 years; BMI = 27.01 ± 4.35 submitted to a physical activity program, and a control group (CG; n = 20; 67.01 ± 3.51 years; BMI = 26.71 ± 5.74. Functional autonomy was assessed using tests from the GDLAM autonomy protocol: 10 meter walk test (10MW, rising from a sitting position (RSP, rising from a ventral decubitus position (RVDP, rising from a chair and moving around the house (RCMH and putting on and taking off a t-shirt (PTT, after which the autonomy index (AI was calculated. In the EG, ANOVA showed significant reductions in execution times for the RSP (∆ = -3.92 s; p = 0.0001, RCMH (∆ = -9.61 s; p = 0.0001, 10MW (∆ = -0.94 s; p = 0.038 and RVDP (∆ = -1.15 s; p = 0.036 tests, as well as the AI (∆ = -6.27; p = 0.0001. This was not observed in the CG. Intergroup comparisons demonstrated that execution times for the RSP (∆% = -36.63; p = 0.0001, RCMH (∆% = -20.27; p = 0.0001, 10mW (∆% = -12.54; p = 0.002 and RVDP (∆% = -25.10; p = 0.005 tests and the AI (∆% = -21.37; p = 0.0001 of the EG were shorter than those of the CG. These results indicate that elderly subjects in the EG showed improved performance in activities of daily living after engaging in physical exercise.  

  3. Financial Autonomy as a Necessary Condition for the Functioning of Public Institutions of Higher Education in Ukraine

    Directory of Open Access Journals (Sweden)

    Vynogradnya Vita

    2016-11-01

    Full Text Available The article analyzes the main directions of development of financial autonomy of universities. The alternative sources of funding universities in terms of the lack of funding are determined. It has been found out that the proper organization of financial structure and expansion of the areas of fundraising by universities contributes to their competitiveness.

  4. Visual functions and disability in diabetic retinopathy patients

    Directory of Open Access Journals (Sweden)

    Gauri Shankar Shrestha

    2014-01-01

    Conclusion: Impairment of near visual acuity, contrast sensitivity, and peripheral visual field correlated significantly with different types of visual disability. Hence, these clinical tests should be an integral part of the visual assessment of diabetic eyes.

  5. Psychological and School Functioning of Latino Siblings of Children with Intellectual Disability

    Science.gov (United States)

    Lobato, Debra; Kao, Barbara; Plante, Wendy; Seifer, Ronald; Grullon, Edicta; Cheas, Lydia; Canino, Glorisa

    2011-01-01

    Background: Siblings of children with disabilities are at risk for internalizing psychological disorders; however, little is known about how culture influences this effect. This study examined the psychological and school functioning of Latino siblings of children with intellectual disability (ID). Methods: Participants were 100 Latino (L) and…

  6. The Relation between Intellectual Functioning and Adaptive Behavior in the Diagnosis of Intellectual Disability

    Science.gov (United States)

    Tassé, Marc J.; Luckasson, Ruth; Schalock, Robert L.

    2016-01-01

    Intellectual disability originates during the developmental period and is characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. In this article, we present a brief history of the diagnostic criteria of intellectual disability for both…

  7. Self-Report Assessment of Executive Functioning in College Students with Disabilities

    Science.gov (United States)

    Grieve, Adam; Webne-Behrman, Lisa; Couillou, Ryan; Sieben-Schneider, Jill

    2014-01-01

    This study presents a unique assessment of executive functioning (EF) among postsecondary students with disabilities, with the aim of understanding the extent to which students with different disabilities and in different age groups assess their own difficulties with relevant and educationally-adaptive skills such as planning, initiating, managing…

  8. Relationships between Humor Styles and Family Functioning in Parents of Children with Disabilities

    Science.gov (United States)

    Rieger, Alicja; McGrail, J. Patrick

    2015-01-01

    The humor styles and family functioning of parents of children with disabilities are understudied subjects. This study seeks to shed quantitative light on these areas. Seventy-two parents of children with disabilities completed the "Family Adaptability and Cohesion Evaluation Scales" (FACES IV) and the "Humor Styles…

  9. The Impact of Intellectual Disability, Caregiver Burden, Family Functioning, Marital Quality, and Sense of Coherence

    Science.gov (United States)

    Al-Krenawi, Alean; Graham, John R.; Al Gharaibeh, Fakir

    2011-01-01

    The present article is the first to consider the impact of intellectual disability on Bedouin-Arab families' caregiver burden, family functioning, marital quality, and sense of coherence. A random sample of 300 Bedouin-Arab parents with one or more intellectually disabled children, and a control group (n = 100) completed the McMaster Family…

  10. The blepharospasm disability scale: an instrument for the assessment of functional health in blepharospasm

    NARCIS (Netherlands)

    Lindeboom, R.; de Haan, R.; Aramideh, M.; Speelman, J. D.

    1995-01-01

    Assessment of the functional status in patients with blepharospasm is of major importance for clinical practice and outcome studies. The Blepharospasm Disability Scale (BDS) is specifically directed to measure the disability in these patients. The metric properties of this instrument were evaluated.

  11. Autonomy and Automation

    Science.gov (United States)

    Shively, Jay

    2017-01-01

    A significant level of debate and confusion has surrounded the meaning of the terms autonomy and automation. Automation is a multi-dimensional concept, and we propose that Remotely Piloted Aircraft Systems (RPAS) automation should be described with reference to the specific system and task that has been automated, the context in which the automation functions, and other relevant dimensions. In this paper, we present definitions of automation, pilot in the loop, pilot on the loop and pilot out of the loop. We further propose that in future, the International Civil Aviation Organization (ICAO) RPAS Panel avoids the use of the terms autonomy and autonomous when referring to automated systems on board RPA. Work Group 7 proposes to develop, in consultation with other workgroups, a taxonomy of Levels of Automation for RPAS.

  12. Intelligence and specific cognitive functions in intellectual disability: implications for assessment and classification.

    Science.gov (United States)

    Bertelli, Marco O; Cooper, Sally-Ann; Salvador-Carulla, Luis

    2018-03-01

    Current diagnostic criteria for intellectual disability categorize ability as measured by IQ tests. However, this does not suit the new conceptualization of intellectual disability, which refers to a range of neuropsychiatric syndromes that have in common early onset, cognitive impairments, and consequent deficits in learning and adaptive functioning. A literature review was undertaken on the concept of intelligence and whether it encompasses a range of specific cognitive functions to solve problems, which might be better reported as a profile, instead of an IQ, with implications for diagnosis and classification of intellectual disability. Data support a model of intelligence consisting of distinct but related processes. Persons with intellectual disability with the same IQ level have different cognitive profiles, based on varying factors involved in aetiopathogenesis. Limitations of functioning and many biopsychological factors associated with intellectual disability are more highly correlated with impairments of specific cognitive functions than with overall IQ. The current model of intelligence, based on IQ, is of limited utility for intellectual disability, given the wide range and variability of cognitive functions and adaptive capacities. Assessing level of individual impairment in executive and specific cognitive functions may be a more useful alternative. This has considerable implications for the revision of the International Classification of Diseases and for the cultural attitude towards intellectual disability in general.

  13. Autonomy as Aesthetic Practice

    NARCIS (Netherlands)

    Lütticken, S.

    2014-01-01

    This essay examines various conceptions of autonomy in relation to recent artistic practices. Starting from the apparent opposition between modernist notions of the autonomy of art and theorizations of political autonomy, the text problematizes the notion of the autonomy of art by using Jacques

  14. Discrete-Trial Functional Analysis and Functional Communication Training with Three Adults with Intellectual Disabilities and Problem Behavior

    Science.gov (United States)

    Chezan, Laura C.; Drasgow, Erik; Martin, Christian A.

    2014-01-01

    We conducted a sequence of two studies on the use of discrete-trial functional analysis and functional communication training. First, we used discrete-trial functional analysis (DTFA) to identify the function of problem behavior in three adults with intellectual disabilities and problem behavior. Results indicated clear patterns of problem…

  15. Development of disability in chronic obstructive pulmonary disease: beyond lung function.

    Science.gov (United States)

    Eisner, Mark D; Iribarren, Carlos; Blanc, Paul D; Yelin, Edward H; Ackerson, Lynn; Byl, Nancy; Omachi, Theodore A; Sidney, Stephen; Katz, Patricia P

    2011-02-01

    COPD is a major cause of disability, but little is known about how disability develops in this condition. The authors analysed data from the Function, Living, Outcomes and Work (FLOW) Study which enrolled 1202 Kaiser Permanente Northern California members with COPD at baseline and re-evaluated 1051 subjects at 2-year follow-up. The authors tested the specific hypothesis that the development of specific non-respiratory impairments (abnormal body composition and muscle strength) and functional limitations (decreased lower extremity function, poor balance, mobility-related dyspnoea, reduced exercise performance and decreased cognitive function) will determine the risk of disability in COPD, after controlling for respiratory impairment (FEV(1) and oxygen saturation). The Valued Life Activities Scale was used to assess disability in terms of a broad range of daily activities. The primary disability outcome measure was defined as an increase in the proportion of activities that cannot be performed of 3.3% or greater from baseline to 2-year follow-up (the estimated minimal important difference). Multivariable logistic regression was used for analysis. Respiratory impairment measures were related to an increased prospective risk of disability (multivariate OR 1.75; 95% CI 1.26 to 2.44 for 1 litre decrement of FEV(1) and OR 1.57 per 5% decrement in oxygen saturation; 95% CI 1.13 to 2.18). Non-respiratory impairment (body composition and lower extremity muscle strength) and functional limitations (lower extremity function, exercise performance, and mobility-related dyspnoea) were all associated with an increased longitudinal risk of disability after controlling for respiratory impairment (pdeterminants of disablement. Prevention and treatment of disability require a comprehensive approach to the COPD patient.

  16. Effects of dance on depression, physical function, and disability in underserved adults.

    Science.gov (United States)

    Murrock, Carolyn J; Graor, Christine Heifner

    2014-07-01

    This study documented the feasibility and immediate effects of a dance intervention two times per week for 12 weeks on depression, physical function, and disability in older, underserved adults. The one-group, pretest-posttest study had a convenience sample of 40 participants recruited from a federally subsidized apartment complex located in an economically depressed, inner-city neighborhood. Depression, physical function, and disability were measured at baseline and 12 weeks. Average age was 63 years (SD = 7.9), 92% were female, and 75% were African American. At baseline, participants reported increased depression (M = 20.0, SD = 12.4), decreased physical function (M = 56.6, SD = 10.9), and increased disability limitations (M = 65.7, SD = 14.9). At posttest, paired t tests showed that the dance intervention significantly decreased depression, t = 6.11, p dance intervention may be an effective adjunct therapy to improve depression, disability, and physical function in underserved adults.

  17. Designing Functional Clothes for Persons with Locomotor Disabilities

    Directory of Open Access Journals (Sweden)

    Curteza Antonela

    2014-12-01

    Full Text Available The life quality improvement issue is a problem of national and international interest. This acquires total different values when it is to refer to a series of disadvantaged categories, that is the persons with locomotor disabilities. It is an inevitable social responsibility to create equal opportunities for disabled people, to prevent any intentional or unintentional discrimination that they face and apply positive discrimination if necessary to improve their living standards and to let them have an equal share from social development as productive individuals of society.

  18. Psychometric properties of the Late-Life Function and Disability Instrument

    DEFF Research Database (Denmark)

    Beauchamp, Marla K; Schmidt, Catherine T; Pedersen, Mette M

    2014-01-01

    The choice of measure for use as a primary outcome in geriatric research is contingent upon the construct of interest and evidence for its psychometric properties. The Late-Life Function and Disability Instrument (LLFDI) has been widely used to assess functional limitations and disability...... in studies with older adults. The primary aim of this systematic review was to evaluate the current available evidence for the psychometric properties of the LLFDI....

  19. Physical practice is associated with less functional disability in medical students with migraine

    OpenAIRE

    Domingues,Renan B.; Teixeira,Antônio Lúcio; Domingues,Simone A.

    2011-01-01

    The aim of this study was to investigate possible association between migraine and physical practice among 480 medical students who were submitted to a questionnaire about headaches and physical practices. Migraine diagnosis was assessed by ID-Migraine and functional disability was evaluated with MIDAS. The type (aerobic or strength training), the weekly frequency and the intensity of physical practice and body mass index (BMI) were assessed. There was a reduction in functional disability of ...

  20. Autonomy and Accountability: Teacher Perspectives on Evidence-Based Practice and Decision-Making for Students with Intellectual and Developmental Disabilities

    Science.gov (United States)

    Greenway, Rosanne; McCollow, Meaghan; Hudson, Roxanne F.; Peck, Charles; Davis, Carol A.

    2013-01-01

    The purpose of this study was to examine teacher perspectives about evidence-based practices (EBP) and decision-making for students with intellectual and developmental disabilities. Given the current EBP movement, our study sought to understand practitioner definitions and perspectives on EBP and decision-making. Interview data from nine special…

  1. Leisure, functional disability and depression among older Chinese living in residential care homes.

    Science.gov (United States)

    Ouyang, Zheng; Chong, Alice M L; Ng, Ting Kin; Liu, Susu

    2015-01-01

    Previous research has rarely examined the intervening and buffering effects of leisure on the relationship between age-related stress and health among institutionalized elders, especially in the Chinese context. This study thus examines the extent to which participation in leisure activities mediates and moderates the impact of functional disability on depression among older adults living in residential care homes in China. A total of 1429 participants (858 men) aged over 60 living in residential care homes, of which 46.1% experienced depression using a cut-off score ≥ 5 on the 15-item Geriatric Depression Scale, were selected from a national survey across China by using the probability proportional to size sampling method. The findings showed that depression was positively predicted by functional disability and negatively predicted by participation in leisure activities. The results of the mediation analysis showed that participation in leisure activities partially mediated the relationship between functional disability and depression. Functional disability predicted depression both directly and indirectly through its negative influence on participation in leisure activities. Participation in leisure activities also significantly buffered the relationship between functional disability and depression such that the impact of functional disability was weaker for those who participated in leisure activities more frequently. These results provide support for the mediating and moderating roles of leisure in the stress-health relationship among institutionalized elders. To enhance residents' psychological health, residential care homes are recommended to organize more leisure activities.

  2. Growth retardation and functional disability in patients with juvenile idiopathic arthritis

    International Nuclear Information System (INIS)

    Saeed, S.; Zammurrad, S.; Rasheed, U.

    2017-01-01

    To determine the frequency of growth retardation and functional disability in patients with juvenile idiopathic arthritis (JIA). Methods: This descriptive cross sectional study was carried out at the Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad from March 2016 to December 2016. 92 patients with JIA were included in the study. Height and weight of each patient was recorded and BMI calculated. Functional Disability was determined by calculating the CHAQ Score, while disease activity was estimated through JADAS 27 score. Growth Retardation was defined as height, weight and/or BMI below the 3rd centile according to the CDC growth charts. A cut off of ?1 for CHAQ Score was used to define severe functional disability. Results: Out of 92 patients, there were 47 male (51.1%) and 45 (48.9%) females. Height, weight and BMI below 3rd centile was observed in 30(32.6%), 49(53.3%) and 41(44.6%) patients, respectively. The overall frequency of growth retardation was 64.1% (n=59) and severe functional disability (CHAQ Score ?1) was seen in 32.6% (n=30) of patients. Conclusions: Growth retardation was seen in more than half of patients with JIA and a significant proportion had severe functional disability. Severe functional disability was seen only in patients with active disease. (author)

  3. Predictors of Functional Improvement and Future Work Status After the Disability Benefit Claim: A Prospective Cohort Study

    NARCIS (Netherlands)

    Cornelius, L.R.; van der Klink, J.J.L.; de Boer, M.R.; Groothoff, J.W.; Brouwer, S.

    2014-01-01

    Objective In most industrialized countries, disability benefit rates have increased substantially in the past decade. Few beneficiaries return into employment once disability benefit is awarded. The present study aims to investigate which factors predict functional improvement and future work status

  4. Disability, social functioning and school inclusion among older children and adolescents living with HIV in Zimbabwe.

    Science.gov (United States)

    Rukuni, Ruramayi; McHugh, Grace; Majonga, Edith; Kranzer, Katharina; Mujuru, Hilda; Munyati, Shungu; Nathoo, Kusum; Gregson, Celia L; Kuper, Hannah; Ferrand, Rashida A

    2018-02-01

    Increasing numbers of children with HIV are surviving to adolescence and encountering multiple clinical and social consequences of long-standing HIV infection. We aimed to investigate the association between HIV and disability, social functioning and school inclusion among 6- to 16-year-olds in Zimbabwe. HIV-infected children receiving antiretroviral therapy from a public-sector HIV clinic and HIV-uninfected children attending primary care clinics in the same catchment area were recruited. Standardised questionnaires were used to collect socio-demographic, social functioning and disability data. Multivariable logistic regression was used to assess the relationship between HIV status and disability and functioning. We recruited 202 HIV-infected and 285 HIV-uninfected children. There was no difference in age and gender between the two groups, but a higher proportion of HIV-infected children were orphaned. The prevalence of any disability was higher in HIV-infected than uninfected children (37.6% vs. 18.5%, P disability to those with HIV but no disabilities. Children with HIV commonly experience disabilities, and this is associated with social and educational exclusion. Rehabilitation and support services are needed to facilitate educational attainment and social participation in this group. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  5. Muscle reaction function of individuals with intellectual disabilities may be improved through therapeutic use of a horse.

    Science.gov (United States)

    Giagazoglou, Paraskevi; Arabatzi, Fotini; Kellis, Eleftherios; Liga, Maria; Karra, Chrisanthi; Amiridis, Ioannis

    2013-09-01

    Reaction time and muscle activation deficits might limit the individual's autonomy in activities of daily living and in participating in recreational activities. The aim of the present study was to assess the effects of a 14-week hippotherapy exercise program on movement reaction time and muscle activation in adolescents with intellectual disability (ID). Nineteen adolescents with moderate ID were assigned either to an experimental group (n=10) or a control group (n=9). The experimental group attended a hippotherapy exercise program, consisting of two 30-min sessions per week for 14 weeks. Reaction time, time of maximum muscle activity and electromyographic activity (EMG) of rectus femoris and biceps femoris when standing up from a chair under three conditions: in response to audio, visual and audio with closed eyes stimuli were measured. Analysis of variance designs showed that hippotherapy intervention program resulted in significant improvements in reaction time and a reduction in time to maximum muscle activity of the intervention group comparing to the control group in all 3 three conditions that were examined (phippotherapy training. Hippotherapy probably creates a changing environment with a variety of stimuli that enhance deep proprioception as well as other sensory inputs. In conclusion, this study provides evidence that hippotherapy can improve functional task performance by enhancing reaction time. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Perceived functioning and disability in adults with myotonic dystrophy type 1: a survey according to the International Classification Of Functioning, Disability and Health.

    Science.gov (United States)

    Kierkegaard, Marie; Harms-Ringdahl, Karin; Widén Holmqvist, Lotta; Tollbäck, Anna

    2009-06-01

    The purpose of this study was to describe and analyse self-rated perceived functioning, disability and environmental facilitators/barriers with regard to disease severity, using the International Classification of Functioning, Disability and Health (ICF) checklist, in adults with myotonic dystrophy type 1. Cross-sectional design. Forty-one women and 29 men with myotonic dystrophy type 1. A modified ICF checklist was used for self-rating of perceived problems in 29 body-function categories, difficulties in 52 activity and participation categories, and facilitators/barriers in 23 environmental-factor categories according to the verbal anchors of the ICF qualifiers. Disease severity classification was based on the muscular impairment rating scale. Of the persons with myotonic dystrophy type 1, 80% perceived problems of excessive daytime sleepiness, 76% of muscle power, and 66% of energy and drive functions, while over 59% perceived difficulties in physically demanding mobility activities. Disabilities in mobility, self-care and domestic life were more frequently reported by persons with severe disease. Support from the immediate family, medicines and social security services were perceived as facilitators for 50-60% of the participants. Disabilities and important environmental facilitators in adults with myotonic dystrophy type 1 were identified, and this clinically-relevant information can be used for developing health services for people with this condition.

  7. Identification of aspects of functioning, disability and health relevant to patients experiencing vertigo: a qualitative study using the international classification of functioning, disability and health

    Science.gov (United States)

    2012-01-01

    Purpose Aims of this study were to identify aspects of functioning and health relevant to patients with vertigo expressed by ICF categories and to explore the potential of the ICF to describe the patient perspective in vertigo. Methods We conducted a series of qualitative semi-structured face-to-face interviews using a descriptive approach. Data was analyzed using the meaning condensation procedure and then linked to categories of the International Classification of Functioning, Disability and Health (ICF). Results From May to July 2010 12 interviews were carried out until saturation was reached. Four hundred and seventy-one single concepts were extracted which were linked to 142 different ICF categories. 40 of those belonged to the component body functions, 62 to the component activity and participation, and 40 to the component environmental factors. Besides the most prominent aspect “dizziness” most participants reported problems within “Emotional functions (b152), problems related to mobility and carrying out the daily routine. Almost all participants reported “Immediate family (e310)” as a relevant modifying environmental factor. Conclusions From the patients’ perspective, vertigo has impact on multifaceted aspects of functioning and disability, mainly body functions and activities and participation. Modifying contextual factors have to be taken into account to cover the complex interaction between the health condition of vertigo on the individuals’ daily life. The results of this study will contribute to developing standards for the measurement of functioning, disability and health relevant for patients suffering from vertigo. PMID:22738067

  8. Increasing Compliance in Students with Intellectual Disabilities Using Functional Behavioral Assessment and Self-Monitoring

    Science.gov (United States)

    Wadsworth, Jamie P.; Hansen, Blake D.; Wills, Sarah B.

    2015-01-01

    Noncompliance in three elementary age students with intellectual disabilities was assessed using functional behavioral assessments. Escape was identified as the primary function of the behavior in all three students, and access to tangible items was identified in one of the students as a secondary function. Teacher-monitoring and self-monitoring…

  9. Functional Impairment In People with Schizophrenia: Focus on Employability and Eligibility for Disability Compensation

    Science.gov (United States)

    Harvey, Philip D.; Heaton, Robert K.; Carpenter, William T.; Green, Michael F.; Gold, James M.; Schoenbaum, Michael

    2012-01-01

    Background The Social Security Administration (SSA) is considering whether schizophrenia may warrant inclusion in their new “Compassionate Allowance” process, which aims to identify diseases and other medical conditions that invariably quality for Social Security disability benefits and require no more than minimal objective medical information. This paper summarizes evidence on the empirical association between schizophrenia and vocational disability. A companion paper examines the reliability and validity of schizophrenia diagnosis which is critically relevant for granting a long-term disability on the basis of current diagnosis. Methods This is a selective literature review and synthesis, based on a work plan developed in a meeting of experts convened by the National Institute of Mental Health and the SSA. This review of the prevalence of disability is focused on the criteria for receipt of disability compensation for psychotic disorders currently employed by the SSA. Results Disability in multiple functional domains is detected in nearly every person with schizophrenia. Clinical remission is much more common than functional recovery, but most patients experience occasional relapses even with treatment adherence, and remissions do not predict functional recovery. Under SSA’s current disability determination process, approximately 80% of SSDI/SSI applications in SSA’s diagnostic category of “Schizophrenia/Paranoid Functional Disorders” are allowed, compared to around half of SSDI/SSI applications overall. Moreover, the allowance rate is even higher among applicants with schizophrenia. Many unsuccessful applicants are not denied, but rather simply are unable to manage the process of appeal after initial denials. Discussion Research evidence suggests that disability applicants with a valid diagnosis of schizophrenia have significant impairment across multiple dimensions of functioning, and will typically remain impaired for the duration of normal

  10. Depression, functional disability and quality of life among Nigerian older adults: Prevalences and relationships.

    Science.gov (United States)

    Akosile, Christopher Olusanjo; Mgbeojedo, Ukamaka Gloria; Maruf, Fatai Adesina; Okoye, Emmanuel Chiebuka; Umeonwuka, Ifeanyi Chuka; Ogunniyi, Adesola

    2018-01-01

    Ageing is associated with increased morbidity, depression and decline in function. These may consequently impair the quality of life (QoL) of older adults. This study was used to investigate the prevalence of functional disability, depression, and level of quality of life of older adults residing in Uyo metropolis and its environs, Nigeria. This cross sectional survey involved 206 (116 females and 90 males) older adults with mean age of 69.8±6.7. The World Health Organization Quality of Life-OLD, Functional status Questionnaire (FSQ) and Geriatric Depression Scale (GDS) were used to measure quality of life, functional disability and depression respectively. Data was analysed using frequency counts and percentages and Spearman rank-order correlation coefficient, at 0.05 alpha level. 45.5% of participants had depression, and at least 30% had functional disability in at least one domain, but their quality of life was fairly good (>60.0%) across all domains. Significant correlation existed between depression scores and individual quality of life and functional disability domains and between overall QoL and each functional disability domain (pquality of life of the older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Language and functionality of post-stroke adults: evaluation based on International Classification of Functioning, Disability and Health (ICF).

    Science.gov (United States)

    Santana, Maria Tereza Maynard; Chun, Regina Yu Shon

    2017-03-09

    Cerebrovascular accident is an important Public Health problem because of the high rates of mortality and sequelae such as language disorders. The conceptual health changes have led to the incorporation of functional and social aspects in the assessments as proposed by the World Health Organization in the International Classification of Functioning, Disability and Health. The purpose was to evaluate and classify language aspects, functionality and participation of post-stroke individuals based on the concepts of the International Classification of Functioning, Disability and Health and characterize the sociodemographic profile of participants. Data collection was carried out through the application of a clinical instrument to evaluate language, participation and functionality in fifty individuals based on the International Classification of Functioning, Disability and Health. The age of the participants varied between 32 and 88 years, and the majority were elderly men. Among body functions, the participants reported more difficulties in "memory functions". As for activity and participation, more difficulties were reported in "recreation and leisure". As for environmental factors, the component "healthcare professionals" was indicated as a facilitator by the majority of participants. The results show the impact of language difficulties in the lives of post-stroke adults and reinforce the applicability of the International Classification of Functioning, Disability and Health as an important complementary tool for assessing language, functionality and participation in a comprehensive and humane approach, towards the improvement of health assistance in ambulatory care.

  12. University autonomy as sensemaking

    DEFF Research Database (Denmark)

    Lind, Jonas Krog

    The formal autonomy of universities in Europe has generally increased over recent decades. However, new forms of accountability measures and more indirect state steering have accompanied this development, making it difficult to assess the actual autonomy. The article addresses this problem...... by applying the sensemaking approach to the study of organizational autonomy. Enacted autonomy is suggested as a new conceptualization that challenges the basic assumption in studies on formal autonomy that autonomy is only about external constraints on action. It does so by insisting on the active subjects...... in the enactment of the environment, thereby questioning the validity of a clear distinction between what is internal and what is external to an organization. By acknowledging the subjective dimension of autonomy, a set of stylized identities is developed as a tool for understanding the enactment of autonomy...

  13. Respect for rational autonomy.

    Science.gov (United States)

    Walker, Rebecca L

    2009-12-01

    The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy.

  14. Evaluation of social disablement, psychiatric symptoms and autonomy in long-stay psychiatric patients Avaliação do comportamento social, sintomas psiquiátricos e autonomia em pacientes psiquiátricos de longa permanência

    Directory of Open Access Journals (Sweden)

    Lúcia Abelha

    2006-01-01

    Full Text Available BACKGROUND: Data on prevalence of social disablement, psychiatric symptoms and independent living skills in long-stay psychiatric patients are scarce in Brazil. Therefore, a cross-sectional study was carried out on a population of 881 long-stay psychiatric patients. METHOD: Data were collected from all the patients living in the Municipal Mental Health Institute from Rio de Janeiro city, using 3 instruments: Social Behaviour Schedule (SBS-BR, Brief Psychiatric Rating Scale (BPRS, and Independent Living Skills Survey (ILSS-BR. RESULTS: 75% of total patients presented poor independent living skills, and high rates of social disablement, specially in the items: poor self care (50,9%, little spontaneous communication (46,2% and underactivity (37,5%. 15.1% of schizophrenic patients showed severe symptoms of hallucinations, delusions and conceptual disorganization.11.5% did not present psychiatric symptoms in the last month, and 16% showed no social disablement CONCLUSION: 50% of patients are older than 65 years and have been living in the institution for more than 38 years. They present high rates of problem behaviours and poor autonomy. Our data should suggest the adoption of treatment programs or interventions for those patients. Also, there is a group without psychiatric symptoms, good autonomy degree and no social disablement that could live in therapeutic residences in the community.INTRODUÇÃO: No Brasil ainda são escassos os dados sobre limitações no comportamento social, sintomas psiquiátricos e habilidades de vida independente. Nesse sentido foi realizado um estudo seccional em uma população de 881 pacientes psiquiátricos de longa permanência. METODOLOGIA: Foram coletados dados de todos os pacientes residentes no Instituto Municipal Juliano Moreira, utilizando três instrumentos: Avaliação das Limitações no Comportamento Social (SBS-BR, Brief Psychiatric Rating Scale (BPRS e o Inventário de Habilidades de Vida Independente para

  15. Core Self-Evaluations as a Mediator between Functional Disability and Life Satisfaction in College Students with Disabilities Majoring in Science and Technology

    Science.gov (United States)

    Smedema, Susan Miller; Pfaller, Joseph S.; Yaghmaian, Rana A.; Weaver, Hayley; da Silva Cardoso, Elizabeth; Chan, Fong

    2015-01-01

    Purpose: To examine the mediational effect of core self-evaluations (CSE) on the relationship between functional disability and life satisfaction. Methods: A quantitative descriptive design using multiple regression analysis. The participants were 97 college students with disabilities receiving services through Hunter College's Minority-Disability…

  16. Regimes of Autonomy

    NARCIS (Netherlands)

    Anderson, Joel

    2014-01-01

    Like being able to drive a car, being autonomous is a socially attributed, claimed, and contested status. Normative debates about criteria for autonomy (and what autonomy entitles one to) are best understood, not as debates about what autonomy, at core, really is, but rather as debates about the

  17. Low back pain functional disability in athletes; conceptualization and initial development of a questionnaire.

    Science.gov (United States)

    Zamani, Elham; Kordi, Ramin; Nourian, Ruhollah; Noorian, Negin; Memari, Amir Hossein; Shariati, Mohammad

    2014-12-01

    Low Back Pain (LBP) is one of the most prevalent causes of disability not only in the general population but also in athletes. Despite a large number of self-reported back specific disability questionnaires, there is no specific, well documented, outcome measure for athletes suffering from back pain. This study aimed to identify the main descriptive themes representing functional disability in athletes due to LBP. We conducted a qualitative study using in-depth interviews to characterize the experiences of athletes with LBP. Twenty athletes with LBP were recruited and the main descriptive elements of their LBP related disability were extracted. Then a preliminary questionnaire using these themes was proposed. The main disability indicators were pain intensity; stretching exercises, strengthening exercises, sport specific skills, back range of motion (ROM), sitting, walking, sleep patterns, self-care, and recreational activities, fear of pain and avoidance behavior, and changes in sexual activity. The findings of this study suggest that apart from non-sports items, some sport related items should be included in the assessment of LBP disability levels in athletes. Our results have also been organized as a preliminary LBP disability questionnaire for athletes.

  18. First results of radioiodine therapy of multifocal and disseminated functional thyroid autonomy using a TcTUs-adapted dose concept

    International Nuclear Information System (INIS)

    Oexle, C.; Reinhardt, M.; Moser, E.

    1998-01-01

    Aim: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99m Tc-pertechnetate thyroid uptake under suppression (TcTU s ) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTU s , which is as a measure for the 'autonomous volume' of the thyroid. Methods: The data of 75 patients (54 female, 21 male; age 71±9 years) with MFA or DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target doses were used: For a TcTU s of 1,5-2,5% 150 Gy, for 2,51-3,5% 200 Gy, for 3,51-4,5% 250 Gy, and for >4,5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful when the basal TSH was above 0,5 mU/l and autonomous areas had disapeared in thyroid scintigraphy or the TcTU was below 1,5%, respectively. The average follow-up period was 8±4 months. Results: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occured. Conclusion: The presented data indicate, that even patients with a marked autonomy (TcTU s >3,5%) can thus expected to be cured by of a onetime therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can alltogether be estimated as very low. (orig.) [de

  19. A DESCRIPTIVE STUDY ON THE ASSESSMENT OF FUNCTIONAL MOTOR DISABILITY IN CHILDREN WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Wadugodapitiya .S .I

    2015-08-01

    Full Text Available Background: Cerebral palsy (CP is one of the most common conditions in childhood causing severe physical disability. Spastic paresis is the most common form of CP. According to the topographic classification, CP is divided into spastic hemiplegia, diplegia and quadriplegia. Distribution of functional motor disability is varied in each type of CP. Aims: To describe functional motor disability in children with cerebral palsy using standard scales. Method: This cross-sectional descriptive study included 93 children with cerebral palsy (CP. Functional motor disability of each type of spastic CP was assessed using standard scales. Results: The dominant sub-type of cerebral palsy in the present study was spastic diplegia. Most affected muscle with spasticity was gastrocnemius-soleus group of muscles. Active range of motion of foot eversion and dorsiflexion were the most affected movements in all the types of CP. In the overall sample, only 35% were able to walk independently. Majority of subjects with quadriplegia were in levels III and IV of Gross Motor Functional Classification Scale representing severe disability. There was a significant relationship observed between the muscle tone and range of motion of their corresponding joints as well as between the muscle tone of gastrocnemius-soleus group of muscles and the ankle components of Observational Gait Analysis. Conclusions: Results of the present study confirms the clinical impression of disability levels in each type of CP and showed that the assessment of functional motor disability in children with different types of spastic CP is useful in planning and evaluation of treatment options.

  20. Associations and impact factors between living arrangements and functional disability among older Chinese adults.

    Directory of Open Access Journals (Sweden)

    Hui Wang

    Full Text Available OBJECTIVES: To examine the association of living arrangements with functional disability among older persons and explore the mediation of impact factors on the relationship. DESIGN: Cross-sectional analysis using data from Healthy Aging study in Zhejiang Province. PARTICIPANTS: Analyzed sample was drawn from a representative rural population of older persons in Wuyi County, Zhejiang Province, including 1542 participants aged 60 and over in the second wave of the study. MEASUREMENTS: Living arrangements, background, functional disability, self-rated health, number of diseases, along with contemporaneous circumstances including income, social support (physical assistance and emotional support. Instrument was Activities of Daily Living (ADL scale, including Basic Activities Daily Living (BADL and Instrumental Activities of Daily Living (IADL. RESULTS: Living arrangements were significantly associated with BADL, IADL and ADL disability. Married persons living with or without children were more advantaged on all three dimensions of functional disability. Unmarried older adults living with children only had the worst functional status, even after controlling for background, social support, income and health status variables (compared with the unmarried living alone, ß for BADL: -1.262, ß for IADL: -2.112, ß for ADL: -3.388; compared with the married living with children only, ß for BADL: -1.166, ß for IADL: -2.723, ß for ADL: -3.902. In addition, older adults without difficulty in receiving emotional support, in excellent health and with advanced age had significantly better BADL, IADL and ADL function. However, a statistically significant association between physical assistance and functional disability was not found. CONCLUSION: Functional disabilities vary by living arrangements with different patterns and other factors. Our results highlight the association of unmarried elders living with children only and functioning decline comparing with

  1. Autonomy: Life and Being

    Science.gov (United States)

    Williams, Mary-Anne

    This paper uses robot experience to explore key concepts of autonomy, life and being. Unfortunately, there are no widely accepted definitions of autonomy, life or being. Using a new cognitive agent architecture we argue that autonomy is a key ingredient for both life and being, and set about exploring autonomy as a concept and a capability. Some schools of thought regard autonomy as the key characteristic that distinguishes a system from an agent; agents are systems with autonomy, but rarely is a definition of autonomy provided. Living entities are autonomous systems, and autonomy is vital to life. Intelligence presupposes autonomy too; what would it mean for a system to be intelligent but not exhibit any form of genuine autonomy. Our philosophical, scientific and legal understanding of autonomy and its implications is immature and as a result progress towards designing, building, managing, exploiting and regulating autonomous systems is retarded. In response we put forward a framework for exploring autonomy as a concept and capability based on a new cognitive architecture. Using this architecture tools and benchmarks can be developed to analyze and study autonomy in its own right as a means to further our understanding of autonomous systems, life and being. This endeavor would lead to important practical benefits for autonomous systems design and help determine the legal status of autonomous systems. It is only with a new enabling understanding of autonomy that the dream of Artificial Intelligence and Artificial Life can be realized. We argue that designing systems with genuine autonomy capabilities can be achieved by focusing on agent experiences of being rather than attempting to encode human experiences as symbolic knowledge and know-how in the artificial agents we build.

  2. Mental health as rational autonomy.

    Science.gov (United States)

    Edwards, R B

    1981-08-01

    Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of themselves as treating an illness. Instead, they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real.

  3. Integrated System Health Management (ISHM) and Autonomy

    Science.gov (United States)

    Figueroa, Fernando; Walker, Mark G.

    2018-01-01

    Systems capabilities on ISHM (Integrated System Health Management) and autonomy have traditionally been addressed separately. This means that ISHM functions, such as anomaly detection, diagnostics, prognostics, and comprehensive system awareness have not been considered traditionally in the context of autonomy functions such as planning, scheduling, and mission execution. One key reason is that although they address systems capabilities, both ISHM and autonomy have traditionally individually been approached as independent strategies and models for analysis. Additionally, to some degree, a unified paradigm for ISHM and autonomy has been difficult to implement due to limitations of hardware and software. This paper explores a unified treatment of ISHM and autonomy in the context of distributed hierarchical autonomous operations.

  4. The extremity function index (EFI), a disability severity measure for neuromuscular diseases : psychometric evaluation

    NARCIS (Netherlands)

    Bos, Isaac; Wynia, Klaske; Drost, Gea; Almansa, Josué; Kuks, Joannes

    2017-01-01

    OBJECTIVE: To adapt and to combine the self-report Upper Extremity Functional Index and Lower Extremity Function Scale, for the assessment of disability severity in patients with a neuromuscular disease and to examine its psychometric properties in order to make it suitable for indicating disease

  5. Disability and Functional Profiles of Patients with Myasthenia Gravis Measured with ICF Classification

    Science.gov (United States)

    Leonardi, Matilde; Raggi, Alberto; Antozzi, Carlo; Confalonieri, Paolo; Maggi, Lorenzo; Cornelio, Ferdinando; Mantegazza, Renato

    2009-01-01

    The objective of this study is to describe functional profiles of patients with myasthenia gravis (MG), and the relationships among symptoms, activities and environmental factors (EF), by using WHO's International Classification of Functioning Disability and Health (ICF). Patients were consecutively enrolled at the Besta Institute of Milan, Italy.…

  6. Executive Functioning in Individuals with Intellectual Disabilities and Autism Spectrum Disorders

    Science.gov (United States)

    Roelofs, R. L.; Visser, E. M.; Berger, H. J. C.; Prins, J. B.; Van Schrojenstein Lantman-De Valk, H. M. J.; Teunisse, J. P.

    2015-01-01

    Background: Executive functioning (EF) is important for adequate behavioural functioning and crucial for explaining symptoms of autism spectrum disorders (ASD) in individuals with normal intelligence, but is scarcely studied in individuals with ASD and intellectual disabilities (ID). We therefore study EF in an ID population by comparing…

  7. Effects of Functional Mobility Skills Training for Adults with Severe Multiple Disabilities

    Science.gov (United States)

    Whinnery, Stacie B.; Whinnery, Keith W.

    2011-01-01

    This study investigated the effects of a functional mobility program on the functional standing and walking skills of five adults with developmental disabilities. The Mobility Opportunities Via Education (MOVE) Curriculum was implemented using a multiple-baseline across subjects design. Repeated measures were taken during baseline, intervention…

  8. Von Hippel-Lindau disease: an evaluation of natural history and functional disability.

    Science.gov (United States)

    Feletti, Alberto; Anglani, Mariagiulia; Scarpa, Bruno; Schiavi, Francesca; Boaretto, Francesca; Zovato, Stefania; Taschin, Elisa; Gardi, Mario; Zanoletti, Elisabetta; Piermarocchi, Stefano; Murgia, Alessandra; Pavesi, Giacomo; Opocher, Giuseppe

    2016-07-01

    Although many studies have been published about specific lesions characterizing von Hippel-Lindau(VHL) disease, none have dealt with the natural history of the whole disease and the consequent disabilities. We aim to define the comprehensive natural history of VHL disease and to describe the functional disabilities and their impact upon patients' quality of life, thereby tailoring the follow-up schedule accordingly. We performed a prospective analysis on 128 VHL-affected patients beginning in 1996. For each affected organ, we defined intervals between the first and subsequent VHL-related manifestations and compared them with current VHL surveillance protocols. We looked for any association of the number of involved organs with age, sex, type of VHL gene mutation, and functional domain mutation. Ultimately, we assessed the organ-specific disabilities caused by VHL disease. Hemangioblastomas show different patterns of progression depending on their location, whereas both renal cysts and carcinomas have similar progression rates. Surgery for pheochromocytoma and CNS hemangioblastoma is performed earlier than for pancreatic or renal cancer. The number of involved organs is associated with age but not with sex, type of VHL gene mutation, or functional domain mutation. A thorough analysis of functional disabilities showed that age is related to the first-appearing functional impairment, but it is not predictive of the final number of disabilities. Our study defines the disease progression and provides a comprehensive view of the syndrome over time. We analyzed for the first time the functional disability of VHL patients, assessing the progression for each function. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Sex differences in the mediators of functional disability in Major Depressive Disorder.

    Science.gov (United States)

    Carmona, Nicole E; Subramaniapillai, Mehala; Mansur, Rodrigo B; Cha, Danielle S; Lee, Yena; Fus, Dominika; McIntyre, Roger S

    2018-01-01

    The aim of this study was to investigate sex differences in discrete domains of psychopathology as mediators of functional disability among individuals with Major Depressive Disorder (MDD). Adults (ages 18-65) with moderate-to-severe MDD (n = 100) and age-, sex-, and education-matched healthy controls (HC; n = 100) participated in a clinical trial validating the THINC-integrated tool, a newly developed cognitive assessment tool for patients with MDD. Variables assessed as possible mediators included depression symptom severity, anxiety symptoms, sleep disturbance, perceived cognitive deficits, and objective cognitive performance. Functional disability was assessed using the total score on the Sheehan Disability Scale. Separate mediation analyses were conducted for men and women. No significant differences were detected between men and women on the assessed domains of psychopathology or functional disability (ps > 0.05). However, the mediation analyses demonstrated different patterns with respect to determinants of functional disability in MDD between men and women. Functional disability was mediated by anxiety (95% CI: -3.17, -0.28) and sleep disturbance (95% CI: -0.69, -0.05) among men and by depressive symptom severity (95% CI: -7.82, -0.32) among women. These preliminary results instantiate the need to dimensionalize psychopathology in MDD. Our results at least in part support the hypothesis that, consistent with the sex differences in the prevalence and illness presentation of MDD, determinants of functional outcomes also differ between men and women, underscoring the need to consider sex differences in order to improve functional outcomes in the treatment of MDD. Copyright © 2017. Published by Elsevier Ltd.

  10. The Evolution of Autonomy.

    Science.gov (United States)

    Stammers, Trevor

    2015-01-01

    There can be little doubt, at least in the Western world, that autonomy is theruling principle in contemporary bioethics. In spite of its 'triumph' however,the dominance of the utilitarian concept of autonomy is being increasinglyquestioned. In this paper, I explore the nature of autonomy, how it came todisplace the Hippocratic tradition in medicine and how different conceptsof autonomy have evolved. I argue that the reduction of autonomy to'the exercise of personal choice' in medicine has led to a 'tyranny of autonomy' which can be inimical to ethical medical practice rather than conducive to it.I take the case of Kerrie Wooltorton as an illustration of how misplacedadherence to respect for patient autonomy can lead to tragic consequences.An analysis of autonomy based on the work of Rachel Haliburton isdescribed and applied to the role of autonomy in a recent bioethicaldebate--that arising from Savulescu's proposal that conscientious objection by health-care professionals should not be permitted in the NHS. Inconclusion, I suggest Kukla's concept of conscientious autonomy as onepromising pathway to circumvent both the limitations and adverse effectsof the dominance of current (mis)understandings of autonomy in biomedical ethics.

  11. A qualitative study of Functioning, Disability, and Rehabilitation of patients after hip fracture surgery

    DEFF Research Database (Denmark)

    Ehlers, Monica Milter

    2013-01-01

    A qualitative study of functioning, disability, and rehabilitation of patients after hip fracture surgery Monica Milter Ehlers PhD student, MSc in Nursing Merete Bender Bjerrum* PhD, MA, Associate Professor Claus Vinther Nielsen* Professor, PhD, MD, Specialist in Clinical Social Medicine...... *Department of Public Health, Aarhus University Introduction Hip fractures cause the greatest consumption of bed days in Danish hospitals. The need for rehabilitation of hip fracture patients older than 65 years is increasing because of a growing number of elderly people in Denmark. Rehabilitation of hip...... fracture patients consists primarily of muscle training and daily mobilisation. Patients' functioning, disability, and involvement in their rehabilitation process have not been investigated in scientific studies. Aims To establish a specific research-based knowledge for functioning, disability...

  12. A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

    DEFF Research Database (Denmark)

    Fässberg, Madeleine Mellqvist; Cheung, Gary; Canetto, Silvia Sara

    2016-01-01

    were included in the review. RESULTS: Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including......OBJECTIVES: To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. METHOD: Articles published through November 2014...... were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities...

  13. Improving Assessment of Work Related Mental Health Function Using the Work Disability Functional Assessment Battery (WD-FAB).

    Science.gov (United States)

    Marfeo, Elizabeth E; Ni, Pengsheng; McDonough, Christine; Peterik, Kara; Marino, Molly; Meterko, Mark; Rasch, Elizabeth K; Chan, Leighton; Brandt, Diane; Jette, Alan M

    2018-03-01

    Purpose To improve the mental health component of the Work Disability Functional Assessment Battery (WD-FAB), developed for the US Social Security Administration's (SSA) disability determination process. Specifically our goal was to expand the WD-FAB scales of mood & emotions, resilience, social interactions, and behavioral control to improve the depth and breadth of the current scales and expand the content coverage to include aspects of cognition & communication function. Methods Data were collected from a random, stratified sample of 1695 claimants applying for the SSA work disability benefits, and a general population sample of 2025 working age adults. 169 new items were developed to replenish the WD-FAB scales and analyzed using factor analysis and item response theory (IRT) analysis to construct unidimensional scales. We conducted computer adaptive test (CAT) simulations to examine the psychometric properties of the WD-FAB. Results Analyses supported the inclusion of four mental health subdomains: Cognition & Communication (68 items), Self-Regulation (34 items), Resilience & Sociability (29 items) and Mood & Emotions (34 items). All scales yielded acceptable psychometric properties. Conclusions IRT methods were effective in expanding the WD-FAB to assess mental health function. The WD-FAB has the potential to enhance work disability assessment both within the context of the SSA disability programs as well as other clinical and vocational rehabilitation settings.

  14. Functional disability and suicidal behavior in middle-aged and older adults: A systematic critical review.

    Science.gov (United States)

    Lutz, Julie; Fiske, Amy

    2018-02-01

    Middle-aged and older adults have elevated rates of suicide around the globe, but there is a paucity of knowledge about risk factors for suicide in these age groups. One possible risk factor may be functional disability, which is more common at later ages. The current systematic critical review examined findings regarding the associations between functional disability and suicidal behavior (suicidal ideation, suicide attempts, and death by suicide) in middle-aged and older adults (i.e. age 50 and older). Forty-five studies were found that examined these associations. The majority of studies supported a significant association between functional disability and suicidal ideation. In addition, findings to date strongly suggest that depression serves as a mediator of the association between functional disability and suicidal ideation, though most studies did not directly test for mediation. Firm conclusions regarding suicide attempts and death by suicide, as well as mediation, cannot be drawn due to a relative lack of research in these areas. The association between functional disability and suicidal behavior suggests an important area for prevention and intervention among middle-aged and older adults, but additional research is necessary to clarify the specifics of these associations and examine appropriate intervention strategies. Important future directions for research in this area include the direct comparison of associations of risk factors with different types of suicidal behavior, greater use of longitudinal data with multiple time points, and further examination of potential mediators and moderators of the association between functional disability and suicidal behavior. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Autonomy, Automation, and Systems

    Science.gov (United States)

    Turner, Philip R.

    1987-02-01

    Aerospace industry interest in autonomy and automation, given fresh impetus by the national goal of establishing a Space Station, is becoming a major item of research and technology development. The promise of new technology arising from research in Artificial Intelligence (AI) has focused much attention on its potential in autonomy and automation. These technologies can improve performance in autonomous control functions that involve planning, scheduling, and fault diagnosis of complex systems. There are, however, many aspects of system and subsystem design in an autonomous system that impact AI applications, but do not directly involve AI technology. Development of a system control architecture, establishment of an operating system within the design, providing command and sensory data collection features appropriate to automated operation, and the use of design analysis tools to support system engineering are specific examples of major design issues. Aspects such as these must also receive attention and technology development support if we are to implement complex autonomous systems within the realistic limitations of mass, power, cost, and available flight-qualified technology that are all-important to a flight project.

  16. Executive functions as predictors of math learning disabilities

    NARCIS (Netherlands)

    Toll, S.W.M.; van der Ven, S.H.G.; Kroesbergen, E.H.; van Luit, J.E.H.

    2011-01-01

    In the past years, an increasing number of studies have investigated executive functions as predictors of individual differences in mathematical abilities. The present longitudinal study was designed to investigate whether the executive functions shifting, inhibition, and working memory differ

  17. School Autonomy and District Support: How Principals Respond to a Tiered Autonomy Initiative in Philadelphia Public Schools

    Science.gov (United States)

    Steinberg, Matthew P.; Cox, Amanda Barrett

    2017-01-01

    A tiered autonomy policy was recently implemented in Philadelphia, where select principals were granted autonomy to manage school operations while others were promised greater district support to improve school functioning. This article provides evidence on how principals used their autonomy and the extent of district support for non-autonomous…

  18. Differences in Brain Structure and Function in Older Adults with Self-Reported Disabling and Non-Disabling Chronic Low Back Pain

    Science.gov (United States)

    Buckalew, Neilly; Haut, Marc W.; Aizenstein, Howard; Morrow, Lisa; Perera, Subashan; Kuwabara, Hiroto; Weiner, Debra K.

    2010-01-01

    Objective The primary aim of this pilot study was to identify structural and functional brain differences in older adults with self-reported disabling chronic low back pain (CLBP) compared with those who reported non-disabling CLBP. Design Cross-sectional. Participants Sixteen cognitively intact older adults, eight with disabling CLBP and eight with non-disabling. Exclusions were psychiatric or neurological disorders, substance abuse, opioid use, or diabetes mellitus. Methods Participants underwent: structural and functional brain MRI; neuropsychological assessment using the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Tests A and B; and physical performance assessment using the Short Physical Performance Battery. Results In the disabled group there was significantly lower white matter (WM) integrity (P < 0.05) of the splenium of the corpus callosum. This group also demonstrated activation of the right medial prefrontal cortex at rest whereas the non-disabled demonstrated activation of the left lateral prefrontal cortex. Combined groups analysis revealed a strong positive correlation (rs = 0.80, P < 0.0002) between WM integrity of the left centrum semiovale with gait-speed. Secondary analysis revealed a strong negative correlation between total months of CLBP and WM integrity of the SCC (rs = −0.59, P < 0.02). Conclusions Brain structure and function is different in older adults with disabling CLBP compared to those with non-disabling CLBP. Deficits in brain morphology combining groups are associated with pain duration and poor physical function. Our findings suggest brain structure and function may play a key role in chronic-pain-related-disability and may be important treatment targets. PMID:20609128

  19. A Conceptual Foundation for Measures of Physical Function and Behavioral Health Function for Social Security Work Disability Evaluation

    Science.gov (United States)

    Marfeo, Elizabeth E.; Haley, Stephen M.; Jette, Alan M.; Eisen, Susan V.; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M.; Chan, Leighton; Brandt, Diane E.; Rasch, Elizabeth K.

    2014-01-01

    Physical and mental impairments represent the two largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person’s underlying capabilities as well as activity demands relevant to the context of work. The objective of this paper is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, two content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability, and Health (ICF) as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies five major domains (1) Behavior Control, (2) Basic Interactions, (3) Temperament and Personality, (4) Adaptability, and (5) Workplace Behaviors. The content model describing physical functioning includes three domains (1) Changing and Maintaining Body Position, (2) Whole Body Mobility, and (3) Carrying, Moving and Handling Objects. These content models informed subsequent measurement properties including item development, measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. PMID:23548543

  20. Cognitive profile in Duchenne muscular dystrophy boys without intellectual disability: The role of executive functions.

    Science.gov (United States)

    Battini, R; Chieffo, D; Bulgheroni, S; Piccini, G; Pecini, C; Lucibello, S; Lenzi, S; Moriconi, F; Pane, M; Astrea, G; Baranello, G; Alfieri, P; Vicari, S; Riva, D; Cioni, G; Mercuri, E

    2018-02-01

    The aim of our prospective observational study was to assess profiles of cognitive function and a possible impairment of executive functions in a cohort of boys with Duchenne muscular dystrophy without intellectual and behavior disability. Forty Duchenne boys (range of age: 6 years to 11 years and 6 months) were assessed by Wechsler Intelligence scale and battery of tests including tasks assessing working memory and executive functions (inhibition and switching, problem solving and planning). In our cohort some aspects of cognitive function were often impaired. These included multitasking, problem solving, inhibition and working memory necessary to plan and direct goal oriented behavior. Our results support the suggestion that aspects of cognitive function could be impaired even in boys without intellectual disability and support the hypothesis that executive functions may play an important role in specific aspects of cognitive impairment in Duchenne muscular dystrophy. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Protecting autonomy as authenticity using Ulysses contracts.

    Science.gov (United States)

    van Willigenburg, Theo; Delaere, Patrick

    2005-08-01

    Pre-commitment directives or Ulysses contracts are often defended as instruments that may strengthen the autonomous self-control of episodically disordered psychiatric patients. Autonomy is understood in this context in terms of sovereignty ("governing" or "managing" oneself). After critically analyzing this idea of autonomy in the context of various forms of self-commitment and pre-commitment, we argue that what is at stake in using Ulysses contracts in psychiatry is not autonomy as sovereignty, but autonomy as authenticity. Pre-commitment directives do not function to protect autonomous self-control. They serve in upholding the guidance that is provided by one's deepest identity conferring concerns. We elucidate this concept of autonomy as authenticity, by showing how Ulysses contracts protect the possibility of being "a self."

  2. Learning Disabilities and Intellectual Functioning in School-Aged Children With Prenatal Cocaine Exposure

    OpenAIRE

    Morrow, Connie E.; Culbertson, Jan L.; Accornero, Veronica H.; Xue, Lihua; Anthony, James C.; Bandstra, Emmalee S.

    2006-01-01

    Risk for developing a learning disability (LD) or impaired intellectual functioning by age 7 was assessed in full-term children with prenatal cocaine exposure drawn from a cohort of 476 children born full term and enrolled prospectively at birth. Intellectual functioning was assessed using the Wechsler Intelligence Scale for Children–Third Edition (Wechsler,1991) shortform, and academic functioning was assessed using the Wechsler Individual Achievement Test (WIAT; Wechsler,1993) Screener by e...

  3. The Relation Between Intellectual Functioning and Adaptive Behavior in the Diagnosis of Intellectual Disability.

    Science.gov (United States)

    Tassé, Marc J; Luckasson, Ruth; Schalock, Robert L

    2016-12-01

    Intellectual disability originates during the developmental period and is characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. In this article, we present a brief history of the diagnostic criteria of intellectual disability for both the DSM-5 and AAIDD. The article also (a) provides an update of the understanding of adaptive behavior, (b) dispels two thinking errors regarding mistaken temporal or causal link between intellectual functioning and adaptive behavior, (c) explains that there is a strong correlational, but no causative, relation between intellectual functioning and adaptive behavior, and (d) asserts that once a question of determining intellectual disability is raised, both intellectual functioning and adaptive behavior are assessed and considered jointly and weighed equally in the diagnosis of intellectual disability. We discuss the problems created by an inaccurate statement that appears in the DSM-5 regarding a causal link between deficits in intellectual functioning and adaptive behavior and propose an immediate revision to remove this erroneous and confounding statement.

  4. Improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery

    OpenAIRE

    Elliott, D.; Patla, A.; Bullimore, M.

    1997-01-01

    AIMS—To determine the improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery.
METHODS—Clinical vision (monocular and binocular high and low contrast visual acuity, contrast sensitivity, and disability glare), functional vision (face identity and expression recognition, reading speed, word acuity, and mobility orientation), and perceived visual disability (Activities of Daily Vision Scale) were measured in 25 subjects before a...

  5. EFFICACY OF ADDUCTOR PULL BACK EXERCISE ON PAIN AND FUNCTIONAL DISABILITY FOR SACROILIAC JOINT DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    Sai Kumar .N

    2015-08-01

    Full Text Available Background: Sacroiliac joint dysfunction (SIJD is a common problem that causes pain and disability. Adductor pull back exercise is widely used for treating sacroiliac joint dysfunction. No yet research has been directly examined the efficacy of adductor pull back exercise for sacroiliac joint dysfunction. The purpose of the study to find the efficacy of adductor pull back exercise on pain and functional disability for subjects with sacroiliac joint dysfunction. Methods: An experimental study design, 40 subjects with unilateral Sacroiliac joint dysfunction were randomized into two groups: study group (n=20, and control group (n=20. Subjects in study group received adductor pull back exercise along with conventional exercise and Subjects in control group received conventional exercise. The duration of treatment was given for two weeks, three times a day, total six days per week. Outcome measures such as pain was measured using Visual analog scale (VAS, and functional disability was measured using Oswestry Disability Index questionnaire (ODI before and after 2 weeks of the treatment in both the groups. Results: When means were analyzed using Independent ‘t’ test as a parametric and Mann Whitney U test as a non-parametric test, there is a statistically significant improvements in means of VAS, and ODI within the groups. When means were compared using Independent ‘t’ and Mann Whitney U test, there is a significant difference in post-means of VAS and ODI between the groups. Conclusion: The present study concludes that the 2 weeks of adductor pull back exercise along with conventional exercise found statistically and clinically significant effect on improving pain, functional disability for subjects with sacroiliac joint dysfunction. Adductors pull back exercise along with conventional exercise techniques shown to have greater percentage of improvement in improving pain and functional disability for subjects with sacroiliac joint dysfunction.

  6. Marine Robot Autonomy

    CERN Document Server

    2013-01-01

    Autonomy for Marine Robots provides a timely and insightful overview of intelligent autonomy in marine robots. A brief history of this emerging field is provided, along with a discussion of the challenges unique to the underwater environment and their impact on the level of intelligent autonomy required.  Topics covered at length examine advanced frameworks, path-planning, fault tolerance, machine learning, and cooperation as relevant to marine robots that need intelligent autonomy.  This book also: Discusses and offers solutions for the unique challenges presented by more complex missions and the dynamic underwater environment when operating autonomous marine robots Includes case studies that demonstrate intelligent autonomy in marine robots to perform underwater simultaneous localization and mapping  Autonomy for Marine Robots is an ideal book for researchers and engineers interested in the field of marine robots.      

  7. Correlation of PROMIS Physical Function and Pain CAT Instruments With Oswestry Disability Index and Neck Disability Index in Spine Patients.

    Science.gov (United States)

    Papuga, Mark O; Mesfin, Addisu; Molinari, Robert; Rubery, Paul T

    2016-07-15

    A prospective and retrospective cross-sectional cohort analysis. The aim of this study was to show that Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT) assessments for physical function and pain interference can be efficiently collected in a standard office visit and to evaluate these scores with scores from previously validated Oswestry Disability Index (ODI) and Neck Disability Index (NDI) providing evidence of convergent validity for use in patients with spine pathology. Spinal surgery outcomes are highly variable, and substantial debate continues regarding the role and value of spine surgery. The routine collection of patient-based outcomes instruments in spine surgery patients may inform this debate. Traditionally, the inefficiency associated with collecting standard validated instruments has been a barrier to routine use in outpatient clinics. We utilized several CAT instruments available through PROMIS and correlated these with the results obtained using "gold standard" legacy outcomes measurement instruments. All measurements were collected at a routine clinical visit. The ODI and the NDI assessments were used as "gold standard" comparisons for patient-reported outcomes. PROMIS CAT instruments required 4.5 ± 1.8 questions and took 35 ± 16 seconds to complete, compared with ODI/NDI requiring 10 questions and taking 188 ± 85 seconds when administered electronically. Linear regression analysis of retrospective scores involving a primary back complaint revealed moderate to strong correlations between ODI and PROMIS physical function with r values ranging from 0.5846 to 0.8907 depending on the specific assessment and patient subsets examined. Routine collection of physical function outcome measures in clinical practice offers the ability to inform and improve patient care. We have shown that several PROMIS CAT instruments can be efficiently administered during routine clinical visits. The

  8. Neuromodulation, agency and autonomy.

    Science.gov (United States)

    Glannon, Walter

    2014-01-01

    Neuromodulation consists in altering brain activity to restore mental and physical functions in individuals with neuropsychiatric disorders and brain and spinal cord injuries. This can be achieved by delivering electrical stimulation that excites or inhibits neural tissue, by using electrical signals in the brain to move computer cursors or robotic arms, or by displaying brain activity to subjects who regulate that activity by their own responses to it. As enabling prostheses, deep-brain stimulation and brain-computer interfaces (BCIs) are forms of extended embodiment that become integrated into the individual's conception of himself as an autonomous agent. In BCIs and neurofeedback, the success or failure of the techniques depends on the interaction between the learner and the trainer. The restoration of agency and autonomy through neuromodulation thus involves neurophysiological, psychological and social factors.

  9. Autonomy, Independence, Inclusion

    Directory of Open Access Journals (Sweden)

    Filippo Angelucci

    2015-04-01

    Full Text Available The living environment must not only meet the primary needs of living, but also the expectations of improvement of life and social relations and people’s work. The need for a living environment that responds to the needs of users with their different abilities, outside of standardizations, is increasingly felt as autonomy, independence and well-being are the result of real usability and adaptability of the spaces. The project to improve the inclusivity of living space and to promote the rehabilitation of fragile users need to be characterized as an interdisciplinary process in which the integration of specialized contributions leads to adaptive customization of space solutions and technological that evolve with the changing needs, functional capacities and abilities of individuals.

  10. On the relationship between motor performance and executive functioning in children with intellectual disabilities.

    NARCIS (Netherlands)

    Hartman, E.; Houwen, S.; Scherder, E.J.A.; Visscher, C.

    2010-01-01

    Background: It has been suggested that children with intellectual disabilities (ID) have motor problems and higher-order cognitive deficits. The aim of this study was to examine the motor skills and executive functions in school-age children with borderline and mild ID. The second aim was to

  11. Identifying classes of persons with mild intellectual disability or borderline intellectual functioning : A latent class analysis

    NARCIS (Netherlands)

    Nouwens, P.J.G.; Lucas, R.; Smulders, N.B.M.; Embregts, P.J.C.M.; van Nieuwenhuizen, Ch.

    2017-01-01

    Background Persons with mild intellectual disability or borderline intellectual functioning are often studied as a single group with similar characteristics. However, there are indications that differences exist within this population. Therefore, the aim of this study was to identify classes of

  12. Violence Prevention and Students with Disabilities: Thinking Functionally and Providing Evidence Based Supports and Accommodations

    Science.gov (United States)

    Rosenberg, Michael S.

    2012-01-01

    Students with disabilities who engage in high rates of challenging behaviors require educators who employ function-based thinking and have a particular sensitivity to the wide range of factors that influence student behavior. In essence, educators working with special needs students need to know what makes their instruction "special"; they must…

  13. Grandmother Support, Family Functioning, and Parenting Stress in Families with a Child with a Disability

    Science.gov (United States)

    Tumbarello, Natasha

    2010-01-01

    This study examined the relationship among grandparent support, family functioning, and parental stress on families with children with and without disabilities between the ages of 2 and 12 years. Families are viewed as an ever-changing complex system with reciprocal interactions. One possible stressor on the family system is the birth of a child…

  14. Functional Deficits in Phonological Working Memory in Children with Intellectual Disabilities

    Science.gov (United States)

    Schuchardt, Kirsten; Maehler, Claudia; Hasselhorn, Marcus

    2011-01-01

    Recent studies indicate that children with intellectual disabilities have functional limitations primarily in the phonological loop of working memory (Baddeley, 1986). These findings are indicative of a specific structural deficit. Building on this research, the present study examines whether it is possible to identify specific phonological…

  15. On the relationship between motor performance and executive functioning in children with intellectual disabilities

    NARCIS (Netherlands)

    Hartman, E.; Houwen, S.; Scherder, E.; Visscher, C.

    Background It has been suggested that children with intellectual disabilities (ID) have motor problems and higher-order cognitive deficits. The aim of this study was to examine the motor skills and executive functions in school-age children with borderline and mild ID. The second aim was to

  16. Motor Performance of Children with Mild Intellectual Disability and Borderline Intellectual Functioning

    Science.gov (United States)

    Vuijk, P. J.; Hartman, E.; Scherder, E.; Visscher, C.

    2010-01-01

    Background: There is a relatively small body of research on the motor performance of children with mild intellectual disabilities (MID) and borderline intellectual functioning (BIF). Adequate levels of motor skills may contribute to lifelong enjoyment of physical activity, participation in sports and healthy lifestyles. The present study compares…

  17. Relationships between Learning Disability, Executive Function, and Psychopathology in Children with ADHD

    Science.gov (United States)

    Mattison, Richard E.; Mayes, Susan Dickerson

    2012-01-01

    Objective: Learning disabilities (LD), executive function (EF), and psychopathology were investigated to clarify their relationships in 595 children with ADHD. Method: Standard instruments for IQ, achievement, EF, and parent and teacher ratings of psychopathology were obtained at the time of outpatient evaluation. Results: Comparisons between the…

  18. Motor performance of children with mild intellectual disability and borderline intellectual functioning

    NARCIS (Netherlands)

    Vuijk, P. J.; Hartman, E.; Scherder, E.; Visscher, C.

    2010-01-01

    Background There is a relatively small body of research on the motor performance of children with mild intellectual disabilities (MID) and borderline intellectual functioning (BIF). Adequate levels of motor skills may contribute to lifelong enjoyment of physical activity, participation in sports and

  19. Instruments used to assess functional limitations in workers applying for disability benefit : a systematic review

    NARCIS (Netherlands)

    Spanjer, Jerry; Groothoff, Johan W.; Brouwer, Sandra

    2011-01-01

    Purpose. To systematically review the quality of the psychometric properties of instruments for assessing functional limitations in workers applying for disability benefit. Method. Electronic searches of Medline, Embase, CINAHL and PsycINFO were performed to identify studies focusing on the

  20. Postural Care for People with Intellectual Disabilities and Severely Impaired Motor Function: A Scoping Review

    Science.gov (United States)

    Robertson, Janet; Baines, Susannah; Emerson, Eric; Hatton, Chris

    2018-01-01

    Background: Poor postural care can have severe and life-threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function. Method: Studies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and…

  1. A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

    Science.gov (United States)

    Fässberg, Madeleine Mellqvist; Cheung, Gary; Canetto, Silvia Sara; Erlangsen, Annette; Lapierre, Sylvie; Lindner, Reinhard; Draper, Brian; Gallo, Joseph J.; Wong, Christine; Wu, Jing; Duberstein, Paul; Wærn, Margda

    2016-01-01

    Objectives: To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. Method: Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. Results: Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. Conclusion: Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults. PMID:26381843

  2. The Impact of Behavioural Executive Functioning and Intelligence on Math Abilities in Children with Intellectual Disabilities

    Science.gov (United States)

    Dekker, M. C.; Ziermans, T. B.; Swaab, H.

    2016-01-01

    Background: Little is known about the role of behavioural executive functioning (EF) skills and level of intelligence (IQ) on math abilities in children with mild to borderline intellectual disabilities. Method: Teachers of 63 children attending a school for special education (age: 10 to 13 years; IQ: 50 to 85) filled out a Behaviour Rating…

  3. Strengths and Weaknesses in Executive Functioning in Children with Intellectual Disability

    Science.gov (United States)

    Danielsson, Henrik; Henry, Lucy; Messer, David; Ronnberg, Jerker

    2012-01-01

    Children with intellectual disability (ID) were given a comprehensive range of executive functioning measures, which systematically varied in terms of verbal and non-verbal demands. Their performance was compared to the performance of groups matched on mental age (MA) and chronological age (CA), respectively. Twenty-two children were included in…

  4. Contrasting deficits on executive functions between ADHD and reading disabled children

    NARCIS (Netherlands)

    Marzocchi, G.M.; Oosterlaan, J.; Zuddas, A.; Cavolina, P.; Geurts, H.; Redigilo, D.; Vio, C.; Sergeant, J.A.

    2008-01-01

    Background: The object of this study was to analyze the executive functioning of children with attention deficit hyperactivity disorder (ADHD) or reading disability (RD) independent of their non-executive deficits. Methods: Three carefully diagnosed groups of children, aged between 7 and 12 years

  5. A Factor-Analytic Study of Adaptive Behavior and Intellectual Functioning in Learning Disabled Children.

    Science.gov (United States)

    Yeargan, Dollye R.

    The factorial structure of intellectual functioning and adaptive behavior was examined in 160 learning disabled students (6 to 16 years old). Ss were administered the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Coping Inventory (CI). Factor analysis of WISC-R scores revealed three factors: verbal comprehenson, perceptual…

  6. FUNCTIONAL DISABILITY IN EARLY RHEUMATOID-ARTHRITIS - DESCRIPTION AND RISK-FACTORS

    NARCIS (Netherlands)

    GUILLEMIN, F; SUURMEIJER, T; KROL, B; BOMBARDIER, C; BRIANCON, S; DOEGLAS, D; SANDERMAN, R; VANDENHEUVEL, W

    Objective. To provide a description and identify risk factors for functional disability in early rheumatoid arthritis (RA). Methods. A cohort of 337 patients with early RA with disease duration under 5 years was constituted in 2 areas in Fiance and The Netherlands. Examination included the Ritchie

  7. Autonomy of State Agencies

    DEFF Research Database (Denmark)

    Hansen, Morten Balle; Niklasson, Birgitta; Roness, Paul

    agencies in four Nordic countries: Denmark, Finland, Norway and Sweden. By using survey data from more than 500 state agencies in the four countries, the article analyses whether there is indeed a Scandinavian style of autonomy and result control and assesses which structural, cultural, and environmental......NPM-doctrines states that ideal-type agencies should have a high level of managerial autonomy, while being controlled through result-based control instruments, like performance contracts. In this article, the authors present a first preliminary attempt to comparatively analyze the autonomy of state...... variables might explain similarities and differences in the autonomy of agencies....

  8. Working memory functions in children with different degrees of intellectual disability.

    Science.gov (United States)

    Schuchardt, K; Gebhardt, M; Mäehler, C

    2010-04-01

    In recent years, there has been increased research interest in the functioning of working memory in people with intellectual disabilities. Although studies have repeatedly found these individuals to have weak working memory skills, few investigations have distinguished between different degrees of intellectual disability. This study aims to help close this research gap and, in so doing, to examine whether the deficits observed reflect a developmental lag or a qualitative deviation from normal development. In a 5-group design, the working memory performance of a group of 15-year-olds with mild intellectual disability (IQ 50-69) was compared with that of two groups of children (aged 10 and 15 years) with borderline intellectual disability (IQ 70-84) and with that of two groups of children with average intellectual abilities (IQ 90-115) matched for mental and chronological age (aged 7 and 15 years). All children were administered a comprehensive battery of tests assessing the central executive, the visual-spatial sketchpad, and the phonological loop. The results showed deficits in all three components of working memory, and revealed that these deficits increased with the degree of intellectual disability. The findings indicate that, relative to their mental age peers, children with learning difficulties show structural abnormalities in the phonological store of the phonological loop, but developmental lags in the other two subsystems. Similar patterns of results emerged for both subgroups of children with intellectual disability, indicating that problems with phonological information processing seem to be one of the causes of cognitive impairment in individuals with intellectual disability.

  9. A problem with inclusion in learning disability research.

    Science.gov (United States)

    McClimens, Alex; Allmark, Peter

    2011-09-01

    People with severe learning disability are particularly difficult to include in the research process. As a result, researchers may be tempted to focus on those with learning disability who can be included. The problem is exacerbated in this field as the political agenda of inclusion and involvement is driven by those people with learning disability who are the higher functioning. To overcome this we should first detach the notion of consent from ideas about autonomy and think instead of it as a way to avoid wronging others; this fits the original historical use of consent in research. This allows us to think in terms of including participants to the best of their abilities rather than in terms of a threshold of autonomy. Researchers could then use imaginative ways to include the least able and to ensure they are not wronged in research or by exclusion from it.

  10. Executive functions as predictors of visual-motor integration in children with intellectual disability.

    Science.gov (United States)

    Memisevic, Haris; Sinanovic, Osman

    2013-12-01

    The goal of this study was to assess the relationship between visual-motor integration and executive functions, and in particular, the extent to which executive functions can predict visual-motor integration skills in children with intellectual disability. The sample consisted of 90 children (54 boys, 36 girls; M age = 11.3 yr., SD = 2.7, range 7-15) with intellectual disabilities of various etiologies. The measure of executive functions were 8 subscales of the Behavioral Rating Inventory of Executive Function (BRIEF) consisting of Inhibition, Shifting, Emotional Control, Initiating, Working memory, Planning, Organization of material, and Monitoring. Visual-motor integration was measured with the Acadia test of visual-motor integration (VMI). Regression analysis revealed that BRIEF subscales explained 38% of the variance in VMI scores. Of all the BRIEF subscales, only two were statistically significant predictors of visual-motor integration: Working memory and Monitoring. Possible implications of this finding are further elaborated.

  11. The Influence of Functional Fitness and Cognitive Training of Physical Disabilities of Institutions

    Directory of Open Access Journals (Sweden)

    I-Chen Yeh

    2015-01-01

    Full Text Available According to an investigation done by Taiwan Ministry of the Interior in 2013, there was more than 90% of the disability care institutions mainly based on life care. Previous studies have shown that individuals can effectively improve physical and cognitive training, improved in independent living and everyday competence. The purpose of the study was to investigate influence of the intervention program applying functional fitness and cognitive training to disabled residents in the institution. The subjects were disabled persons of a care institution in southern Taiwan and were randomly divided into training and control groups, both having 17 subjects. The age of the subjects was between 56 and 98 years with a mean age of 79.08 ± 10.04 years; the subjects of training group implemented 12 weeks of training on physical and cognitive training, while the control group subjects did not have any training program. The results revealed that subjects of the training group have significantly improved their functional shoulder rotation flexibility of left and right anterior hip muscle group flexibility of right, sitting functional balance of left and right, naming, attention, delayed recall, orientation, and Montreal cognitive assessment (MOCA. The study suggested developing physical fitness programs and physical and cognitive prescriptions for the disabled people of the institutions.

  12. Autonomy and minority rights

    DEFF Research Database (Denmark)

    Barten, Ulrike

    2008-01-01

    on the content of the syllabus. When autonomy is understood in the literal sense, of giving oneself one's own laws, then there is a clear connection. Autonomy is usually connected to politics and a geographically limited territory. Special political rights of minorities - e.g. is the Danish minority party SSW...

  13. Meeting the support needs of persons with mild intellectual disability or borderline intellectual functioning: still a long way to go.

    Science.gov (United States)

    Nouwens, P J G; Smulders, N B M; Embregts, P J C M; van Nieuwenhuizen, C

    2017-12-01

    Among persons with a mild intellectual disability or borderline intellectual functioning, differences in their characteristics imply that a differentiated approach is required to meet their needs. This retrospective study examined whether the history of support/treatment programs and the type of healthcare providers involved matched the specific support needs of persons with a mild intellectual disability or borderline intellectual functioning. Five (previously identified) profiles of persons with a mild intellectual disability or borderline intellectual functioning were used to investigate to what extent the support needs of this group had been met. For the 250 persons with mild intellectual disability or borderline intellectual functioning who matched these five profiles, data were collected retrospectively from their case files. Persons with mild intellectual disability or borderline intellectual functioning received a very similar amount and type of support/treatment programs. Differences between the profiles were found for non-verbal therapy, residential treatment and contacts with social work. Regarding the type of healthcare providers involved, differences between the profiles emerged for specialised intellectual disability services, youth services and specialised addiction services. The support programs for a heterogeneous population of persons with mild intellectual disability or borderline intellectual functioning seem to be suboptimal, indicating that more differentiation is required in the services offered to these individuals. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  14. Social position and functional decline among non-disabled old men and women

    DEFF Research Database (Denmark)

    Avlund, Kirsten; Damsgaard, Mogens Trab; Osler, Merete

    2004-01-01

    material wealth were related to functional decline and death in both men and women, but the patterns differed: housing tenure was related to functional decline and death among the men, while income was related to functional decline and death among the women. The associations were not attenuated when...... adjusted by behavioural factors. CONCLUSION: The results indicate that poor material wealth is associated with functional decline independent of behavioural factors in a selected population of non-disabled older adults. Thus, the cumulative influence of material wealth throughout the life-course cannot...

  15. On autonomy and participation in rehabilitation.

    OpenAIRE

    Cardol, M.; Jong, B.A. de; Ward, C.D.

    2002-01-01

    To explore the concept of autonomy as a basis for social participation, with particular reference to rehabilitation. Method: A study of relevant literature from the field of rehabilitation, building on theory developed in other fields (ethics, social sciences), and deriving important concepts and strategies for rehabilitation practice. Results: The focus of rehabilitation for people with a chronic disabling condition is shifting from a biomedical to a client-centred perspective. Conceptions o...

  16. Mapping SAGE questionnaire to the International Classification of Functioning, Disability and Health (ICF).

    Science.gov (United States)

    Raggi, Alberto; Quintas, Rui; Russo, Emanuela; Martinuzzi, Andrea; Costardi, Daniela; Frisoni, Giovanni Battista; Franco, Maria Grazia; Andreotti, Alessandra; Ojala, Matti; Peña, Sebastián; Perales, Jaime; Chatterji, Somnath; Miret, Marta; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Frattura, Lucilla; Leonardi, Matilde

    2014-01-01

    The collaborative research on ageing in Europe protocol was based on that of the World Health Organization Study on global AGEing and adult health (SAGE) project that investigated the relationship between health and well-being and provided a set of instruments that can be used across countries to monitor health and health-related outcomes of older populations as well as the strategies for addressing issues concerning the ageing process. To evaluate the degree to which SAGE protocol covered the spectrum of disability given the scope of the World Health Organization International Classification of Functioning, Disability and Health (ICF), a mapping exercise was performed with SAGE protocol. Results show that the SAGE protocol covers ICF domains in a non-uniform way, with environmental factors categories being underrepresented, whereas mental, cardiovascular, sensory functions and mobility were overrepresented. To overcome this partial coverage of ICF functioning categories, new assessment instruments have been developed. PRACTITIONER MESSAGE: Mapping exercises are valid procedures to understand the extent to which a survey protocol covers the spectrum of functioning. The mapping exercise with SAGE protocol shows that it provides only a partial representation of body functions and activities and participation domains, and the coverage of environmental factors is poor. New instruments are therefore needed for researchers to properly understand the health and disability of ageing populations. Copyright © 2013 John Wiley & Sons, Ltd.

  17. The ICF has made a difference to functioning and disability measurement and statistics.

    Science.gov (United States)

    Madden, Rosamond H; Bundy, Anita

    2018-02-12

    Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and principles, and how the ICF has been used to improve measurement of functioning and related statistics. In a scoping review, we investigated research published 2001-2015 relating to measurement and statistics for evidence of: a change in thinking; alignment of applications with ICF specifications and philosophy; and the emergence of new knowledge. The ICF is used in diverse applications, settings and countries, with processes largely aligned with the ICF and intended to improve measurement and statistics: new national surveys, information systems and ICF-based instruments; and international efforts to improve disability data. Knowledge is growing about the components and interactions of the ICF model, the diverse effects of the environment on functioning, and the meaning and measurement of participation. The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge. Nevertheless, the field needs to mature. Identified gaps suggest ways to improve measurement and statistics to underpin policies, services and outcomes. Implications for Rehabilitation The ICF offers a conceptualization of functioning and disability that can underpin assessment and documentation in rehabilitation, with a growing body of experience to draw on for guidance. Experience with the ICF reminds practitioners to consider all the domains of participation, the effect of the environment on participation and the importance of involving clients/patients in assessment and service planning. Understanding the variability of functioning within everyday environments and designing interventions for removing barriers in various environments is a vital part of

  18. Relationship between functional disability and costs one and two years post stroke

    Science.gov (United States)

    Lekander, Ingrid; Willers, Carl; von Euler, Mia; Lilja, Mikael; Sunnerhagen, Katharina S.; Pessah-Rasmussen, Hélène; Borgström, Fredrik

    2017-01-01

    Background and purpose Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS) or hemorrhagic stroke (ICH)). Method Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services) and indirect (productivity losses) costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS). Results The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000–480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000–1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability. Conclusion Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH) was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke. PMID:28384164

  19. Relationship between functional disability and costs one and two years post stroke.

    Directory of Open Access Journals (Sweden)

    Ingrid Lekander

    Full Text Available Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS or hemorrhagic stroke (ICH.Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services and indirect (productivity losses costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS.The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000-480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000-1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability.Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke.

  20. Conceptual foundation for measures of physical function and behavioral health function for Social Security work disability evaluation.

    Science.gov (United States)

    Marfeo, Elizabeth E; Haley, Stephen M; Jette, Alan M; Eisen, Susan V; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M; Chan, Leighton; Brandt, Diane E; Rasch, Elizabeth K

    2013-09-01

    Physical and mental impairments represent the 2 largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person's underlying capabilities as well as activity demands relevant to the context of work. The objective of this article is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, 2 content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability and Health as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies 5 major domains: (1) behavior control, (2) basic interactions, (3) temperament and personality, (4) adaptability, and (5) workplace behaviors. The content model describing physical functioning includes 3 domains: (1) changing and maintaining body position, (2) whole-body mobility, and (3) carrying, moving, and handling objects. These content models informed subsequent measurement properties including item development and measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Paradoxical effects of radioiodine therapy in functional thyroid autonomy and mild immunothyropathy; Paradoxe Effekte der Radiojodtherapie bei funktioneller Schilddruesenautonomie und milder Immunthyreopathie

    Energy Technology Data Exchange (ETDEWEB)

    Dunkelmann, S.; Rudolph, F.; Prillwitz, A.; Groth, P.; Schuemichen, C. [Rostock Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    1998-01-01

    Aim: To examine all cases with Graves` disease after radioiodine therapy of autonomously functioning thyroid tissue (AFFT) in order to find the cause. Methods: We retrospectively studied 1428 pts who were treated between 11/93 and 3/97 with radioiodine for AFTT and who underwent at least one control examination. Results: 15 (1.1%) of all pts developed Graves` disease 8.4 (4-13) months after radioiodine therapy. There was no direct suggestion of Graves` disease (TRAK negative, no endocrine ophthalmopathy) in any pt at the time of radioiodine therapy. More detailed analysis of anamnestic data, however, revealed evidence that immunothyropathy predated radioiodine therapy in 11 of the 15 pts. Paradoxical effects of radioiodine therapy manifested as an increase in immunothyropathy 14 pts, a deterioration in metabolism in 11 pts and a first occurrence of endocrine ophthalmopathy in 5 pts. Conclusion: Exacerbation of preexisting, functional primarily insignificant immunothyropathia is held responsible in most cases for the observed paradoxical effects after radioiodine therapy, resulting in radiation-induced manifest Graves` disease; however no therapeutical consequences are recommended. (orig.) [Deutsch] Ziel: Erfassung von Pat. mit einer nach Radiojodtherapie wegen einer funktionellen Autonomie aufgetretenen Immunhyperthyreose sowie deren Ursachen. Methoden: Wir untersuchten in einer retrospektiven Studie 1428 Pat., die im Zeitraum 11/93 bis 3/97 wegen einer funktionellen Autonomie mit Radiojod behandelt wurden und die sich mindestens einer Kontrolluntersuchung unterzogen hatten. Ergebnisse: 15 (1,1%) der Pat. entwickelten 8,4 (4-13) Monate nach Radiojodtherapie eine postradiogene Immunhyperthyreose. Bei allen 15 Pat. lag zum Zeitpunkt der Radiojodtherapie kein direkter Hinweis auf eine Immunhyperthyreose vor (TRAK neg., keine endokrine Orbitopathie). Bei einer genauen Analyse anamnestischer Daten fanden sich jedoch bei 11 der 15 Pat. erste Hinweise auf das Vorliegen

  2. FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS

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    Luis Muñiz Luna

    2016-03-01

    Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

  3. Physical practice is associated with less functional disability in medical students with migraine

    Directory of Open Access Journals (Sweden)

    Renan B. Domingues

    2011-02-01

    Full Text Available The aim of this study was to investigate possible association between migraine and physical practice among 480 medical students who were submitted to a questionnaire about headaches and physical practices. Migraine diagnosis was assessed by ID-Migraine and functional disability was evaluated with MIDAS. The type (aerobic or strength training, the weekly frequency and the intensity of physical practice and body mass index (BMI were assessed. There was a reduction in functional disability of migraine in students reporting physical practice (no physical practice - MIDAS=8.81±1.40, physical practice - MIDAS=15.49±1.78; P=0.03. Frequency, intensity, and type of physical practices were not associated with functional impact of migraine. BMI did not correlate with migraine impact (normal weight - MIDAS=12.34±1.33, overweight or obese - MIDAS=17.45±3.86; P=0.33. These results were confirmed by multivariate analysis. Our data suggest that physical practice is inversely related with functional disability of migraine in university students regardless of BMI.

  4. The Future of Reproductive Autonomy.

    Science.gov (United States)

    Johnston, Josephine; Zacharias, Rachel L

    2017-12-01

    In a project The Hastings Center is now running on the future of prenatal testing, we are encountering clear examples, both in established law and in the practices of individual providers, of failures to respect women's reproductive autonomy: when testing is not offered to certain demographics of women, for instance, or when the choices of women to terminate or continue pregnancies are prohibited or otherwise not supported. But this project also raises puzzles for reproductive autonomy. We have learned that some clinicians and patients do not discuss the fact that prenatal testing can lead to a decision about whether to terminate a pregnancy-they just don't talk about it. And while the decision whether to agree to prenatal screening and diagnostic testing is to be made with women's free and informed consent, many screening tests have been routinized in such a way that some women do not even recall agreeing to testing, while others feel that agreeing to testing is what their clinicians expect of them or that the testing is necessary to protect themselves and their families from the significant financial hardship of raising a child with a disability. In the face of these pressures, can one really say that women are freely choosing to undergo testing or are freely choosing to continue or terminate a pregnancy following receipt of test results? The reality of these pressures is requiring us to consider expanding the scope of our investigation beyond the clinical encounter to the broader context-to think harder about what reproductive autonomy means and how best to enhance it. © 2017 The Hastings Center.

  5. Strengths and weaknesses in executive functioning in children with intellectual disability

    OpenAIRE

    Danielsson, H.; Henry, L.; Messer, D. J.; Ronnberg, J.

    2012-01-01

    Children with intellectual disability (ID) were given a comprehensive range of executive functioning measures, which systematically varied in terms of verbal and non-verbal demands. Their performance was compared to the performance of groups matched on mental age (MA) and chronological age (CA), respectively. Twenty-two children were included in each group. Children with ID performed on par with the MA group on switching, verbal executive-loaded working memory and most fluency tasks, but belo...

  6. Cognitive rehabilitation: an important tool in disability improvement after brain injuries

    OpenAIRE

    Ioana Stanescu; Gabriela Dogaru

    2016-01-01

    Cognitive rehabilitation is as an important goal of rehabilitation therapy, which aims to help the person with neurological disability to acquire the highest level of cognitive functioning and of functional autonomy. Cognitive impairments in memory, language, judgement, attention, visuo-spatial perception are important blocks in acquiring functional independence. Cognitive rehabilitation therapy is “a systematic, functionally oriented service of therapeutic cognitive activities directed to ...

  7. Neuro-ophthalmologic evaluation, quality of life, and functional disability in patients with MS.

    Science.gov (United States)

    Garcia-Martin, Elena; Rodriguez-Mena, Diego; Herrero, Raquel; Almarcegui, Carmen; Dolz, Isabel; Martin, Jesus; Ara, Jose R; Larrosa, Jose M; Polo, Vicente; Fernández, Javier; Pablo, Luis E

    2013-07-02

    To evaluate correlations between longitudinal changes in neuro-ophthalmologic measures and quality of life (QOL) and disability in patients with multiple sclerosis (MS), using optical coherence tomography (OCT), visual evoked potentials (VEP), and visual field examination. Fifty-four patients with relapsing-remitting MS were enrolled in this study and underwent Multiple Sclerosis Quality of Life questionnaire (54 items) (MSQOL-54) and Expanded Disability Status Scale (EDSS) evaluation, as well as complete neuro-ophthalmologic examination including visual field testing and retinal nerve fiber layer (RNFL) measurements using Cirrus and Spectralis OCT and VEP. All patients were re-evaluated at 12, 24, and 36 months. Logistical regression was performed to analyze which measures, if any, could predict QOL. Overall, RNFL thickness results at the baseline evaluation were significantly different from those at 3 years (p ≤ 0.05), but there were no differences in functional measures (visual acuity, contrast sensitivity, color vision, visual field, and VEP). A reduced MSQOL-54 score was associated with an increase in EDSS score and a decrease in both functional and structural parameters. Patients with longer MS duration presented with a lower MSQOL-54 score (reduction in QOL). Patients with progressive axonal loss as seen in RNFL results had a lower QOL and more functional disability.

  8. Entrepreneurial autonomy and its dynamics

    NARCIS (Netherlands)

    van Gelderen, M.W.

    2016-01-01

    Founding and owning an independent business does not automatically provide the owner/founder with autonomy. Autonomy-motivated entrepreneurs must often make an effort to achieve and maintain autonomy. The aim of this research is to investigate the experience of autonomy, its variations over time,

  9. Does the economy affect functional restoration outcomes for patients with chronic disabling occupational musculoskeletal disorders?

    Science.gov (United States)

    Hartzell, Meredith M; Mayer, Tom G; Neblett, Randy; Marquardt, Dennis J; Gatchel, Robert J

    2015-06-01

    To determine how the economy affects psychosocial and socioeconomic treatment outcomes in a cohort of chronic disabling occupational musculoskeletal disorder (CDOMD) patients who completed a functional restoration program (FRP). A cohort of 969 CDOMD patients with active workers' compensation claims completed an FRP (a medically-supervised, quantitatively-directed exercise progression program, with multi-modal disability management). A good economy (GE) group (n = 532) was released to work during a low unemployment period (2005-2007), and a poor economy (PE) group (n = 437) was released during a higher unemployment period (2008-2010). Patients were evaluated upon admission for demographic and psychosocial variables, and were reassessed at discharge. Socioeconomic outcomes, including work return and work retention 1 year post-discharge, were collected. Some significant differences in psychosocial self-report data were found, but most of the effect sizes were small, so caution should be made when interpreting the data. Compared to the PE group, the GE group reported more depressive symptoms and disability at admission, but demonstrated a larger decrease in depressive symptoms and disability and increase in self-reported quality of life at discharge. The PE group had lower rates of work return and retention 1-year after discharge, even after controlling for other factors such as length of disability and admission work status. CDOMD patients who completed an FRP in a PE year were less likely to return to, or retain, work 1-year after discharge, demonstrating that a PE can be an additional barrier to post-discharge work outcomes. A difference in State unemployment rates of <3% (7 vs. 5%) had a disproportionate effect on patients' failure to return to (19 vs. 6%) or retain (28 vs. 15%) work.

  10. Changing professional autonomy?

    DEFF Research Database (Denmark)

    Jespersen, Peter Kragh

    The paper presents a typology for the analysis for professional autonomy and an application of the typology in realation to discourses of quality development in the 'Health Care sector in Denmark and Norway......The paper presents a typology for the analysis for professional autonomy and an application of the typology in realation to discourses of quality development in the 'Health Care sector in Denmark and Norway...

  11. Anagogy of autonomy.

    Science.gov (United States)

    Boyd, A L

    2000-07-01

    The philosophical and ethical concept of autonomy is herein examined, ex post facto, using an existential lens to examine the process of a personal friend's dying. Anagogy, defined as interpretation of a word, passage, or text that finds beyond the literal, allegorical, and moral senses a fourth and ultimate spiritual or mystical sense, is intended to enlarge the understanding of the use of autonomy in this case. The idea of personhood linked inextricably to reason is, therefore, understood as empowering an individual to choose among various actions, to define and redefine life goals, and to give priority to selected values and moral tenants, which reveal a moral hermeneutic. Conditions and circumstances, existentially exposed, limit choice in unexpected ways, such that the predicted value of autonomy is vulnerable to misuse or misunderstanding. The intent to respect the dignity of every person is central to the philosophy of Respect for Persons ethics, and assumes that autonomy, as freedom of the moral agent, is a moral duty. Implicit reality of freedom is, in a practical sense, essential to being rational agents who can thereby exercise informed choice. The moral law, law of freedom, involves the autonomy of the will and an ultimate end to which all action is directed. Defined as the highest good, morality unites virtue and happiness by ascribing the ultimate end sought as God. The freedom to use rational will finds principles within its own rational nature. The ability to create maxims is autonomy of the will, which equates with the dignity of persons. My recent experience as a companion to a personal friend with a terminal illness inspired me to re-evaluate the concept of autonomy as it is too often interpreted in modern ethical discourse as a individualistic right of choice as opposed to the hermeneutic of dignity of person. This paper describes a shift of position in understanding the paradox of autonomy in this existential context.

  12. Functional autonomy of elderly women enrolled in a physical activity program = Autonomia funcional de mulheres idosas participantes de um programa de atividades físicas

    Directory of Open Access Journals (Sweden)

    Silvia Bacellar

    2012-07-01

    Full Text Available The present study aimed to determine the effects of a physical activity program on the functional autonomy of elderly women. The sample was divided into an experimental group (EG; n = 20; 68.51 ± 5.02 years; BMI = 27.01 ± 4.35 submitted to a physical activity program, and a control group (CG; n = 20; 67.01 ± 3.51 years; BMI = 26.71 ± 5.74. Functional autonomy was assessed using tests from the GDLAM autonomy protocol: 10 meter walk test (10MW, rising from a sitting position (RSP, rising from a ventral decubitus position (RVDP, rising from a chair and moving around the house (RCMH and putting on and taking off a t-shirt (PTT, after which the autonomy index (AI was calculated. In the EG, ANOVA showed significant reductions in execution times for the RSP (∆ = -3.92 s; p = 0.0001, RCMH (∆ = -9.61 s; p = 0.0001, 10MW (∆ = -0.94 s; p = 0.038 and RVDP (∆ = -1.15 s; p = 0.036 tests, as well as the AI (∆ = -6.27; p = 0.0001. This was not observed in the CG. Intergroup comparisons demonstrated that execution times for the RSP (∆% = -36.63; p = 0.0001, RCMH (∆% = -20.27; p = 0.0001, 10mW (∆% = -12.54; p = 0.002 and RVDP (∆% = -25.10; p = 0.005 tests and the AI (∆% = -21.37; p = 0.0001 of the EG were shorter than those of the CG. These results indicate that elderly subjects in the EG showed improved performance in activities of daily living after engaging in physical exercise.O objetivo do estudo foi verificar os efeitos de um programa de atividade física sobre a autonomia funcional em mulheres idosas. A amostra foi distribuída em grupo experimental (GE; n = 20; 68,51 ± 5,02 anos; IMC = 27,01 ± 4,35 submetido a um programa de atividade física e grupo controle (GC; n = 20; 67,01 ± 3,51 anos; IMC = 26,71 ± 5,74. A autonomia funcional foi avaliada por meio dos testes do protocolo de autonomia GDLAM, caminhar 10 m (C10 m, levantar-se da posição sentada (LPS, levantar-se da posição decúbito ventral (LPDV, levantar-se da cadeira

  13. [The Brazilian Functionality Index: perceptions of professionals and persons with disabilities in the context of Complementary Law 142/2013].

    Science.gov (United States)

    Pereira, Éverton Luís; Barbosa, Livia

    2016-10-01

    This article derives from a study conducted on the validation of the Brazilian Functionality Index (IF-BrA) applied to the granting of retirement benefits to disabled persons. The retirement of persons with disabilities is regulated by Complementary Law 142 of May 8, 2013. The aim is to discuss how the individuals involved in application of the instrument perceive the concept of disability and the possible implications for ensuring the right to retirement. Eleven agencies of the National Social Security Institute (INSS) were visited and 16 physicians, 16 social workers and 40 persons with disabilities were interviewed. The evaluation and assessment process was also observed. The results indicate that there are conceptual tensions between the perspective on disability of the professionals and the IF-BrA concepts. Social workers and physicians are challenged in their technical specialties in the application of the instrument. Persons with disabilities do not always consider themselves to be disabled in their daily lives. Disability is either presented as a political description of the body in accordance with the social model of disability, or it is described as a specific difficulty justifying the right to seek retirement.

  14. Activity-related summation of pain and functional disability in patients with whiplash injuries.

    Science.gov (United States)

    Sullivan, Michael J L; Larivière, Christian; Simmonds, Maureen

    2010-11-01

    This study investigated the relation between repetition-induced summation of activity-related pain (RISP) and indicators of functional disability in a sample of 62 individuals who had sustained whiplash injuries. Participants completed measures of pain severity, pain catastrophizing, fear of movement and depression prior to lifting a series of 36 weighted canisters. An index of RISP was computed as the increase in pain reported by participants over successive lifts of the weighted canisters. Measures of functional disability included physical lifting tolerance, self-reported disability and perceived work demands. Regression analyses revealed that the index of RISP accounted for significant variance in measures of lifting tolerance and perceived work demands, even when controlling for age, sex and pain severity. The index of RISP was also significantly correlated with pain catastrophizing and pain duration. The discussion addresses the mechanisms by which physiological and psychological factors might contribute to increases in pain during repeated physical activity. Discussion also addresses whether RISP might represent a risk factor for problematic recovery outcomes following whiplash injury. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  15. Assessment of health, functioning and disability of a population aged 60–70 in south-eastern Poland using the WHO Disability Assessment Schedule (WHODAS 2.0

    Directory of Open Access Journals (Sweden)

    Agnieszka Ćwirlej-Sozańska

    2018-03-01

    Regarding the studied population, it was found that many health problems become worse over the years. The state of health that deteriorates with age causes limitations in daily functioning, which lead to disability, activity limitations and participation in everyday life. The progressive ageing of the Polish population will cause an increasing demand for medical care and on the social services.

  16. IMPLEMENTATION OF INTERNATIONAL CLASSIFICATION OF FUNCTION, DISABILITY AND HEALTH IN FIELD OF PEDIATRICS

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    Dragoslav KOPACHEV

    2004-12-01

    Full Text Available The author, as an active participant at the Seminar IMPLEMENTATION OF ICF IN THE FIELD OF PEDIATRICS, held on 14-15 July 2004 at the hotel Panorama – Skopje, states his insight about the organization, work and aims of the seminar. He makes a review on attitudes and fields ICF in pediatric field commits. The commitments of ICF (International Classification of Function, Disability and Health in the Field of Pediatrics have been put on the child with developmental disabilities to be attention-centered; on bio-developmental model in interaction with the environment, on greater possibilities, safety and satisfaction of needs, as well as on greater freedom in participation in the community to realize the legal rights. It is pointed out that ICF in the field of pediatrics supports the idea ‘One for all’.

  17. Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study.

    Science.gov (United States)

    Godino, Job G; Appel, Lawrence J; Gross, Alden L; Schrack, Jennifer A; Parrinello, Christina M; Kalyani, Rita R; Windham, Beverly Gwen; Pankow, James S; Kritchevsky, Stephen B; Bandeen-Roche, Karen; Selvin, Elizabeth

    2017-01-01

    There is a need for continued surveillance of diabetes-related functional disability. In the present study, we examined associations between diabetes, hyperglycemia, and the burden of functional disability in a community-based population. A cross-sectional analysis was conducted of 5035 participants who attended Visit 5 (2011-13) of the Atherosclerosis Risk in Communities study. Functional disability was dichotomously defined by any self-reported difficulty performing 12 tasks essential to independent living grouped into four functional domains. Associations of diagnosed diabetes (via self-report) and undiagnosed diabetes and prediabetes (via HbA1c) with functional disability were evaluated using Poisson regression. Participants had a mean age of 75 years, 42 % were male, 22 % were Black, and 31 % had diagnosed diabetes. Those with diagnosed diabetes had a significantly greater burden of functional disability than those without diabetes, even after adjustment for demographics, health behaviors, and comorbidities: prevalence ratios (95 % confidence intervals) were 1.24 (1.15, 1.34) for lower extremity mobility, 1.14 (1.07, 1.21) for general physical activities, 1.33 (1.16, 1.52) for instrumental activities of daily living (ADL), and 1.46 (1.24, 1.73) for ADL (all P  0.05). Among older adults, the burden of functional disability associated with diabetes was not entirely explained by known risk factors, including comorbidities. Hyperglycemia below the threshold for the diagnosis of diabetes was not associated with disability. Research into effective strategies for the prevention of functional disability among older adults with diabetes is needed. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  18. Prevalence of functioning and disability in older patients with joint contractures: a cross-sectional study.

    Science.gov (United States)

    Fischer, U; Müller, M; Strobl, R; Bartoszek, G; Meyer, G; Grill, E

    2015-06-01

    Joint contractures are a common problem for older, frail people, particularly in rehabilitation, nursing home and homecare settings. Joint contractures are underreported and sparsely empirically investigated despite their high prevalence. The objective of this study was to examine the prevalence of functional impairments, activity limitations and participation restrictions of patients with joint contractures using the International Classification of Functioning, Disability and Health (ICF) as a framework. We also examined contextual factors as potential mediators for functioning and disability. Cross-sectional study- Three acute-geriatric hospitals in and around Munich (Germany). Patients aged 65 and over with confirmed joint contractures requiring rehabilitation care. The patients were asked to answer a questionnaire that comprised 124 categories of the ICF. Patients' problems in functioning were registered separately for each category. Data were collected through face-to-face interviews with patients and health professionals and from patients' medical records. One hundred and fifty patients were eligible and agreed to participate. Mean age was 82.5 years (SD: 7.4), 64.8% of the patients were female. Problems in "muscle power functions" (95.9%) and "driving human-powered transportation" (89,6%) were those most frequently identified. 'Health services, systems and policies' (98,6%) was the most frequent environmental facilitator. Aged persons with joint contractures experience high levels of disability. Specifically, mobility, participation restrictions and interactions with the environment emerged as important issues of our study. Mobility and support by others were frequently mentioned as aspects relevant for persons with joint contractures. These aspects have to be considered when assessing the impact of joint contractures.

  19. Older adults' preferences for formal social support of autonomy and dependence in pain: development and validation of a scale.

    Science.gov (United States)

    Bernardes, Sónia F; Matos, Marta; Goubert, Liesbet

    2017-09-01

    Chronic pain among older adults is common and often disabling. Pain-related formal social support (e.g., provided by staff at day-care centers, nursing homes), and the extent to which it promotes functional autonomy or dependence, plays a significant role in the promotion of older adults' ability to engage in their daily activities. Assessing older adults' preferences for pain-related social support for functional autonomy or dependence could contribute to increase formal social support responsiveness to individuals' needs. Therefore, this study aimed at developing and validating the preferences for formal social support of autonomy and dependence in pain inventory (PFSSADI). One hundred and sixty-five older adults with chronic musculoskeletal pain ( M age  = 79.1, 67.3% women), attending day-care centers, completed the PFSSADI, the revised formal social support for autonomy and dependence in pain inventory, and a measure of desire for (in)dependence; the PFSSADI was filled out again 6 weeks later. Confirmatory factor analyses showed a structure of two correlated factors ( r  = .56): (a) preferences for autonomy support ( α  = .99) and (b) preferences for dependence support ( α  = .98). The scale showed good test-retest reliability, sensitivity and discriminant and concurrent validity; the higher the preferences for dependence support, the higher the desire for dependence ( r  = .33) and the lower the desire for independence ( r  = -.41). The PFSSADI is an innovative tool, which may contribute to explore the role of pain-related social support responsiveness on the promotion of older adults' functional autonomy when in pain.

  20. Child pain catastrophizing mediates the relationship between parent responses to pain and disability in youth with functional abdominal pain

    Science.gov (United States)

    Cunningham, Natoshia Raishevich; Lynch-Jordan, Anne; Barnett, Kimberly; Peugh, James; Sil, Soumitri; Goldschneider, Kenneth; Kashikar-Zuck, Susmita

    2014-01-01

    Objectives Functional abdominal pain (FAP) in youth is associated with substantial impairment in functioning and prior research has shown that overprotective parent responses can heighten impairment. Little is known about how a range of parental behaviors in response to their child’s pain (overprotection, minimizing and/or encouragement) interact with child coping characteristics (e.g., catastrophizing) to influence functioning in youth with FAP. In this study, it was hypothesized that the relationship between parenting factors and child disability would be mediated by children’s level of maladaptive coping (i.e., pain catastrophizing). Methods Seventy-five patients with FAP presenting to a pediatric pain clinic and their caregivers participated. Youth completed measures of pain intensity (Numeric Rating Scale), pain catastrophizing (Pain Catastrophizing Scale), and disability (Functional Disability Inventory). Caregivers completed measures of parent pain catastrophizing (Pain Catastrophizing Scale), and parent responses to child pain behaviors (Adult Responses to Child Symptoms: protection, minimizing, and encouragement/monitoring subscales). Results Increased functional disability was significantly related to higher child pain intensity, increased child and parent pain catastrophizing, and higher levels of encouragement/monitoring and protection. Parent minimization was not related to disability. Child pain catastrophizing fully mediated the relationship between parent encouragement/monitoring and disability and partially mediated the relationship between parent protectiveness and disability. Conclusions The impact of parenting behaviors in response to FAP on child disability is determined in part by the child’s coping style. Findings highlight a more nuanced understanding of the parent-child interaction in determining pain-related disability levels, which should be taken into consideration in assessing and treating youth with FAP. PMID:25121521

  1. Child pain catastrophizing mediates the relation between parent responses to pain and disability in youth with functional abdominal pain.

    Science.gov (United States)

    Cunningham, Natoshia R; Lynch-Jordan, Anne; Barnett, Kimberly; Peugh, James; Sil, Soumitri; Goldschneider, Kenneth; Kashikar-Zuck, Susmita

    2014-12-01

    Functional abdominal pain (FAP) in youth is associated with substantial impairment in functioning, and prior research has shown that overprotective parent responses can heighten impairment. Little is known about how a range of parental behaviors (overprotection, minimizing, and/or encouragement) in response to their child's pain interact with child coping characteristics (eg, catastrophizing) to influence functioning in youth with FAP. In this study, it was hypothesized that the relation between parenting factors and child disability would be mediated by children's levels of maladaptive coping (ie, pain catastrophizing). Seventy-five patients with FAP presenting to a pediatric pain clinic and their caregivers participated in the study. Youth completed measures of pain intensity (Numeric Rating Scale), pain catastrophizing (Pain Catastrophizing Scale), and disability (Functional Disability Inventory). Caregivers completed measures of parent pain catastrophizing (Pain Catastrophizing Scale), and parent responses to child pain behaviors (Adult Responses to Child Symptoms: Protection, Minimizing, and Encouragement/Monitoring subscales). Increased functional disability was significantly related to higher child pain intensity, increased child and parent pain catastrophizing, and higher levels of encouragement/monitoring and protection. Parent minimization was not related to disability. Child pain catastrophizing fully mediated the relation between parent encouragement/monitoring and disability and partially mediated the relation between parent protectiveness and disability. The impact of parenting behaviors in response to FAP on child disability is determined, in part, by the child's coping style. Findings highlight a more nuanced understanding of the parent-child interaction in determining pain-related disability levels, which should be taken into consideration in assessing and treating youth with FAP.

  2. Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age

    Directory of Open Access Journals (Sweden)

    Aremis Villalobos

    2017-07-01

    Full Text Available Objective. To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. Materials and methods. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. Results. While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4% and depression (1.5% daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. Conclusions. Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.

  3. Patient autonomy: a view from the kitchen.

    Science.gov (United States)

    Struhkamp, Rita M

    2005-01-01

    In contemporary liberal ethics patient autonomy is often interpreted as the right to self-determination: when it comes to treatment decisions, the patient is given the right to give or withhold informed consent. This paper joins in the philosophical and ethical criticism of the liberal interpretation as it does not regard patient autonomy as a right, rule or principle, but rather as a practice. Patient autonomy, or so I will argue, is realised in the concrete activities of day-to-day health care, in the material and technological context of care, in arrangements of health care institutions, in the physical training of people with disabilities, as well as in the concrete activities of care-giving. This move from conversations in the consultation room to other sites and situations in the practice of care takes seriously the empirical reality of medical care and intends to show that patient autonomy is practically realised in a much richer and more creative way than most ethical theory seems to assume.

  4. Inhibitory control as a factor of adaptive functioning of children with mild intellectual disability

    Directory of Open Access Journals (Sweden)

    Gligorović Milica

    2012-01-01

    Full Text Available Bearing in mind that the adaptive behaviour is one of the defining parameters of intellectual disability, determining of the influence of inhibitory control on adaptive functioning in children with mild intellectual disability was defined as a basic aim of this research. The sample covered 95 children with mild intellectual disability (MID, of both genders, from 10 to 14 years of age. By analysis of the data of schools' pedagogical-psychological departments, data on age and intellectual abilities of participants were collected. Inhibitory control was estimated by Go no Go task, consisted of Conflict Response and Response Delay sets. Adaptive skills data were gained on the basis of a standardized interview with special education teachers, by applying of AAMR Scale of adaptive functioning. On the basis of factor analysis, Scale scores were grouped in five factors: Personal independence, Social Independence, Personal and Social Responsibility, Social Adaptability and Personal Adaptability. Significance of relations among the observed variables was established by Pearson's correlation coefficient, by partial correlation coefficient and multifactorial variance analysis. Based on the analysis of results a statistically significant relationship between errors in the execution of tasks that belong to the set of conflict motor responses and adaptive functioning (p≤0.000 was established. The relationship between errors that belong to the set of the response delay, and adaptive functioning is not statistically significant (p=0.324. Inhibition of the interference response is a significant factor of practical (partial η2=0.227, conceptual (partial η2=0.341 and social (partial η2=0.131 adaptive skills, while the response delay is significantly associated with the conceptual skills (p=0.029 only. Inhibitory control did not prove itself a significant factor in behaviour problems of externalizing and internalized type.

  5. Long-lasting functional disabilities in patients who recover from coma after cardiac operations.

    Science.gov (United States)

    Rodriguez, Rosendo A; Nair, Shona; Bussière, Miguel; Nathan, Howard J

    2013-03-01

    Uncertainty regarding the long-term functional outcome of patients who awaken from coma after cardiac operations is difficult for families and physicians and may delay rehabilitation. We studied the long-term functional status of these patients to determine if duration of coma predicted outcome. We followed 71 patients who underwent cardiac operations; recovered their ability to respond to verbal commands after coma associated with postoperative stroke, encephalopathy, and/or seizures; and were discharged from the hospital. The Glasgow Outcome Scale Extended (GOSE) was used to assess functional disability 2 to 4 years after discharge. Outcomes were classified as favorable (GOSE scores 7 and 8) and unfavorable (GOSE scores 1-6). Of 71 patients identified, 39 were interviewed, 15 died, 1 refused to be interviewed, and 16 were lost to follow-up. Of the 54 patients with completed GOSE evaluations, only 15 (28%) had favorable outcomes. Among patients with unfavorable outcomes, 15 (28%) died, 14 (26%) survived with moderate disabilities, and 10 (18%) had severe disabilities. Factors associated with unfavorable outcomes were increases in duration of coma (p = 0.007), time in intensive care (p = 0.006), length of hospitalization (p = 0.004), and postoperative serum creatine kinase levels (p = 0.006). Only duration of coma was an independent predictor of unfavorable outcome (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.008-1.537; p = 0.042). Patients with durations of coma greater than 4 days were more likely to have unfavorable outcomes (OR, 5.1; 95% CI, 1.3-21.3; p = 0.02). Two thirds of comatose patients who survived to discharge after cardiac operations had unfavorable long-term functional outcomes. A longer duration of unconsciousness is a predictor of unfavorable outcome. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Examining transgender health through the International Classification of Functioning, Disability, and Health's (ICF) Contextual Factors.

    Science.gov (United States)

    Jacob, Melissa; Cox, Steven R

    2017-12-01

    For many transgender individuals, medical intervention is necessary to live as their desired gender. However, little is known about Contextual Factors (i.e., Environmental and Personal) that may act as facilitators and barriers in the health of transgender individuals. Therefore, this paper sought to examine Contextual Factors of the World Health Organization's International Classification of Functioning, Disability, and Health that may facilitate or negatively impact the physical, psychological, and social functioning of transgender individuals. A literature review was conducted to identify Environmental and Personal Factors that may influence transgender individuals' physical, psychological, and social functioning. Seven electronic databases were searched. In total, 154 records were reviewed, and 41 articles and other records met inclusion criteria. Three general themes emerged for Environmental Factors: family and social networks, education, and health care. Three general themes also emerged for Personal Factors: socioeconomic status, race, and age. Transgender individuals benefit from gender-affirming services, improved family and social support systems, and competent provider care. Educational training programs, including medical curricula or workshops, might provide the greatest benefit in improving transgender health by increasing the knowledge and cultural competency of health professionals working with this population. Given the diversity of gender expression, differences in lived experiences, and potential for enduring persistent "double discrimination" due to the intersectional relationships between socioeconomic status, race, and/or age, health professionals must approach transgender health using a holistic lens such as the World Health Organization's International Classification of Functioning, Disability, and Health.

  7. Classification in childhood disability: focusing on function in the 21st century.

    Science.gov (United States)

    Rosenbaum, Peter; Eliasson, Ann-Christin; Hidecker, Mary Jo Cooley; Palisano, Robert J

    2014-08-01

    Classification systems in health care are usually based on current understanding of the condition. They are often derived empirically and adopted applying sound principles of measurement science to assess whether they are reliable (consistent) and valid (true) for the purposes to which they are applied. In the past 15 years, the authors have developed and validated classification systems for specific aspects of everyday function in people with cerebral palsy--gross motor function, manual abilities, and communicative function. This article describes the approaches used to conceptualize each aspect of function, develop the tools, and assess their reliability and validity. We report on the utility of each system with respect to clinical applicability, use of these tools for research, and the uptake and impact that they have had around the world. We hope that readers will find these accounts interesting, relevant, and applicable to their daily work with children and youth with disabilities. © The Author(s) 2014.

  8. Epistemics for Learning Disabilities: Contributions from Magnetoencephalography, a Functional Neuroimaging Tool

    Directory of Open Access Journals (Sweden)

    VÍCTOR SANTIUSTE-BERMEJO

    2008-01-01

    Full Text Available The syndrome known as Learning Disabilities (LD was described by S. Kirk in 1963. From that point on, institutions from the US, Canada and Spain have engaged in refining the concept and classification of LDs. The Complutense University in Spain, has proposed a descriptive and all-embracing definition, and has studied the different manifestations of LD, pursuing the description of biological markers and neurological features of LD’s main expressions: dyslexia, dyscalculia, dysorthographia, Attention Deficit and Hyperactivity Disorder –ADHD, and so forth. Findings in LD using functional neuroimaging techniques, namely Magnetoencephalography (MEG, are described. MEG is a non-invasive technique, which records magnetic fields naturally generated by the brain and their spatial distribution. It allows simultaneous functional and structural information. MEG is therefore used in the study of primary and superior cognitive functions, in surveillance of patterns of normal cognitive function and those specific to the different LD clinical manifestations.

  9. Biallelic loss-of-function variants in DOCK3 cause muscle hypotonia, ataxia, and intellectual disability.

    Science.gov (United States)

    Helbig, K L; Mroske, C; Moorthy, D; Sajan, S A; Velinov, M

    2017-10-01

    DOCK3 encodes the dedicator of cytokinesis 3 protein, a member of the DOCK180 family of proteins that are characterized by guanine-nucleotide exchange factor activity. DOCK3 is expressed exclusively in the central nervous system and plays an important role in axonal outgrowth and cytoskeleton reorganization. Dock3 knockout mice exhibit motor deficiencies with abnormal ataxic gait and impaired learning. We report 2 siblings with biallelic loss-of-function variants in DOCK3. Diagnostic whole-exome sequencing (WES) and chromosomal microarray were performed on a proband with severe developmental disability, hypotonia, and ataxic gait. Testing was also performed on the proband's similarly affected brother. A paternally inherited 458 kb deletion in chromosomal region 3p21.2 disrupting the DOCK3 gene was identified in both affected siblings. WES identified a nonsense variant c.382C>G (p.Gln128*) in the DOCK3 gene (NM_004947) on the maternal allele in both siblings. Common features in both affected individuals include severe developmental disability, ataxic gait, and severe hypotonia, which recapitulates the Dock3 knockout mouse phenotype. We show that complete DOCK3 deficiency in humans leads to developmental disability with significant hypotonia and gait ataxia, probably due to abnormal axonal development. © 2017 The Authors. Clinical Genetics published by John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Understanding nurse practitioner autonomy.

    Science.gov (United States)

    Weiland, Sandra A

    2015-02-01

    This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care. A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis. Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role. The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role. ©2014 American Association of Nurse Practitioners.

  11. Parents' Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life

    DEFF Research Database (Denmark)

    Illum, Niels Ove; Gradel, Kim Oren

    2017-01-01

    : Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers......AIM: To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. METHOD...... of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after...

  12. Autonomy and Housing Accessibility Among Powered Mobility Device Users

    Science.gov (United States)

    Brandt, Åse; Lexell, Eva Månsson; Iwarsson, Susanne

    2015-01-01

    OBJECTIVE. To describe environmental barriers, accessibility problems, and powered mobility device (PMD) users’ autonomy indoors and outdoors; to determine the home environmental barriers that generated the most housing accessibility problems indoors, at entrances, and in the close exterior surroundings; and to examine personal factors and environmental components and their association with indoor and outdoor autonomy. METHOD. This cross-sectional study was based on data collected from a sample of 48 PMD users with a spinal cord injury (SCI) using the Impact of Participation and Autonomy and the Housing Enabler instruments. Descriptive statistics and logistic regression were used. RESULTS. More years living with SCI predicted less restriction in autonomy indoors, whereas more functional limitations and accessibility problems related to entrance doors predicted more restriction in autonomy outdoors. CONCLUSION. To enable optimized PMD use, practitioners must pay attention to the relationship between client autonomy and housing accessibility problems. PMID:26356666

  13. A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics.

    Science.gov (United States)

    Jarl, Gustav; Ramstrand, Nerrolyn

    2017-09-01

    The International Classification of Functioning, Disability and Health is a classification of human functioning and disability and is based on a biopsychosocial model of health. As such, International Classification of Functioning, Disability and Health seems suitable as a basis for constructing models defining the clinical P&O process. The aim was to use International Classification of Functioning, Disability and Health to facilitate development of such a model. Proposed model: A model, the Prosthetic and Orthotic Process (POP) model, is proposed. The Prosthetic and Orthotic Process model is based on the concepts of the International Classification of Functioning, Disability and Health and comprises four steps in a cycle: (1) Assessment, including the medical history and physical examination of the patient. (2) Goals, specified on four levels including those related to participation, activity, body functions and structures and technical requirements of the device. (3) Intervention, in which the appropriate course of action is determined based on the specified goal and evidence-based practice. (4) Evaluation of outcomes, where the outcomes are assessed and compared to the corresponding goals. After the evaluation of goal fulfilment, the first cycle in the process is complete, and a broad evaluation is now made including overriding questions about the patient's satisfaction with the outcomes and the process. This evaluation will determine if the process should be ended or if another cycle in the process should be initiated. The Prosthetic and Orthotic Process model can provide a common understanding of the P&O process. Concepts of International Classification of Functioning, Disability and Health have been incorporated into the model to facilitate communication with other rehabilitation professionals and encourage a holistic and patient-centred approach in clinical practice. Clinical relevance The Prosthetic and Orthotic Process model can support the implementation

  14. Using the International Classification of Functioning, Disability and Health (ICF) to address facilitators and barriers to participation at work.

    Science.gov (United States)

    Martins, Anabela Correia

    2015-01-01

    The International Classification of Functioning, Disability and Health (ICF) was approved by the World Health Assembly in 2001. Ten years later, strong arguments have arisen regarding the added value of ICF to the policies on employment and the outcomes at the workplace. As a conceptual framework, ICF has universality because of its inclusive and comprehensive view of human functioning. At a practical level ICF can be used to quantify the impact of impairment on an individual's ability to act in his/her environment and to assess interventions to minimize the impact of disability and maximize functioning. To explore key indicators of social participation (life habits) of persons with disabilities, particularly related to work, among environmental and personal factors. Data were collected by self-administered questionnaires from a convenience sample of 149 working-age persons with disabilities. Social participation is a construct composed by multiple components and employment domain is the strongest indicator of participation. Correlations between social participation and personal factors, such as self-efficacy and attitudes towards disability were moderate. Those who are employed scored higher quality of life in terms of satisfaction with life, more positive attitudes toward disabilities and higher self-efficacy than the ones who are retired or unemployed. Persons using adapted wheelchair and those who were involved in wheelchair selection scored higher in social participation in general, performance at work, and quality of life. Age and disability duration were not associated with participants' employment status. These findings suggest that rehabilitation and vocational agents, like physiotherapists and other professionals, should have knowledge and understanding of the multiple factors that influence persons with disabilities' participation at work. Programs should provide appropriate wheelchairs, skills training, empowerment and problem-solving strategies in

  15. Autonomy in chimpanzees.

    Science.gov (United States)

    Beauchamp, Tom L; Wobber, Victoria

    2014-04-01

    Literature on the mental capacities and cognitive mechanisms of the great apes has been silent about whether they can act autonomously. This paper provides a philosophical theory of autonomy supported by psychological studies of the cognitive mechanisms that underlie chimpanzee behavior to argue that chimpanzees can act autonomously even though their psychological mechanisms differ from those of humans. Chimpanzees satisfy the two basic conditions of autonomy: (1) liberty (the absence of controlling influences) and (2) agency (self-initiated intentional action), each of which is specified here in terms of conditions of understanding, intention, and self-control. In this account, chimpanzees make knowledge-based choices reflecting a richly information-based and socially sophisticated understanding of the world. Finally, two major theories of autonomy (Kantian theory and two-level theory) are rejected as too narrow to adequately address these issues, necessitating the modifications made in the present approach.

  16. Semantic aspects of the International Classification of Functioning, Disability and Health: towards sharing knowledge and unifying information.

    Science.gov (United States)

    Andronache, Adrian Stefan; Simoncello, Andrea; Della Mea, Vincenzo; Daffara, Carlo; Francescutti, Carlo

    2012-02-01

    During the last decade, under the World Health Organization's direction, the International Classification of Functioning, Disability and Health (ICF) has become a reference tool for monitoring and developing various policies addressing people with disability. This article presents three steps to increase the semantic interoperability of ICF: first, the representation of ICF using ontology tools; second, the alignment to upper-level ontologies; and third, the use of these tools to implement semantic mappings between ICF and other tools, such as disability assessment instruments, health classifications, and at least partially formalized terminologies.

  17. [What is patient autonomy?

    Science.gov (United States)

    Durand, Guillaume

    What does patient autonomy mean? If an autonomous choice is defined as an objective and rational choice, is the doctor's prescription not always the best route? Our contemporary democracies are marked by moral and religious pluralism which obliges society to respect a multiplicity of choices of existence. Three levels are important in terms of autonomy: a range of intellectual capacities, freedom with regard to constraints (external and internal), the capacity to be in control of one's existence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Disabled is a putative adaptor protein that functions during signaling by the sevenless receptor tyrosine kinase.

    Science.gov (United States)

    Le, N; Simon, M A

    1998-08-01

    DRK, the Drosophila homolog of the SH2-SH3 domain adaptor protein Grb2, is required during signaling by the sevenless receptor tyrosine kinase (SEV). One role of DRK is to provide a link between activated SEV and the Ras1 activator SOS. We have investigated the possibility that DRK performs other functions by identifying additional DRK-binding proteins. We show that the phosphotyrosine-binding (PTB) domain-containing protein Disabled (DAB) binds to the DRK SH3 domains. DAB is expressed in the ommatidial clusters, and loss of DAB function disrupts ommatidial development. Moreover, reduction of DAB function attenuates signaling by a constitutively activated SEV. Our biochemical analysis suggests that DAB binds SEV directly via its PTB domain, becomes tyrosine phosphorylated upon SEV activation, and then serves as an adaptor protein for SH2 domain-containing proteins. Taken together, these results indicate that DAB is a novel component of the SEV signaling pathway.

  19. Does functional disability mediate the pain-depression relationship in older adults with osteoarthritis? A longitudinal study in China.

    Science.gov (United States)

    Wang, Qian; Jayasuriya, Rohan; Man, Wing Young Nicola; Fu, Hua

    2015-03-01

    Older adults with osteoarthritis have been found to be impaired in physical functioning and report higher levels of depression. This study examined the relationships between pain, functional disability, and depression to test the activity restriction model in a cohort of 176 older adults in China. This model states that disability is a mediator for the relationship between pain and depression. Other investigators have found that pain and disability were two independent correlates of depression. In both cross-sectional and longitudinal analyses, the authors found that disability is a mediator, using commonly accepted methods (indirect effect 44%, Sobel Z = 4.07, P mediation effect was not seen when the outcome was residualized with the baseline value. When the baseline level of depression is residualized, the effect size of the relationship is reduced, requiring larger sample size to test its effect. © 2012 APJPH.

  20. Care coordination, the family-centered medical home, and functional disability among children with special health care needs.

    Science.gov (United States)

    Litt, Jonathan S; McCormick, Marie C

    2015-01-01

    Children with special health care needs (CSHCN) are at increased risk for functional disabilities. Care coordination has been shown to decrease unmet health service use but has yet been shown to improve functional status. We hypothesize that care coordination services lower the odds of functional disability for CSHCN and that this effect is greater within the context of a family-centered medical home. A secondary objective was to test the mediating effect of unmet care needs on functional disability. Our sample included children ages 0 to 17 years participating the 2009-2010 National Survey of Children with Special Health Care Needs. Care coordination, unmet needs, and disability were measured by parent report. We used logistic regression models with covariate adjustment for confounding and a mediation analysis approach for binary outcomes to assess the effect of unmet needs. There were 34,459 children in our sample. Care coordination was associated with lower odds of having a functional disability (adjusted odds ratio 0.82, 95% confidence interval 0.77, 0.88). This effect was greater for care coordination in the context of a medical home (adjusted odds ratio 0.71, 95% confidence interval 0.66, 0.76). The relationship between care coordination and functional disability was mediated by reducing unmet services. Care coordination is associated with lower odds of functional disability among CSHCN, especially when delivered in the setting of a family-centered medical home. Reducing unmet service needs mediates this effect. Our findings support a central role for coordination services in improving outcomes for vulnerable children. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  1. A Comparison of Functional Behavioral Assessment and Functional Analysis Methodology among Students with Mild Disabilities

    Science.gov (United States)

    Lewis, Timothy J.; Mitchell, Barbara S.; Harvey, Kristin; Green, Ambra; McKenzie, Jennifer

    2015-01-01

    Functional behavioral assessment (FBA) and functional analyses (FA) are grounded in the applied behavior analysis principle that posits problem behavior is functionally related to the environment in which it occurs and is maintained by either providing access to reinforcing outcomes or allowing the individual to avoid or escape that which they…

  2. Effects of Functional Disability and Depressive Symptoms on Mortality in Older Mexican-American Adults with Diabetes Mellitus.

    Science.gov (United States)

    Mutambudzi, Miriam; Chen, Nai-Wei; Markides, Kyriakos S; Al Snih, Soham

    2016-11-01

    To examine the effect of co-occurring depressive symptoms and functional disability on mortality in older Mexican-American adults with diabetes mellitus. Longitudinal cohort study. Hispanic Established Populations for the Epidemiological Study of the Elderly (HEPESE) survey conducted in the southwestern United States (Texas, Colorado, Arizona, New Mexico, California). Community-dwelling Mexican Americans with self-reported diabetes mellitus participating in the HEPESE survey (N = 624). Functional disability was assessed using a modified version of the Katz activity of daily living scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Mortality was determined by examining death certificates and reports from relatives. Cox proportional hazards regression analyses were used to examine the hazard of mortality as a function of co-occurring depressive symptoms and functional disability. Over a 9.2-year follow-up, 391 participants died. Co-occurring high depressive symptoms and functional disability increased the risk of mortality (hazard ratio (HR) = 3.02, 95% confidence interval (CI) = 2.11-4.34). Risk was greater in men (HR = 8.11, 95% CI = 4.34-16.31) than women (HR = 2.21, 95% CI = 1.42-3.43). Co-occurring depressive symptoms and functional disability in older Mexican-American adults with diabetes mellitus increases mortality risk, especially in men. These findings have important implications for research, practice, and public health interventions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  3. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

    Reilly, John; Turcan, Romeo V.; Bugaian, Larisa

    2016-01-01

    discussion of challenges. The other outcome is the extent to which academic colleagues in a wide-range of disciplines and not directly engaged with research on university autonomy may not perceive or engage with the wider autonomy outcomes of their work and as a result their own case studies may not fully...... identify the autonomy impact real or potential. Many academic staff take for granted university autonomy without questioning its sometimes contradictory assumptions and impacts....

  4. Perspectives on the International Classification of Functioning, Disability, and Health: Child and Youth Version (ICF-CY) and Occupational Therapy Practice

    Science.gov (United States)

    Cramm, Heidi; Aiken, Alice B.; Stewart, Debra

    2012-01-01

    Classifying disability for children and youth has typically meant describing a diagnosis or developmental lag. The publication of the "International Classification of Functioning, Disability and Health: Child & Youth" version (ICF-CY) marks a global paradigm shift in the conceptualization and classification of childhood disability. Knowledge and…

  5. Finding Autonomy in Birth*

    Science.gov (United States)

    Kukla, Rebecca; Kuppermann, Miriam; Little, Margaret; Lyerly, Anne Drapkin; Mitchell, Lisa M; Armstrong, Elizabeth M.; Harris, Lisa

    2009-01-01

    Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women ‘choosing’ to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside of this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women’s agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be ‘for’ or ‘against’ women’s access to cesarean delivery in the absence of traditional medical indications - and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach, but rather, taking the value of women’s autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women’s full inclusion in a safe and positive birth process. PMID:19076937

  6. Om evalueringsforskningens relative autonomi

    DEFF Research Database (Denmark)

    Nørholm, Morten

    2008-01-01

    Det empiriske udgangspunkt for artiklen "Om evalueringsforskningens relative autonomi - dansk normal evalueringsforskning som et ikke-autonomt (sub)felt i magtens felt" er en række tekster af fire dominerende danske evalueringsforskere. Det teoretiske udgangspunkt er især Pierre Bourdieus teori om...

  7. The economic value of autonomy

    NARCIS (Netherlands)

    Boot, A.W.A.; Thakor, A.V.

    2003-01-01

    We develop an economic theory of "autonomy", which we interpret as the discretion or ability to make a decision that others disagree with. We show that autonomy is essentially an option for the decisionmaker, and can be valued as such. The value of the autonomy option is decreasing in the extent to

  8. Senegal : School Autonomy and Accountability

    OpenAIRE

    World Bank

    2012-01-01

    Senegal has accelerated the decentralization of education since 1996. Budgetary autonomy is latent. Autonomy over the management of operational budgets has been delegated to the communes, but salaries for teachers are managed at the central level. Autonomy in personnel management is latent. Both school directors and teachers are appointed at the central level. The role of the school counci...

  9. Compulsory Autonomy-Promoting Education

    Science.gov (United States)

    Schinkel, Anders

    2010-01-01

    Today, many liberal philosophers of education worry that certain kinds of education may frustrate the development of personal autonomy, with negative consequences for the individuals concerned, the liberal state, or both. Autonomy liberals hold not only that we should promote the development of autonomy in children, but also that this aim should…

  10. Cognitive tutoring induces widespread neuroplasticity and remediates brain function in children with mathematical learning disabilities.

    Science.gov (United States)

    Iuculano, Teresa; Rosenberg-Lee, Miriam; Richardson, Jennifer; Tenison, Caitlin; Fuchs, Lynn; Supekar, Kaustubh; Menon, Vinod

    2015-09-30

    Competency with numbers is essential in today's society; yet, up to 20% of children exhibit moderate to severe mathematical learning disabilities (MLD). Behavioural intervention can be effective, but the neurobiological mechanisms underlying successful intervention are unknown. Here we demonstrate that eight weeks of 1:1 cognitive tutoring not only remediates poor performance in children with MLD, but also induces widespread changes in brain activity. Neuroplasticity manifests as normalization of aberrant functional responses in a distributed network of parietal, prefrontal and ventral temporal-occipital areas that support successful numerical problem solving, and is correlated with performance gains. Remarkably, machine learning algorithms show that brain activity patterns in children with MLD are significantly discriminable from neurotypical peers before, but not after, tutoring, suggesting that behavioural gains are not due to compensatory mechanisms. Our study identifies functional brain mechanisms underlying effective intervention in children with MLD and provides novel metrics for assessing response to intervention.

  11. Functioning and disability in patients with Angelman syndrome: utility of the International Classification of functioning disability and health, children and youth adaptation framework.

    Science.gov (United States)

    Bonanni, Paolo; Gobbo, Annamaria; Nappi, Sara; Moret, Ornella; Nogarol, Anita; Santin, Michela; Randazzo, Giovanna; Martinuzzi, Andrea

    2009-01-01

    Angelman syndrome (AS) accounts for upto 6% of all cases with severe mental retardation and epilepsy. Clinical findings include developmental delay, severely impaired expressive language, ataxic gait, tremulousness of limbs and a typical behavioral profile including a happy demeanour, hyperactive behavior and low attention span. Seizures, abnormal electroencephalogram, microcephaly and scoliosis are observed in >80% of patients. Cognitive, language and orthopedic problems must be addressed with vigorous rehabilitation programs. Classification of functioning disability and health, children and youth adaptation (ICF-CY) can provide the most adequate framework to describe the condition of the persons towards whom rehabilitative efforts are concentrated. The aim of the study is to test whether the ICF-CY framework is effectively able to capture the various dimensions of health in AS. We applied the ICF-CY, to the detail of second level codes, to a cohort of 11 patients with AS of various ages. The coding was obtained by the multi-professional team following these children for the rehabilitation program. The functional profile obtained applying the ICF-CY is complete and comparable with the characteristics of the syndrome described in literature. The possibility of highlighting not only the problems but also the points of strength appears as very helpful. The second level codes may be too broad to provide insight in the clinical and rehabilitative peculiarities, and the use of the full power of the classification may be more advisable for clinical use. This prelimiary study shows that ICF-CY is a valid tool to frame the clinical characteristics of a complex syndrome as AS, and may give a strong foundation for the rehabilitation programming.

  12. Measuring patterns of disability using the International Classification of Functioning, Disability and Health in the post-acute stroke rehabilitation setting.

    Science.gov (United States)

    Goljar, Nika; Burger, Helena; Vidmar, Gaj; Leonardi, Matilde; Marincek, Crt

    2011-06-01

    To determine whether the International Classification of Functioning, Disability and Health (ICF) model is adequate for assessing disability patterns in stroke survivors in the sub-acute rehabilitation setting in terms of potential changes in functional profiles over time. Functional profiles of 197 stroke patients were assessed using the ICF Checklist and the Functional Independence Measure (FIMTM) at admission and discharge from rehabilitation hospital. The ICF Checklist was applied based on medical documentation and rehabilitation team meetings. Descriptive analyses were performed to identify changes in ICF categories and qualifiers from admission to discharge, and correlations between different improvement measures were calculated. Mean rehabilitation duration was 60 days; patients' mean age was 60 years, with mean FIM-score 75 at admission. Mean FIM-score improvement at discharge was 12.5. Within Body Functions, changes in at least 10% of patients were found regarding 13 categories; no categories within Body Structures, 24 within Activities and Participation, and 2 within Environmental Factors. Changes were mostly due to improvement in qualifiers, except for within Environmental Factors, where they were due to use of additional categories. Correlations between improvements in Body Functions and Activities and Participation (regarding capacity and performance), as well as between capacity and performance within Activities and Participation, were approximately 0.4. Rating ICF categories with qualifiers enables the detection of changes in functional profiles of stroke patients who underwent an inpatient rehabilitation programme. :

  13. Development of a computer-adaptive physical function instrument for Social Security Administration disability determination.

    Science.gov (United States)

    Ni, Pengsheng; McDonough, Christine M; Jette, Alan M; Bogusz, Kara; Marfeo, Elizabeth E; Rasch, Elizabeth K; Brandt, Diane E; Meterko, Mark; Haley, Stephen M; Chan, Leighton

    2013-09-01

    To develop and test an instrument to assess physical function for Social Security Administration (SSA) disability programs, the SSA-Physical Function (SSA-PF) instrument. Item response theory (IRT) analyses were used to (1) create a calibrated item bank for each of the factors identified in prior factor analyses, (2) assess the fit of the items within each scale, (3) develop separate computer-adaptive testing (CAT) instruments for each scale, and (4) conduct initial psychometric testing. Cross-sectional data collection; IRT analyses; CAT simulation. Telephone and Internet survey. Two samples: SSA claimants (n=1017) and adults from the U.S. general population (n=999). None. Model fit statistics, correlation, and reliability coefficients. IRT analyses resulted in 5 unidimensional SSA-PF scales: Changing & Maintaining Body Position, Whole Body Mobility, Upper Body Function, Upper Extremity Fine Motor, and Wheelchair Mobility for a total of 102 items. High CAT accuracy was demonstrated by strong correlations between simulated CAT scores and those from the full item banks. On comparing the simulated CATs with the full item banks, very little loss of reliability or precision was noted, except at the lower and upper ranges of each scale. No difference in response patterns by age or sex was noted. The distributions of claimant scores were shifted to the lower end of each scale compared with those of a sample of U.S. adults. The SSA-PF instrument contributes important new methodology for measuring the physical function of adults applying to the SSA disability programs. Initial evaluation revealed that the SSA-PF instrument achieved considerable breadth of coverage in each content domain and demonstrated noteworthy psychometric properties. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Learning disabilities and intellectual functioning in school-aged children with prenatal cocaine exposure.

    Science.gov (United States)

    Morrow, Connie E; Culbertson, Jan L; Accornero, Veronica H; Xue, Lihua; Anthony, James C; Bandstra, Emmalee S

    2006-01-01

    Risk for developing a learning disability (LD) or impaired intellectual functioning by age 7 was assessed in full-term children with prenatal cocaine exposure drawn from a cohort of 476 children born full term and enrolled prospectively at birth. Intellectual functioning was assessed using the Wechsler Intelligence Scale for Children-Third Edition (Wechsler, 1991) short form, and academic functioning was assessed using the Wechsler Individual Achievement Test (WIAT; Wechsler, 1993) Screener by examiners blind to exposure status. LDs were categorized based on ability-achievement discrepancy scores, using the regression-based predicted achievement method described in the WIAT manual. The sample in this report included 409 children (212 cocaine-exposed, 197 non-cocaine-exposed) from the birth cohort with available data. Cumulative incidence proportions and relative risk values were estimated using STATA software (Statacorp, 2003). No differences were found in the estimate of relative risk for impaired intellectual functioning (IQ below 70) between children with and without prenatal cocaine exposure (estimated relative risk = .95; 95% confidence interval [CI] = 0.65, 1.39; p = .79). The cocaine-exposed children had 2.8 times greater risk of developing a LD by age 7 than non-cocaine-exposed children (95% CI = 1.05, 7.67; p = .038; IQ >/= 70 cutoff). Results remained stable with adjustment for multiple child and caregiver covariates, suggesting that children with prenatal cocaine exposure are at increased risk for developing a learning disability by age 7 when compared to their non-cocaine-exposed peers.

  15. Autonomy and the principle of respect for autonomy.

    Science.gov (United States)

    Gillon, R

    1985-06-15

    Autonomy is defined as the capacity to think, decide, and act freely and independently on the basis of such thought and decisions. Three types of autonomy are distinguished: autonomy of thought, which embraces the wide range of human intellectual activities called "thinking for oneself"; autonomy of will, or the capacity to decide to do things on the basis of one's deliberations; and autonomy of action, the absence of which is illustrated by the situation of a patient whose voluntary muscles are paralyzed by curariform drugs and who thus cannot tell the surgeon that the anesthetist has forgotten the nitrous oxide. Autonomy is viewed as a prerequisite for all the virtues, rather than as a virtue in its own right. The arguments of Immanuel Kant and John Stuart Mill concerning the principle of respect for autonomy are summarized as exemplars respectively of the deontological and utilitarian philosophical approaches.

  16. Assessment of Global Functioning in Adolescents with Autism Spectrum Disorders: Utility of the Developmental Disability-Child Global Assessment Scale

    Science.gov (United States)

    White, Susan W.; Smith, Laura A.; Schry, Amie R.

    2014-01-01

    Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment…

  17. Exercisers' perceptions of their fitness instructor's interacting style, perceived competence, and autonomy as a function of self-determined regulation to exercise, enjoyment, affect, and exercise frequency.

    Science.gov (United States)

    Puente, Rogelio; Anshel, Mark H

    2010-02-01

    The primary purpose of the present investigation was to test the hypothesis, derived from Self-Determination Theory (SDT), that an individual's perceived competence and autonomy mediate the relationship between the exercisers' perception of their instructor's interaction style and the exercisers' motivation to exercise. A secondary purpose was to identify the affective and behavioral outcomes derived from self-determined regulation. It was hypothesized that SDT would significantly explain and predict exercise behavior. Participants consisted of 238 college students, 103 males and 135 females (M age = 20.4 years, SD = 2.16), who volunteered to participate in the study. They were asked to complete a battery of questionnaires measuring instructor's interacting style, self-regulation to exercise, perceived autonomy and competence, enjoyment, positive and negative affect, and exercise frequency. Using structural equation modeling with observed variables, the results showed that perceived competence and autonomy mediated the relationship between perceived instructor's interacting style and self-determined regulation. It was also found that self-determined regulation was significantly related to exercise enjoyment, positive affect, and exercise frequency. It was concluded that understanding the motivational factors and emotional and behavioral consequences of physical activity will partially explain an individual's motives to engage regularly in exercise.

  18. The impact of cataract surgery on visual functioning, vision-related disability and psychological distress: a randomized controlled trial.

    Science.gov (United States)

    Walker, Janine G; Anstey, Kaarin J; Hennessy, Michael P; Lord, Stephen R; von Sanden, Chwee

    2006-11-01

    Determine whether there are changes in visual functioning, vision-related disability, health status and mood after cataract surgery. 45 adults (mean age = 73.7 years) with bilateral cataract needing surgery for the first eye were recruited from public ophthalmology clinics. The Visual Functioning-14 survey assessed visual disability. Minimal angle of resolution tested visual acuity, and the Melbourne Edge Test examined contrast sensitivity. Demographic, psychological, health and medication use variables were examined. Participants were randomized to either an intervention or control arm. Controls were assessed on two occasions at a 3-month interval before having surgery. The intervention group was assessed 1-2 weeks before surgery and then reassessed 3 months after surgery. Visual functioning improved for those who had cataract surgery with better visual acuity in the better (P = 0.010) and worse (P = 0.028) eye compared with controls. The intervention group reported fewer difficulties with overall vision-related disability (P = 0.0001), reading (P = 0.004) and instrumental activities of daily living (P = 0.010) post-surgery compared with controls. People with improved depression scores (P = 0.048) after surgery had less difficulty with reading compared with those with unchanged or worsened depression scores. Cataract surgery did not improve health status. First eye cataract surgery is effective in improving outcomes in visual functioning and disability. Improved mood after surgery was related to less vision-related disability compared with unchanged or worse depression.

  19. Sleep problems and functional disability in children with functional gastrointestinal disorders: An examination of the potential mediating effects of physical and emotional symptoms

    Directory of Open Access Journals (Sweden)

    Schurman Jennifer

    2012-10-01

    Full Text Available Abstract Background Sleep disturbances are increasingly recognized as a common problem for children and adolescents with chronic pain conditions, but little is known about the prevalence, type, and impact of sleep problems in pediatric functional gastrointestinal disorders (FGIDs. The objectives of the current study were two-fold: 1 to describe the pattern of sleep disturbances reported in a large sample of children and adolescents with FGIDs; and, 2 to explore the impact of sleep by examining the inter-relationships between sleep disturbance, physical symptoms, emotional problems, and functional disability in this population. Methods Over a 3-year period, 283 children aged 8–17 years who were diagnosed with an FGID and a primary caretaker independently completed questionnaires regarding sleep, emotional functioning, physical symptoms, and functional disability during an initial evaluation for chronic abdominal pain at a pediatric tertiary care center. A verbal review of systems also was collected at that time. Descriptive statistics were used to characterize the pattern of sleep disturbances reported, while structural equation modeling (SEM was employed to test theorized meditational relationships between sleep and functional disability through physical and emotional symptoms. Results Clinically significant elevations in sleep problems were found in 45% of the sample, with difficulties related to sleep onset and maintenance being most common. No difference was seen by specific FGID or by sex, although adolescents were more likely to have sleep onset issues than younger children. Sleep problems were positively associated with functional disability and physical symptoms fully mediated this relationship. Emotional symptoms, while associated with sleep problems, evidenced no direct link to functional disability. Conclusions Sleep problems are common in pediatric FGIDs and are associated with functional disability through their impact on physical

  20. University Autonomy: Two Fault-Lines

    Science.gov (United States)

    Evans, G. R.

    2010-01-01

    The doctrine of university autonomy in the UK contains a least two major "fault-lines" where the structure is inherently weak and there is danger of functional breakdown. The first occurs at the junction between the institution and the state, the second within the institution, where the unity in policy-making between academic and…

  1. Rehabilitation and the International Classification of Functioning, Disability and Health: Past, Present, and Future Directions

    OpenAIRE

    Nochajski, Susan M.

    2004-01-01

    This article provides a brief overview of the history of disability in the United States and discusses the three paradigms: rehabilitation, independent living, and support and empowerment that have guided rehabilitative services for persons with disabilities. Within the context of this historical background, the article also presents various models used to define and classify disability. The effect and influence of society's perceptions of people with disabilities on the evolution and refinem...

  2. Fear of falling predicts incidence of functional disability two years later: A perspective from an international cohort study.

    Science.gov (United States)

    Auais, Mohammad; French, Simon; Alvarado, Beatriz; Pirkle, Catherine; Belanger, Emmanuelle; Guralnik, Jack

    2017-12-06

    To study the extent to which fear of falling (FOF) is associated with the onset of functional disability over a 2-year period in older adults using self-reported and performance-based measures. In 2012, 1,601 participants (aged 65-74) were recruited from four sites: Kingston and Saint-Hyacinthe, Canada; Manizales, Colombia; and Natal, Brazil. They were re-assessed in 2014. We quantified FOF using the Fall Efficacy Scale-International (FES-I; range: 16-64). Functional disability measures were 1) self-reported incident mobility disability, defined as difficulty climbing a flight of stairs or walking 400 meters and 2) incident poor physical performance, defined as a score <9 on the Short Physical Performance Battery. In the Poisson regression analysis, we included only those participants without functional disability at baseline to calculate incident risk ratios in 2014. 1,355 participants completed the 2014 assessment, of which 917 and 1,078 had no mobility disability and poor physical performance at baseline, respectively. In 2014, 131 (14.3%), and 166 (15.4%) participants reported incident mobility disability and poor physical performance, respectively. After adjusting for age, sex, socioeconomic, and health covariates, a one-point increase in FES-I at baseline was associated with a 4% increase in the risk of reporting incident mobility disability (95% CI: 1.02-1.05) and a 3% increase in the risk of developing poor physical performance at follow up in the overall sample (95%CI: 1.01-1.05). FOF is associated with a higher risk of incident mobility disability and poor physical performance in a cohort of older adults. It is increasingly important to study FOF's effect on functional disability and to take necessary measures to prevent the transition to end-stage disability. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Application of the International Classification of Functioning, Disability and Health system to symptoms of the Duchenne and Becker muscular dystrophies.

    Science.gov (United States)

    Conway, Kristin M; Ciafaloni, Emma; Matthews, Dennis; Westfield, Chris; James, Kathy; Paramsothy, Pangaja; Romitti, Paul A

    2018-07-01

    Duchenne and Becker muscular dystrophies, collectively referred to as dystrophinopathies, are X-linked recessive diseases that affect dystrophin production resulting in compromised muscle function across multiple systems. The International Classification of Functioning, Disability and Health provides a systematic classification scheme from which body functions affected by a dystrophinopathy can be identified and used to examine functional health. The infrastructure of the Muscular Dystrophy Surveillance, Tracking, and Research Network was used to identify commonly affected body functions and link selected functions to clinical surveillance data collected through medical record abstraction. Seventy-one (24 second-, 41 third- and 7 fourth-level) body function categories were selected via clinician review and consensus. Of these, 15 of 24 retained second-level categories were linked to data elements from the Muscular Dystrophy Surveillance, Tracking, and Research Network surveillance database. Our findings support continued development of a core set of body functions from the International Classification of Functioning, Disability and Health system that are representative of disease progression in dystrophinopathies and the incorporation of these functions in standardized evaluations of functional health and implementation of individualized rehabilitation care plans. Implications for Rehabilitation Duchenne and Becker muscular dystrophies, collectively referred to as dystrophinopathies, are X-linked recessive disorders that affect the production of dystrophin resulting in compromised muscle function across multiple systems. The severity and progressive nature of dystrophinopathies can have considerable impact on a patient's participation in activities across multiple life domains. Our findings support continued development of an International Classification of Functioning, Disability and Health core set for childhood-onset dystrophinopathies. A standardized

  4. Use of The International Classification of Functioning, Disability and Health (ICF as a conceptual framework and common language for disability statistics and health information systems

    Directory of Open Access Journals (Sweden)

    Kostanjsek Nenad

    2011-05-01

    Full Text Available Abstract A common framework for describing functional status information is needed in order to make this information comparable and of value. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF, which has been approved by all its member states, provides this common language and framework. The article provides an overview of ICF taxonomy, introduces the conceptual model which underpins ICF and elaborates on how ICF is used at population and clinical level. Furthermore, the article presents key features of the ICF tooling environment and outlines current and future developments of the classification.

  5. Law, autonomy and advance directives.

    Science.gov (United States)

    Willmott, Lindy; White, Ben; Mathews, Ben

    2010-12-01

    The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

  6. Translation, Validation, and Reliability of the Dutch Late-Life Function and Disability Instrument Computer Adaptive Test.

    Science.gov (United States)

    Arensman, Remco M; Pisters, Martijn F; de Man-van Ginkel, Janneke M; Schuurmans, Marieke J; Jette, Alan M; de Bie, Rob A

    2016-09-01

    Adequate and user-friendly instruments for assessing physical function and disability in older adults are vital for estimating and predicting health care needs in clinical practice. The Late-Life Function and Disability Instrument Computer Adaptive Test (LLFDI-CAT) is a promising instrument for assessing physical function and disability in gerontology research and clinical practice. The aims of this study were: (1) to translate the LLFDI-CAT to the Dutch language and (2) to investigate its validity and reliability in a sample of older adults who spoke Dutch and dwelled in the community. For the assessment of validity of the LLFDI-CAT, a cross-sectional design was used. To assess reliability, measurement of the LLFDI-CAT was repeated in the same sample. The item bank of the LLFDI-CAT was translated with a forward-backward procedure. A sample of 54 older adults completed the LLFDI-CAT, World Health Organization Disability Assessment Schedule 2.0, RAND 36-Item Short-Form Health Survey physical functioning scale (10 items), and 10-Meter Walk Test. The LLFDI-CAT was repeated in 2 to 8 days (mean=4.5 days). Pearson's r and the intraclass correlation coefficient (ICC) (2,1) were calculated to assess validity, group-level reliability, and participant-level reliability. A correlation of .74 for the LLFDI-CAT function scale and the RAND 36-Item Short-Form Health Survey physical functioning scale (10 items) was found. The correlations of the LLFDI-CAT disability scale with the World Health Organization Disability Assessment Schedule 2.0 and the 10-Meter Walk Test were -.57 and -.53, respectively. The ICC (2,1) of the LLFDI-CAT function scale was .84, with a group-level reliability score of .85. The ICC (2,1) of the LLFDI-CAT disability scale was .76, with a group-level reliability score of .81. The high percentage of women in the study and the exclusion of older adults with recent joint replacement or hospitalization limit the generalizability of the results. The Dutch LLFDI

  7. A Comparison of Back Pain Functional Scale with Roland Morris Disability Questionnaire, Oswestry Disability Index and Short Form 36-Health Survey.

    Science.gov (United States)

    Koç, Meltem; Bayar, Banu; Bayar, Kılıçhan

    2017-10-03

    A comparison study of Back Pain Functional Scale (BPFS) with Roland Morris Questionnaire (RMQ), Oswestry Disability Index (ODI) and Short Form 36-Health Survey (SF-36). The aim of this study is to investigate the correlation of BPFS with RMQ, ODI and SF-36. The primary goal in the treatment of patients with low back pain is to improve the patients' levels of activities and participation. Many questionnaires focusing on function have been developed in patients with low back pain. BPFS is one of these questionnaires. No studies have investigated the correlation of BPFS with ODI and SF-36. This study was conducted with 120 patients receiving outpatient and inpatient treatment in physiotherapy and rehabilitation units of a state hospital. BPFS, RMQ, ODI, SF-36 questionnaires were used to assess the disability in low back pain. Spearman and Pearson Correlation were used to compare the data obtained in the study. There was a good correlation among the five functional outcome measures (correlation r = -0.693 for BPFS/RMQ, r = -0.794 for BPFS/ODI, r = 0.697 for BPFS/SF-36 Physical function and r = 0.540 for BPFS/SF-36 Pain). BPFS demonstrated good correlation with RMQ, ODI, SF-36 physical function and SF-36 pain. 2.

  8. Autonomy and the emotions

    OpenAIRE

    Tappolet, Christine

    2006-01-01

    Can actions caused by emotions be free and autonomous? The rationalist conception of autonomy denies this. Only actions done in the light of reflective choices can be autonomous and hence free. I argue that the rationalist conception does not make room for akratic actions, that is, free and intentional actions performed against the agent’s best judgement. I then develop an account inspired by Harry Frankfurt and David Shoemaker, according to which an action is autonomous when it is determined...

  9. The Autonomy of Deportation

    Directory of Open Access Journals (Sweden)

    Nicholas de Genova

    2017-06-01

    Full Text Available As ostensibly unwanted or undesirable non-citizens, the utter disposability of deportees appears to be finally and conclusively verified by deportation as a sovereign state power’s perfunctory and mundane act of 'taking out the trash.' Hence, it is no accident that, etymologically, the origins of the very word 'deportation' would indicate a carrying away, a removal, a disposal. The eradication of deportees’ individual lives — their personal identities and life trajectories — emerges as a frightfully routine and prosaic fact of deportation. In spite of the sheer violence of the ruptures inflicted though deportation, however, those who have been rendered the objects of this power persistently reassert their own subjectivity. Ethnographic insights into the lived struggles of the deported (as well as their loved ones and communities elucidates the enduring subjectivity of those who have been made the objects of such sovereign acts of state power and subjected to deportation's techniques of eradication, and illustrates the stubborn incorrigibility of human life against the myriad forces that would seek to enforce its precarity and disposability. In the post-deportation condition, we confront anew the elementary and elemental human freedom of movement, and the incorrigibility of the autonomy and subjectivity of migration. Much as the autonomy of migration instigates a contest in which state power never has the first word, what we may now conceive as the autonomy of deportation — an autonomy and subjectivity of the deported within and against their predicaments of deportation — similarly ensures that state power never has the last word, either.

  10. Perspectives on autonomy.

    Science.gov (United States)

    Keys, Yolanda

    2009-09-01

    This department, sponsored by the AONE, presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of AONE anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients. This article describes how 9 Magnet-hospital, chief nursing officers perceive their autonomy and its importance in accomplishing their work.

  11. Autonomy, Trust, and Respect.

    Science.gov (United States)

    Nys, Thomas

    2016-02-01

    This article seeks to explore and analyze the relationship between autonomy and trust, and to show how these findings could be relevant to medical ethics. First, I will argue that the way in which so-called "relational autonomy theories" tie the notions of autonomy and trust together is not entirely satisfying Then, I will introduce the so-called Encapsulated Interest Account as developed by Russell Hardin. This will bring out the importance of the reasons for trust. What good reasons do we have for trusting someone? I will criticize Hardin's business model as insufficiently robust, especially in the context of health care, and then turn to another source of trust, namely, love. It may seem that trust-through-love is much better suited for the vulnerability that is often involved in health care, but I will also show that it has its own deficiencies. Good health care should therefore pay attention to both models of trust, and I will offer some tentative remarks on how to do this. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Autonomy, recognition and education

    Directory of Open Access Journals (Sweden)

    Angelo Vitório Cenci

    2015-01-01

    Full Text Available This paper addresses Honneth’s concept of autonomy from two dimensions of his work, distinct, though inseparable. The first one is suggested through the subject’s positive practical self-relation linked to the patterns of reciprocal recognition of love, right and social esteem; the second is formulated as non-centered autonomy opposed to the present-day criticism of the modern autonomous subject encompassing three levels, namely: the capacity of linguistic articulation, the narrative coherence of life and the complementation of being guided by principles with some criteria of moral sensitivity to the context. We defend the position that, by metaphysically anchoring the concept of autonomy onto the intersubjective assumptions of his/her theory of the subject, and exploring it linked to the subject’s positive practical self-relation and to a non-centered meaning, Honneth has managed to renew it, which allows drawing important consequences of such effort to the field of education.

  13. Ignorance, information and autonomy.

    Science.gov (United States)

    Harris, J; Keywood, K

    2001-09-01

    People have a powerful interest in genetic privacy and its associated claim to ignorance, and some equally powerful desires to be shielded from disturbing information are often voiced. We argue, however, that there is no such thing as a right to remain in ignorance, where a fight is understood as an entitlement that trumps competing claims. This does not of course mean that information must always be forced upon unwilling recipients, only that there is no prima facie entitlement to be protected from true or honest information about oneself. Any claims to be shielded from information about the self must compete on equal terms with claims based in the rights and interests of others. In balancing the weight and importance of rival considerations about giving or withholding information, if rights claims have any place, rights are more likely to be defensible on the side of honest communication of information rather than in defence of ignorance. The right to free speech and the right to decline to accept responsibility to take decisions for others imposed by those others seem to us more plausible candidates for fully fledged rights in this field than any purported right to ignorance. Finally, and most importantly, if the right to autonomy is invoked, a proper understanding of the distinction between claims to liberty and claims to autonomy show that the principle of autonomy, as it is understood in contemporary social ethics and English law, supports the giving rather than the withholding of information in most circumstances.

  14. Social functioning and self-esteem in young people with disabilities participating in adapted competitive sport.

    Science.gov (United States)

    Dinomais, M; Gambart, G; Bruneau, A; Bontoux, L; Deries, X; Tessiot, C; Richard, I

    2010-08-01

    The aim of this study was to investigate social functioning quality of life and self-esteem in young people with disabilities taking part in adapted competitive sport. A sample of 496 athletes (mean age 16 years 4 months, range: 9 years to 20 years 9 months) was obtained from the 540 participants (91.8%) involved in a French national championship. The main outcome measurements were a social functioning inventory (PedsQL 4.0 social functioning) and a self-esteem inventory in physical areas (physical self inventory 6 PSI-6). The mean PedsQL SF score was 74.6 (SD: 17.7). Comparisons of PedsQL SF according to gender, age, self mobility and training revealed no significant differences between the groups. PedsQL SF was weakly but significantly correlated with all subscales of the PSI-6 in the total population. PSI-6 scores were significantly different between boys and girls, with better self-esteem for boys on general self-esteem (7.7 vs. 6.9, P=0.018), physical condition (6.8 vs. 6.0, P=0.023) and attractive body subscores (6.5 vs. 5.1, Pself-concept, social functioning quality of life and participation in adapted sport activities require further studies. Georg Thieme Verlag KG Stuttgart.New York.

  15. The International Classification of Functioning, Disability and Health: a systematic review of observational studies.

    Science.gov (United States)

    Castaneda, Luciana; Bergmann, Anke; Bahia, Ligia

    2014-01-01

    To systematically review the use of the International Classification of Functioning, Disability and Health (ICF) in observational studies. This study is a systematic review of articles that use the ICF in observational studies. We took into account the observational design papers available in databases such as PubMed, Lilacs and SciELO, published in English and Portuguese from January 2001 to June 2011. We excluded those in which the samples did not comprise individuals, those about children and adolescents, and qualitative methodology articles. After reading the abstracts of 265 identified articles, 65 met the inclusion criteria. Of these, 18 were excluded. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) adapted Checklist, with 15 items needed for observational studies, was applied to the 47 remaining articles. Any paper that met 12 of these criteria was included in this systematic review. 29 articles were reviewed. Regarding the ICF application methodology, the checklist was used in 31% of the articles, the core set in 31% and the ICF categories in 31%. In the remaining 7%, it was not possible to define the applied methodology. In most papers (41%), qualifiers were used in their original format. As far as the area of knowledge is concerned, most of the studies were related to Rheumatology (24%) and Orthopedics (21%). Regarding the study design, 83% of the articles used cross-sectional studies. Results indicate a wide scientific production related to ICF over the past 10 years. Different areas of knowledge are involved in the debate on the improvement of information on morbidity. However, there are only a few quantitative epidemiological studies involving the use of ICF. Future studies are needed to improve data related to functioning and disability.

  16. The validity and reliability of the Functional Strength Measurement (FSM) in children with intellectual disabilities.

    Science.gov (United States)

    Aertssen, W F M; Steenbergen, B; Smits-Engelsman, B C M

    2018-06-07

    There is lack of valid and reliable field-based tests for assessing functional strength in young children with mild intellectual disabilities (IDs). The aim of this study was to investigate the test-retest reliability and construct validity of the Functional Strength Measurement in children with ID (FSM-ID). Fifty-two children with mild ID (40 boys and 12 girls, mean age 8.48 years, SD = 1.48) were tested with the FSM. Test-retest reliability (n = 32) was examined by a two-way interclass correlation coefficient for agreement (ICC 2.1A). Standard error of measurement and smallest detectable change were calculated. Construct validity was determined by calculating correlations between the FSM-ID and handheld dynamometry (HHD) (convergent validity), FSM-ID, FSM-ID and subtest strength of the Bruininks-Oseretsky test of motor proficiency - second edition (BOT-2) (convergent validity) and the FSM-ID and balance subtest of the BOT-2 (discriminant validity). Test-retest reliability ICC ranged 0.89-0.98. Correlation between the items of the FSM-ID and HHD ranged 0.39-0.79 and between FSM-ID and BOT-2 (strength items) 0.41-0.80. Correlation between items of the FSM-ID and BOT-2 (balance items) ranged 0.41-0.70. The FSM-ID showed good test-retest reliability and good convergent validity with the HHD and BOT-2 subtest strength. The correlations assessing discriminant validity were higher than expected. Poor levels of postural control and core stability in children with mild IDs may be the underlying factor of those higher correlations. © 2018 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  17. A prospective cohort study of depression course, functional disability, and NEET status in help-seeking young adults.

    Science.gov (United States)

    O'Dea, Bridianne; Lee, Rico S C; McGorry, Patrick D; Hickie, Ian B; Scott, Jan; Hermens, Daniel F; Mykletun, Arnstein; Purcell, Rosemary; Killackey, Eoin; Pantelis, Christos; Amminger, G Paul; Glozier, Nicholas

    2016-10-01

    To examine the associations between depression course, functional disability, and Not in Education or Training (NEET) status in a clinical sample of young adults with mental health problems. Young adults aged 15-25 years seeking help from four primary mental health services were invited to participate in a prospective cohort study evaluating the course of psychiatric disorders in youth. Demographic and clinical characteristics, including depressive symptomatology and functioning, were evaluated through clinical interview and self-report at baseline and 12 month follow-up. A total of 448 young adults participated (70 % female; M: 20.05 years, SD = 2.85). A significant interaction effect for time and depression course was found, such that those who became depressed reported an increase in functional disability and those whose depression remitted reported a significant reduction in functional disability. Developing depression was not a significant predictor of becoming NEET and vice versa: remitted depression did not make a person more likely to reengage in employment or education. This is the first study to examine the course of depression, functional disability, and NEET rates among help-seeking young adults. This study confirms the importance of symptom reduction for improved functioning; however, functional disability remained greater than that seen in young people in the community and there was no association between a change in depression and a change in NEET status. These results argue that services need to address functional outcomes and reengagement with education and employment in addition to symptom reduction.

  18. Autonomy and autonomy competencies: a practical and relational approach.

    Science.gov (United States)

    Atkins, Kim

    2006-10-01

    This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals' formation of choices. In response to this problem, I will present a brief overview of Diana Meyers's account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, self-knowledge, and self-direction. This account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical 'self-reading'. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills.

  19. Brief Report: Predicting Functional Disability: One-Year Results From the Scottish Early Rheumatoid Arthritis Inception Cohort.

    Science.gov (United States)

    Kronisch, Caroline; McLernon, David J; Dale, James; Paterson, Caron; Ralston, Stuart H; Reid, David M; Tierney, Ann; Harvie, John; McKay, Neil; Wilson, Hilary E; Munro, Robin; Saunders, Sarah; Richmond, Ruth; Baxter, Derek; McMahon, Mike; Kumar, Vinod; McLaren, John; Siebert, Stefan; McInnes, Iain B; Porter, Duncan; Macfarlane, Gary J; Basu, Neil

    2016-07-01

    To identify baseline prognostic indicators of disability at 1 year within a contemporary early inflammatory arthritis inception cohort and then develop a clinically useful tool to support early patient education and decision-making. The Scottish Early Rheumatoid Arthritis (SERA) inception cohort is a multicenter, prospective study of patients with newly presenting RA or undifferentiated arthritis. SERA data were analyzed to determine baseline predictors of disability (defined as a Health Assessment Questionnaire [HAQ] score of ≥1) at 1 year. Clinical and psychosocial baseline exposures were entered into a forward stepwise logistic regression model. The model was externally validated using newly accrued SERA data and subsequently converted into a prediction tool. Of the 578 participants (64.5% female), 36.7% (n = 212) reported functional disability at 1 year. Functional disability was independently predicted by baseline disability (odds ratio [OR] 2.67 [95% confidence interval (95% CI) 1.98, 3.59]), depression (OR 2.52 [95% CI 1.18, 5.37]), anxiety (OR 2.37 [95% CI 1.33, 4.21]), being in paid employment with absenteeism during the last week (OR 1.19 [95% CI 0.63, 2.23]), not being in paid employment (OR 2.36 [95% CI 1.38, 4.03]), and being overweight (OR 1.61 [95% CI 1.04, 2.50]). External validation (using 113 newly acquired patients) evidenced good discriminative performance with a C statistic of 0.74, and the calibration slope showed no evidence of model overfit (P = 0.31). In the context of modern early inflammatory arthritis treatment paradigms, predictors of disability at 1 year appear to be dominated by psychosocial rather than more traditional clinical measures. This indicates the potential benefit of early access to nonpharmacologic interventions targeting key psychosocial factors, such as mental health and work disability. © 2016, American College of Rheumatology.

  20. Impact of Sensory Impairments on Functional Disability in Adults With Arthritis

    Science.gov (United States)

    Fisher, Diana E.; Ward, Michael M.; Hoffman, Howard J.; Li, Chuan-Ming; Cotch, Mary Frances

    2015-01-01

    Introduction Mobility is reduced in people with sensory impairments and those with arthritis. The joint impact of these conditions may be underappreciated. This study examines the associations between impairments in vision, hearing, and balance and functional ability in adults with versus without arthritis. Methods Using National Health and Nutrition Examination Survey data from 1999–2004, arthritis status, functional ability, and sensory impairments (vision, hearing, and balance) were assessed from self-reported responses by 6,654 individuals aged ≥50 years (mean age, 63.4 years; 46.3% male). Multivariable regression analyses, conducted in 2014, assessed the associations between sensory impairment and arthritis on functional ability and mobility. Results Among study participants, 41.8% reported having arthritis; of these, 27.1%, 44.9%, and 35.1% reported impaired vision, hearing, or balance, respectively. Having multiple sensory impairments was significantly associated with reduced functional ability in people with arthritis; individuals with three sensory impairments reported the highest levels of disability for all functional domains (compared with no impairment; lower extremity mobility, 80.2% vs 39.1%; general physical activities, 94.7% vs 75.9%; activities of daily living, 69.7% vs 27.2%; instrumental activities of daily living, 77.2% vs 37.4%; leisure and social activities, 66.3% vs 30.6%; impaired gait speed, 48.1% vs 16.3%; all parthritis, had the greatest impact on mobility, with odds of impaired mobility at least twice as high as for individuals without arthritis. Conclusions Addressing sensory deficits, especially difficulties with vision, may improve functional ability, which may be particularly helpful for adults with arthritis. PMID:26410186

  1. Executive Functions and Adaptive Behaviour in Autism Spectrum Disorders with and without Intellectual Disability

    Science.gov (United States)

    Panerai, Simonetta; Tasca, Domenica; Ferri, Raffaele; Genitori D'Arrigo, Valentina; Elia, Maurizio

    2014-01-01

    Executive functions (EF) in autism spectrum disorders (ASD) have been often investigated, although results seem to be rather inconsistent. The first aim of this study was to detect which EF components are common to the ASD continuum (from high- to low-functioning ASD) and identify a possible EF profile for ASD people. Planning, mental flexibility, inhibition of response, generativity, and ecologic EF were investigated. This study was extended not only to high-functioning ASD, but also to ASD with intellectual disability (ID). The second aim was to find EF aspects correlating with adaptive skills in ASD. A total of 61 children participated in the study (27 ASD with and without ID and 34 controls). Results highlight an executive profile characterised by impaired flexibility and deficient planning; these deficits are associated with decreased adaptive ability, particularly socialization, and a deficient shifting in ecologic conditions. These features are present in all ASD subgroups with and without ID; for this reason, they might be assumed as being specific features in ASD. PMID:24829905

  2. Mapping the Mayo-Portland adaptability inventory to the international classification of functioning, disability and health.

    Science.gov (United States)

    Lexell, Jan; Malec, James F; Jacobsson, Lars J

    2012-01-01

    To examine the contents of the Mayo-Portland Adaptability Inventory (MPAI-4) by mapping it to the International Classification of Functioning, Disability and Health (ICF). Each of the 30 scoreable items in the MPAI-4 was mapped to the most precise ICF categories. All 30 items could be mapped to components and categories in the ICF. A total of 88 meaningful concepts were identified. There were, on average, 2.9 meaningful concepts per item, and 65% of all concepts could be mapped. Items in the Ability and Adjustment subscales mapped to categories in both the Body Functions and Activity/Participation components of the ICF, whereas all except 1 in the Participation subscale were to categories in the Activity/Participation component. The items could also be mapped to 34 (13%) of the 258 Environmental Factors in the ICF. This mapping provides better definition through more concrete examples (as listed in the ICF) of the types of body functions, activities, and participation indicators that are represented by the 30 scoreable MPAI-4 items. This may assist users throughout the world in understanding the intent of each item, and support further development and the possibility to report results in the form of an ICF categorical profile, making it universally interpretable.

  3. Development and functional demonstration of a wireless intraoral inductive tongue computer interface for severely disabled persons.

    Science.gov (United States)

    N S Andreasen Struijk, Lotte; Lontis, Eugen R; Gaihede, Michael; Caltenco, Hector A; Lund, Morten Enemark; Schioeler, Henrik; Bentsen, Bo

    2017-08-01

    Individuals with tetraplegia depend on alternative interfaces in order to control computers and other electronic equipment. Current interfaces are often limited in the number of available control commands, and may compromise the social identity of an individual due to their undesirable appearance. The purpose of this study was to implement an alternative computer interface, which was fully embedded into the oral cavity and which provided multiple control commands. The development of a wireless, intraoral, inductive tongue computer was described. The interface encompassed a 10-key keypad area and a mouse pad area. This system was embedded wirelessly into the oral cavity of the user. The functionality of the system was demonstrated in two tetraplegic individuals and two able-bodied individuals Results: The system was invisible during use and allowed the user to type on a computer using either the keypad area or the mouse pad. The maximal typing rate was 1.8 s for repetitively typing a correct character with the keypad area and 1.4 s for repetitively typing a correct character with the mouse pad area. The results suggest that this inductive tongue computer interface provides an esthetically acceptable and functionally efficient environmental control for a severely disabled user. Implications for Rehabilitation New Design, Implementation and detection methods for intra oral assistive devices. Demonstration of wireless, powering and encapsulation techniques suitable for intra oral embedment of assistive devices. Demonstration of the functionality of a rechargeable and fully embedded intra oral tongue controlled computer input device.

  4. University Internationalization and University Autonomy

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Gulieva, Valeria

    2016-01-01

    Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability are d......, dissimilar, and sometimes conflicting dimensions of the financial, legal, organisational, staffing, and academic autonomy of the host country, are compromising key aspects of their own autonomy and core mission?......Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability...... are determined by the structure and exercise of university autonomy settings at home and in the host countries, and that the process itself cannot be successfully achieved and maintained without changes in the autonomy settings. The key question the authors ask is to what degree universities, in embracing new...

  5. Children with Mild to Borderline Intellectual Disabilities and Externalizing Behavior: Individual Characteristics, Family functioning and Treatment Effectiveness

    NARCIS (Netherlands)

    Schuiringa, H.D.

    2014-01-01

    Children with mild to borderline intellectual disabilities (MBID; IQ between 55 and 85 with problems in adaptive functioning) have been found to show higher rates of emotional and externalizing behavior problems and their externalizing behavior problems tend to persist over time, more so than those

  6. Self-Monitoring Checklists for Inquiry Problem-Solving: Functional Problem-Solving Methods for Students with Intellectual Disability

    Science.gov (United States)

    Miller, Bridget; Taber-Doughty, Teresa

    2014-01-01

    Three students with mild to moderate intellectual and multiple disability, enrolled in a self-contained functional curriculum class were taught to use a self-monitoring checklist and science notebook to increase independence in inquiry problem-solving skills. Using a single-subject multiple-probe design, all students acquired inquiry…

  7. Individuals with mild intellectual disability or borderline intellectual functioning in a forensic addiction treatment centre: Prevalence and clinical characteristics

    NARCIS (Netherlands)

    Luteijn, I.; Didden, H.C.M.; Nagel, J.E.L. van der

    2017-01-01

    Knowledge regarding substance-related problems and offending behavior in individuals with mild intellectual disability or borderline intellectual functioning (MBID; IQ 50-85) has increased over the last years, but is still limited. The present study examined differences in prevalence and clinical

  8. The impact of physical performance and cognitive status on subsequent ADL disability in low-functioning older adults

    NARCIS (Netherlands)

    Kempen, GIJM; Ormel, J

    Objectives. The purpose of this study was to examine the independent contributions of physical performance and cognitive status to subsequent levels of ADL disability in low-functioning non-institutionalized older adults. Methods. A prospective cohort study included 416 women and 141 men 57 years of

  9. Internet Use in Aphasia: A Case Study Viewed through the International Classification of Functioning, Disability, and Health

    Science.gov (United States)

    Menger, Fion; Morris, Julie; Salis, Christos

    2017-01-01

    Purpose: This article uses an illustrative case example to discuss a means of producing a holistic profile of Internet use for individuals with aphasia. Methods: The authors used the International Classification of Functioning, Disability, and Health as a framework to select novel and existing assessments to explore the Internet use and skills of…

  10. Meeting the support needs of persons with mild intellectual disability or borderline intellectual functioning : Still a long way to go

    NARCIS (Netherlands)

    Nouwens, P J G; Smulders, N B M; Embregts, P J C M; van Nieuwenhuizen, C

    2017-01-01

    Background: Among persons with a mild intellectual disability or borderline intellectual functioning, differences in their characteristics imply that a differentiated approach is required to meet their needs. This retrospective study examined whether the history of support/treatment programs and the

  11. Math practice and its influence on math skills and executive functions in adolescents with mild to borderline intellectual disability

    NARCIS (Netherlands)

    Jansen, B.R.J.; Lange, E.; van der Molen, M.J.

    2013-01-01

    Adolescents with mild to borderline intellectual disability (MBID) often complete schooling without mastering basic math skills, even though basic math is essential for math-related challenges in everyday life. Limited attention to cognitive skills and low executive functioning (EF) may cause this

  12. Math Practice and Its Influence on Math Skills and Executive Functions in Adolescents with Mild to Borderline Intellectual Disability

    Science.gov (United States)

    Jansen, Brenda R. J.; De Lange, Eva; Van der Molen, Mariet J.

    2013-01-01

    Adolescents with mild to borderline intellectual disability (MBID) often complete schooling without mastering basic math skills, even though basic math is essential for math-related challenges in everyday life. Limited attention to cognitive skills and low executive functioning (EF) may cause this delay. We aimed to improve math skills in an…

  13. Subjective Cognitive Complaints and Functional Disability in Patients With Borderline Personality Disorder and Their Nonaffected First-Degree Relatives

    Science.gov (United States)

    Ruocco, Anthony C; Lam, Jaeger; McMain, Shelley F

    2014-01-01

    Objective: To examine the contributions of subjective cognitive complaints to functional disability in patients with borderline personality disorder (BPD) and their nonaffected relatives. Method: Patients with BPD (n = 26), their first-degree biological relatives (n = 17), and nonpsychiatric control subjects (n = 31) completed a self-report measure of cognitive difficulties and rated the severity of their functional disability on the World Health Organization Disability Assessment Schedule 2.0. Results: After accounting for group differences in age and severity of depressive symptoms, patients and relatives endorsed more inattention and memory problems than control subjects. Whereas probands reported greater disability than relatives and control subjects across all functional domains, relatives described more difficulties than control subjects in managing multiple life activities, including domestic activities and occupational and academic functioning, and participating in society. For both probands and relatives, inattention and memory problems were linked primarily to difficulties with life activities, independent of depression and other comorbid psychiatric disorders. Conclusions: Problems with inattention and forgetfulness may lead to difficulties carrying out activities of daily living and occupational or academic problems in patients with BPD, as well as their nonaffected first-degree relatives. PMID:25007408

  14. Exercise, Diet, and Stress Management as Mediators between Functional Disability and Health-Related Quality of Life in Multiple Sclerosis

    Science.gov (United States)

    Sung, Connie; Chiu, Chung-Yi; Lee, Eun-Jeong; Bezyak, Jill; Chan, Fong; Muller, Veronica

    2013-01-01

    The main objective of this study was to examine the mediational and moderational effect of exercise, diet, and stress management on the relationship between functional disability and health-related quality of life. Quantitative descriptive research design using multiple regression and correlation techniques was used. Participants were 215…

  15. "No Child Left Behind," the "Individuals with Disabilities Education Act" and Functional Curricula: A Conflict of Interest?

    Science.gov (United States)

    Bouck, Emily C.

    2009-01-01

    Is a functional curriculum aligned with the federal education policies of No Child Left Behind (2002) and the Individuals with Disabilities Education Act (IDEA, 2004)? This article analyzes the alignment, or lack thereof, between this approach to educating secondary students with mild mental impairment and the two main federal education laws…

  16. A cross-cultural comparison of the coexistence and domain superiority of individuating and relating autonomy.

    Science.gov (United States)

    Yeh, Kuang-Hui; Bedford, Olwen; Yang, Yung-Jui

    2009-06-01

    The consensus definition of autonomy in the psychological literature emphasizes self-governance through free volition, not separation or independence from others. Since the concept of self may differ cross-culturally, several researchers have tried to incorporate types of self into the notion of autonomy; however, only the dual model of autonomy has been able to do this while retaining an emphasis on volition. The dual model describes two distinct forms of autonomy-individuating and relating-each with superior function in a specific domain of individual functioning. Individuating autonomy represents a volitional capacity to act against social constraints and offers a route to achieve an independent self-identity by expressing individualistic attributes and distinctions. Relating autonomy represents a volitional capacity to act by emphasizing the harmony of self-in-relation-to-others, the quality of interpersonal relationships, and self-transcendence. These two forms of autonomy have been shown to coexist at the individual level in a Taiwanese sample. This study takes the next step, with a cross-cultural test of the coexistence and domain superiority hypotheses of individuating and relating autonomy. Participants included 306 college students from Taiwan and 183 college students from the United States. Structural equation modelling by multigroup analyses confirmed the cross-cultural equivalence of the two-factor individuating autonomy and relating autonomy measurement model. Across both samples the two forms of autonomy were shown to be mutually inclusive and not exclusive or independent. The domain-superior function of each form of autonomy was also confirmed cross-culturally; each form of autonomy has a dominant, but not necessarily exclusive, domain of functioning. Specifically, individuating autonomy was more associated with intrapersonal than interpersonal domain dependent variables, while relating autonomy was more associated with interpersonal than

  17. A systematic review of functioning in vocational rehabilitation using the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Escorpizo, Reuben; Finger, Monika E; Glässel, Andrea; Gradinger, Felix; Lückenkemper, Miriam; Cieza, Alarcos

    2011-06-01

    Vocational rehabilitation (VR) is aimed at engaging or re-engaging individuals with work participation and employment. The International Classification of Functioning, Disability and Health (ICF) by the World Health Organization can be operationalized in the context of VR. The objective of this study is to review the literature to identify outcomes or measures being used in VR using a systematic review methodology and link those measures to the ICF. We applied a structured search strategy using multiple databases. Items or constructs of the measures or outcomes identified were linked to the ICF by two trained individuals. We have identified 648 measures which contained 10,582 concepts that were linked to the ICF which resulted in 87 second-level ICF categories. Out of the 87 categories, 31 (35.6%) were related to body functions, 43 (49.4%) were related to activities and participation, and 13 (14.9%) were related to environmental factors. No category was related to body structures. Our review found great diversity in the ICF contents of the measures used in different VR settings and study populations, which indicates the complexity of VR. This systematic review has provided a list of ICF categories which could be considered towards a successful VR.

  18. Upper extremity function in stroke subjects: relationships between the international classification of functioning, disability, and health domains.

    Science.gov (United States)

    Faria-Fortini, Iza; Michaelsen, Stella Maris; Cassiano, Janine Gomes; Teixeira-Salmela, Luci Fuscaldi

    2011-01-01

    Upper limb (UL) impairments are the most common disabling deficits after stroke and have complex relationships with activity and participation domains. However, relatively few studies have applied the ICF model to identify the contributions of specific UL impairments, such as muscular weakness, pain, and sensory loss, as predictors of activity and participation. The purposes of this predictive study were to evaluate the relationships between UL variables related to body functions/structures, activity, and participation domains and to determine which would best explain activity and participation with 55 subjects with chronic stroke. Body functions/structures were assessed by measures of grip, pinch, and UL strength, finger tactile sensations, shoulder pain, and cognition (MMSE); activity domain by measures of observed performance (BBT, NHPT, and TEMPA); and participation by measures of quality of life (SSQOL). Upper-limb and grip strength were related to all activity measures (0.52

  19. Psychological distress and visual functioning in relation to vision-related disability in older individuals with cataracts.

    Science.gov (United States)

    Walker, J G; Anstey, K J; Lord, S R

    2006-05-01

    To determine whether demographic, health status and psychological functioning measures, in addition to impaired visual acuity, are related to vision-related disability. Participants were 105 individuals (mean age=73.7 years) with cataracts requiring surgery and corrected visual acuity in the better eye of 6/24 to 6/36 were recruited from waiting lists at three public out-patient ophthalmology clinics. Visual disability was measured with the Visual Functioning-14 survey. Visual acuity was assessed using better and worse eye logMAR scores and the Melbourne Edge Test (MET) for edge contrast sensitivity. Data relating to demographic information, depression, anxiety and stress, health care and medication use and numbers of co-morbid conditions were obtained. Principal component analysis revealed four meaningful factors that accounted for 75% of the variance in visual disability: recreational activities, reading and fine work, activities of daily living and driving behaviour. Multiple regression analyses determined that visual acuity variables were the only significant predictors of overall vision-related functioning and difficulties with reading and fine work. For the remaining visual disability domains, non-visual factors were also significant predictors. Difficulties with recreational activities were predicted by stress, as well as worse eye visual acuity, and difficulties with activities of daily living were associated with self-reported health status, age and depression as well as MET contrast scores. Driving behaviour was associated with sex (with fewer women driving), depression, anxiety and stress scores, and MET contrast scores. Vision-related disability is common in older individuals with cataracts. In addition to visual acuity, demographic, psychological and health status factors influence the severity of vision-related disability, affecting recreational activities, activities of daily living and driving.

  20. Vocational rehabilitation evaluation and the International Classification of Functioning, Disability, and Health (ICF).

    Science.gov (United States)

    Saltychev, Mikhail; Kinnunen, Aila; Laimi, Katri

    2013-03-01

    To identify the most frequent functional limitations according to the International Classification of Functioning, Disability, and Health (ICF) obtained by unstandardised clinical assessment of patients with chronic musculoskeletal disorders who underwent vocational rehabilitation evaluation; and to compare the obtained list with simplified versions of ICF. The descriptions of functional limitations were retrospectively identified for 32 patients. The original vocational rehabilitation evaluation was conducted by a multi-professional team in an out-patient clinic of a university hospital. The obtained descriptions were converted to ICF codes, the most frequent being compared with the ICF Checklist of the World Health Organization (WHO) and the ICF Comprehensive and Brief Core Sets suggested by the ICF Research Branch. In the study population (53 % women), 141 ICF codes were identified with a preciseness of three or more digits, the average being 21 codes/subject (median 20.0, range 9-40). When truncated to three digits, 84 ICF codes remained (average 18 codes/subject, range 9-25), 45 of which appeared in over 10 % of the study population, 24 also being found in the ICF Comprehensive, 5 in the ICF Brief Core Sets, and 33 in the WHO ICF Checklist. The list of most frequent ICF codes retrospectively obtained in this study from unstandardised records showed a similarity with ICF Comprehensive and Brief Core Sets by ICF Research Branch and the ICF Checklist by WHO, but with a bias towards the identification of body structures and functions. The results support the use of ICF in vocational rehabilitation evaluation to ensure comprehensiveness of evaluation. The ICF Comprehensive Core Set seems to be the most useful for the needs of multiprofessional team when assessing functioning of patients.

  1. Neuropsychological evaluation of deficits in executive functioning for ADHD children with or without learning disabilities.

    Science.gov (United States)

    Wu, Kitty K; Anderson, Vicki; Castiello, Umberto

    2002-01-01

    This study investigates multiple aspects of executive functioning in children with attention deficit/hyperactivity disorder (ADHD). These areas include attentional components, impulsiveness, planning, and problem solving. The rationale of the study is based on neurophysiological studies that suggest frontal lobe dysfunction in ADHD. As frontal lobe functioning is related to abilities in executive control, ADHD is hypothesised to be associated with deficits in various areas of executive functioning. The specific effect of comorbidity of learning disability (LD) was also investigated. Eighty-three children with ADHD and 29 age-matched controls (age 7-13) participated in the study. A battery of neuropsychological tests was utilized to evaluate specific deficits in speed of processing, selective attention, switching attention, sustained attention, attentional capacity, impulsiveness, planning and problem solving. Findings indicated that children with ADHD have slower verbal responses and sustained attention deficit. Deficits in selective attention and attentional capacity observed were largely related to the presence of LD. No specific deficit associated with ADHD or the comorbidity of LD was identified in switching attention, impulsiveness, planning, and problem solving. These results revealed that ADHD is not associated with a general deficit in executive functioning. Instead, ADHD is related to a specific deficit in regulation for attentional resources. The importance of isolating the deficit related to LDs for examining the specific deficit associated with ADHD is highlighted. Results also emphasised the importance of isolating the effect of lower level of abilities (e.g., speed of processing) and the utilization of specific definition for the examination of executive functions.

  2. Autonomy, Social Interactions and Culture

    OpenAIRE

    Marini, Annalisa; Navarra, Pietro

    2016-01-01

    The present paper, using a social interactions model, studies the impact of culture on autonomy of immigrants. The results suggest that: (i) immigrants' autonomy is largely influenced by the autonomy of individuals living in a host country; (ii) some immigrants are better off in countries and regions with better institutional environments. The results are robust to sensitivity checks. The contributions of the paper are as follows. First, we estimate a social interactions model that models bot...

  3. Measuring Disability in Population Based Surveys: The Interrelationship between Clinical Impairments and Reported Functional Limitations in Cameroon and India.

    Science.gov (United States)

    Mactaggart, Islay; Kuper, Hannah; Murthy, G V S; Oye, Joseph; Polack, Sarah

    2016-01-01

    To investigate the relationship between two distinct measures of disability: self-reported functional limitations and objectively-screened clinical impairments. We undertook an all age population-based survey of disability in two areas: North-West Cameroon (August/October 2013) and Telangana State, India (Feb/April 2014). Participants were selected for inclusion via two-stage cluster randomised sampling (probability proportionate to size cluster selection and compact segment sampling within clusters). Disability was defined as the presence of self-reported functional limitations across eight domains, or presence of moderate or greater clinical impairments. Clinical impairment screening comprised of visual acuity testing for vision impairment, pure tone audiometry for hearing impairment, musculoskeletal functioning assessment for musculoskeletal impairment, reported seizure history for epilepsy and reported symptoms of clinical depression (depression adults only). Information was collected using structured questionnaires, observations and examinations. Self-reported disability prevalence was 5.9% (95% CI 4.7-7.4) and 7.5% (5.9-9.4) in Cameroon and India respectively. The prevalence of moderate or greater clinical impairments in the same populations were 8.4% (7.5-9.4) in Cameroon and 10.5% (9.4-11.7) in India. Overall disability prevalence (self-report and/or screened positive to a moderate or greater clinical impairment) was 10.5% in Cameroon and 12.2% in India, with limited overlap between the sub-populations identified using the two types of tools. 33% of participants in Cameroon identified to have a disability, and 45% in India, both reported functional limitations and screened positive to objectively-screened impairments, whilst the remainder were identified via one or other tool only. A large proportion of people with moderate or severe clinical impairments did not self-report functional difficulties despite reporting participation restrictions. Tools to

  4. Disability Overview

    Science.gov (United States)

    ... 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 ...

  5. Architecture for autonomy

    Science.gov (United States)

    Broten, Gregory S.; Monckton, Simon P.; Collier, Jack; Giesbrecht, Jared

    2006-05-01

    In 2002 Defence R&D Canada changed research direction from pure tele-operated land vehicles to general autonomy for land, air, and sea craft. The unique constraints of the military environment coupled with the complexity of autonomous systems drove DRDC to carefully plan a research and development infrastructure that would provide state of the art tools without restricting research scope. DRDC's long term objectives for its autonomy program address disparate unmanned ground vehicle (UGV), unattended ground sensor (UGS), air (UAV), and subsea and surface (UUV and USV) vehicles operating together with minimal human oversight. Individually, these systems will range in complexity from simple reconnaissance mini-UAVs streaming video to sophisticated autonomous combat UGVs exploiting embedded and remote sensing. Together, these systems can provide low risk, long endurance, battlefield services assuming they can communicate and cooperate with manned and unmanned systems. A key enabling technology for this new research is a software architecture capable of meeting both DRDC's current and future requirements. DRDC built upon recent advances in the computing science field while developing its software architecture know as the Architecture for Autonomy (AFA). Although a well established practice in computing science, frameworks have only recently entered common use by unmanned vehicles. For industry and government, the complexity, cost, and time to re-implement stable systems often exceeds the perceived benefits of adopting a modern software infrastructure. Thus, most persevere with legacy software, adapting and modifying software when and wherever possible or necessary -- adopting strategic software frameworks only when no justifiable legacy exists. Conversely, academic programs with short one or two year projects frequently exploit strategic software frameworks but with little enduring impact. The open-source movement radically changes this picture. Academic frameworks

  6. Auditory and Visual Working Memory Functioning in College Students with Attention-Deficit/Hyperactivity Disorder and/or Learning Disabilities.

    Science.gov (United States)

    Liebel, Spencer W; Nelson, Jason M

    2017-12-01

    We investigated the auditory and visual working memory functioning in college students with attention-deficit/hyperactivity disorder, learning disabilities, and clinical controls. We examined the role attention-deficit/hyperactivity disorder subtype status played in working memory functioning. The unique influence that both domains of working memory have on reading and math abilities was investigated. A sample of 268 individuals seeking postsecondary education comprise four groups of the present study: 110 had an attention-deficit/hyperactivity disorder diagnosis only, 72 had a learning disability diagnosis only, 35 had comorbid attention-deficit/hyperactivity disorder and learning disability diagnoses, and 60 individuals without either of these disorders comprise a clinical control group. Participants underwent a comprehensive neuropsychological evaluation, and licensed psychologists employed a multi-informant, multi-method approach in obtaining diagnoses. In the attention-deficit/hyperactivity disorder only group, there was no difference between auditory and visual working memory functioning, t(100) = -1.57, p = .12. In the learning disability group, however, auditory working memory functioning was significantly weaker compared with visual working memory, t(71) = -6.19, p attention-deficit/hyperactivity disorder only group, there were no auditory or visual working memory functioning differences between participants with either a predominantly inattentive type or a combined type diagnosis. Visual working memory did not incrementally contribute to the prediction of academic achievement skills. Individuals with attention-deficit/hyperactivity disorder did not demonstrate significant working memory differences compared with clinical controls. Individuals with a learning disability demonstrated weaker auditory working memory than individuals in either the attention-deficit/hyperactivity or clinical control groups. © The Author 2017. Published by Oxford University

  7. Executive Functions, Time Organization and Quality of Life among Adults with Learning Disabilities.

    Directory of Open Access Journals (Sweden)

    Kineret Sharfi

    Full Text Available This study compared the executive functions, organization in time and perceived quality of life (QoL of 55 adults with learning disabilities (LD with those of 55 matched controls (mean age 30 years. Furthermore, relationships and predictive relationships between these variables among the group with LD were examined.All participants completed the Behavioral Rating Inventory of Executive Functions (BRIEF-A, the Time Organization and Participation (TOPS, A-C and the World Health Organization Quality of Life (WHOQOL questionnaires. Chi-square tests, independent t-tests and MANOVA were used to examine group differences in each of the subscales scores and ratings of each instrument. Pearson correlations and regression predictive models were used to examine the relationships between the variables in the group with LD.Adults with LD had significantly poorer executive functions (BRIEF-A, deficient organization in time abilities (TOPS A-B, accompanied with negative emotional response (TOPS- C, and lower perceived QoL (physical, psychological, social and environmental in comparison to adults without LD. Regression analysis revealed that Initiation (BRIEF-A significantly predicted approximately 15% of the participants' organization in time abilities (TOPS A, B scores beyond group membership. Furthermore, initiation, emotional control (BRIEF-A subscales and emotional responses following unsuccessful organization of time (TOPS-C together accounted for 39% of the variance of psychological QoL beyond the contribution of group membership.Deficits in initiation and emotional executive functions as well as organization in time abilities and emotional responses to impairments in organizing time affect the QoL of adults with LD and thus should be considered in further research as well as in clinical applications.

  8. Executive Functions, Time Organization and Quality of Life among Adults with Learning Disabilities.

    Science.gov (United States)

    Sharfi, Kineret; Rosenblum, Sara

    2016-01-01

    This study compared the executive functions, organization in time and perceived quality of life (QoL) of 55 adults with learning disabilities (LD) with those of 55 matched controls (mean age 30 years). Furthermore, relationships and predictive relationships between these variables among the group with LD were examined. All participants completed the Behavioral Rating Inventory of Executive Functions (BRIEF-A), the Time Organization and Participation (TOPS, A-C) and the World Health Organization Quality of Life (WHOQOL) questionnaires. Chi-square tests, independent t-tests and MANOVA were used to examine group differences in each of the subscales scores and ratings of each instrument. Pearson correlations and regression predictive models were used to examine the relationships between the variables in the group with LD. Adults with LD had significantly poorer executive functions (BRIEF-A), deficient organization in time abilities (TOPS A-B), accompanied with negative emotional response (TOPS- C), and lower perceived QoL (physical, psychological, social and environmental) in comparison to adults without LD. Regression analysis revealed that Initiation (BRIEF-A) significantly predicted approximately 15% of the participants' organization in time abilities (TOPS A, B scores) beyond group membership. Furthermore, initiation, emotional control (BRIEF-A subscales) and emotional responses following unsuccessful organization of time (TOPS-C) together accounted for 39% of the variance of psychological QoL beyond the contribution of group membership. Deficits in initiation and emotional executive functions as well as organization in time abilities and emotional responses to impairments in organizing time affect the QoL of adults with LD and thus should be considered in further research as well as in clinical applications.

  9. The Evaluation of the Effect of Neuropathic Pain on Functional Disability in Patients with Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    Yalkın Çalık

    2015-12-01

    Full Text Available Objective: The aim of this study was to evaluate both the prevalence of neuropathic pain (NP and the effect of functional disability of NP in patients with chronic low back pain (CLBP. Materials and Methods: In this study, outpatients data were reviewed retrospectively from January 2014 to December 2014 to determine the patients with CLBP. 190 patients with CLBP meeting the inclusion criteria were included. NP scores of the patients were assessed using Leeds Assessment of Neuropathic Symptoms and Signs (LANSS and the evaluation of pain was performed using the Visual analoque scale (VAS and functional disability scores was determined by the Oswestry disability index (ODI. Results: In this study NP was detected in 39.4% of the patients with CLBP. The number of female patients with NP (n=60, %80 was significantly higher than the number of male patients with NP (n=15, %20, (p<0.05. ODI and VAS scores of the patients with NP [(19.81±7.28, (5.08±0.76] was significantly higher than those of the patients without NP [(15.28±6.83, (4.44±1.14], (p<0,001. Conclusion: It was found that the co-existence of NP with CLBP increases pain and functional disability.

  10. [Concordance between a head circumference growth function and intellectual disability in relation with the cause of microcephaly].

    Science.gov (United States)

    Coronado, R; Macaya Ruíz, A; Giraldo Arjonilla, J; Roig-Quilis, M

    2015-08-01

    Our aim was to investigate the correlations between patterns of head growth and intellectual disability among distinct aetiological presentations of microcephaly. 3,269 head circumference (HC) charts of patients from a tertiary neuropediatric unit were reviewed and 136 microcephalic participants selected. Using the Z-scores of registered HC measurements we defined the variables: HC Minimum, HC Drop and HC Catch-up. We classified patients according to the presence or absence of intellectual disability (IQ below 71) and according to the cause of microcephaly (idiopathic, familial, syndromic, symptomatic and mixed). Using Discriminant Analysis a C-function was defined as C=HC Minimum + HC Drop with a cut-off level of C=-4.32 Z-score. In our sample 95% of patients scoring below this level, severe microcephaly, were classified in the disabled group while the overall concordance was 66%. In the symptomatic-mixed group the concordance between HC function and outcome reached 82% in contrast to only 54% in the idiopathic-syndromic group (P-value=0.0002). We defined a HC growth function which discriminates intellectual disability of microcephalic patients better than isolated HC measurements, especially for those with secondary and mixed aetiologies. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  11. Parents' Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life.

    Science.gov (United States)

    Illum, Niels Ove; Gradel, Kim Oren

    2017-01-01

    To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken. The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were -1.10 (range: -5.31 to 5.25) and -1.11 (range: -5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions

  12. Disability and functional assessment in former polio patients with and without postpolio syndrome

    NARCIS (Netherlands)

    Nollet, F.; Beelen, A.; Prins, M. H.; de Visser, M.; Sargeant, A. J.; Lankhorst, G. J.; de Jong, B. A.

    1999-01-01

    OBJECTIVES: To compare perceived health problems and disability in former polio subjects with postpolio syndrome (PPS) and those without postpolio syndrome (non-PPS), and to evaluate perceived health problems, disability, physical performance, and muscle strength. DESIGN: Cross-sectional survey;

  13. Why and when social support predicts older adults' pain-related disability: a longitudinal study.

    Science.gov (United States)

    Matos, Marta; Bernardes, Sónia F; Goubert, Liesbet

    2017-10-01

    Pain-related social support has been shown to be directly associated with pain-related disability, depending on whether it promotes functional autonomy or dependence. However, previous studies mostly relied on cross-sectional methods, precluding conclusions on the temporal relationship between pain-related social support and disability. Also, research on the behavioral and psychological processes that account for such a relationship is scarce. Therefore, this study aimed at investigating the following longitudinally: (1) direct effects of social support for functional autonomy/dependence on pain-related disability, (2) mediating role of physical functioning, pain-related self-efficacy, and fear, and (3) whether pain duration and pain intensity moderate such mediating processes. A total of 168 older adults (Mage = 78.3; SDage = 8.7) participated in a 3-month prospective design, with 3 moments of measurement, with a 6-week lag between them. Participants completed the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Brief Pain Inventory, the 36-SF Health Survey, behavioral tasks from the Senior Fitness Test, the Pain Self-Efficacy Questionnaire, and the Tampa Scale for Kinesiophobia. Moderated mediation analyses showed that formal social support for functional dependence (T1) predicted an increase in pain-related disability (T3), that was mediated by self-reported physical functioning (T2) and by pain-related self-efficacy (T2) at short to moderate pain duration and at low to moderate pain intensity, but not at higher levels. Findings emphasized that social support for functional dependence is a risk factor for pain-related disability and uncovered the "why" and "when" of this relationship. Implications for the design of social support interventions aiming at promoting older adults' healthy aging despite chronic pain are drawn.

  14. Employing the International Classification of Functioning, Disability and Health to enhance services for children and youth with chronic physical health conditions and disabilities.

    Science.gov (United States)

    McDougall, Janette; Horgan, Karen; Baldwin, Patricia; Tucker, Mary Ann; Frid, Pamela

    2008-03-01

    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.

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

    Science.gov (United States)

    Khan, Fary; Pallant, Julie F

    2007-01-01

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

  16. Ethical values in personal assistance: narratives of people with disabilities.

    Science.gov (United States)

    Wadensten, Barbro; Ahlström, Gerd

    2009-11-01

    The aim of this study was to investigate the experiences of persons with severe functional disabilities who receive personal assistance in their homes, the focus being on their daily life in relation to the ethical principles represented in the Swedish Disability Act: autonomy, integrity, influence and participation. Qualitative interviews were performed with 26 persons and thereafter subjected to qualitative latent content analysis. The experiences of personal assistance were very much in accordance with the said principles, the most important factor being that one is met with understanding. The participants described situations in which their integrity was violated in that they were not treated as competent adults. This indicates the importance of future efforts in nursing to support personal assistants with ethical knowledge and supervision so that they can empower people with disabilities and thereby enable them to maintain their self-esteem and dignity.

  17. Compulsory autonomy-promoting education

    NARCIS (Netherlands)

    A. Schinkel (Anders)

    2010-01-01

    textabstractToday, many liberal philosophers of education worry that certain kinds of education may frustrate the development of personal autonomy, with negative consequences for the individuals concerned, the liberal state, or both. Autonomy liberals hold not only that we should promote the

  18. Autonomy, Vulnerability, Recognition, and Justice

    NARCIS (Netherlands)

    Anderson, J.H.; Honneth, A.

    2005-01-01

    One of liberalism’s core commitments is to safeguarding individuals’ autonomy. And a central aspect of liberal social justice is the commitment to protecting the vulnerable. Taken together, and combined with an understanding of autonomy as an acquired set of capacities to lead one’s own life,

  19. Personal Autonomy and Rational Suicide.

    Science.gov (United States)

    Webber, May A.; Shulman, Ernest

    That certain suicides (which can be designated as rational) ought not to be interfered with is closely tied to the notion of the "right to autonomy." Specifically it is because the individual in question has this right that interference is prohibited. A proper understanding of the right to autonomy, while essential to understanding why…

  20. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

    This book challenges traditional approach to university autonomy which is based on four pillars: organisational, financial, human resource, and academic. The main thesis is that a fuller understanding of university autonomy can only be obtained through a more holistic view of the complex inter-re...

  1. The Principalship, Autonomy, and After

    Science.gov (United States)

    Eacott, Scott

    2015-01-01

    Contemporary discourses in educational administration have exponentially grown the number of adjectival leaderships, challenged traditional organisational structures, and offered autonomy as a solution to performance issues. In this theoretical paper, I ask "what does the principalship look like after autonomy?" Despite the range of…

  2. Teacher Autonomy: Power or Control?

    Science.gov (United States)

    Lawson, Tony

    2004-01-01

    The article explores the issue of teacher autonomy in relation to its potential for freedom or control. It examines the concept of empowerment as applied to education, arguing that, although it is traditionally cast as a means of achieving autonomy, an alternative approach sees empowerment as part of the disciplinary apparatus of late modern…

  3. Pain perception and low back pain functional disability after a 10-week core and mobility training program: A pilot study.

    Science.gov (United States)

    Lima, Vicente Pinheiro; de Alkmim Moreira Nunes, Rodolfo; da Silva, Jurandir Baptista; Paz, Gabriel Andrade; Jesus, Marco; de Castro, Juliana Brandão Pinto; Dantas, Estélio Henrique Martin; de Souza Vale, Rodrigo Gomes

    2018-03-02

    The aim of this study was to evaluate the effects of a 10-week core and mobility training program on pain perception and low back disability score in professors, students and employees of a university. Twenty-four individuals of a university who previously reported pain and low back disability were randomly assigned to an experimental group (EG; n= 8) that received 2 weekly sessions of 50 minutes of core and mobility training for 10 weeks; or to a control group (CG; n= 16). Both groups received a guideline to adopt ergonomic postures during work and activities of daily living. The visual analog pain scale (VAS) and the Roland-Morris questionnaire (RMQ) were applied pre and post intervention. Significant reductions in the pain intensity perception (p= 0.014) and low back functional disability (p= 0.011) were noted in the EG pre and post measures. However, no significant difference was observed in the CG. Thus, there was a significant difference between the EG and the CG in the post-intervention measures (p= 0.001). Core and mobility training and home-ergonomic instructions were effective to reduce the pain intensity perception and low back functional disability in the EG.

  4. Comparison of executive functions in students with and without specific learning disability with the characteristic reading and writing

    Directory of Open Access Journals (Sweden)

    Saba Hasanvandi

    2017-03-01

    Full Text Available Background: The aim of present study was to investigate executive functions included of working memory, organization-planning and reasoning in the children with and without specific learning disability with the characteristic reading and writing. Materials and methods: The design of this research was Ex-Post Facto design. Statistical population was all male students of third grade primary schools in Tehran which were referred to education institution with diagnosis special learning disorders in educational centers. The sample included of 90 students chosen and assigned into 3 groups of 30 students, included of: children who had specific learning disability with characteristic reading, children who had specific learning disability with characteristic writing, normal children were selected by systematic randomized sampling and 3 groups were compared. The data instruments were: Wechsler’ subtests of similarities and digit differences, Andre Ray test, in formal (unofficial reading and dictation test. The obtained data were analyzed with ANOVA. Results: The results showed that there was difference between the group of normal children and other group in executive functions including working memory, organization-planning and reasoning (P<0.05. Also there was difference between two children groups with specific learning disability with  characteristic reading and writing in working memory and reasoning, whereas for organization-planning parameter there were not seen any differences between these two groups (P<0.05. Conclusion: Regarding to obtained results, it is recommended to adoption some ways for improvements of working memory, organization-planning and reasoning

  5. Resource allocation in health care and the role of personal autonomy.

    Science.gov (United States)

    Gandjour, A

    2015-03-01

    Resource allocation decisions in health care require the consideration of ethical values. Major ethical theories include Amartya Sen's capability approach, Norman Daniels's theory of justice for health, and preference utilitarian theory. This paper argues that while only preference utilitarian theory explicitly considers the impact of an individual's actions on others, all 3 theories agree in terms of providing individual autonomy. Furthermore, it shows that all 3 theories emphasise the role of informed preferences in securing individual autonomy. Still, stressing personal autonomy has limited direct implications for priority setting. 2 priority rules for resource allocation could be identified: 1) to give priority to patients with mental disability (over those with pure physical disability); and 2) to give priority to patients with a large expected loss of autonomy without treatment. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Effects of proprioceptive neuromuscular facilitation-based abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients.

    Science.gov (United States)

    Kim, Beom-Ryong; Lee, Hye-Jin

    2017-08-01

    The purpose of this study was to evaluate the effect of abdominal muscle strengthening training (AMST) using proprioceptive neuromuscular facilitation (PNF) on pulmonary function, pain, and functional disability index in chronic low back pain (CLBP) patients. Thirty CLBP patients were randomly assigned to the traditional physical therapy (control) group (n=15) and PNF-AMST group (n=15). Forced expiratory volume at 1 second (FEV 1 ) was measured to measure changes in pulmonary function. To measure the degree of pain, a visual analog scale (VAS) was used. The Oswestry Disability Index (ODI) was used to assess the disability level due to low back pain. A paired t -test was performed to compare differences within the groups before and after intervention. An independent t -test was performed to compare differences between the test and control groups. The level of significance was set at α=0.05. Within-group changes in FEV 1 were significantly different in the experimental group ( P disability index inpatients with CLBP. We expect it to be useful as one of the programs for CLBP patients in the future.

  7. Pronounced Structural and Functional Damage in Early Adult Pediatric-Onset Multiple Sclerosis with No or Minimal Clinical Disability

    Directory of Open Access Journals (Sweden)

    Antonio Giorgio

    2017-11-01

    Full Text Available Pediatric-onset multiple sclerosis (POMS may represent a model of vulnerability to damage occurring during a period of active maturation of the human brain. Whereas adaptive mechanisms seem to take place in the POMS brain in the short-medium term, natural history studies have shown that these patients reach irreversible disability, despite slower progression, at a significantly younger age than adult-onset MS (AOMS patients. We tested for the first time whether significant brain alterations already occurred in POMS patients in their early adulthood and with no or minimal disability (n = 15 in comparison with age- and disability-matched AOMS patients (n = 14 and to normal controls (NC, n = 20. We used a multimodal MRI approach by modeling, using FSL, voxelwise measures of microstructural integrity of white matter tracts and gray matter volumes with those of intra- and internetwork functional connectivity (FC (analysis of variance, p ≤ 0.01, corrected for multiple comparisons across space. POMS patients showed, when compared with both NC and AOMS patients, altered measures of diffusion tensor imaging (reduced fractional anisotropy and/or increased diffusivities and higher probability of lesion occurrence in a clinically eloquent region for physical disability such as the posterior corona radiata. In addition, POMS patients showed, compared with the other two groups, reduced long-range FC, assessed from resting functional MRI, between default mode network and secondary visual network, whose interaction subserves important cognitive functions such as spatial attention and visual learning. Overall, this pattern of structural damage and brain connectivity disruption in early adult POMS patients with no or minimal clinical disability might explain their unfavorable clinical outcome in the long term.

  8. Intention, autonomy, and brain events.

    Science.gov (United States)

    Gillett, Grant

    2009-07-01

    Informed consent is the practical expression of the doctrine of autonomy. But the very idea of autonomy and conscious free choice is undercut by the view that human beings react as their unconscious brain centres dictate, depending on factors that may or may not be under rational control and reflection. This worry is, however, based on a faulty model of human autonomy and consciousness and needs close neurophilosophical scrutiny. A critique of the ethics implied by the model takes us towards a 'care of the self' view of autonomy and the subject's attunement to the truth as the crux of reasoning rather than the inner mental/neural state views of autonomy and human choice on offer at present.

  9. The Challenge of University Autonomy

    DEFF Research Database (Denmark)

    Reilly, John; Turcan, Romeo V.; Bugaian, Larisa

    2016-01-01

    The authors introduce the reader to the book, providing a historical perspective and a current understanding of university autonomy. While appreciating the central role of the four dimensions of university autonomy – organisational, financial, human resource, and academic – the authors conjecture...... that a fuller understanding of university autonomy can only be obtained through a holistic view of the complex inter-relationships between stakeholders and policies which can reinforce and, equally, pull in opposite directions. This holistic view is represented in a model of institutional university autonomy......, which is discussed at length in the chapter. The authors conclude by presenting international case studies that give new insights and reinforce our understanding that the issues relating to institutional university autonomy are genuinely global....

  10. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

    This book challenges traditional approach to university autonomy which is based on four pillars: organisational, financial, human resource, and academic. The main thesis is that a fuller understanding of university autonomy can only be obtained through a more holistic view of the complex inter......-relationships between stakeholders and policies which can reinforce and equally pull in opposite directions. The holistic view is expressed in a model of institutional university autonomy that brings together the traditional basic four pillars of autonomy, and five interfaces: government–university; university......–university staff; academic staff–students; university–business; and university–internationalisation. This model is explored through international case studies that give new insights and reinforce our understanding that the issues relating to institutional university autonomy are complex, interactive and genuinely...

  11. Memory Functioning in Children with Reading Disabilities and/or Attention-Deficit/Hyperactivity Disorder: A Clinical Investigation of Their Working Memory and Long-term Memory Functioning

    OpenAIRE

    Kibby, Michelle Y.; Cohen, Morris J.

    2008-01-01

    We examined memory functioning in children with reading disabilities (RD), ADHD, and RD/ADHD using a clinic sample with a clinical instrument: the Children’s Memory Scale, enhancing its generalizability. Participants included 23 children with RD, 30 with ADHD, 30 with RD/ADHD, and 30 controls. Children with RD presented with reduced verbal short-term memory (STM) but intact visual STM, central executive (CE) and long-term memory (LTM) functioning. Their deficit in STM appeared specific to tas...

  12. Footwear interventions for foot pain, function, impairment and disability for people with foot and ankle arthritis: A literature review.

    Science.gov (United States)

    Frecklington, Mike; Dalbeth, Nicola; McNair, Peter; Gow, Peter; Williams, Anita; Carroll, Matthew; Rome, Keith

    2017-11-03

    To conduct a literature review on the effectiveness of footwear on foot pain, function, impairment and disability for people with foot and ankle arthritis. A search of the electronic databases Scopus, Medline, CINAHL, SportDiscus and the Cochrane Library was undertaken in September 2017. The key inclusion criteria were studies reporting on findings of footwear interventions for people with arthritis with foot pain, function, impairment and/or disability. The Quality Index Tool was used to assess the methodological quality of studies included in the qualitative synthesis. The methodological variation of the included studies was assessed to determine the suitability of meta-analysis and the grading of recommendations, assessment, development and evaluation (GRADE) system. Between and within group effect sizes were calculated using Cohen's d. 1440 studies were identified for screening with 11 studies included in the review. Mean (range) quality scores were 67% (39-96%). The majority of studies investigated rheumatoid arthritis (n = 7), but also included gout (n = 2), and 1st metatarsophalangeal joint osteoarthritis (n = 2). Meta-analysis and GRADE assessment were not deemed appropriated based on methodological variation. Footwear interventions included off-the-shelf footwear, therapeutic footwear and therapeutic footwear with foot orthoses. Key footwear characteristics included cushioning and a wide toe box for rheumatoid arthritis; cushioning, midsole stability and a rocker-sole for gout; and a rocker-sole for 1st metatarsophalangeal joint osteoarthritis. Between group effect sizes for outcomes ranged from 0.01 to 1.26. Footwear interventions were associated with reductions in foot pain, impairment and disability for people with rheumatoid arthritis. Between group differences were more likely to be observed in studies with shorter follow-up periods in people with rheumatoid arthritis (12 weeks). Footwear interventions improved foot pain, function and disability in

  13. Patient autonomy in home care: Nurses' relational practices of responsibility.

    Science.gov (United States)

    Jacobs, Gaby

    2018-01-01

    Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted in a professional development course ('learning circle') for home care nurses, including participant observations and focus groups. The theoretical notion of 'relational agency' and the moral concept of 'practices of responsibility' were used to conduct a narrative analysis on the nurses' stories about autonomy. Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients' strengths and collaboration with patients and informal caregivers. On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.

  14. The Gestalt of functioning in autism spectrum disorder: Results of the international conference to develop final consensus International Classification of Functioning, Disability and Health core sets.

    Science.gov (United States)

    Bölte, Sven; Mahdi, Soheil; de Vries, Petrus J; Granlund, Mats; Robison, John E; Shulman, Cory; Swedo, Susan; Tonge, Bruce; Wong, Virginia; Zwaigenbaum, Lonnie; Segerer, Wolfgang; Selb, Melissa

    2018-01-01

    Autism spectrum disorder is associated with diverse social, educational, and occupational challenges. To date, no standardized, internationally accepted tools exist to assess autism spectrum disorder-related functioning. World Health Organization's International Classification of Functioning, Disability and Health can serve as foundation for developing such tools. This study aimed to identify a comprehensive, a common brief, and three age-appropriate brief autism spectrum disorder Core Sets. Four international preparatory studies yielded in total 164 second-level International Classification of Functioning, Disability and Health candidate categories. Based on this evidence, 20 international autism spectrum disorder experts applied an established iterative decision-making consensus process to select from the candidate categories the most relevant ones to constitute the autism spectrum disorder Core Sets. The consensus process generated 111 second-level International Classification of Functioning, Disability and Health categories in the Comprehensive Core Set for autism spectrum disorder-one body structure, 20 body functions, 59 activities and participation categories, and 31 environmental factors. The Common Brief Core Set comprised 60 categories, while the age-appropriate core sets included 73 categories in the preschool version (0- to 5-year-old children), 81 in the school-age version (6- to 16-year-old children and adolescents), and 79 in the older adolescent and adult version (⩾17-year-old individuals). The autism spectrum disorder Core Sets mark a milestone toward the standardized assessment of autism spectrum disorder-related functioning in educational, administrative, clinical, and research settings.

  15. Prevalence of disability in a composite ≥75 year-old population in Spain: A screening survey based on the International Classification of Functioning

    Directory of Open Access Journals (Sweden)

    Gascon-Bayarri Jordi

    2011-03-01

    Full Text Available Abstract Background The prevalence and predictors of functional status and disability of elderly people have been studied in several European countries including Spain. However, there has been no population-based study incorporating the International Classification of Functioning, Disability and Health (ICF framework as the basis for assessing disability. The present study reports prevalence rates for mild, moderate, and severe/extreme disability by the domains of activities and participation of the ICF. Methods Nine populations surveyed in previous prevalence studies contributed probabilistic and geographically defined samples in June 2005. The study sample was composed of 503 subjects aged ≥75 years. We implemented a two-phase screening design using the MMSE and the World Health Organization-Disability Assessment Schedule 2nd edition (WHO-DAS II, 12 items as cognitive and disability screening tools, respectively. Participants scoring within the positive range of the disability screening were administered the full WHO-DAS II (36 items; score range: 0-100 assessing the following areas: Understanding and communication, Getting along with people, Life activities, Getting around, Participation in society, and Self-care. Each disability area assessed by WHO-DAS II (36 items was reported according to the ICF severity ranges (No problem, 0-4; Mild disability, 5-24; Moderate disability, 25-49; Severe/Extreme disability, 50-100. Results The age-adjusted disability prevalence figures were: 39.17 ± 2.18%, 15.31 ± 1.61%, and 10.14 ± 1.35% for mild, moderate, and severe/extreme disability, respectively. Severe and extreme disability prevalence in mobility and life activities was three times higher than the average, and highest among women. Sex variations were minimal, although life activities for women of 85 years and over had more severe/extreme disability as compared to men (OR = 5.15 95% CI 3.19-8.32. Conclusions Disability is highly prevalent among

  16. International Classification of Functioning, Disability and Health categories explored for self-rated participation in Swedish adolescents and adults with a mild intellectual disability.

    Science.gov (United States)

    Arvidsson, Patrik; Granlund, Mats; Thyberg, Ingrid; Thyberg, Mikael

    2012-06-01

    To explore internal consistency and correlations between perceived ability, performance and perceived importance in a preliminary selection of self-reported items representing the activity/participation component of the International Classification of Functioning, Disability and Health (ICF). Structured interview study. Fifty-five Swedish adolescents and adults with a mild intellectual disability. Questions about perceived ability, performance and perceived importance were asked on the basis of a 3-grade Likert-scale regarding each of 68 items representing the 9 ICF domains of activity/participation. Internal consistency for perceived ability (Cronbach's alpha for all 68 items): 0.95 (values for each domain varied between 0.57 and 0.85), for performance: 0.86 (between 0.27 and 0.66), for perceived importance: 0.84 (between 0.27 and 0.68). Seventy-two percent of the items showed correlations >0.5 (mean=0.59) for performance vs perceived importance, 41% >0.5 (mean=0.47) for perceived ability vs performance and 12% >0.5 (mean=0.28) for perceived ability vs perceived importance. Measures of performance and perceived importance may have to be based primarily on their estimated clinical relevance for describing aspects of the ICF participation concept. With a clinimetric approach, parts of the studied items and domains may be used to investigate factors related to different patterns and levels of participation, and outcomes of rehabilitation.

  17. The International Classification of Functioning, Disability and Health (ICF): a unifying model for the conceptual description of the rehabilitation strategy.

    Science.gov (United States)

    Stucki, Gerold; Cieza, Alarcos; Melvin, John

    2007-05-01

    An important basis for the successful development of rehabilitation practice and research is a conceptually sound description of rehabilitation understood as a health strategy based on a universally accepted conceptual model and taxonomy of human functioning. With the approval of the International Classification of Functioning, Disability and Health (ICF) by the World Health Assembly in 2001 and the reference to the ICF in the World Health Assembly's resolution on "Disability, including prevention, management and rehabilitation" in 2005, we can now rely on a universally accepted conceptual model. It is thus time to initiate the process of evolving an ICF-based conceptual description that can serve as a basis for similar conceptual descriptions and according definitions of the professions applying the rehabilitation strategy and of distinct scientific fields of human functioning and rehabilitation research. In co-operation with the Physical and Rehabilitation Medicine (PRM) section of the European Union of Medical Specialists (UEMS) and its professional practice committee, we present a first tentative version of an ICF-based conceptual description in this paper. A brief definition describes rehabilitation as the health strategy applied by PRM and professionals in the health sector and across other sectors that aims to enable people with health conditions experiencing or likely to experience disability to achieve and maintain optimal functioning in interaction with the environment. Readers of the Journal of Rehabilitation Medicine are invited to contribute towards achieving an internationally accepted ICF-based conceptual description of rehabilitation by submitting commentaries to the Editor of this journal.

  18. Effects of Functional Communication Training (FCT) on the Communicative, Self-Initiated Toileting Behavior for Students with Developmental Disabilities in a School Setting

    Science.gov (United States)

    Kim, Jinnie

    2012-01-01

    Far less is known about the effects of functional communication-based toileting interventions for students with developmental disabilities in a school setting. Furthermore, the currently available toileting interventions for students with disabilities include some undesirable procedures such as the use of punishment, unnatural clinic/university…

  19. Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China

    DEFF Research Database (Denmark)

    Zeng, Yi; Feng, Qiushi; Hesketh, Therese

    2017-01-01

    age at the time of the assessment in the 1998 and 2008 surveys. Four health outcomes were investigated: annual death rate, Activities of Daily Living (ADL), physical performance in three tests and cognitive function measured by Mini-Mental State Examination (MMSE). We used different tests......BACKGROUND: The oldest-old (those aged ≥80 years) are the most rapidly growing age group globally, and are most in need of health care and assistance. We aimed to assess changes in mortality, disability in activities of daily living, and physical and cognitive functioning among oldest......, and that disability according to activities of daily living had significantly reduced annually between 0·8% and 2·8%. However, cognitive impairment in the later cohorts increased annually between 0·7% and 2·2% and objective physical performance capacity (standing up from a chair, picking up a book from the floor...

  20. Portugal's special education law: implementing the International Classification of Functioning, Disability and Health in policy and practice.

    Science.gov (United States)

    Sanches-Ferreira, Manuela; Simeonsson, Rune J; Silveira-Maia, Mónica; Alves, Sílvia; Tavares, Ana; Pinheiro, Sara

    2013-05-01

    The International Classification of Functioning, Disability and Health (ICF) was introduced in Portuguese education law as the compulsory system to guide eligibility policy and practice in special education. This paper describes the implementation of the ICF and its utility in the assessment process and eligibility determination of students for special education. A study to evaluate the utility of the ICF was commissioned by the Portuguese Ministry of Education and carried out by an external evaluation team. A document analysis was made of the assessment and eligibility processes of 237 students, selected from a nationally representative sample. The results provided support for the use of the ICF in student assessment and in the multidimensional approach of generating student functioning profiles as the basis for determining eligibility. The use of the ICF contributed to the differentiation of eligible and non eligible students based on their functioning profiles. The findings demonstrate the applicability of the ICF framework and classification system for determining eligibility for special education services on the basis of student functioning rather than medical or psychological diagnose. The use of the International Classification of Functioning, Disability and Health (ICF) framework in special education policy is as follows: • The functional perspective of the ICF offers a more comprehensive, holistic assessment of student needs than medical diagnoses. • ICF-based assessment of the nature and severity of functioning can serve as the basis for determining eligibility for special education and habilitation. • Profiles of functioning can support decision making in designing appropriate educational interventions for students.

  1. Perceived Autonomy Support in the NIMH RAISE Early Treatment Program.

    Science.gov (United States)

    Browne, Julia; Penn, David L; Bauer, Daniel J; Meyer-Kalos, Piper; Mueser, Kim T; Robinson, Delbert G; Addington, Jean; Schooler, Nina R; Glynn, Shirley M; Gingerich, Susan; Marcy, Patricia; Kane, John M

    2017-09-01

    This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.

  2. The potential of virtual reality-based training to enhance the functional autonomy of Alzheimer's disease patients in cooking activities: A single case study.

    Science.gov (United States)

    Foloppe, Déborah A; Richard, Paul; Yamaguchi, Takehiko; Etcharry-Bouyx, Frédérique; Allain, Philippe

    2018-07-01

    Impairments in performing activities of daily living occur early in the course of Alzheimer's disease (AD). There is a great need to develop non-pharmacological therapeutic interventions likely to reduce dependency in everyday activities in AD patients. This study investigated whether it was possible to increase autonomy in these patients in cooking activities using interventions based on errorless learning, vanishing-cue, and virtual reality techniques. We recruited a 79-year-old woman who met NINCDS-ADRDA criteria for probable AD. She was trained in four cooking tasks for four days per task, one hour per day, in virtual and in real conditions. Outcome measures included subjective data concerning the therapeutic intervention and the experience of virtual reality, repeated assessments of training activities, neuropsychological scores, and self-esteem and quality of life measures. The results indicated that our patient could relearn some cooking activities using virtual reality techniques. Transfer to real life was also observed. Improvement of the task performance remained stable over time. This case report supports the value of a non-immersive virtual kitchen to help people with AD to relearn cooking activities.

  3. Three-Pronged Assessment and Diagnosis of Personality Disorder and its Consequences: Personality Functioning, Pathological Traits, and Psychosocial Disability

    Science.gov (United States)

    Clark, Lee Anna; Ro, Eunyoe

    2014-01-01

    The alternative dimensional model of personality disorder (PD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013), Section III, has two main criteria: Impairment in personality functioning and one or more pathological personality traits. The former is defined as disturbances in self functioning (viz., identity, self-direction), and/or interpersonal functioning (viz., empathy, intimacy). Distinguishing personality functioning and traits is important conceptually, because simply having extreme traits is not necessarily pathological. However, adding personality functioning to PD diagnosis represents an empirical challenge, because the constructs overlap conceptually. Further, there is debate regarding whether diagnosis of mental disorder requires either distress or disability, concepts that also overlap with maladaptive-range personality traits and personality dysfunction. We investigated interrelations among these constructs using multiple self-report measures of each domain in a mixed community-patient sample (N = 402). We examined the structures of functioning (psychosocial disability and personality), and personality traits, first independently, then jointly. The disability/functioning measures yielded the three dimensions we have found previously (Ro & Clark, 2013). Trait measures had a hierarchical structure which, at the five-factor level, reflected neuroticism/negative affectivity (N/NA), (low) sociability, disinhibition, (dis)agreeableness, and rigid goal engagement. When all measures were co-factored, a hierarchical structure again emerged which, at the five-factor level, included (1) internalizing (N/NA and self-pathology vs. quality-of-life/satisfaction), (2) externalizing (social/interpersonal dysfunction, low sociability, and disagreeableness), (3) disinhibition, (4) poor basic functioning, and (5) rigid goal engagement. Results are discussed in terms of developing an integrated PD

  4. Children with Mild to Borderline Intellectual Disabilities and Externalizing Behavior: Individual Characteristics, Family functioning and Treatment Effectiveness

    OpenAIRE

    Schuiringa, H.D.

    2014-01-01

    Children with mild to borderline intellectual disabilities (MBID; IQ between 55 and 85 with problems in adaptive functioning) have been found to show higher rates of emotional and externalizing behavior problems and their externalizing behavior problems tend to persist over time, more so than those in peers with average intelligence (defined here as an IQ above 85). The processes underlying these externalizing behavior problems in children with MBID nevertheless largely remained unclear and e...

  5. The use of the international classification of functioning, disability and health in primary care: Findings of exploratory implementation throughout life

    OpenAIRE

    Debrouwere, Inge; Lebeer, Jo; Prinzie, Peter

    2016-01-01

    markdownabstract__Purpose:__ The International Classification of Functioning (ICF) has found widespread acceptance since it was launched in 2001. Yet, little is known about its use in Primary Care. This paper aims to contribute to the dialogue about the practical use of the ICF by exploring how this framework constitutes a supplementary source to inform disability-related decision making in integrated Primary Care. __Method:__ The implementation process of the ICF in a Latin American Primary ...

  6. The Effectiveness of Brain Based Teaching on the Executive Functions of the Students with Mathematics Learning Disability

    OpenAIRE

    Salar Faramarzi; Maryam Samadi; Ahmad Yarmohammadian; Salman Dezhara

    2014-01-01

    Target: With advances in cognitive neuroscience and the developing connection between neuroscience and education in recent years, new windows has been opened in the realm of teaching and learning for the education experts. So education has vastly benefited from the results of researches in neuroscience to improve learning. The study strived to investigate the effectiveness of “brain based teaching” on the executive functions of the students with mathematics learning disability in Isfahan city...

  7. Recentralization within decentralization: County hospital autonomy under devolution in Kenya

    Science.gov (United States)

    Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

    2017-01-01

    Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

  8. Some aspects of executive functions as predictors of understanding textual mathematical tasks in students with mild intellectual disability

    Directory of Open Access Journals (Sweden)

    Japundža-Milisavljević Mirjana

    2016-01-01

    Full Text Available The most significant segment during the process of solving mathematical tasks is translation from mathematical to native language, in the basis o which, among others, are the following factors: resistance to distraction and forming adequate verbal strategies. The goal of this research is to evaluate the contribution of some aspects of executive functions in explaining the variance of solving illustrative mathematical tasks in students with mild intellectual disability. The sample consists of 90 students with mild intellectual disability aged from 12 to 16 (M=14.7; SD=1.6, of both sexes (44.4% boys and 55.6% girls. The Twenty questions test and the Stroop test were used to estimate the executive functions. Verbal problem tasks were used for the purpose of understanding mathematical language The obtained results show that the estimated aspects of executive functions are significant predictors of understanding mathematical language in students with intellectual disabilities. The strongest predictor is distraction resistance (p=0.01.

  9. Does walking improve disability status, function, or quality of life in adults with chronic low back pain? A systematic review.

    Science.gov (United States)

    Lawford, Belinda J; Walters, Julie; Ferrar, Katia

    2016-06-01

    To establish the effectiveness of walking alone and walking compared to other non-pharmacological management methods to improve disability, quality of life, or function in adults with chronic low back pain. A systematic search of the following databases was undertaken: Medline, Embase, CINAHL, Scopus, Pedro, SportDiscus, Cochrane Central Register of Controlled Trials. The following keywords were used: 'back pain' or 'low back pain' or 'chronic low back pain' and 'walk*' or 'ambulation' or 'treadmill*' or 'pedometer*' or 'acceleromet*' or 'recreational' and 'disability' or 'quality of life' or 'function*'. Primary research studies with an intervention focus that investigated walking as the primary intervention compared to no intervention or any other non-pharmacological method in adults with chronic low back pain (duration >3 months). Seven randomised controlled trials involving 869 participants were included in the review. There was no evidence that walking was more effective than other management methods such as usual care, specific strength exercises, medical exercise therapy, or supervised exercise classes. One study found over-ground walking to be superior to treadmill walking, and another found internet-mediated walking to be more beneficial than non-internet-mediated walking in the short term. There is low quality evidence to suggest that walking is as effective as other non-pharmacological management methods at improving disability, function, and quality of life in adults with chronic low back pain. © The Author(s) 2015.

  10. The Effectiveness of Brain Based Teaching on the Executive Functions of the Students with Mathematics Learning Disability

    Directory of Open Access Journals (Sweden)

    Salar Faramarzi

    2014-04-01

    Full Text Available Target: With advances in cognitive neuroscience and the developing connection between neuroscience and education in recent years, new windows has been opened in the realm of teaching and learning for the education experts. So education has vastly benefited from the results of researches in neuroscience to improve learning. The study strived to investigate the effectiveness of “brain based teaching” on the executive functions of the students with mathematics learning disability in Isfahan city. Method: To this end, three students with mathematical learning disability were selected using purposeful sampling. In this investing used a single subject with A-B design. Intervention was started after determining the base-line. The “brain based teaching” package was taught to each single participant for 26 intervention sessions. And 1 month after the intervention period follow-up test was performed. The instruments used, included, Raven intelligence test, The Iran key math diagnostic arithmetic and Conner’s questionnaire neuropsychological. The gathered data was analyzed using descriptive statistics and visual analysis. Results: Based on that, Results revealed that during the visual analysis of data graphs for executive function deficits, the study intervention was significantly effective for all 3 participants. Conclusions: This study showed that brain based teaching improves the executive functions of the students and thus, could be used in educating children with learning disabilities.

  11. Predictors of Secondary Role Strains Among Spousal Caregivers of Older Adults With Functional Disability.

    Science.gov (United States)

    Polenick, Courtney A; DePasquale, Nicole

    2018-01-08

    Aging spouses commonly care for a partner with functional disability, but little is known about how spousal caregiving may impact different life domains. This study evaluated how caregiving characteristics are associated with secondary role strains among spousal caregivers. This cross-sectional study examined 367 spousal caregivers and their partners from the 2011 National Health and Aging Trends Study and National Study of Caregiving. Hierarchical regressions were estimated to determine how caregiver background factors (sociodemographics, health conditions) along with primary objective (care activities, care recipient health conditions, and dementia status) and subjective (emotional caregiving difficulties, role overload) stressors are linked to care-related valued activity restriction, negative caregiving relationship quality, and care-related family disagreements. Gender differences were considered. After accounting for all predictors, older caregivers and caregivers providing more help with activities of daily living and health system interactions (e.g., scheduling appointments) were more likely to report activity restriction, whereas caregivers with more emotional difficulties reported higher negative caregiving relationship quality. Role overload was positively associated with all three secondary strains. For husbands only, caring for a partner with more chronic conditions was linked to higher negative caregiving relationship quality and caring for a partner with dementia was associated with a greater likelihood of family disagreements. Secondary role strains may develop through similar and unique pathways for caregiving wives and husbands. Further research is needed to identify those who could benefit from support in managing their care responsibilities alongside other life areas. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Learning and memory disabilities in IUGR babies: Functional and molecular analysis in a rat model.

    Science.gov (United States)

    Camprubí Camprubí, Marta; Balada Caballé, Rafel; Ortega Cano, Juan A; Ortega de la Torre, Maria de Los Angeles; Duran Fernández-Feijoo, Cristina; Girabent-Farrés, Montserrat; Figueras-Aloy, Josep; Krauel, Xavier; Alcántara, Soledad

    2017-03-01

    1Intrauterine growth restriction (IUGR) is the failure of the fetus to achieve its inherent growth potential, and it has frequently been associated with neurodevelopmental problems in childhood. Neurological disorders are mostly associated with IUGR babies with an abnormally high cephalization index (CI) and a brain sparing effect. However, a similar correlation has never been demonstrated in an animal model. The aim of this study was to determine the correlations between CI, functional deficits in learning and memory and alterations in synaptic proteins in a rat model of IUGR. 2Utero-placental insufficiency was induced by meso-ovarian vessel cauterization (CMO) in pregnant rats at embryonic day 17 (E17). Learning performance in an aquatic learning test was evaluated 25 days after birth and during 10 days. Some synaptic proteins were analyzed (PSD95, Synaptophysin) by Western blot and immunohistochemistry. 3Placental insufficiency in CMO pups was associated with spatial memory deficits, which are correlated with a CI above the normal range. CMO pups presented altered levels of synaptic proteins PSD95 and synaptophysin in the hippocampus. 4The results of this study suggest that learning disabilities may be associated with altered development of excitatory neurotransmission and synaptic plasticity. Although interspecific differences in fetal response to placental insufficiency should be taken into account, the translation of these data to humans suggest that both IUGR babies and babies with a normal birth weight but with intrauterine Doppler alterations and abnormal CI should be closely followed to detect neurodevelopmental alterations during the postnatal period.

  13. Psychosocial Issues in Learning Disabilities.

    Science.gov (United States)

    Heisler, Alice B.

    1983-01-01

    Emotional development from infancy to adolescence is traced and the effects of psychosocial issues on a child with a learning disability are considered for five of E. Erikson's seven proposed stages (trust, autonomy, initiative, industry, adolescence). The need for intervention and parent counseling at each state is emphasized. (CL)

  14. ICF-DOC: the ICF dedicated checklist for evaluating functioning and disability in people with disorders of consciousness.

    Science.gov (United States)

    Leonardi, Matilde; Covelli, Venusia; Giovannetti, Ambra M; Raggi, Alberto; Sattin, Davide

    2014-09-01

    Clinicians need a comprehensive description of patients' functioning state to capture the complex interaction between symptoms and environmental factors, and to determine the actual level of functioning in patients in a vegetative state or a minimally conscious state. The aim of this study is to develop an International Classification of Functioning, Disability, and Health (ICF) checklist for patients with disorders of consciousness (DOC) so as to capture and describe, with a tailored list of categories, the most common health, disability, and functioning issues of adult patients with DOC. The WHO ICF checklist was used as a basis for collecting data. This was an observational, cross-sectional, multicenter study conducted in 69 Italian centers. Specific methodological procedures were used to identify the most appropriate categories for DOC patients to be added to or deleted from the ICF checklist so as to develop the ICF-DOC checklist. A total of 566 adult patients were enrolled: 398 in a vegetative state and 168 in a minimally conscious state. A total of 127 ICF categories reached the threshold of 20% concerning the presence of a problem: 37 categories from the body functions chapter, 13 from the body structures chapter, 46 from the activities and participations chapter, and 31 from the environmental factors chapter. ICF categories identified in this study can be useful guidelines for clinicians and researchers to collect data on functioning and disability of adult patients with DOC. The new ICF-DOC checklist allows monitoring of the effects of interventions on functional areas and possible changes in each patient in follow-up studies.

  15. Functional disability in patients with low back pain: the mediator role of suffering and beliefs about pain control in patients receiving physical and chiropractic treatment.

    Science.gov (United States)

    Pereira, M Graça; Roios, Edite; Pereira, Marta

    Low back pain is the leading cause of disability worldwide. There is evidence that depression, anxiety, and external locus of control are negative predictors of functional disability in low back patients. This study focused on the mediator role of suffering and beliefs about pain control in the relationship between psychological morbidity and functional disability in patients receiving physical therapy and chiropractic treatment for chronic low back pain. The sample included 213 patients receiving chiropractic treatment and 125 receiving physical therapy, who answered the following instruments: Beliefs about Pain Control Questionnaire; Inventory of Subjective Experiences of Suffering in Illness; Oswestry Low Back Pain Disability Questionnaire; and the Hospital Anxiety and Depression Scales. Suffering was a mediator in the relationship between depression and functional disability in both treatment groups. Only beliefs related to external chance events mediated the relationship between depression and functional disability in the physical therapy group, but not in the chiropratic teratment group. Intervention should focus on suffering regardless of the type of treatment and target beliefs about pain control, in patients receiving physical therapy treatment since they seem to play a key role in functional disability in patients with low back pain. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  16. The Portuguese formal social support for autonomy and dependence in pain inventory (FSSADI_PAIN): a preliminary validation study.

    Science.gov (United States)

    Matos, Marta; Bernardes, Sónia F

    2013-09-01

    Development and preliminary validation of a Portuguese measure of perceived Formal Social Support for Autonomy and Dependence in Pain (FSSADI_PAIN). One hundred and fifty-one older adults (88.1% women), between 56 and 94 years of age (M = 75.41; SD = 9.11), who attended one of the following institutions--day care centre (33.1%), nursing home (36.4%) and senior university (30.5%)--were recruited for this study. Along with the FSSADI_PAIN, participants filled out the Portuguese versions of the Brief Pain Inventory (Azevedo et al., 2007, Dor, 15, 6) and the Social Support Scale of Medical Outcomes Survey (Pais-Ribeiro & Ponte, 2009, Psicologia, Saúde & Doença, 10, 163). The factorial structure reflected the functions of perceived promotion of (1) dependence and (2) autonomy, showing good internal consistency (α > .70) and sensitivity indices. The FSSADI_PAIN showed good content, discriminant and criterion validity; it differentiated the perceptions of promotion of dependence/autonomy according to individual's pain severity and disability, as well as the type of institution. These preliminary findings suggest that the FSSADI_PAIN is an innovative and promising measure of perceived formal social support adapted to pain-related contexts. © 2012 The British Psychological Society.

  17. Subsidiary Autonomy and Knowledge Transfer

    DEFF Research Database (Denmark)

    Søberg, Peder Veng; Wæhrens, Brian Vejrum

    2015-01-01

    Purpose: This paper explores the effect of subsidiary autonomy on knowledge transfers during captive R&D offshoring to emerging markets. Design/methodology/approach: A framework to this end is developed and illustrated in relation to four cases of captive R&D offshoring to emerging markets....... Findings: Subsidiary autonomy has a mainly negative effect on primary knowledge transfer and a mainly positive effect on reverse knowledge transfer. Newly established R&D subsidiaries in emerging markets need primary knowledge transfer in order to build up their competence before they can add...... to the knowledge level of the MNE. Originality: A dual role of subsidiary autonomy is identified. Gradual increase in R&D subsidiary autonomy is beneficial for subsidiary innovation performance....

  18. Intramitochondrial autonomy in rat tissues

    International Nuclear Information System (INIS)

    Subramanian, M.; Rajwade, M.S.; Satav, J.G.; Katyare, S.S.; Fatterpaker, P.; Sreenivasan, A.

    1974-01-01

    The biogenesis of mitochondria in rat liver and their protein turnover has been investigated using 1- 14 C leucine. The results indicate that intramitochondrial autonomy exists both with respect to their genesis and turnover. (M.G.B.)

  19. Institutional Financial Autonomy in Practice

    DEFF Research Database (Denmark)

    Szwebs, Witold

    2016-01-01

    The article reveals how university autonomy may in practice prove to be restrictive for units within the university. The need to implement and interpret external regulations and protect the institution may, argued in the paper, lead to a risk averse, conservative approach which is experienced...... by departments as bureaucratic and hampering effective research. Thus autonomy has produced new internal tensions between the central management/administration and the departments which it is argued is counter-productive and not beneficial for research and could be seen as a perverse aspect of greater autonomy....... Indeed because university policy and ‘interference’ is much closer to the researcher than in former less autonomous times and the university may now exercise other direct incentives through resource allocation, promotion and salary enhancement, the department and the individual may view autonomy...

  20. Learning for autonomy

    Science.gov (United States)

    Rivero, Jose

    1989-12-01

    There is a need for a new concept of post-literacy which goes beyond the learning of codes. The target population is defined on the basis of their need to be given the capacity to take decisions on essential economic, civic, political and day-to-day aspects of their lives. The main arena of post-literacy lies in the countries of the Third World, where the economic crisis has serious effects on the quality of life and impairs the motivation to learn. Particular reference is made to the concept of participation and to the ability to determine four types of basic educational need: fundamental needs, productivity needs, social service needs and community organization needs. Four Latin American programmes linked to these four types of need are presented and discussed in terms of their particular features: popular participation in decision making; the search for methods and techniques which give the population a certain degree of autonomy; and respect for the cultures and world visions of the communities in the conduct of post-literacy, educational innovation and other activities. The programmes are: post-literacy in Nicaragua (fundamental education needs); research on post-literacy and employment in 13 countries (productivity needs); the CIPCA project for peasants in Piura, on the northern coast of Peru (social service needs); and the `Talking Maps' project developed with the Paez community in Cauca, Colombia (community organization needs).

  1. International Classification of Functioning, Disability and Health Core Sets for cerebral palsy, autism spectrum disorder, and attention-deficit-hyperactivity disorder.

    Science.gov (United States)

    Schiariti, Verónica; Mahdi, Soheil; Bölte, Sven

    2018-05-30

    Capturing functional information is crucial in childhood disability. The International Classification of Functioning, Disability and Health (ICF) Core Sets promote assessments of functional abilities and disabilities in clinical practice regarding circumscribed diagnoses. However, the specificity of ICF Core Sets for childhood-onset disabilities has been doubted. This study aimed to identify content commonalities and differences among the ICF Core Sets for cerebral palsy (CP), and the newly developed Core Sets for autism spectrum disorder (ASD) and attention-deficit-hyperactivity disorder (ADHD). The categories within each Core Set were aggregated at the ICF component and chapter levels. Content comparison was conducted using descriptive analyses. The activities and participation component of the ICF was the most covered across all Core Sets. Main differences included representation of ICF components and coverage of ICF chapters within each component. CP included all ICF components, while ADHD and ASD predominantly focused on activities and participation. Environmental factors were highly represented in the ADHD Core Sets (40.5%) compared to the ASD (28%) and CP (27%) Core Sets. International Classification of Functioning, Disability and Health Core Sets for CP, ASD, and ADHD capture both common but also unique functional information, showing the importance of creating condition-specific, ICF-based tools to build functional profiles of individuals with childhood-onset disabilities. The International Classification of Functioning, Disability and Health (ICF) Core Sets for cerebral palsy (CP), autism spectrum disorder (ASD), and attention-deficit-hyperactivity disorder (ADHD) include unique functional information. The ICF-based tools for CP, ASD, and ADHD differ in terms of representation and coverage of ICF components and ICF chapters. Representation of environmental factors uniquely influences functioning and disability across ICF Core Sets for CP, ASD and ADHD.

  2. Participation in leisure activities and tourism among older people with and without disabilities in Poland.

    Science.gov (United States)

    Rowiński, Rafał; Morgulec-Adamowicz, Natalia; Ogonowska-Slodownik, Anna; Dąbrowski, Andrzej; Geigle, Paula Richley

    2017-11-01

    Health conditions associated with aging might be related to disability and lead to decreased independence. Physical activity assists in maintaining independence throughout life as well as improves quality of life. Individuals with disabilities demonstrate overall less activity than sedentary persons without disabilities. Efforts to reduce age-related functional autonomy decline and to increase physical activity may require separate approaches for older adults with and without disabilities. The aim of the study was to compare physical activity and participation in leisure activities and tourism among older people with and without disabilities in Poland. A cross-sectional, multicenter study (PolSenior) randomly recruited participants aged 65 years and over, in a stratified, proportional draw performed in three stages from all 16 Polish provinces. 3743 people, 2653 (70.9%) without disabilities, and 1090 (29.1%) with disabilities responded providing general sociodemographic characteristics and various health behaviors including subjective physical activity level, leisure time activities, tourism and activity limitations. Older males without disability reported more physical activity than women with disability, while no differences were observed for females with and without disability. Polish older people with and without disability were more involved in gardening and staying in a garden allotment or a holiday home rather than participating in organized forms of sport, physical activity, and tourism. Health conditions arose as the most frequently indicated barrier toward participation in sport physical activity and tourism. In conclusion, strategies and programs to increase physical activity among older Polish people, with and without disability, should focus on preserving health and physical function. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Futility, autonomy, and informed consent.

    Science.gov (United States)

    Trau, J M

    1994-03-01

    If clinicians deem a treatment medically futile, is it appropriate to mention such a treatment to patients? Do healthcare professionals violate informed consent if they do not offer patients an opportunity to decline futile treatments? The notion of futility involves an assessment of patient best interest--both short-term and long-term therapeutic benefit for a patient and the community in which he or she intends to survive and flourish. Although survival interests may be construed as long term, a treatment that offers survival without any promise of flourishing is not the goal of medicine and is futile. Flourishing requires some cognitive and affective function. The goal of informed consent practices is to ensure that patients accept the benefits of treatment with cognizance of the burdens and risks. Given the impact of illness on the emotional and psychological states of patients and their families and their resultant vulnerability, the omission of futile options from treatment plans is logical and exemplifies the best of paternalistic behavior. The claim that requests for futile treatment must be honored is based on a perverse understanding of patient autonomy. Rational medicine demands that patients' requests be reasonable from a clinical perspective, as well as from a subjective one. The practice of informed consent can be implemented as a balance between these two interests.

  4. Comparative Policy Brief: Status of Intellectual Disabilities in the Republic of Haiti

    Science.gov (United States)

    Jacobson, Erik

    2008-01-01

    An estimated 800,000 persons have disabilities in Haiti, but there are no data that refer specifically to those with intellectual disabilities. Traditional fears and stigma about disability are widespread. While the constitution supports the idea that people with disabilities should have autonomy and education, there are no laws to mandate…

  5. Autism Spectrum Disorder, Intellectual Disability, and Emotional Functioning: Relatedness and Particular Impact on Challenging Behavior

    NARCIS (Netherlands)

    Sappok, Tanja; Sterkenburg, Paula; Bohm, Julia

    2017-01-01

    Aims: Persons with an intellectual disability (ID) show high rates of challenging behaviour (CB), especially in cases of co-occurring autism spectrum disorder (ASD). The aim of this retrospective study was to examine the relatedness and impact of ASD, the severity of ID, and the level of emotional

  6. Visual impairments in people with severe and profound multiple disabilities: An inventory of visual functioning

    NARCIS (Netherlands)

    van den Broek, E.G.C.; Janssen, C.G.C.; van Ramshorst, T.; Deen, L.

    2006-01-01

    Background: The prevalence of visual impairments in people with severe and profound multiple disabilities (SPMD) is the subject of considerable debate and is difficult to assess. Methods: In a typical Dutch care organization, all clients with SPMD (n = 76) participated in the study and specific

  7. Functional Technology for Individuals with Intellectual Disabilities: Meta-Analysis of Mobile Device-Based Interventions

    Science.gov (United States)

    Kim, Jemma; Kimm, Christina H.

    2017-01-01

    This study employs a meta-analysis of single-subject design research to investigate the efficacy of mobile device-based interventions for individuals with intellectual disabilities (ID) and to further examine possible variables that may moderate the intervention outcomes. A total of 23 studies, 78 participants, and 140 observed cases that met the…

  8. Development of an instrument to measure behavioral health function for work disability: item pool construction and factor analysis.

    Science.gov (United States)

    Marfeo, Elizabeth E; Ni, Pengsheng; Haley, Stephen M; Jette, Alan M; Bogusz, Kara; Meterko, Mark; McDonough, Christine M; Chan, Leighton; Brandt, Diane E; Rasch, Elizabeth K

    2013-09-01

    To develop a broad set of claimant-reported items to assess behavioral health functioning relevant to the Social Security disability determination processes, and to evaluate the underlying structure of behavioral health functioning for use in development of a new functional assessment instrument. Cross-sectional. Community. Item pools of behavioral health functioning were developed, refined, and field tested in a sample of persons applying for Social Security disability benefits (N=1015) who reported difficulties working because of mental or both mental and physical conditions. None. Social Security Administration Behavioral Health (SSA-BH) measurement instrument. Confirmatory factor analysis (CFA) specified that a 4-factor model (self-efficacy, mood and emotions, behavioral control, social interactions) had the optimal fit with the data and was also consistent with our hypothesized conceptual framework for characterizing behavioral health functioning. When the items within each of the 4 scales were tested in CFA, the fit statistics indicated adequate support for characterizing behavioral health as a unidimensional construct along these 4 distinct scales of function. This work represents a significant advance both conceptually and psychometrically in assessment methodologies for work-related behavioral health. The measurement of behavioral health functioning relevant to the context of work requires the assessment of multiple dimensions of behavioral health functioning. Specifically, we identified a 4-factor model solution that represented key domains of work-related behavioral health functioning. These results guided the development and scale formation of a new SSA-BH instrument. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  9. Caregivers' reported functional limitations in activities of daily living among middle-aged adults with intellectual disabilities.

    Science.gov (United States)

    Lin, Lan-Ping; Hsia, Yi-Chen; Hsu, Shang-Wei; Loh, Ching-Hui; Wu, Chia-Ling; Lin, Jin-Ding

    2013-12-01

    This study was conducted to describe the functioning of Activities of Daily Living (ADL) and to examine socio-economic effects on ADL functioning among adults with intellectual disabilities (ID) aged 45 years and older (N=480) in Taiwan. The Barthel Index (BI) was used to determine a baseline level of ADL functioning in the study participants. There are five categories of functional impairment using the following cut-off values in Taiwan: total dependence (BI score 0-20), severe (BI score 21-60), moderate (BI score 61-90), mild (BI score 91-99), and total independence (BI score 100) (Taiwan Department of Health, 2012). The results revealed that 2.3% of adults with ID were in total dependence, 11.9% were in severe dependence, 27.9% were in moderate dependence, 8.1% had a mild dependence, and 49.8% were totally independent. In the multiple linear regression model of the ADL score, we determined that educational level, comorbid Down's syndrome, and disability level are the variables able to significantly predict ADL score (R(2)=0.190) after controlling for the factors of age, marital status, and other comorbidity conditions. Those ID adults with a lower education level (primary vs. literate, β=4.780, p=0.031; intermediate vs. literate, β=6.642, p=0.030), with comorbid Down's syndrome (β=-7.135, p=0.063), and with a more severe disability condition (severe vs. mild, β=-7.650, p=0.007; profound vs. mild, β=-19.169, p<0.001) had significantly lower ADL scores. The present study highlights the need to support mobility in older adults with ID as much as possible to optimize independence in this group. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Abnormal functional connectivity and cortical integrity influence dominant hand motor disability in multiple sclerosis: a multimodal analysis.

    Science.gov (United States)

    Zhong, Jidan; Nantes, Julia C; Holmes, Scott A; Gallant, Serge; Narayanan, Sridar; Koski, Lisa

    2016-12-01

    Functional reorganization and structural damage occur in the brains of people with multiple sclerosis (MS) throughout the disease course. However, the relationship between resting-state functional connectivity (FC) reorganization in the sensorimotor network and motor disability in MS is not well understood. This study used resting-state fMRI, T1-weighted and T2-weighted, and magnetization transfer (MT) imaging to investigate the relationship between abnormal FC in the sensorimotor network and upper limb motor disability in people with MS, as well as the impact of disease-related structural abnormalities within this network. Specifically, the differences in FC of the left hemisphere hand motor region between MS participants with preserved (n = 17) and impaired (n = 26) right hand function, compared with healthy controls (n = 20) was investigated. Differences in brain atrophy and MT ratio measured at the global and regional levels were also investigated between the three groups. Motor preserved MS participants had stronger FC in structurally intact visual information processing regions relative to motor impaired MS participants. Motor impaired MS participants showed weaker FC in the sensorimotor and somatosensory association cortices and more severe structural damage throughout the brain compared with the other groups. Logistic regression analysis showed that regional MTR predicted motor disability beyond the impact of global atrophy whereas regional grey matter volume did not. More importantly, as the first multimodal analysis combining resting-state fMRI, T1-weighted, T2-weighted and MTR images in MS, we demonstrate how a combination of structural and functional changes may contribute to motor impairment or preservation in MS. Hum Brain Mapp 37:4262-4275, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability.

    Science.gov (United States)

    Janssen, Ian; Heymsfield, Steven B; Ross, Robert

    2002-05-01

    To establish the prevalence of sarcopenia in older Americans and to test the hypothesis that sarcopenia is related to functional impairment and physical disability in older persons. Cross-sectional survey. Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III). Fourteen thousand eight hundred eighteen adult NHANES III participants aged 18 and older. The presence of sarcopenia and the relationship between sarcopenia and functional impairment and disability were examined in 4,504 adults aged 60 and older. Skeletal muscle mass was estimated from bioimpedance analysis measurements and expressed as skeletal muscle mass index (SMI = skeletal muscle mass/body mass x 100). Subjects were considered to have a normal SMI if their SMI was greater than -one standard deviation above the sex-specific mean for young adults (aged 18-39). Class I sarcopenia was considered present in subjects whose SMI was within -one to -two standard deviations of young adult values, and class II sarcopenia was present in subjects whose SMI was below -two standard deviations of young adult values. The prevalence of class I and class II sarcopenia increased from the third to sixth decades but remained relatively constant thereafter. The prevalence of class I (59% vs 45%) and class II (10% vs 7%) sarcopenia was greater in the older (> or = 60 years) women than in the older men (P normal SMI, respectively. Some of the associations between class II sarcopenia and functional impairment remained significant after adjustment for age, race, body mass index, health behaviors, and comorbidity. Reduced relative skeletal muscle mass in older Americans is a common occurrence that is significantly and independently associated with functional impairment and disability, particularly in older women. These observations provide strong support for the prevailing view that sarcopenia may be an important and potentially reversible cause of

  12. Assistive technology needs, functional difficulties, and services utilization and coordination of children with developmental disabilities in the United States.

    Science.gov (United States)

    Lin, Sue C; Gold, Robert S

    2018-01-01

    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.

  13. The joint association of depression and cognitive function with severe disability among community-dwelling older adults in Finland, Poland and Spain.

    Science.gov (United States)

    Olaya, Beatriz; Moneta, Maria Victoria; Koyanagi, Ai; Lara, Elvira; Miret, Marta; Ayuso-Mateos, José Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Lobo, Antonio; Haro, Josep Maria

    2016-04-01

    To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. Cross-sectional. Community-based. Population-based sample of 7987 non-institutionalized adults aged 50 and older. The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.

  14. THE CHALLENGE OF AUTONOMY: AN EMPIRICAL STUDY OF THE VARIOUS DIMENSIONS OF AUTONOMY

    OpenAIRE

    Cristi IFTENE

    2009-01-01

    There are various dimensions of autonomy (policy, financial, structural, personnel, legal, institutional) as different scholars demonstrated (Christensen 2001, Verhoest et. al. 2004). In the present paper we will focus only on political and financial autonomy. As Yesilkagit and van Thiel demonstrated there is a difference between formal and de facto autonomy. They found that formal autonomy does not reinforce de facto autonomy and that organizations with less autonomy report higher levels of ...

  15. Reproductive autonomy: A case study

    African Journals Online (AJOL)

    [1] Women are encouraged to expect a 'perfect baby', disability ... inclusivity, recognising and providing persons with disabilities opportunities for capability and worthwhile .... have other consequences, e.g. affecting employment or insurance.

  16. Olfactory identification and its relationship to executive functions, memory, and disability one year after severe traumatic brain injury.

    Science.gov (United States)

    Sigurdardottir, Solrun; Andelic, Nada; Skandsen, Toril; Anke, Audny; Roe, Cecilie; Holthe, Oyvor Oistensen; Wehling, Eike

    2016-01-01

    To explore the frequency of posttraumatic olfactory (dys)function 1 year after severe traumatic brain injury (TBI) and determine whether there is a relationship between olfactory identification and neuropsychological test performance, injury severity and TBI-related disability. A population-based multicenter study including 129 individuals with severe TBI (99 males; 16 to 85 years of age) that could accomplish neuropsychological examinations. Olfactory (dys)function (anosmia, hyposmia, normosmia) was assessed by the University of Pennsylvania Smell Identification Test (UPSIT) or the Brief Smell Identification Test (B-SIT). Three tests of the Delis-Kaplan Executive Function System (D-KEFS) were used to assess processing speed, verbal fluency, inhibition and set-shifting, and the California Verbal Learning Test-II was used to examine verbal memory. The Glasgow Outcome Scale-Extended (GOSE) was used to measure disability level. Employing 2 different smell tests in 2 equal-sized subsamples, the UPSIT sample (n = 65) classified 34% with anosmia and 52% with hyposmia, while the B-SIT sample (n = 64) classified 20% with anosmia and 9% with hyposmia. Individuals classified with anosmia by the B-SIT showed significantly lower scores for set-shifting, category switching fluency and delayed verbal memory compared to hyposmia and normosmia groups. Only the B-SIT scores were significantly correlated with neuropsychological performance and GOSE scores. Brain injury severity (Rotterdam CT score) and subarachnoid hemorrhage were related to anosmia. Individuals classified with anosmia demonstrated similar disability as those with hyposmia/normosmia. Different measures of olfaction may yield different estimates of anosmia. Nevertheless, around 1 third of individuals with severe TBI suffered from anosmia, which may also indicate poorer cognitive outcome. (c) 2015 APA, all rights reserved).

  17. Respect for autonomy in the healthcare context: observations from a qualitative study of young adults with cerebral palsy.

    Science.gov (United States)

    Racine, E; Larivière-Bastien, D; Bell, E; Majnemer, A; Shevell, M

    2013-11-01

    Respect for patient autonomy is a cornerstone of contemporary medical ethics and clinical practice. In its different shapes and forms (e.g. being informed, being engaged in discussions and decisions about medical care and being supported in developing healthcare preferences and choices), patient autonomy has been fostered by both paediatric and adult professional societies. The transition from paediatric to adult care creates a complex situation where autonomy for medical decisions shifts to the developing adolescent. More specific challenges to respect for autonomy may be experienced by young adults with cerebral palsy in the transition period where, for example, language and motor impairments may affect communication skills and this may be conflated with cognitive disability. To characterize perspectives towards autonomy in the healthcare context for young adults with cerebral palsy. We carried out semi-structured interviews with 14 young adults (aged 18-25) with cerebral palsy. The audiotaped interviews were transcribed verbatim and analysed using a conventional thematic qualitative content analysis. Participants displayed a range of attitudes towards autonomy, suggesting that the value of autonomy is considered in light of competing values and of context. Testimonials from participants demonstrated that both contextual (e.g. ill-adapted health care, lack of specialized public transport) and relational (e.g. attitudes towards parental involvement in decision making) factors negatively or positively impact autonomy. We observed that there were four key elements interwoven in participants' characterization of autonomy: the coupling of decisional and physical autonomy, the influences of family and society on autonomy, the influence of healthcare professionals on autonomy and the need for preparation for autonomy. © 2012 John Wiley & Sons Ltd.

  18. Effective Municipal Emergency Planning for People With Disabilities and Others With Access and Functional Needs

    Science.gov (United States)

    2012-09-01

    second reader Dr. Christopher Bellavita. Glen’s wisdom and tutelage was a rare jewel and I am truly grateful. Dr. Bellavita challenged my mind and...www.census.gov/hhes/www/disability/sipp/disab10/table_1.pdf. 2 creation and policy implementation-with the life-and-death difference between theory and...accommodated? If she had autism , mental health, or behavioral health support needs, would programs be flexible to provide a quiet area to assist her

  19. The identification of job opportunities for severely disabled sick-listed employees

    Directory of Open Access Journals (Sweden)

    Broersen Jake PJ

    2012-03-01

    Full Text Available Abstract Background Work disability is a major problem for both the worker and society. To explore the work opportunities in regular jobs of persons low in functional abilities, we tried to identify occupations low in task demands. Because of the variety of functional abilities and of the corresponding work demands, the disabled persons need to be classified by type of disability in a limited number of subgroups. Within each subgroup, occupations judged suitable for the most seriously disabled will be selected as having a very low level of the corresponding task demands. These occupations can be applied as reference occupations to assess the presence or absence of work capacity of sick-listed employees in regular jobs, and as job opportunities for people with a specific type of functional disability. Methods Registered data from 50,931 disability assessments within the Dutch social security system were used in a second order factor analysis to identify types of disabilities in claimants for a disability pension. Threshold values were chosen to classify claimants according to the severity of the disability. In the disability assessment procedure, a labour expert needs to select jobs with task demands not exceeding the functional abilities of the claimant. For each type of disability, the accessible jobs for the subgroup of the most severely disabled claimants were identified as lowest in the corresponding demand. Results The factor analysis resulted in four types of disabilities: general physical ability; autonomy; psychological ability; and manual skills. For each of these types of disablement, a set of four to six occupations low in task demands were selected for the subgroup of most severely disabled claimants. Because of an overlap of the sets of occupations, 13 occupations were selected in total. The percentage of claimants with at least one of the occupations of the corresponding set (the coverage, ranged from 84% to 93%. An alternative

  20. Loss-of-function mutation in RUSC2 causes intellectual disability and secondary microcephaly.

    Science.gov (United States)

    Alwadei, Ali H; Benini, Ruba; Mahmoud, Adel; Alasmari, Ali; Kamsteeg, Erik-Jan; Alfadhel, Majid

    2016-12-01

    Inherited aberrancies in intracellular vesicular transport are associated with a variety of neurological and non-neurological diseases. RUSC2 is a gene found on chromosome 9p13.3 that codes for iporin, a ubiquitous protein with high expression in the brain that interacts with Rab proteins (GTPases implicated in intracellular protein trafficking). Although mutations in Rab proteins have been described as causing brain abnormalities and intellectual disability, until now no disease-causing mutations in RUSC2 have ever been reported in humans. We describe, to our knowledge for the first time, three patients with inherited homozygous nonsense mutations identified in RUSC2 on whole-exome sequencing. All three patients had central hypotonia, microcephaly, and moderate to severe intellectual disability. Two patients had additional features of early-onset epilepsy and absence of the splenium. This report adds to the ever-expanding landscape of genetic causes of intellectual disability and increases our understanding of the cellular processes underlying this important neurological entity. © 2016 Mac Keith Press.

  1. The International Classification of Functioning, Disability and Health: a unifying model for the conceptual description of physical and rehabilitation medicine.

    Science.gov (United States)

    Stucki, Gerold; Melvin, John

    2007-05-01

    There is a need to develop a contemporary and internationally accepted conceptual description of physical and rehabilitation medicine (PRM). The process of evolving such a definition can now rely on the unifying conceptual model and taxonomy of the International Classification of Functioning, Disability and Health (ICF) and an ICF-based conceptual description of rehabilitation understood as a health strategy. The PRM section of the European Union of Medical Specialists (UEMS) has endorsed the application of the ICF as a unifying conceptual model for PRM and supports the process of moving towards an "ICF-based conceptual description and according definitions of PRM". With this goal in mind, the authors have developed a first tentative conceptual description in co-operation with the professional practice committee of the UEMS-PRM-section. A respective brief definition describes PRM as the medical specialty that, based on the assessment of functioning and including the diagnosis and treatment of health conditions, performs, applies and co-ordinates biomedical and engineering and a wide range of other interventions with the goal of optimizing functioning of people experiencing or likely to experience disability. Readers of the Journal of Rehabilitation Medicine are invited to contribute to the process of achieving an internationally accepted ICF-based conceptual description of PRM by submitting commentaries to the Editor of this journal.

  2. European validation of The Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis from the perspective of patients with osteoarthritis of the knee or hip.

    Science.gov (United States)

    Weigl, Martin; Wild, Heike

    2017-09-15

    To validate the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis from the patient perspective in Europe. This multicenter cross-sectional study involved 375 patients with knee or hip osteoarthritis. Trained health professionals completed the Comprehensive Core Set, and patients completed the Short-Form 36 questionnaire. Content validity was evaluated by calculating prevalences of impairments in body function and structures, limitations in activities and participation and environmental factors, which were either barriers or facilitators. Convergent construct validity was evaluated by correlating the International Classification of Functioning, Disability and Health categories with the Short-Form 36 Physical Component Score and the SF-36 Mental Component Score in a subgroup of 259 patients. The prevalences of all body function, body structure and activities and participation categories were >40%, >32% and >20%, respectively, and all environmental factors were relevant for >16% of patients. Few categories showed relevant differences between knee and hip osteoarthritis. All body function categories and all but two activities and participation categories showed significant correlations with the Physical Component Score. Body functions from the ICF chapter Mental Functions showed higher correlations with the Mental Component Score than with the Physical Component Score. This study supports the validity of the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis. Implications for Rehabilitation Comprehensive International Classification of Functioning, Disability and Health Core Sets were developed as practical tools for application in multidisciplinary assessments. The validity of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis in this study supports its application in European patients with

  3. The Danish version of Lymphoedema Functioning, Disability and Health Questionnaire (Lymph-ICF) for breast cancer survivors

    DEFF Research Database (Denmark)

    Grarup, Karin R; Devoogdt, Nele; Strand, Liv Inger

    2018-01-01

    PURPOSE: To translate and culturally adapt the Lymphoedema Functioning, Disability and Health Questionnaire (Lymph-ICF) for breast cancer survivors with arm lymphedema into Danish and examine its content validity and reliability. METHODS: (1) Translation and cultural adaptation was performed in 10...... steps following international guidelines (International Society for Pharmacoeconomics and Outcome Research); (2) cognitive interviewing (step 7) was conducted in 15 women with breast cancer related arm lymphedema to explore understandability, interpretation, and cultural relevance; (3) after adjustments...... for the domains ranged from 0.84 to 0.94. SEM values differed for the domains, 6.4 (physical function), 5.7 (mobility activities), 7.09 (life and social activities), 9.1 (mental functions), and 10.2 (household activities). CONCLUSION: The translated and adjusted Lymph-ICF DK (Denmark) is reliable and valid...

  4. The Ideal of Moral Autonomy

    Directory of Open Access Journals (Sweden)

    Ricardo Marquisio Aguirre

    2017-10-01

    Full Text Available Some elements of the ideal of moral autonomy are discussed in this paper. Such ideal is a key assumption in social practices focused on normative imputation, particularly morality and law. First, a constructivist conception of normativity is introduced, taking reasons as an essential and non-reducible element, and focused on the conceptual features of moral reasons within the normative domain. Then, an idea of moral autonomy based on the self-constitution is developed including three key features: the possibility of responding to reasons based on shared social expectations; the responsibility for certain scope of actions, according to a set of reasons available to the individual and to their maximum extent of expansion; and the need to preserve autonomy as a purpose unifying the set of autonomous actions of moral agents.

  5. [Assessment of functioning in patients with head and neck cancer based on the international classification of functioning, disability and health (ICF)].

    Science.gov (United States)

    Tschiesner, U

    2011-09-01

    The article approaches with the question how preservation of function after treatment of head and neck cancer (HNC) can be defined and measured across treatment approaches. On the basis of the "International Classification of Functioning, Disability and Health (ICF)" a series of efforts are summarized how all relevant aspects of the interdisciplinary team can be integrated into a common concept.Different efforts on the development, validation and implementation of ICF Core Sets for head and neck cancer (ICF-HNC) are discussed. The ICF-HNC covers organ-based problems with food ingestion, breathing, and speech, as well as psychosocial difficulties.Relationships between the ICF-HNC and well-established outcome measures are illustrated. This enables the user to integrate different aspects of functional outcome into a consolidated approach towards preservation/rehabilitation of functioning after HNC - applicable for a variety of treatment-approaches and health-professions. George Thieme Verlag KG Stuttgart · New York.

  6. Validation of Catquest-9SF-A Visual Disability Instrument to Evaluate Patient Function After Corneal Transplantation.

    Science.gov (United States)

    Claesson, Margareta; Armitage, W John; Byström, Berit; Montan, Per; Samolov, Branka; Stenvi, Ulf; Lundström, Mats

    2017-09-01

    Catquest-9SF is a 9-item visual disability questionnaire developed for evaluating patient-reported outcome measures after cataract surgery. The aim of this study was to use Rasch analysis to determine the responsiveness of Catquest-9SF for corneal transplant patients. Patients who underwent corneal transplantation primarily to improve vision were included. One group (n = 199) completed the Catquest-9SF questionnaire before corneal transplantation and a second independent group (n = 199) completed the questionnaire 2 years after surgery. All patients were recorded in the Swedish Cornea Registry, which provided clinical and demographic data for the study. Winsteps software v.3.91.0 (Winsteps.com, Beaverton, OR) was used to assess the fit of the Catquest-9SF data to the Rasch model. Rasch analysis showed that Catquest-9SF applied to corneal transplant patients was unidimensional (infit range, 0.73-1.32; outfit range, 0.81-1.35), and therefore, measured a single underlying construct (visual disability). The Rasch model explained 68.5% of raw variance. The response categories of the 9-item questionnaire were ordered, and the category thresholds were well defined. Item difficulty matched the level of patients' ability (0.36 logit difference between the means). Precision in terms of person separation (3.09) and person reliability (0.91) was good. Differential item functioning was notable for only 1 item (satisfaction with vision), which had a differential item functioning contrast of 1.08 logit. Rasch analysis showed that Catquest-9SF is a valid instrument for measuring visual disability in patients who have undergone corneal transplantation primarily to improve vision.

  7. ARMD Strategic Thrust 6: Assured Autonomy for Aviation Transformation

    Science.gov (United States)

    Ballin, Mark; Holbrook, Jon; Sharma, Shivanjli

    2016-01-01

    In collaboration with the external community and other government agencies, NASA will develop enabling technologies, standards, and design guidelines to support cost-effective applications of automation and limited autonomy for individual components of aviation systems. NASA will also provide foundational knowledge and methods to support the next epoch. Research will address issues of verification and validation, operational evaluation, national policy, and societal cost-benefit. Two research and development approaches to aviation autonomy will advance in parallel. The Increasing Autonomy (IA) approach will seek to advance knowledge and technology through incremental increases in machine-based support of existing human-centered tasks, leading to long-term reallocation of functions between humans and machines. The Autonomy as a New Technology (ANT) approach seeks advances by developing technology to achieve goals that are not currently possible using human-centered concepts of operation. IA applications are mission-enhancing, and their selection will be based on benefits achievable relative to existing operations. ANT applications are mission-enabling, and their value will be assessed based on societal benefit resulting from a new capability. The expected demand for small autonomous unmanned aircraft systems (UAS) provides an opportunity for development of ANT applications. Supervisory autonomy may be implemented as an expansion of the number of functions or systems that may be controlled by an individual human operator. Convergent technology approaches, such as the use of electronic flight bags and existing network servers, will be leveraged to the maximum extent possible.

  8. Development of a self-report physical function instrument for disability assessment: item pool construction and factor analysis.

    Science.gov (United States)

    McDonough, Christine M; Jette, Alan M; Ni, Pengsheng; Bogusz, Kara; Marfeo, Elizabeth E; Brandt, Diane E; Chan, Leighton; Meterko, Mark; Haley, Stephen M; Rasch, Elizabeth K

    2013-09-01

    To build a comprehensive item pool representing work-relevant physical functioning and to test the factor structure of the item pool. These developmental steps represent initial outcomes of a broader project to develop instruments for the assessment of function within the context of Social Security Administration (SSA) disability programs. Comprehensive literature review; gap analysis; item generation with expert panel input; stakeholder interviews; cognitive interviews; cross-sectional survey administration; and exploratory and confirmatory factor analyses to assess item pool structure. In-person and semistructured interviews and Internet and telephone surveys. Sample of SSA claimants (n=1017) and a normative sample of adults from the U.S. general population (n=999). Not applicable. Model fit statistics. The final item pool consisted of 139 items. Within the claimant sample, 58.7% were white; 31.8% were black; 46.6% were women; and the mean age was 49.7 years. Initial factor analyses revealed a 4-factor solution, which included more items and allowed separate characterization of: (1) changing and maintaining body position, (2) whole body mobility, (3) upper body function, and (4) upper extremity fine motor. The final 4-factor model included 91 items. Confirmatory factor analyses for the 4-factor models for the claimant and the normative samples demonstrated very good fit. Fit statistics for claimant and normative samples, respectively, were: Comparative Fit Index=.93 and .98; Tucker-Lewis Index=.92 and .98; and root mean square error approximation=.05 and .04. The factor structure of the physical function item pool closely resembled the hypothesized content model. The 4 scales relevant to work activities offer promise for providing reliable information about claimant physical functioning relevant to work disability. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  9. Population profiles associated with severe functioning difficulties and disability among two to four years old children in Mexico

    Directory of Open Access Journals (Sweden)

    Rosalba Rojas-Martínez

    2017-07-01

    Full Text Available Objective. To describe the prevalence and factors associated with severe child functioning difficulties and disability (CFD among two to four year old children in Mexico, and estimates the probability of presenting CFD based on specific population profiles. Materials and methods. The sample consists of 5 104 children who participated in the National Survey of Children and Women 2015 (ENIM. We used postestimation exploration by computing predicted values of CFD to interpret the logistic models for discrete combinations of the independent variables. Results. CFD prevalence is 2%,which means at least 130 000 two to four year-old children are at risk of experiencing severely limited participation in an unaccommodating environment. The probability of presenting CFD is dramatically higher in specific sub-groups of the population, in particular, male children of women with low education, who live in the poorest households. Conclusions. A significant proportion of Mexican children face important challenges due to functioning difficulties and disability. Public policies must be developed to accommodate the needs of these children and provide a proper environment for their development.

  10. The ADEPT Framework for Intelligent Autonomy

    National Research Council Canada - National Science Library

    Ricard, Michael; Kolitz, Stephan

    2003-01-01

    ...) architecture for intelligent autonomy. Intelligent autonomy is the ability to plan and execute complex activities in a manner that provides rapid, effective response to stochastic and dynamic mission events...

  11. Functional Independence and Quality of Life for Persons with Locomotor Disabilities in Institutional Based Rehabilitation and Community Based Rehabilitation - A Comparative Study

    Directory of Open Access Journals (Sweden)

    A Amarnath

    2012-12-01

    Full Text Available Purpose: To compare the functional independence and quality of life of persons with locomotor disabilities who undergo Institutional Based Rehabilitation (IBR and similar persons who undergo Community Based Rehabilitation (CBR. Methods: Purposive sampling was done. Thirty males with locomotor disabilities -15 from IBR and 15 from CBR- were selected. Both the groups were first administered the Functional Independence Measure (FIM questionnaire, followed by the Quality of Life (WHOQOL-BREF questionnaire.Results: There were no significant differencse between IBR and CBR with regard to functional independence  (t value = -1.810, P doi: 10.5463/dcid.v23i3.147

  12. Memory functioning in children with reading disabilities and/or attention deficit/hyperactivity disorder: a clinical investigation of their working memory and long-term memory functioning.

    Science.gov (United States)

    Kibby, Michelle Y; Cohen, Morris J

    2008-11-01

    We examined memory functioning in children with reading disabilities (RD), Attention deficit/hyperactivity disorder (ADHD), and RD/ADHD using a clinic sample with a clinical instrument: the Children's Memory Scale, enhancing its generalizability. Participants included 23 children with RD, 30 with ADHD, 30 with RD/ADHD, and 30 controls. Children with RD presented with reduced verbal short-term memory (STM) but intact visual STM, central executive (CE), and long-term memory (LTM) functioning. Their deficit in STM appeared specific to tasks requiring phonetic coding of material. Children with ADHD displayed intact CE and LTM functioning but reduced visual-spatial STM, especially when off stimulant medication. Children with RD/ADHD had deficits consistent with both disorders.

  13. Full autonomy; Autarkie im Komplettpaket

    Energy Technology Data Exchange (ETDEWEB)

    Augsten, Eva

    2011-05-31

    Normally, those who talk of full solar autonomy refer to the annual balance of a house. Now, architect Timo Leukefeld and Helma Eigenheimbau AG presented a really autonomous solar house which is available on a turnkey basis for 363,000 Euros.

  14. Privatization, convergence, and institutional autonomy

    NARCIS (Netherlands)

    Rooijen, van M.

    2011-01-01

    Some of the trends incoming for 2011 – greater institutional autonomy, public/private convergence, entrepreneurial management, civic engagement – suggest innovation for hard times, with socio-economic and political rationales increasingly driving borderless developments. Others – open learning and

  15. A tool for enhancing strategic health planning: a modeled use of the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Sinclair, Lisa Bundara; Fox, Michael H; Betts, Donald R

    2013-01-01

    This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan. Published 2012. This article is a US Government work and is in the public domain in the USA.

  16. Student Perceptions of Their Autonomy at University

    Science.gov (United States)

    Henri, D. C.; Morrell, L. J.; Scott, G. W.

    2018-01-01

    Learner autonomy is a primary learning outcome of Higher Education in many countries. However, empirical evaluation of how student autonomy progresses during undergraduate degrees is limited. We surveyed a total of 636 students' self-perceived autonomy during a period of two academic years using the Autonomous Learning Scale. Our analysis suggests…

  17. School Autonomy, Leadership and Learning: A Reconceptualisation

    Science.gov (United States)

    Cheng, Yin Cheong; Ko, James; Lee, Theodore Tai Hoi

    2016-01-01

    Purpose: The purpose of this paper is to develop a framework for reconceptualising research on school autonomy to redress the limitations of traditional research, strengthen the conceptual links between school autonomy and learning outcomes and offer a range of new strategies for studying the interplay of school autonomy, leadership and learning.…

  18. Respect for autonomy and technological risks

    NARCIS (Netherlands)

    Asveld, L.

    2008-01-01

    Technological developments can undermine the autonomy of the individual. Autonomy is one's ability to make and act upon decisions according to one's own moral framework. Respect for autonomy dictates that risks should not be imposed on the individual without her consent. Technological developments

  19. Rawls: The Problem of Autonomy and Coherentism

    Directory of Open Access Journals (Sweden)

    Elnora Gondim

    2010-12-01

    Full Text Available The transformation of the idea of autonomy into that of justice as equality modifies the work of Rawls taken as a whole. Thus, while in the Theory of Justice, a Kantian- type of autonomy is adopted, in Political Liberalism, autonomy is extended to the sphere of the political.

  20. The Connotations of Language Teacher Autonomy

    Science.gov (United States)

    Han, Ligang

    2017-01-01

    With the research on the development of learner autonomy in foreign language education, teacher autonomy has become a hot topic in the research of foreign language teacher education. However, it is the most difficult question to define language teacher autonomy and any answer to it is likely to be subjective. On the basis of expounding upon the…

  1. Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-conceptualization

    Science.gov (United States)

    Naik, Aanand D.; Dyer, Carmel B.; Kunik, Mark E.; McCullough, Laurence B.

    2010-01-01

    The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with chronic care. The purpose of this article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. PMID:19180389

  2. Executive Functions in Intellectual Disabilities: A Comparison between Williams Syndrome and Down Syndrome

    Science.gov (United States)

    Costanzo, Floriana; Varuzza, Cristiana; Menghini, Deny; Addona, Francesca; Gianesini, Tiziana; Vicari, Stefano

    2013-01-01

    Executive functions are a set of high cognitive abilities that control and regulate other functions and behaviors and are crucial for successful adaptation. Deficits in executive functions are frequently described in developmental disorders, which are characterized by disadaptive behavior. However, executive functions are not widely examined in…

  3. Same but different: Comparative modes of information processing are implicated in the construction of perceptions of autonomy support.

    Science.gov (United States)

    Lee, Rebecca Rachael; Chatzisarantis, Nikos L D

    2017-11-01

    An implicit assumption behind tenets of self-determination theory is that perceptions of autonomy support are a function of absolute modes of information processing. In this study, we examined whether comparative modes of information processing were implicated in the construction of perceptions of autonomy support. In an experimental study, we demonstrated that participants employed comparative modes of information processing in evaluating receipt of small, but not large, amounts of autonomy support. In addition, we found that social comparison processes influenced a number of outcomes that are empirically related to perceived autonomy support such as sense of autonomy, positive affect, perceived usefulness, and effort. Findings shed new light upon the processes underpinning construction of perceptions related to autonomy support and yield new insights into how to increase the predictive validity of models that use autonomy support as a determinant of motivation and psychological well-being. © 2017 The British Psychological Society.

  4. Mapping the rehabilitation interventions of a community stroke team to the extended International Classification of Functioning, Disability and Health Core Set for Stroke.

    Science.gov (United States)

    Evans, Melissa; Hocking, Clare; Kersten, Paula

    2017-12-01

    This study aim was to evaluate whether the Extended International Classification of Functioning, Disability and Health Core Set for Stroke captured the interventions of a community stroke rehabilitation team situated in a large city in New Zealand. It was proposed that the results would identify the contribution of each discipline, and the gaps and differences in service provision to Māori and non-Māori. Applying the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in this way would also inform whether this core set should be adopted in New Zealand. Interventions were retrospectively extracted from 18 medical records and linked to the International Classification of Functioning, Disability and Health and the Extended International Classification of Functioning, Disability and Health Core Set for Stroke. The frequencies of linked interventions and the health discipline providing the intervention were calculated. Analysis revealed that 98.8% of interventions provided by the rehabilitation team could be linked to the Extended International Classification of Functioning, Disability and Health Core Set for Stroke, with more interventions for body function and structure than for activities and participation; no interventions for emotional concerns; and limited interventions for community, social and civic life. Results support previous recommendations for additions to the EICSS. The results support the use of the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in New Zealand and demonstrates its use as a quality assurance tool that can evaluate the scope and practice of a rehabilitation service. Implications for Rehabilitation The Extended International Classification of Functioning Disability and Health Core Set for Stroke appears to represent the stroke interventions of a community stroke rehabilitation team in New Zealand. As a result, researchers and clinicians may have

  5. Learned helplessness predicts functional disability, pain and fatigue in patients with recent-onset inflammatory polyarthritis.

    Science.gov (United States)

    Camacho, Elizabeth M; Verstappen, Suzanne M M; Chipping, Jacqueline; Symmons, Deborah P M

    2013-07-01

    Cross-sectional studies have found that learned helplessness (LH) is associated with disease outcome in patients with RA. However, little is known about the longitudinal impact of LH. The aim of this study was to investigate whether LH is associated with future disease outcome (disability, pain and fatigue) and to investigate whether LH changes over time in patients with recent-onset inflammatory polyarthritis (IP), the broader group of conditions of which RA is the major constituent. Patients included in this investigation had been recruited to the Norfolk Arthritis Register, a primary-care-based inception cohort. LH was measured at baseline as patients' total score on the Rheumatology Attitudes Index (RAI). A total of 443 patients completed the HAQ and visual analogue scales of pain and fatigue at baseline and after 2 years of follow-up. Greater feelings of LH at baseline were associated with higher HAQ scores at follow-up [difference in HAQ score per 1-point increase in RAI score (β-coefficient) 0.02; 95% CI 0.01, 0.04]. Greater baseline LH was also associated with more pain (β-coefficient 1.0; 95% CI 0.4, 1.5) and more fatigue (β-coefficient 1.0; 95% CI 0.2, 1.4) at follow-up. LH was highly changeable during follow-up, with 87% of patients showing any change and 50% improving. Baseline LH independently predicted disability, pain and fatigue at follow-up. Half of patients reported fewer feelings of helplessness after 2 years of follow-up, suggesting that LH may potentially be a modifiable risk factor for disease outcome in IP and a target for intervention.

  6. Functional Disability and Social Conflict Increase Risk of Depression in Older Adulthood Among Bolivian Forager-Farmers.

    Science.gov (United States)

    Stieglitz, Jonathan; Schniter, Eric; von Rueden, Christopher; Kaplan, Hillard; Gurven, Michael

    2015-11-01

    To present an explanatory framework for depression in older adulthood in a small-scale society. We propose that depression is a consequence of functional disability, which can reduce subsistence productivity and resource transfers within and across generations. Social conflict can also disrupt resource flows and should be associated with depression. To evaluate depression among Tsimane forager-farmers of Bolivia, we developed a reliable interview based on focus groups and a review of validated depression scales. Older adults (mean ± SD age = 62 ± 9, n = 325) were recruited regardless of their health status. Demographic, economic, and medical data were collected during annual censuses and routine medical exams. Depression is associated with reduced energetic status, greater physical limitations, and reduced subsistence involvement after controlling for potential confounds such as age, sex, number of reported unresolved conflicts, and market involvement. Depression is also associated with greater reported conflict, particularly with non-kin. Tsimane depression is associated with disability, reduced subsistence productivity, and interpersonal conflict, all of which can disrupt resource flows. Depression appears to be a response to conditions regularly experienced over human history, and not simply a by-product of modernity. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. A cybernetic theory of morality and moral autonomy.

    Science.gov (United States)

    Chambers, J

    2001-04-01

    Human morality may be thought of as a negative feedback control system in which moral rules are reference values, and moral disapproval, blame, and punishment are forms of negative feedback given for violations of the moral rules. In such a system, if moral agents held each other accountable, moral norms would be enforced effectively. However, even a properly functioning social negative feedback system could not explain acts in which individual agents uphold moral rules in the face of contrary social pressure. Dr. Frances Kelsey, who withheld FDA approval for thalidomide against intense social pressure, is an example of the degree of individual moral autonomy possible in a hostile environment. Such extreme moral autonomy is possible only if there is internal, psychological negative feedback, in addition to external, social feedback. Such a cybernetic model of morality and moral autonomy is consistent with certain aspects of classical ethical theories.

  8. The Relationship between Stress and Social Functioning in Adults with Autism Spectrum Disorder and without Intellectual Disability

    Science.gov (United States)

    Bishop-Fitzpatrick, Lauren; Mazefsky, Carla A.; Minshew, Nancy J.; Eack, Shaun M.

    2014-01-01

    Scientific Abstract Adults with autism spectrum disorder (ASD) face substantial challenges accomplishing basic tasks associated with daily living, which are exacerbated by their broad and pervasive difficulties with social interactions. These challenges put people with ASD at increased risk for psychophysiological distress, which likely factors heavily into social functioning for adults with ASD, as suggested by a growing literature on stress in children that indicates that children with ASD have differential responses to stress than healthy children. We hypothesized that adults with ASD and without intellectual disability (n=38) would experience more stress than healthy volunteers (n=37) and that there would be an inverse relationship between stress and social functioning in individuals with ASD. Baseline, semi-structured interview data from a randomized-controlled trial of two treatments for adults with ASD were used to assess differences in stress between adults with ASD and healthy volunteers and to assess the relationship between stress response and social functioning in adults with ASD. Findings indicate that adults with ASD experience greater perceived and interviewer-observed stress than did healthy volunteers and that stress is significantly related to social functioning in adults with ASD. These findings highlight the role of stress in adult functioning and outcomes and suggest the need to develop and assess treatments designed to target stress and coping in adults with ASD. PMID:25524571

  9. Cognitive functions and their effect on disability in learning process and knowledge application in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    S. Ya. Yanovska

    2018-02-01

    Full Text Available Arterial hypertension (AH is one of the most important medical and social problems due to the high incidence, disability and mortality of the population in Ukraine. The aim of the investigation is to determine the influence of cognitive functions on disability in learning process and knowledge application in patients with hypertension. Materials and methods. 139 patients with essential AH of II and III st. (with the consequences of a stroke at the age of 30–59 were examined. The patients were divided into 2 groups: the first group – patients with AH, stage II (29 patients and the second group – patients with AH, stage III (110 patients. An average age of the patients with stage II was 43.1 ± 3.1, with stage III – 45.3 ± 5.6. Psychological examination and disability tests were carried out according to generally accepted methods. Statistical processing was performed in Microsoft Excel and Ascess, the results of the correlation analysis were described at a confidence level of P < 0.05. Results. Light cognitive impairments were detected in all patients with stage II, stage III AH patients had moderate impairments – 25.8 % of cases and light ones – 74.2 % of cases. Significant cognitive functions affects among patients with AH stage II and stage III were determined in memory (44.4 and 97.3 %, attention (77.8 and 90.6 %, intellect (44.4 and 75.6 % and mental process (44.4 and 64.9 % of cases. Patients with stage III AH after a stroke had significant problems with their eyesight and hearing, concentration of attention and process of thinking, solving simple and complex problems. Moreover, a number of the following factors have contributed to the above-mentioned condition: emotional instability, nonconformity, desire to present themselves in a "favorable light", anxiety, depressive and paranoid tendencies, sensitive, egocentric, anosognotic response to the disease, exacerbation of accentuation of an excitable nature and low work efficiency

  10. Professional autonomy and the normative structure of medical practice

    NARCIS (Netherlands)

    Hoogland, Jan; Jochemsen, Henk

    2000-01-01

    Professional autonomy is often described as a claim of professionals that has to serve primarily their own interests. However, it can also be seen as an element of a professional ideal that can function as a standard for professional, i.e. medical practice. This normative understanding of the

  11. EFFECT OF KINESIO TAPING AND SOFT ORTHOSIS APPLICATION ON THE PAIN AND FUNCTIONAL DISABILITY IN LUMBAR REGION PATHOLOGIES WITHOUT NEUROLOGICAL DEFICITS: A RANDOMIZED CONTROLLED EXPERIMENTAL STUDY

    Directory of Open Access Journals (Sweden)

    Burcu TALU

    2016-12-01

    Full Text Available Background: Back pain caused by lumbar region pathologies is a condition that leads to loss of productivity and physical disability, with high costs of diagnosis and treatment. This study was planned to investigate the effect of taping and soft orthosis application on the pain and functional disability in the pathology of lumbar region without neurological deficit. Methods: This study is randomized controlled trial. Sixty-three volunteer patients were randomly divided into three groups of 21 people. Group I, soft orthotics and stabilization exercise program; Group II, Kinesio taping and stabilization exercise program; Group III, stabilization exercise program was applied. After obtaining demographic data of the participants; patients were evaluated in terms of range of motion and muscle strength. We used visual analog scale for pain level assessment, sit and reach test for flexibility assessment, timed up and go test (TUG for functional ambulation and balance, modified Schober test for lumbar spine flexibility, Oswestry Disability Index in the assessment of functional disability. They were assessed at the pretreatment, third (post treatment and six week (home programs and follow-up. Results: The results showed that significant differences (p<0.05 occurred over time in the study parameters such as functional ambulation, flexibility, lumbar flexibility, functional disability, pain, strength, range of motion in all groups. In comparisons between groups, there was a difference mainly in favor of Group II (p<0.05. Conclusions: We have concluded that in lumbar region pathologies without neurological deficits, stabilization exercises combined with orthotics and Kinesio taping applications reduces pain and functional disability.

  12. Public Health Autonomy: A Critical Reappraisal.

    Science.gov (United States)

    Zimmerman, Frederick J

    2017-11-01

    The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.

  13. Associated factors with functional disability and health-related quality of life in Chinese patients with gout: a case-control study.

    Science.gov (United States)

    Fu, Ting; Cao, Haixia; Yin, Rulan; Zhang, Lijuan; Zhang, Qiuxiang; Li, Liren; Gu, Zhifeng

    2017-11-03

    Gout is a painful, inflammatory disease that may cause decreased function and health-related quality of life (HRQoL). Limited study did not take the influence of gout characteristics and anxiety on HRQoL into consideration and there are no studies associated with functional disability in individuals with gout from China. This study aims to investigate the related factors of functional disability and HRQoL in gout patients recruited from China. A total of 226 consecutive gout patients and 232 age- and gender-matched healthy individuals were involved in the study. A series of questionnaires (the Short Form 36 health survey, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale, and the Health Assessment Questionnaire-Disability Index) were applied. Blood samples were taken to examine the level of serum uric acid. Independent samples t-tests, Chi square tests, U test, Spearman rank correlation, logistic regression modeling, and linear regression were used to analyze the data. After adjusted demographic variables, individuals with gout have poorer HRQoL compared to healthy controls. Univariate tests presented that patients with functional disability had longer disease duration, more frequent flares/last year, more severe total pain, more number of tophi, higher degree of depression and anxiety, with a trend toward diabetes, the treatment of colchicine and corticosteroids use, compared to patients without functional disability. Meanwhile, place of residence, hypertension, DM, disease duration, cardiovascular disease, number of flares/last year, total pain, more number of tophi, presence of tender joints, depression, anxiety, currently using colchicine and corticosteroids were correlated significantly with HRQoL. Additionally, multiple regression analysis identified severe pain, depression, and colchicine use as predictors of functional disability. Cardiovascular disease, total pain, number of flares/last year

  14. The effectiveness of psychosocial interventions for children with a psychiatric disorder and mild intellectual disability to borderline intellectual functioning: A systematic literature review and meta-analysis.

    Science.gov (United States)

    Kok, Lidwien; van der Waa, Anne; Klip, Helen; Staal, Wouter

    2016-01-01

    Children with intellectual disability frequently have difficulties in adapting to their environment. The extent of the experienced problems does not only depend on cognitive functioning but is influenced by other factors, such as the presence of a psychiatric disorder or other brain disorders, or adverse environmental factors. Several epidemiological studies show that children with intellectual disabilities are at an increased risk to develop psychiatric disorders. This is also true for youth with a mild intellectual disability and even those with borderline intellectual functioning (mild to borderline intellectual disability (MBID)). Psychiatric disorders are often overlooked because behavioral problems are rather attributed to the intellectual disability. Consequently, effective psychiatric interventions, which are needed to improve the level of functioning, are not applied. This review aimed to systematically evaluate the currently available, qualitatively sound research concerning the effectiveness of psychosocial interventions, specifically directed at psychiatric disorders in children with MBID. Assessed for eligibility were 1409 unique reports, and the review ultimately included only 12 reports. Review of the results and meta-analyses showed that the majority of studies suffer from multiple limitations and that methodological variations between studies are extensive. This possibly reflects the high variance of factors that may be involved in MBID. It will be important in future research to address multi-causality. © The Author(s) 2015.

  15. The Discriminant Analysis: an Exploratory Study Concerning the Degree of Financial Autonomy of Companies in the Context of the Romanian Business Environment

    OpenAIRE

    Marinela Mironiuc; Mihaela Robu; Ion Robu

    2010-01-01

    This study aims at analyzing the evolution of financial autonomy on a sample of 80 companies quoted in the Bucharest Stock Exchange, between 2006-2008. Classically, financial autonomy is measured using the global and day-to-day rates of financial autonomy. However, this study has tested the dependency between the global rate of financial autonomy (Own Capital/ Total debts) and a series of economic and financial indicators, with the purpose of obtaining both a score function that would help ma...

  16. Applying the International Classification of Functioning, Disability and Health to guide home health care services planning and delivery in Thailand.

    Science.gov (United States)

    Pimdee, Atipong; Nualnetr, Nomjit

    2017-01-01

    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.

  17. An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities.

    Science.gov (United States)

    Kurtz, Patricia F; Boelter, Eric W; Jarmolowicz, David P; Chin, Michelle D; Hagopian, Louis P

    2011-01-01

    This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force, 1995) and adapted by Jennett and Hagopian (2008) for evaluation of single-case research studies were used to examine the support for FCT. Results indicated that FCT far exceeds criteria to be designated as a well-established treatment for problem behavior exhibited by children with ID and children with autism spectrum disorder, and can be characterized as probably efficacious with adults. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. The Bobath Concept in Walking Activity in Chronic Stroke Measured Through the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Benito García, Miguel; Atín Arratibel, María Ángeles; Terradillos Azpiroz, Maria Estíbaliz

    2015-12-01

    The aim of this study is to evaluate the effectiveness of a rehabilitation programme based on the Bobath concept in order to improve walking activity in patients with chronic stroke and to show the usefulness of the International Classification of Functioning, Disability and Health (ICF) as a tool for gathering functioning information. This study is a repeated measures study. The setting of this study is an outpatient neurological rehabilitation centre based on a multidisciplinary approach. Twenty-four participants suffering from chronic stroke (>1 year and a half and Bobath concept principles with three weekly individual physiotherapy sessions of 45 min each over a 6-month period was the intervention for this study. The measures used were Modified Emory Functional Ambulation Profile, 10-m walk test, 6-min walk test, muscle strength testing and subsequent codification of these results into ICF qualifiers. The results of the study showed significant improvement in activities of walking long distances, on different surfaces and around obstacles. There was no significant improvement in the activity of walking short distances or for muscle power functions. A rehabilitation programme based on the Bobath Concept improved walking activities in people with chronic stroke. For this intervention, the use of the ICF qualifiers was sensitive in perceiving post-treatment changes. Copyright © 2014 John Wiley & Sons, Ltd.

  19. Defining Disability: Understandings of and Attitudes Towards Ableism and Disability

    Directory of Open Access Journals (Sweden)

    Carli Friedman

    2017-03-01

    Full Text Available Disabled people, amidst political and social gains, continue to experience discrimination in multiple areas. Understanding how such discrimination, named here as ableism, operates is important and may require studying perspectives of people who do not claim a disability identity.  Ableism may be expressed in a number of ways, and examining how a particular group, in this case siblings of disabled people, understand and value disability may contribute to overall understandings about how ableism works. Thus, the purpose of this study is to explore relationships between siblings of disabled people's broad societal understandings of disability and their attitudes towards it. In order to tease out this relationship further we have also examined factors that impact how people define disability. Using both social psychological and sociological approaches, we have contextualized individual attitudes as providing additional new information about social meanings of disability, and set this study's results against the larger backdrops of debates over meanings of disability within Disability Studies. In our research, participants revealed complex understandings of disability, but most often defined disability as preventing or slowing action, as an atypical function, a lack of independence, and as a socially constructed obstacle. Participants' unconscious (implicit disability attitudes significantly related to their understandings of disability as lacking independence, impairment, and/or in relation to the norm, and their conscious (explicit disability attitudes. Moreover, longer employment in a disability-related industry was correlated with defining disability as a general difference, rather than as slowing or limiting of tasks.

  20. Enhancing autonomy in paid surrogacy.

    Science.gov (United States)

    Damelio, Jennifer; Sorensen, Kelly

    2008-06-01

    The gestational surrogate--and her economic and educational vulnerability in particular--is the focus of many of the most persistent worries about paid surrogacy. Those who employ her, and those who broker and organize her services, usually have an advantage over her in resources and information. That asymmetry exposes her to the possibility of exploitation and abuse. Accordingly, some argue for banning paid surrogacy. Others defend legal permission on grounds of surrogate autonomy, but often retain concerns about the surrogate. In response to the dilemma of a ban versus bald permission, we propose a 'soft law' approach: states should require several hours of education of surrogates--education aimed at informing and enhancing surrogate autonomy.

  1. Epistemic merit, autonomy, and testimony

    Directory of Open Access Journals (Sweden)

    Jesús VEGA ENCABO

    2008-01-01

    Full Text Available In this paper, it is argued that both the informer and the hearer in a testimonial situation deserve epistemic merit insofar as they contribute to the collaborative achievement of sharing knowledge. The paper introduces a distinction between the ideals of self-sufficiency and epistemic autonomy. The autonomous exercise of our epistemic agency is very often carried out under strong conditions of epistemic dependence. Testimony exhibits a kind of social dependence that does not threaten the autonomy of the subjects that need to consider their own epistemic capacities. When involved in a testimonial situation, both speaker and hearer declare, at least implicitly, the standings they occupy in an epistemic space and are obliged to recognise certain epistemic requirements.

  2. Autonomy and the akratic patient.

    Science.gov (United States)

    McKnight, C J

    1993-01-01

    I argue that the distinction which is current in much writing on medical ethics between autonomous and non-autonomous patients cannot cope comfortably with weak-willed (incontinent) patients. I describe a case involving a patient who refuses a blood transfusion even though he or she agrees that it would be in his or her best interests. The case is discussed in the light of the treatment of autonomy by B Brody and R Gillon. These writers appear to force us to treat an incontinent patient either as autonomous, just like a rational agent whose decisions are in accordance with his beliefs or as non-autonomous, like comatose patients or children. Though neither is entirely satisfactory I opt for describing such patients as autonomous but point out that in cases like this the principle of respect for autonomy does not give a determinate answer about how the patient ought to be treated. PMID:8308874

  3. Effect of aerobic dance on pain, functional disability and quality of life on patients with chronic low back pain

    Directory of Open Access Journals (Sweden)

    U.A.C. Okafor

    2012-12-01

    Full Text Available Low back pain (LBP is often an indication of pathologicalcondition of the intervertebral discs, vertebral bodies or supporting soft tissuesof the lower vertebral region. Chronic Low Back Pain (CLBP presents withenormous consequence on the general performance of the sufferer, exerting ahuge cost on the individual, the family and the society. Dance therapy is arelatively new approach in the management of low back pain. This study wastherefore designed to investigate the effect of dance therapy on pain, functionaldisability and quality of life in patients with chronic low back pain.Thirty subjects diagnosed with non-specific CLBP particpated in the study.They were randomly divided into 2 groups, A and B, each comprising 15 subjects.In addition to conventional physiotherapy programme given to both groups,subjects in Group A also received aerobic dance, which comprised a four stage protocol. The entire treatment routinewas administered in a group session three times weekly consecutively for six weeks. Data as obtained in the copies ofcompleted questionnaires (Roland Morris Diability questionnaires and Nottingham Health Profile questionnaires andother measurements were summarized using mean, standard deviation and frequency tables. Student T-test was used toanalyze the data at 95 % confidence interval.There was a statistically significant difference (p<0.05 between the pre- and post- intervention scores for painintensity, functional disability and quality of life within the groups. There was also a statistically significant difference(p<0.05 in the mean change (pre/post intervention scores between Group A and Group B for pain intensity,functional disability and quality of life. Also the opinions and testimonies given by participants formed part of theevidence-based data.Whereas both conventional physiotherapy and aerobic dance showed significant effects in the pre/post-interventionscores, the aerobic dance group reported more significant effect in all

  4. The many faces of autonomy.

    Science.gov (United States)

    Gracia, Diego

    2012-02-01

    What does autonomy mean from a moral point of view? Throughout Western history, autonomy has had no less than four different meanings. The first is political: the capacity of old cities and modern states to give themselves their own laws. The second is metaphysical, and was introduced by Kant in the second half of the 18th century. In this meaning, autonomy is understood as an intrinsic characteristic of all rational beings. Opposed to this is the legal meaning, in which actions are called autonomous when performed with due information and competency and without coercion. This last meaning, the most frequently used in bioethics, is primarily legal instead of moral. Is there a proper moral meaning of the word autonomy? If so, this would be a fourth meaning. Acts can only be called moral when they are postconventional (using the terminology coined by Lawrence Kohlberg), inner-directed (as expressed by David Riesman), and responsible (according to Hannah Arendt). Such acts are autonomous in this new, fourth, and to my mind, the only one proper, moral meaning. The goal of ethics cannot be other than forming human beings capable of making autonomous and responsible decisions, and doing so because they think this is their duty and not because of any other nonmoral motivation, like comfort, convenience, or satisfaction. The goal of ethics is to promote postconventional and mature human beings. This was what Socrates tried to do with the young people of Athens. And it is also the objective of every course of ethics and of any process of training.

  5. Aerobot Autonomy Architecture

    Science.gov (United States)

    Elfes, Alberto; Hall, Jeffery L.; Kulczycki, Eric A.; Cameron, Jonathan M.; Morfopoulos, Arin C.; Clouse, Daniel S.; Montgomery, James F.; Ansar, Adnan I.; Machuzak, Richard J.

    2009-01-01

    An architecture for autonomous operation of an aerobot (i.e., a robotic blimp) to be used in scientific exploration of planets and moons in the Solar system with an atmosphere (such as Titan and Venus) is undergoing development. This architecture is also applicable to autonomous airships that could be flown in the terrestrial atmosphere for scientific exploration, military reconnaissance and surveillance, and as radio-communication relay stations in disaster areas. The architecture was conceived to satisfy requirements to perform the following functions: a) Vehicle safing, that is, ensuring the integrity of the aerobot during its entire mission, including during extended communication blackouts. b) Accurate and robust autonomous flight control during operation in diverse modes, including launch, deployment of scientific instruments, long traverses, hovering or station-keeping, and maneuvers for touch-and-go surface sampling. c) Mapping and self-localization in the absence of a global positioning system. d) Advanced recognition of hazards and targets in conjunction with tracking of, and visual servoing toward, targets, all to enable the aerobot to detect and avoid atmospheric and topographic hazards and to identify, home in on, and hover over predefined terrain features or other targets of scientific interest. The architecture is an integrated combination of systems for accurate and robust vehicle and flight trajectory control; estimation of the state of the aerobot; perception-based detection and avoidance of hazards; monitoring of the integrity and functionality ("health") of the aerobot; reflexive safing actions; multi-modal localization and mapping; autonomous planning and execution of scientific observations; and long-range planning and monitoring of the mission of the aerobot. The prototype JPL aerobot (see figure) has been tested extensively in various areas in the California Mojave desert.

  6. Relationship between working memory and intellectual functioning in children with mild intellectual disability

    Directory of Open Access Journals (Sweden)

    Buha Nataša

    2012-01-01

    Full Text Available The research was aimed to determine the relationship between working memory and intelligence in children with mild intellectual disability (MID, ages 10 to 14. The sample encompassed 53 children with MID, 47.2% of girls and 52.8% of boys. Their IQ ranges from 50 to 70 (AS=63.17; SD=6.56. The tasks that assess the Central Executive aspect of the working memory system, namely in verbal and non-verbal modality, have been selected. The obtained results indicate that working memory ('central executor' and intelligence are the constructs that significantly correlate in the range of 0.29 to 0.41, depending upon the working memory modality. It was determined that IQ category explains about 19% of the variability of the verbal and non-verbal working memory results, grouped in the unified model (p<0.05. However, the statistically significant relation was determined by means of the individual variables analysis only between IQ and non-verbal working memory (p<0.01. The statistically significant differences have also been determined in the non-verbal working memory development in the participants belonging to lower and higher IQ categories (p<0.05.

  7. A comparison of correlates of self-rated health and functional disability of older persons in the Far East: Japan and Korea.

    Science.gov (United States)

    Lee, Yunhwan; Shinkai, Shoji

    2003-01-01

    Self-rated health and physical functioning are recognized as important indicators of health in older persons. Rarely, however, there have been studies done which examine cross-cultural differences in the health of older people using these measures, especially among non-Western countries. The objective of this study was to examine patterns of association of self-rated health and functional disability of Japanese and Korean elderly people living in the community, using nationwide surveys of persons aged 60 years or over. There were striking similarities in the general pattern of associations with covariates. In the multivariate analysis, age, work status, comorbidity, depressive symptoms, life satisfaction, hospitalization, and functional disability were strongly associated with self-rated health in both populations. For functional disability, older age, female, low social contact, depressive symptoms, poor life satisfaction, and poor self-rated health were found to be significantly associated. Some differences in the structure of associations with self-rated health, however, were noted. Women tended to assess their health more favorably than men in Korea, but in the Japanese elderly gender differences disappeared when other variables were taken into account. Health-related variables tended to be more closely associated with functional disability in the Japanese sample. An overall similarity, however, in the pattern of associations of these measures supports their utility in assessing and comparing the health of older populations in this region.

  8. Functioning and disability in people living with spinal cord injury in high- and low-resourced countries: a comparative analysis of 14 countries.

    Science.gov (United States)

    Reinhardt, Jan D; Mansmann, Ulrich; Fellinghauer, Bernd A G; Strobl, Ralf; Grill, Eva; von Elm, Erik; Stucki, Gerold

    2011-06-01

    We examined whether persons with spinal cord injury (SCI) from countries with differential resources and resource distribution differ in the level and structure of functioning and disability. We analysed cross-sectional data of 1,048 persons with SCI from 14 countries based on the International Classification of Functioning, Disability and Health (ICF). We used penalized logistic regression to identify ICF categories distinguishing lower- and higher-resourced countries. Hierarchical linear models were employed to predict the number of problems in functioning. The association structure of ICF categories was compared between higher- and lower-resourced countries using graphical models. A total of 96 ICF categories separated lower- and higher-resourced countries. Differences were not univocal. Lower resources and unequal distribution were predictive of more functional problems in persons with higher age or tetraplegia. In the graphical models, few associations between ICF categories persisted across countries. Higher-resourced countries do not score higher in all ICF categories. Countries' economic resources and their distribution are significant predictors of disability in vulnerable groups such as tetraplegics and the elderly. Functioning is multi-dimensional and structures of association suggest that country-specific pathways towards disability exist.

  9. The Social Functions of Antisocial Behavior: Considerations for School Violence Prevention Strategies for Students with Disabilities

    Science.gov (United States)

    Farmer, Thomas W.; Lane, Kathleen L.; Lee, David L.; Hamm, Jill V.; Lambert, Kerrylin

    2012-01-01

    Research on school social dynamics suggests that antisocial behavior is often supported by peer group processes particularly during late childhood and adolescence. Building from a social interactional framework, this article explores how information on the social functions of aggressive and disruptive behavior may help to guide function-based…

  10. The Assessment of Executive Functioning in People with Intellectual Disabilities: An Exploratory Analysis

    Science.gov (United States)

    Bevins, Shelley; Hurse, Emily

    2016-01-01

    The following article details a piece of service development work undertaken as part of the Plymouth Down Syndrome Screening Programme. The work aimed to review the use of three measures assessing executive functioning skills used within the Programme as well as with people without Down syndrome. Three tasks assessing executive functioning (the…

  11. A Functional Assessment of Handmouthing among Persons with Severe and Profound Intellectual Disability

    Science.gov (United States)

    Swender, Stephen L.; Matson, Johnny L.; Mayville, Stephen B.; Gonzalez, Melissa L.; McDowell, Donald

    2006-01-01

    Background: The behavioural function of handmouthing has been assessed across various studies utilising analogue functional analyses. The aim of the current study was to expand upon research on this relatively understudied behaviour by examining the relationship between handmouthing and "Gastro-Esophageal Reflux Disorder" (GERD), and the potential…

  12. Integrated Disability Management

    Directory of Open Access Journals (Sweden)

    Silvia Angeloni

    2013-10-01

    Full Text Available This article sets out to increase awareness regarding the wide and universal significance of disability, as well as the important benefits of an Integrated Disability Management (IDM approach. The scientific basis for IDM is explored in the first place through an analysis of its relationship to the International Classification of Functioning, Disability and Health (ICF. The conceptual paradigm of the ICF shares an ideological position with the IDM approach in that they are both underpinned by dynamic and multidimensional constructions of disability, which imply equally holistic and interdisciplinary responses. The IDM approach can be applied across a diversity of human situations to provide solutions that reflect the multifaceted and widespread nature of disability. The IDM approach is intended as a strategy capable of handling: inclusion of people with disabilities, active aging of human resources, health and safety in the workplace, prevention of disabilities and various diseases, return-to-work, absenteeism, and presenteeism.

  13. Identification of health problems in patients with acute inflammatory arthritis, using the International Classification of Functioning, Disability and Health (ICF).

    Science.gov (United States)

    Zochling, J; Grill, E; Scheuringer, M; Liman, W; Stucki, G; Braun, J

    2006-01-01

    To identify the most common health problems experienced by patients with acute inflammatory arthritis using the International Classification of Functioning, Disability and Health (ICF), and to provide empirical data for the development of an ICF Core Set for acute inflammatory arthritis. Cross-sectional survey of patients with acute inflammatory arthritis of two or more joints requiring admission to an acute hospital. The second level categories of the ICF were used to collect information on patients' health problems. Relative frequencies of impairments, limitations and restrictions in the study population were reported for the ICF components Body Functions, Body Structures, and Activities and Participations. For the component Environmental Factors absolute and relative frequencies of perceived barriers or facilitators were reported. In total, 130 patients were included in the survey. The mean age of the population was 59.9 years (median age 63.0 years), 75% of the patients were female. Most had rheumatoid arthritis (57%) or early inflammatory polyarthritis (22%). Fifty-four second-level ICF categories had a prevalence of 30% or more: 3 (8%) belonged to the component Body Structures and 10 (13%) to the component Body Functions. Most categories were identified in the components Activities and Participation (19; 23%) and Environmental Factors (22; 56%). Patients with acute inflammatory arthritis can be well described by ICF categories and components. This study is the first step towards the development of an ICF Core Set for patients with acute inflammatory arthritis.

  14. The moderating role of autonomy and control on the benefits of written emotion expression.

    Science.gov (United States)

    Weinstein, Netta; Hodgins, Holley S

    2009-03-01

    Two studies examined the hypothesis that relative to control motivation, autonomy motivation is associated with effective written expression and regulation, leading to positive emotional, physical, and cognitive outcomes over time. Participants viewed a Hiroshima-Nagasaki documentary in each of two sessions. Study 1 showed that dispositionally autonomous participants, particularly those who expressed, had positive well-being, energy, and memory after the second viewing. Study 2 explored benefits of situational motivation by priming autonomy and control. Results showed that dispositionally controlled individuals received the same benefits as autonomous individuals only when primed with autonomy and encouraged to express. Coding of writing content revealed that the benefits of autonomy were mediated by nondefensive and effective emotional processing, as reflected in greater use of self-referencing and cognitive mechanism words and lower use of concrete words. Results support the expectation that autonomy relates to effective expression and emotion regulation, leading to positive functioning over time.

  15. The impact of choice on retributive reactions: how observers' autonomy concerns shape responses to criminal offenders.

    Science.gov (United States)

    van Prooijen, Jan-Willem; Kerpershoek, Emiel F P

    2013-06-01

    The present research examined the psychological origins of retributive reactions, which are defined as independent observers' anger-based emotions, demonized perceptions, and punishment intentions in response to criminal offenders. Based on the idea that society's justice system has an autonomy-protective function, we reason that chronic autonomy interacts with situational autonomy cues (i.e., opportunities to make choices) to predict retributive reactions to criminal offenders. More specifically, we hypothesized that choice opportunities in an unrelated decision-making context would prompt people to display stronger retributive reactions to offenders than no-choice opportunities, and that these effects of choice would be particularly pronounced among people who chronically experience deprivation of autonomy needs. Results from two experiments supported this hypothesis. It is concluded that retributive reactions to criminal offenders originate from a desire to regulate basic autonomy needs. © 2011 The British Psychological Society.

  16. Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury

    Science.gov (United States)

    Yaghmanian, Rana; Smedema, Susan Miller; Thompson, Kerry

    2017-01-01

    Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu's (2009) revised World Health Organization's International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were…

  17. Projection of young-old and old-old with functional disability: does accounting for the changing educational composition of the elderly population make a difference?

    Directory of Open Access Journals (Sweden)

    John P Ansah

    Full Text Available This study compares projections, up to year 2040, of young-old (aged 60-79 and old-old (aged 80+ with functional disability in Singapore with and without accounting for the changing educational composition of the Singaporean elderly. Two multi-state population models, with and without accounting for educational composition respectively, were developed, parameterized with age-gender-(education-specific transition probabilities (between active, functional disability and death states estimated from two waves (2009 and 2011 of a nationally representative survey of community-dwelling Singaporeans aged ≥ 60 years (N=4,990. Probabilistic sensitivity analysis with the bootstrap method was used to obtain the 95% confidence interval of the transition probabilities. Not accounting for educational composition overestimated the young-old with functional disability by 65 percent and underestimated the old-old by 20 percent in 2040. Accounting for educational composition, the proportion of old-old with functional disability increased from 40.8 percent in 2000 to 64.4 percent by 2040; not accounting for educational composition, the proportion in 2040 was 49.4 percent. Since the health profiles, and hence care needs, of the old-old differ from those of the young-old, health care service utilization and expenditure and the demand for formal and informal caregiving will be affected, impacting health and long-term care policy.

  18. Relationships between World Health Organization "International Classification of Functioning, Disability and Health" Constructs and Participation in Adults with Severe Mental Illness

    Science.gov (United States)

    Sánchez, Jennifer; Rosenthal, David A.; Chan, Fong; Brooks, Jessica; Bezyak, Jill L.

    2016-01-01

    Purpose: To examine the World Health Organization "International Classification of Functioning, Disability and Health" (ICF) constructs as correlates of community participation of people with severe mental illnesses (SMI). Methods: Quantitative descriptive research design using multiple regression and correlational techniques was used to…

  19. Visual disability, visual function, and myopia among rural chinese secondary school children: the Xichang Pediatric Refractive Error Study (X-PRES)--report 1.

    Science.gov (United States)

    Congdon, Nathan; Wang, Yunfei; Song, Yue; Choi, Kai; Zhang, Mingzhi; Zhou, Zhongxia; Xie, Zhenling; Li, Liping; Liu, Xueyu; Sharma, Abhishek; Wu, Bin; Lam, Dennis S C

    2008-07-01

    To evaluate visual acuity, visual function, and prevalence of refractive error among Chinese secondary-school children in a cross-sectional school-based study. Uncorrected, presenting, and best corrected visual acuity, cycloplegic autorefraction with refinement, and self-reported visual function were assessed in a random, cluster sample of rural secondary school students in Xichang, China. Among the 1892 subjects (97.3% of the consenting children, 84.7% of the total sample), mean age was 14.7 +/- 0.8 years, 51.2% were female, and 26.4% were wearing glasses. The proportion of children with uncorrected, presenting, and corrected visual disability (visual disability when tested without correction, 98.7% was due to refractive error, while only 53.8% (414/770) of these children had appropriate correction. The girls had significantly (P visual disability and myopia visual function (ANOVA trend test, P Visual disability in this population was common, highly correctable, and frequently uncorrected. The impact of refractive error on self-reported visual function was significant. Strategies and studies to understand and remove barriers to spectacle wear are needed.

  20. 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?

    Science.gov (United States)

    Norderyd, Johanna; Faulks, Denise; Molina, Gustavo; Granlund, Mats; Klingberg, Gunilla

    2018-01-01

    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.

  1. Family Functioning Predictors of Self-Concept and Self-Esteem in Children at Risk for Learning Disabilities in Oman: Exclusion of Parent and Gender Contribution

    Science.gov (United States)

    Emam, Mahmoud Mohamed; Abu-Serei, Usama Saad

    2014-01-01

    The study investigated whether family functioning can predict the self-concept and self-esteem of normally achieving (NA) and at risk for learning disabilities (LD) students in Oman regardless of parent education level and gender status. A total of 259 elementary school students were selected from schools in the main districts of Muscat, the…

  2. Wounds, Functional Disability, and Indwelling Devices Are Associated With Cocolonization by Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci in Southeast Michigan

    OpenAIRE

    Flannery, Erika L.; Wang, Linda; Zöllner, Sebastian; Foxman, Betsy; Mobley, Harry L. T.; Mody, Lona

    2011-01-01

    Cocolonization with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) is a precursor to vancomycin-resistant S. aureus emergence. MRSA/VRE cocolonization incidence is higher among skilled nursing facility residents with functional disability and indwelling devices and occurs more frequently in wounds than other anatomical sites.

  3. AUTONOMY AND RELATEDNESS IN MOTHER-TEEN INTERACTIONS AS PREDICTORS OF INVOLVEMENT IN ADOLESCENT DATING AGGRESSION

    Science.gov (United States)

    Niolon, Phyllis Holditch; Kuperminc, Gabriel P.; Allen, Joseph P.

    2015-01-01

    Objective This multi-method, longitudinal study examines the negotiation of autonomy and relatedness between teens and their mothers as etiologic predictors of perpetration and victimization of dating aggression two years later. Method Observations of 88 mid-adolescents and their mothers discussing a topic of disagreement were coded for each individual’s demonstrations of autonomy and relatedness using a validated coding system. Adolescents self-reported on perpetration and victimization of physical and psychological dating aggression two years later. We hypothesized that mother’s and adolescents’ behaviors supporting autonomy and relatedness would longitudinally predict lower reporting of dating aggression, and that their behaviors inhibiting autonomy and relatedness would predict higher reporting of dating aggression. Results Hypotheses were not supported; main findings were characterized by interactions of sex and risk status with autonomy. Maternal behaviors supporting autonomy predicted higher reports of perpetration and victimization of physical dating aggression for girls, but not for boys. Adolescent behaviors supporting autonomy predicted higher reports of perpetration of physical dating aggression for high-risk adolescents, but not for low-risk adolescents. Conclusions Results indicate that autonomy is a dynamic developmental process, operating differently as a function of social contexts in predicting dating aggression. Examination of these and other developmental processes within parent-child relationships is important in predicting dating aggression, but may depend on social context. PMID:25914852

  4. AUTONOMY AND RELATEDNESS IN MOTHER-TEEN INTERACTIONS AS PREDICTORS OF INVOLVEMENT IN ADOLESCENT DATING AGGRESSION.

    Science.gov (United States)

    Niolon, Phyllis Holditch; Kuperminc, Gabriel P; Allen, Joseph P

    2015-04-01

    This multi-method, longitudinal study examines the negotiation of autonomy and relatedness between teens and their mothers as etiologic predictors of perpetration and victimization of dating aggression two years later. Observations of 88 mid-adolescents and their mothers discussing a topic of disagreement were coded for each individual's demonstrations of autonomy and relatedness using a validated coding system. Adolescents self-reported on perpetration and victimization of physical and psychological dating aggression two years later. We hypothesized that mother's and adolescents' behaviors supporting autonomy and relatedness would longitudinally predict lower reporting of dating aggression, and that their behaviors inhibiting autonomy and relatedness would predict higher reporting of dating aggression. Hypotheses were not supported; main findings were characterized by interactions of sex and risk status with autonomy. Maternal behaviors supporting autonomy predicted higher reports of perpetration and victimization of physical dating aggression for girls, but not for boys. Adolescent behaviors supporting autonomy predicted higher reports of perpetration of physical dating aggression for high-risk adolescents, but not for low-risk adolescents. Results indicate that autonomy is a dynamic developmental process, operating differently as a function of social contexts in predicting dating aggression. Examination of these and other developmental processes within parent-child relationships is important in predicting dating aggression, but may depend on social context.

  5. Relevant areas of functioning in patients with adolescent idiopathic scoliosis on the International Classification of Functioning, Disability and Health: The patients' perspective.

    Science.gov (United States)

    Du, Chunping; Yu, Jiadan; Zhang, Jiaqi; Jiang, Jiaojiao; Lai, Huabin; Liu, Wei; Liu, Yang; Li, Hao; Wang, Pu

    2016-10-12

    To investigate relevant aspects of functioning and disability, and environmental factors in people with adolescent idiopathic scoliosis according to patients' self-reports based on the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). Multicentre, empirical, cross-sectional study. Four departments of orthopaedics in 4 hospitals, and 5 departments of rehabilitation medicine in 5 hospitals. Semi-structured interviews were conducted with 975 patients with adolescent idiopathic scoliosis from 5 hospitals according to the patients' self-reporting. In addition, patients were divided into 3 groups according to clinical outcome. Participant information included demographic and disease-related characteristics. Three adolescent idiopathic scoliosis groups were then compared with respect to the problems identified. Interviews were transcribed verbatim. Categories identified by qualitative analysis were subsequently mapped to the ICF-CY using established linking rules. In order to enrich these findings, we also translated the Scoliosis Research Society 22 Patient Questionnaire (SRS-22 PQ) into the language of the ICF-CY, based on ICF linking rules. A total of 1278 themes that linked to 54 ICF-CY cate-gories from 18 chapters were identified. Twenty-two (41%) categories were identified as Body Functions, 7 (13%) as Body Structures, 15 (27%) as Activities and Participation, and 10 (19%) as Environmental Factors. Of the 54 categories, 45 (83%) were second-level, 5 (9%) were third-level, and 4 (7%) were fourth-level. Differences between the SRS-22 PQ results and our findings were observed for several ICF-CY categories. Patients with AIS reported activity limitations and participation restrictions combined with impaired body structures and functions. Environmental factors may act as a barrier to, or facilitator of, patient functioning in daily life. The ICF-CY provides a valuable framework for representing the complexity and

  6. Autonomy and Firefighting: Perceived Competence and Stress.

    Science.gov (United States)

    Chiang, Evelyn S; Baley, John; Ponder, Joy; Padilla, Miguel A

    2016-12-01

    In workplace settings, autonomy is implicated in employee motivation as well as supervisor autonomy support. As a profession of risk, firefighters may experience greater levels of stress. A self-determination paradigm was applied to the firefighter workplace. Of particular interest were perceived competence (to perform job duties) and the experience of stress. Firefighters' levels of autonomous and controlled regulation were surveyed, along with their perceptions of the autonomy support of their immediate supervisor. Autonomous regulation was positively related to perceived competence, whereas controlled regulation was negatively related. Higher levels of controlled regulation were also connected with greater stress. In contrast, greater perceived autonomy support was associated with decreased stress. Both perceived competence and stress are related to firefighter motivation and autonomy support. Recommendations are offered to increase autonomy support by chief officers.

  7. Autonomy and the Sources of Political Normativity

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    Contemporary political liberals argue for extending the scope of reasonable disagreement to include also the principle of autonomy that was central in classical liberal theory. I take outset in Charles Larmore, The Autonomy of Morality (2008), which argues that liberal theory can dispense...... with the commitment to autonomy that one finds in Locke, Kant, and Mill, because "the essential convictions of liberal thought lie at a more fundamental level," namely in the principle of respect for persons. The main question I address is whether we can see the commitment to respect for persons as separable from...... the commitment to autonomy. My focus is the Kantian conception of autonomy, and I argue for understanding this conception practically and politically, rather than metaphysically and theoretically. In this way we can separate the principle of respect for persons from the metaphysical idea of autonomy as self...

  8. Freedom of Expression, Deliberation, Autonomy and Respect

    OpenAIRE

    Rostbøll, Christian F.

    2011-01-01

    This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms w...

  9. A Reconfigurable Testbed Environment for Spacecraft Autonomy

    Science.gov (United States)

    Biesiadecki, Jeffrey; Jain, Abhinandan

    1996-01-01

    A key goal of NASA's New Millennium Program is the development of technology for increased spacecraft on-board autonomy. Achievement of this objective requires the development of a new class of ground-based automony testbeds that can enable the low-cost and rapid design, test, and integration of the spacecraft autonomy software. This paper describes the development of an Autonomy Testbed Environment (ATBE) for the NMP Deep Space I comet/asteroid rendezvous mission.

  10. Late-career unemployment and all-cause mortality, functional disability and depression among the older adults in Taiwan: A 12-year population-based cohort study.

    Science.gov (United States)

    Chu, Wei-Min; Liao, Wen-Chun; Li, Chi-Rong; Lee, Shu-Hsin; Tang, Yih-Jing; Ho, Hsin-En; Lee, Meng-Chih

    2016-01-01

    To evaluate whether late-career unemployment is associated with increased all-cause mortality, functional disability, and depression among older adults in Taiwan. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was conducted from 1996 to 2007. The complete data from 716 men and 327 women aged 50-64 years were retrieved. Participants were categorized as normally employed or unemployed depending on their employment status in 1996. The cumulative number of unemployment after age 50 was also calculated. Logistic regression analysis was used to examine the effect of the association between late-career unemployment and cumulative number of late-career unemployment on all-cause mortality, functional disability, and depression in 2007. The average age of the participants in 1996 was 56.3 years [interquartile range (IQR)=7.0]. A total of 871 participants were in the normally employed group, and 172 participants were in the unemployed group. After adjustment of gender, age, level of education, income, self-rated health and major comorbidities, late-career unemployment was associated with increased all-cause mortality [Odds ratio (OR)=2.79; 95% confidence interval (CI)=1.74-4.47] and functional disability [OR=2.33; 95% CI=1.54-3.55]. The cumulative number of late-career unemployment was also associated with increased all-cause mortality [OR=1.91; 95% CI=1.35-2.70] and functional disability [OR=2.35; 95% CI=1.55-3.55]. Late-career unemployment and cumulative number of late-career unemployment are associated with increased all-cause mortality and functional disability. Older adults should be encouraged to maintain normal employment during the later stage of their career before retirement. Employers should routinely examine the fitness for work of older employees to prevent future unemployment. Copyright © 2016. Published by Elsevier Ireland Ltd.

  11. From solidarity to autonomy: towards a redefinition of the parameters of the notion of autonomy.

    Science.gov (United States)

    Fainzang, Sylvie

    2016-12-01

    Starting from examples of concrete situations in France, I show that autonomy and solidarity can coexist only if the parameters of autonomy are redefined. I show on the one hand that in situations where autonomy is encouraged, solidarity nevertheless remains at the foundation of their practices. On the other hand, in situations largely infused with family solidarity, the individual autonomy may be put in danger. Yet, based on my ethnographic observations regarding clinical encounters and medical secrecy, I show that while solidarity may endanger individual autonomy, it does not necessarily endanger autonomy itself. The social practices observable in France reflect the reality of an autonomy that goes beyond the individual, a reality that involves a collective subject and includes solidarity. The opposition between these two values can then be resolved if the content of the notion of autonomy is understood to be dependent on its cultural context of application and on its social use.

  12. Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country

    Directory of Open Access Journals (Sweden)

    Hairi Noran N

    2010-08-01

    Full Text Available Abstract Background The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries. Methods A population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool. Data were also collected for self reported activities of daily living (ADL using the Barthel Index (ten items. To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking and five basic ADL's (eating, bathing, dressing, transferring and toileting. Results Ten, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9, 14.4% (95% CI 11.9-17.2 and 10.6% (95% CI 8.5-13.1, respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5 of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (≥ 75 years: prevalence ratio (PR 7.9; 95% CI 4.8-12.9, presence of diabetes (PR 1.8; 95% CI 1.4-2.3, stroke (PR 1.5; 95% CI 1.1-2.2, depressive symptomology (PR 1.3; 95% CI 1.1-1.8 and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6. Advancing age (≥ 75 years: PR 3.0; 95% CI 1.7-5.2 being female (PR 2.7; 95% CI 1.2-6.1, presence of arthritis (PR 1.6; 95% CI 1.2-2.1 and depressive symptomology (PR 2.0; 95% CI 1.5-2.7 were significantly associated with functional limitation. Conclusions The prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to

  13. Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country.

    Science.gov (United States)

    Hairi, Noran N; Bulgiba, Awang; Cumming, Robert G; Naganathan, Vasi; Mudla, Izzuna

    2010-08-18

    The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries. A population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool). Data were also collected for self reported activities of daily living (ADL) using the Barthel Index (ten items). To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking) and five basic ADL's (eating, bathing, dressing, transferring and toileting). Ten, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9), 14.4% (95% CI 11.9-17.2) and 10.6% (95% CI 8.5-13.1), respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5) of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (> or = 75 years: prevalence ratio (PR) 7.9; 95% CI 4.8-12.9), presence of diabetes (PR 1.8; 95% CI 1.4-2.3), stroke (PR 1.5; 95% CI 1.1-2.2), depressive symptomology (PR 1.3; 95% CI 1.1-1.8) and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6). Advancing age (> or = 75 years: PR 3.0; 95% CI 1.7-5.2) being female (PR 2.7; 95% CI 1.2-6.1), presence of arthritis (PR 1.6; 95% CI 1.2-2.1) and depressive symptomology (PR 2.0; 95% CI 1.5-2.7) were significantly associated with functional limitation. The prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to developing countries. Associations with socio

  14. Spina bifida: implications for cognitive functioning, disability and health in young adults

    NARCIS (Netherlands)

    Barf, H.A.

    2008-01-01

    Spina bifida is a developmental birth defect involving the neural tube. It can result in a variety of problems, amongst them incontinence, restrictions of mobility and restrictions of cognitive functioning, depending on the severity of the defect. Due to improvements in medical care, the life

  15. Adolescents, Graduated Autonomy, and Genetic Testing

    Directory of Open Access Journals (Sweden)

    Susan Fox

    2012-01-01

    Full Text Available Autonomy takes many shapes. The concept of “graduated autonomy” is conceived as comprising several unique features: (1 it is incremental, (2 it is proportional, and (3 it is related to the telos of the life stage during which it occurs. This paper focuses on graduated autonomy in the context of genetic testing during adolescence. Questions can be raised about other life stages as well, and some of these questions will be addressed by discussing a possible fourth characteristic of graduated autonomy, that is, its elasticity. Further scholarship and analysis is needed to refine the concept of graduated autonomy and examine its applications.

  16. Characteristics of Law-Autonomy Foreign Subsidiaries

    DEFF Research Database (Denmark)

    Gammelgaard, Jens; McDonald, Frank; Stephan, Andreas

    2012-01-01

    This paper examines several characteristics of foreign subsidiaries with low autonomy. Data derived from a survey of 381 MNC subsidiaries located in Denmark, Germany and the UK demonstrate that low-autonomy subsidiaries are highly embedded in their respective MNC networks and that they establish ...... relationship between lower autonomy and the production activities carried out by the subsidiary. In fact, low-autonomy subsidiaries appear to be specialized in that they focus on a few value-chain activities and they typically serve as marketing outlets....

  17. An intercultural nursing perspective on autonomy.

    Science.gov (United States)

    Hanssen, Ingrid

    2004-01-01

    This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients' possibly harmful choices is discussed, the focus is on 'forced' autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively participate neither in the treatment offered nor in making choices regarding that treatment. Nurses' demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person's autonomy is also respect for the person, one's respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second-order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why.

  18. Short term effects of kinesio taping on pain and functional disability in young females with menstrual low back pain: A randomised control trial study.

    Science.gov (United States)

    Forozeshfard, Mohammad; Bakhtiary, Amir Hoshang; Aminianfar, Atefeh; Sheikhian, Sajedeh; Akbarzadeh, Zeinab

    2016-11-21

    Menstrual low back pain (LBP) in young females can reduce daily activity and cause functional disability, while the progressive application of kinesio-taping (KT) on pain reduction and functional correction has been stated. This study has been designed to investigate the efficacy of the lumbar vertebral column KT in young female with menstrual LBP. Thirty-two young females with menstrual LBP participated in this crossover study and were assigned randomly in two separate groups. The first group received KT during their first menstrual cycle and No-KT in their next menstrual, while the other group had no KT during the first mentrual cycle and received KT during the next menstrual cycle. The primary outcome measurements included the visual analogue scale (VAS) of pain, Oswestry disability index and McGill pain questionnaire score which were planned to collect at the end of the third day of the menstrual cycle. Comparing pain and disability between two conditions, of menstrual cycle with KT and menstrual cycle without KT, revealed significant reduction in VAS (mean change = 1.7; 95%CI = 0.6 to 2.8; P= 0.005), McGill pain score (mean change = 20.1; 95%CI = 8.7 to 31.3; P= 0.001) and functional disability (mean change = 12.3; 95%CI = 7.2 to 17.5; Pkinesiotaping in young females with menstrual LBP.

  19. Professional Autonomy versus Corporate Control

    Directory of Open Access Journals (Sweden)

    Pål Nygaard

    2012-06-01

    Full Text Available Professionalism and bureaucracy tend to be understood as incompatible systems of work organization, represented by the ideals of collegiality and auton-omy versus control and supervision. I present a historical case study from early 20th century Norway examining the potential clash between efforts made toward professionalization and bureaucratization in industry. Based on my findings, I argue that there is neither an inherent conflict between professionalism and bureaucracy nor static national trajectories at the level of professional versus bureaucratic work organization.

  20. Autonomy and Acceptance of Long-Term Care

    Science.gov (United States)

    Hsu, Hui-Chuan; Ting, Yu-Shan; Jiang, Ting-Wen; Chien, Ming-Chih; Chien, Chih-Hsin

    2009-01-01

    This study explored the relationship between four types of autonomy (health autonomy, informational autonomy, living autonomy, and financial autonomy) and the acceptance of five types of long-term care (adult day care, respite care, assisted living, unit care, and group home) for the elderly in Taiwan. Data were collected from 167 middle-aged and…

  1. Motivating Proteges' Personal Learning in Teams: A Multilevel Investigation of Autonomy Support and Autonomy Orientation

    Science.gov (United States)

    Liu, Dong; Fu, Ping-ping

    2011-01-01

    This study examined the roles of 3 multilevel motivational predictors in proteges' personal learning in teams: an autonomy-supportive team climate, mentors' autonomy support, and proteges' autonomy orientation. The authors followed 305 proteges in 58 teams for 12 weeks and found that all 3 predictors were positively related to the proteges'…

  2. University Reform and Institutional Autonomy: A Framework for Analysing the Living Autonomy

    Science.gov (United States)

    Maassen, Peter; Gornitzka, Åse; Fumasoli, Tatiana

    2017-01-01

    In this article we discuss recent university reforms aimed at enhancing university autonomy, highlighting various tensions in the underlying reform ideologies. We examine how the traditional interpretation of university autonomy has been expanded in the reform rationales. An analytical framework for studying how autonomy is interpreted and used…

  3. A systematic literature review of the situation of the International Classification of Functioning, Disability, and Health and the International Classification of Functioning, Disability, and Health-Children and Youth version in education: a useful tool or a flight of fancy?

    Science.gov (United States)

    Moretti, Marta; Alves, Ines; Maxwell, Gregor

    2012-02-01

    This article presents the outcome of a systematic literature review exploring the applicability of the International Classification of Functioning, Disability, and Health (ICF) and its Children and Youth version (ICF-CY) at various levels and in processes within the education systems in different countries. A systematic database search using selected search terms has been used. The selection of studies was then refined further using four protocols: inclusion and exclusion protocols at abstract and full text and extraction levels along with a quality protocol. Studies exploring the direct relationship between education and the ICF/ICF-CY were sought.As expected, the results show a strong presence of studies from English-speaking countries, namely from Europe and North America. The articles were mainly published in noneducational journals. The most used ICF/ICF-CY components are activity and participation, participation, and environmental factors. From the analysis of the papers included, the results show that the ICF/ICF-CY is currently used as a research tool, theoretical framework, and tool for implementing educational processes. The ICF/ICF-CY can provide a useful language to the education field where there is currently a lot of disparity in theoretical, praxis, and research issues. Although the systematic literature review does not report a high incidence of the use of the ICF/ICF-CY in education, the results show that the ICF/ICF-CY model and classification have potential to be applied in education systems.

  4. Intelligent autonomy for unmanned naval systems

    Science.gov (United States)

    Steinberg, Marc

    2006-05-01

    This paper provides an overview of the development and demonstration of intelligent autonomy technologies for control of heterogeneous unmanned naval air and sea vehicles and describes some of the current limitations of such technologies. The focus is on modular technologies that support highly automated retasking and fully autonomous dynamic replanning for up to ten heterogeneous unmanned systems based on high-level mission objectives, priorities, constraints, and Rules-of-Engagement. A key aspect of the demonstrations is incorporating frequent naval operator evaluations in order to gain better understanding of the integrated man/machine system and its tactical utility. These evaluations help ensure that the automation can provide information to the user in a meaningful way and that the user has a sufficient level of control and situation awareness to task the system as needed to complete complex mission tasks. Another important aspect of the program is examination of the interactions of higher-level autonomy algorithms with other relevant components that would be needed within the decision-making and control loops. Examples of these are vision and other sensor processing algorithms, sensor fusion, obstacle avoidance, and other lower level vehicle autonomous navigation, guidance, and control functions. Initial experiments have been completed using medium and high-fidelity vehicle simulations in a virtual warfare environment and inexpensive surrogate vehicles in flight and in-water demonstrations. Simulation experiments included integration of multi-vehicle task allocation, dynamic replanning under constraints, lower level autonomous vehicle control, automatic assessment of the impact of contingencies on plans, management of situation awareness data, operator alert management, and a mixed-initiative operator interface. In-water demonstrations of a maritime situation awareness capability were completed in both a river and a harbor environment using unmanned surface

  5. Agency is Distinct from Autonomy

    Directory of Open Access Journals (Sweden)

    Fred Cummins

    2014-11-01

    Full Text Available Both autonomy and agency play central roles in the emerging enactive vocabulary. Although some treat these concepts as practically synonymous, others have sought to be more explicit about the conditions required for agency over and above autonomy. I attempt to be self-conscious about the role of the observer (or scientist in such discussions, and emphasise that the concept of agency, in particular, is deeply entwined with the nature of the observer and the framing of the observation. This is probably well known to enactivists, but runs the risk of being badly misunderstood if it is not made explicit. A heightened awareness of the role of the observer in the attribution of agency may allow us to make advances in questions in which progress is hindered by assuming a single split between subject and object. I argue that human experience is characterized by our embedding in webs of meaning arising from our participation in systems of many sorts, and that this richness demands a corresponding lightness of touch with respect to the identification of agentive subjects.

  6. Autopoiesis: Autology, Autotranscendence and Autonomy

    DEFF Research Database (Denmark)

    and 1990s – particularly in a French context. While his work has remained (to date) at distance from the rising number of suggestions, especi- ally regarding social and cultural theory, that have come out of these debates on self-organization, Castoriadis made a speci¿c and original contribution to them...... ‘reality-modeling’ (John Casti) – whether via cognitive frameworks or models of society and culture. Secondly, attempts to adapt debates within the humanities, e.g. in philosophy, social theory and cultural studies, have tended to end in anti-humanism, ranging from Deleuze and Guattari’s ‘abstract machine......’s philosophy. She argues that a focus on the self-organization of the living being implies not only a distinct move towards an ontology of radical physis in Castoriadis’s later work, but also, along with it, a revised version of his project of autonomy. Autonomy, like autology and the other theme of this issue...

  7. International classification of function, disability and health framework for fall risk stratification in community dwelling older adults

    Directory of Open Access Journals (Sweden)

    Majumi M. Noohu

    2017-05-01

    Full Text Available Falls is an important cause for mortality and morbidity in older adults. The fall risk assessment is an integral component of fall prevention in older adults. The international classification of function, disability and health (ICF can be an ideal comprehensive model for fall risk assessment. There is lack of information relating ICF and fall risk assessment in community dwelling older adults. In this study we tried to assess the fall risk using different domains of ICF using various clinical tools. A total of 255 subjects were recruited through convenient sampling method from geriatric clinic (OPD of All India Institute of Medical Sciences, New Delhi. The study was single session cross-section design. The body mass index (BMI, grip strength, depression score (Geriatric depression scale:short form; GDS-S and co morbidities were used to assess body function and structure domain, timed up and go (TUG, Berg balance scale (BBS and elderly fall screening test (EFST scores were used for activity domain, selfreported cause of fall, medications and uses of assistive device for environmental factors. Then the association of body function and structure, activity and environmental factors were determined with falls. There was an association of fall in analysis in subjects with no fall and one or more falls for, BMI, grip strength (kg, GDS-S score, no. of co morbidities, chronic pain, TUG, BBS, TUG (s, BBS, EFST, slip/trip, walking cane, hypoglycemic and antihypertensives medications (unadjusted and adjusted odds ratio.The diabetes, and hyper tension showed association for adjusted odds ratio only. In subjects with one fall and more than one fall, TUG, BBS, EFST, GDS-S score, NSAIDS and antidepressants use showed a significant association with fall (unadjusted and adjusted odds ratio. The ICF may be used in routine for fall risk assessment in community dwelling older adults.

  8. Families' perception of children / adolescents with language impairment through the International Classification of Functioning, Disability, and Health (ICF-CY).

    Science.gov (United States)

    Ostroschi, Daniele Theodoro; Zanolli, Maria de Lurdes; Chun, Regina Yu Shon

    2017-05-22

    To investigate the perception of family members regarding linguistic conditions and social participation of children and adolescents with speech and language impairments using the International Classification of Functioning, Disability and Health - Children and Youth Version (ICF-CY). Quali-quantitative approach research, in which a survey of medical records of 24 children/adolescents undergoing speech-language therapy and interviews with their family members was conducted. A descriptive analysis of the participants' profiles was performed, followed by a categorization of responses using the ICF-CY. All family members mentioned various aspects of speech/language categorized by the ICF-CY. Initially, they approached it as an organic issue, categorized under the component of Body Functions and Structures. Most reported different repercussions of the speech-language impairments on the domains, such as dealing with stress and speaking, qualified from mild to severe. Participants reported Environmental Factors categorized as facilitators in the immediate family's attitudes and as barriers in the social attitudes. These findings, according to the use of the ICF-CY, demonstrate that the children/adolescents' speech-language impairments, from the families' perception, are primarily understood in the body dimension. However, guided by a broader approach to health, the findings in the Activities and Participation and Environmental Factors demonstrate a broader understanding of the participants of the speech-language impairments. The results corroborate the importance of using the ICF-CY as a health care analysis tool, by incorporating functionality and participation aspects and providing subsidies for the construction of unique therapeutic projects in a broader approach to the health of the group studied.

  9. A Global Oral Health Survey of professional opinion using the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Dougall, Alison; Molina, Gustavo F; Eschevins, Caroline; Faulks, Denise

    2015-06-01

    The concept of oral health is frequently reduced to the absence of disease, despite existing conceptual models exploring the wider determinants of oral health and quality of life. The International Classification of Functioning, Disability and Health (ICF) (WHO) is designed to qualify functional, social and environmental aspects of health. This survey aimed to reach a consensual description of adult oral health, derived from the ICF using international professional opinion. The Global Oral Health Survey involved a two-round, online survey concerning factors related to oral health including functioning, participation and social environment. Four hundred eighty-six oral health professionals from 74 countries registered online. Professionals were pooled into 18 groups of six WHO world regions and three professional groups. In a randomised stratification process, eight professionals from each pool (n=144) completed the survey. The first round consisted of eight open-ended questions. Open expression replies were analysed for meaningful concepts and linked using established rules to the ICF. In Round 2, items were rated for their relevance to oral health (88% response rate). Eighty-nine ICF items and 30 other factors were considered relevant by at least 80% of participants. International professionals reached consensus on a holistic description of oral health, which could be qualified and quantified using the ICF. These results represent the first step towards developing an ICF Core Set in Oral Health, which would provide a practical tool for reporting outcome measures in clinical practice, for research and epidemiology, and for the improvement of interdisciplinary communication regarding oral health. Professional consensus reached in this survey is the foundation stone for developing an ICF Core Set in Oral Health, allowing the holistic aspects of oral health to be qualified and quantified. This tool is necessary to widen our approach to clinical decision making

  10. De novo loss-of-function mutations in WAC cause a recognizable intellectual disability syndrome and learning deficits in Drosophila.

    Science.gov (United States)

    Lugtenberg, Dorien; Reijnders, Margot R F; Fenckova, Michaela; Bijlsma, Emilia K; Bernier, Raphael; van Bon, Bregje W M; Smeets, Eric; Vulto-van Silfhout, Anneke T; Bosch, Danielle; Eichler, Evan E; Mefford, Heather C; Carvill, Gemma L; Bongers, Ernie M H F; Schuurs-Hoeijmakers, Janneke Hm; Ruivenkamp, Claudia A; Santen, Gijs W E; van den Maagdenberg, Arn M J M; Peeters-Scholte, Cacha M P C D; Kuenen, Sabine; Verstreken, Patrik; Pfundt, Rolph; Yntema, Helger G; de Vries, Petra F; Veltman, Joris A; Hoischen, Alexander; Gilissen, Christian; de Vries, Bert B A; Schenck, Annette; Kleefstra, Tjitske; Vissers, Lisenka E L M

    2016-08-01

    Recently WAC was reported as a candidate gene for intellectual disability (ID) based on the identification of a de novo mutation in an individual with severe ID. WAC regulates transcription-coupled histone H2B ubiquitination and has previously been implicated in the 10p12p11 contiguous gene deletion syndrome. In this study, we report on 10 individuals with de novo WAC mutations which we identified through routine (diagnostic) exome sequencing and targeted resequencing of WAC in 2326 individuals with unexplained ID. All but one mutation was expected to lead to a loss-of-function of WAC. Clinical evaluation of all individuals revealed phenotypic overlap for mild ID, hypotonia, behavioral problems and distinctive facial dysmorphisms, including a square-shaped face, deep set eyes, long palpebral fissures, and a broad mouth and chin. These clinical features were also previously reported in individuals with 10p12p11 microdeletion syndrome. To investigate the role of WAC in ID, we studied the importance of the Drosophila WAC orthologue (CG8949) in habituation, a non-associative learning paradigm. Neuronal knockdown of Drosophila CG8949 resulted in impaired learning, suggesting that WAC is required in neurons for normal cognitive performance. In conclusion, we defined a clinically recognizable ID syndrome, caused by de novo loss-of-function mutations in WAC. Independent functional evidence in Drosophila further supported the role of WAC in ID. On the basis of our data WAC can be added to the list of ID genes with a role in transcription regulation through histone modification.

  11. Effects of short-term active video game play on community adults: under International Classification of Functioning, Disability and Health consideration.

    Science.gov (United States)

    Tseng, Wei-Che; Hsieh, Ru-Lan

    2013-06-01

    The effects of active video game play on healthy individuals remain uncertain. A person's functional health status constitutes a dynamic interaction between components identified in the International Classification of Functioning, Disability, and Health (ICF). The aim of this study was to investigate the short-term effects of active video game play on community adults using the ICF. Sixty community adults with an average age of 59.3 years and without physical disabilities were recruited. Over 2 weeks, each adult participated in six sessions of active video game play lasting 20 minutes each. Participants were assessed before and after the intervention. Variables were collected using sources related to the ICF components, including the Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Biodex Stability System, chair- rising time, Frenchay Activity Index, Rivermead Mobility Index, Chronic Pain Grade Questionnaire, Work Ability Index, and World Health Organization Quality of Life-Brief Version. Compared to baseline data, significantly reduced risk of a fall measured by Biodex Stability System and improvements in disability scores measured by the Chronic Pain Grade Questionnaire were noted. There was no significant change in the other variables measured. Short-term, active video game play reduces fall risks and ameliorates disabilities in community adults.

  12. Juridical-Criminal Paternalism, Autonomy and Vulnerability: Legitimation Criteria of Paternalistic Interventions on Individual Autonomy in Criminal Matters

    Directory of Open Access Journals (Sweden)

    Heráclito Mota Barreto Neto

    2015-12-01

    Full Text Available The following paper has as objective questioning the legitimacy of state's paternalistic interventions on individual autonomy by using institutional-criminal instruments. In this path, the paper aims to understand in which cases the State is allowed to interfere in private individual lives under the justification of being promoting a well or avoiding a harm and, as well, in which cases such interference is abusive of individuals self-determination. Into this analysis, the work will study the current concepts of paternalism, the theoretical classifications on paternalistic interventions which will be useful to demonstrate admissible and inadmissible species of paternalism and Joel Feinberg and Gerald Dworkin's anti- paternalistic theories. Following, this subject will be analyzed in association with the implications of juridical-criminal goods involved in conflicts between autonomy, human vulnerabilities and paternalism, specially regarding to the (unavailability of those goods. In the end, the work intends to define legitimation criteria for paternalistic interventions inserted in criminal laws, which superimpose themselves on the individual autonomy, in order to harmonize constitutional values of respect for autonomy, protection of vulnerable individuals and the Criminal Law functions of exclusive protection of juridical goods.

  13. Predictive validity of disability rating scale in determining functional outcome in patients with severe traumatic brain injury.

    Science.gov (United States)

    Deepika, Akhil; Devi, B Indira; Shukla, Dhaval

    2017-01-01

    Most patients with severe traumatic brain injury (TBI) are discharged when they have still not recovered completely. Many such patients are not available for follow up. We conducted this study to determine whether the condition at discharge from acute care setting, as assessed with disability rating scale (DRS), correlates with functional outcome at follow up. This study was conducted at a Neurosurgical intensive care unit (ICU) of a tertiary care referral center. This was a prospective observational study. Patients admitted to ICU with a diagnosis of severe TBI were enrolled for the study. On the day of discharge, all patients underwent DRS assessment. A final assessment was performed using Glasgow outcome scale extended (GOSE) at 6 months after discharge from the hospital. The correlation between the DRS scores at the time of discharge with DRS scores and GOSE categories at 6 months after discharge was determined using Spearman's rho correlation coefficient. A total of 88 patients were recruited for the study. The correlation coefficient of DRS at discharge for DRS at 6 months was 0.536 and for GOSE was -0.553. The area under the curve of DRS score at discharge for predicting unfavorable outcome and mortality at 6 months was 0.770 and 0.820, respectively. The predictive validity of DRS is fair to good in determining GOSE at follow-up. Pending availability of a more accurate outcome assessment tool, DRS at discharge can be used as a surrogate outcome for GOSE at follow up.

  14. Measurement precision and efficiency of multidimensional computer adaptive testing of physical functioning using the pediatric evaluation of disability inventory.

    Science.gov (United States)

    Haley, Stephen M; Ni, Pengsheng; Ludlow, Larry H; Fragala-Pinkham, Maria A

    2006-09-01

    To compare the measurement efficiency and precision of a multidimensional computer adaptive testing (M-CAT) application to a unidimensional CAT (U-CAT) comparison using item bank data from 2 of the functional skills scales of the Pediatric Evaluation of Disability Inventory (PEDI). Using existing PEDI mobility and self-care item banks, we compared the stability of item calibrations and model fit between unidimensional and multidimensional Rasch models and compared the efficiency and precision of the U-CAT- and M-CAT-simulated assessments to a random draw of items. Pediatric rehabilitation hospital and clinics. Clinical and normative samples. Not applicable. Not applicable. The M-CAT had greater levels of precision and efficiency than the separate mobility and self-care U-CAT versions when using a similar number of items for each PEDI subdomain. Equivalent estimation of mobility and self-care scores can be achieved with a 25% to 40% item reduction with the M-CAT compared with the U-CAT. M-CAT applications appear to have both precision and efficiency advantages compared with separate U-CAT assessments when content subdomains have a high correlation. Practitioners may also realize interpretive advantages of reporting test score information for each subdomain when separate clinical inferences are desired.

  15. Math practice and its influence on math skills and executive functions in adolescents with mild to borderline intellectual disability.

    Science.gov (United States)

    Jansen, Brenda R J; De Lange, Eva; Van der Molen, Mariët J

    2013-05-01

    Adolescents with mild to borderline intellectual disability (MBID) often complete schooling without mastering basic math skills, even though basic math is essential for math-related challenges in everyday life. Limited attention to cognitive skills and low executive functioning (EF) may cause this delay. We aimed to improve math skills in an MBID-sample using computerized math training. Also, it was investigated whether EF and math performance were related and whether computerized math training had beneficial effects on EF. The sample consisted of a total of 58 adolescents (12-15 years) from special education. Participants were randomly assigned to either the experimental group or a treatment as usual (TAU) group. In the experimental condition, participants received 5 weeks of training. Math performance and EF were assessed before and after the training period. Math performance improved equally in both groups. However, frequently practicing participants improved more than participants in the control group. Visuo-spatial memory skills were positively related to addition and subtraction skills. Transfer effects from math training to EF were absent. It is concluded that math skills may increase if a reasonable effort in practicing math skills is made. The relation between visuo-spatial memory skills provides opportunities for improving math performance. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Hearing and Cognitive Impairment and the Role of the International Classification of Functioning, Disability and Health as a Rehabilitation Framework

    Science.gov (United States)

    Lind, Christopher; Meyer, Carly; Young, Jessica

    2016-01-01

    The International Classification of Functioning, Disability and Health (ICF) has been applied widely in the literature to describe and differentiate the broad implications of hearing impairment (HI) and cognitive impairment (CI) on communication. As CI and HI are largely age-related conditions, the likelihood of comorbidity of these conditions is high. In the context of an aging population, the prevalence of comorbidity is likely to rise, yet much of the clinical assessment and intervention in HI and CI occur separately. The benefit of addressing the dual impact of these conditions is of increasing clinical importance for all clinicians working with older adults and for audiologists and speech pathologists in particular. In this article, the ICF model will be applied to explore the everyday implications of HI and CI. Furthermore, the clinical implications of the ICF model are explored with particular respect to communication assessment and intervention options. The potential benefit of combining activity- and participation-focused interventions currently offered for HI and CI independently is examined. PMID:27489399

  17. Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy.

    Science.gov (United States)

    Prodinger, Birgit; Cieza, Alarcos; Oberhauser, Cornelia; Bickenbach, Jerome; Üstün, Tevfik Bedirhan; Chatterji, Somnath; Stucki, Gerold

    2016-06-01

    To develop a comprehensive set of the International Classification of Functioning, Disability and Health (ICF) categories as a minimal standard for reporting and assessing functioning and disability in clinical populations along the continuum of care. The specific aims were to specify the domains of functioning recommended for an ICF Rehabilitation Set and to identify a minimal set of environmental factors (EFs) to be used alongside the ICF Rehabilitation Set when describing disability across individuals and populations with various health conditions. Secondary analysis of existing data sets using regression methods (Random Forests and Group Lasso regression) and expert consultations. Along the continuum of care, including acute, early postacute, and long-term and community rehabilitation settings. Persons (N=9863) with various health conditions participated in primary studies. The number of respondents for whom the dependent variable data were available and used in this analysis was 9264. Not applicable. For regression analyses, self-reported general health was used as a dependent variable. The ICF categories from the functioning component and the EF component were used as independent variables for the development of the ICF Rehabilitation Set and the minimal set of EFs, respectively. Thirty ICF categories to be complemented with 12 EFs were identified as relevant to the identified ICF sets. The ICF Rehabilitation Set constitutes of 9 ICF categories from the component body functions and 21 from the component activities and participation. The minimal set of EFs contains 12 categories spanning all chapters of the EF component of the ICF. The identified sets proposed serve as minimal generic sets of aspects of functioning in clinical populations for reporting data within and across heath conditions, time, clinical settings including rehabilitation, and countries. These sets present a reference framework for harmonizing existing information on disability across

  18. Balancing autonomy and protection: A qualitative analysis of court hearings dealing with protective measures.

    Science.gov (United States)

    Fallon-Kund, Marie; Coenen, Michaela; Bickenbach, Jerome E

    Respect for individual autonomy is at the core of the Convention on the Rights of Persons with Disabilities (CRPD). However, the need to protect persons with disabilities, especially those with cognitive impairments and psychosocial conditions, from outright exploitation, violence and abuse is explicitly provided for in article 16. Legal authorities still decide on a daily basis upon the institution of measures, which aim to protect vulnerable persons and unavoidably impact on the autonomy of persons concerned, known as guardianship, curatorship or administration. Observations of court hearings, interviews with judges and analysis of written materials from the cantons of Geneva and Vaud in Switzerland as well as from Belgium - which all have differently composed authorities - were carried out in order to identify what influences authorities in decision-making processes regarding protective measures, and to explore how autonomy and protection can be balanced. We suggest pragmatic considerations that should not be ignored when trying to reach a balance between autonomy and protection from abuse, in line with the CRPD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Validity of the impact on participation and autonomy questionnaire: a comparison between two countries.

    Science.gov (United States)

    Kersten, Paula; Cardol, Mieke; George, Steve; Ward, Christopher; Sibley, Andrew; White, Barney

    2007-10-15

    To evaluate the cross-cultural validity of the five subscales of the Impact on Participation and Autonomy (IPA) measure and the full 31-item scale. Data from two validation studies (Dutch and English) were pooled (n = 106). Participants (aged 18-75), known to rehabilitation services or GP practices, had conditions ranging from minor ailments to significant disability. Validity of the five subscales and the total scale was examined using Rasch analysis (Partial Credit Model). P values smaller than 0.01 were employed to allow for multiple testing. A number of items in all the subscales except 'Outdoor Autonomy' needed rescoring. One 'Indoor Autonomy' item showed uniform DIF by country and was split by country. One 'Work and Education' item displayed uniform and non-uniform DIF by gender. All the subscales fitted the Rasch model and were invariant across country. A 30-item IPA also fitted the Rasch model. The IPA subscales and a 30-item scale are invariant across the two cultures and gender. The IPA can be used validly to assess participation and autonomy in these populations. Further analyses are required to examine whether the IPA is invariant across differing levels of disability and other disease groups not included in this study.

  20. Netherlands: Steady decline in job autonomy

    NARCIS (Netherlands)

    Muller, J.; Hooftmann, W.; Houtman, I.L.D.

    2015-01-01

    Research shows that job autonomy has predominantly positive effects, such as the prevention of stress, burnout and cardiovascular disease. Employees with a good deal of autonomy generally report better well-being, are more productive, more creative, have more self-esteem and have higher work